Female Sexual Pain Disorders and Cognitive Behavioral Therapy

Female sexual pain disorders are prevalent and have a deleterious effect on women's well-being. Because there are psychological elements to this pain, cognitive–behavioral therapy (CBT) may be a viable treatment alternative, particularly when compared to more physically invasive treatments such as surgery or medication. This article provides a critical analysis of research studies in this area by evaluating each study in detail, identifying gaps in the research base, and providing directions for future study. For the most part, all of the studies reviewed in this article found CBT to be effective. However, CBT modalities with minimal therapist direction or interaction were found to be problematic. In addition, there may be other noninvasive treatment types that are equally or more effective, such as biofeedback or supportive psychotherapy.     

Treatment for Hoarding Behaviors: A Review of the Evidence

This article reviews the empirical literature on treating clients with hoarding behaviors, including psychosocial treatments, mainly cognitive behavioral, and pharmacotherapy. Standard treatments used for obsessive compulsive disorder (OCD) such as medication and/or behavior therapy have been associated with poor treatment response for those with hoarding. Recent prospective pharmacotherapy research suggests that serotonergic medication may be helpful to OCD patients with or without hoarding. A multi-component cognitive behavioral treatment (CBT) designed specifically for hoarding has shown promising results especially in trials of individual therapy with periodic home visits. Social work researchers have played a prominent role in the development and testing of this CBT intervention and development of instruments to assess hoarding treatment outcomes. This CBT intervention has demonstrated modest success when delivered individually in an open trial and a waitlist-controlled trial, and in quasi-experimental studies of group treatment modalities, including in-person and web-based groups as well as bibliotherapy-based support groups. Overall, evidence supports the use of specialized CBT methods to improve hoarding symptoms. Future testing may include controlled trials with more diverse samples.     

Gay Affirmative Cognitive Behavioral Therapy for Sexual Minority Youth: A Clinical Adaptation

Sexual minority youth (SMY) are at high risk for negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. However, there has been a disconnect between clinical social work practice and research with SMY, resulting in a lack of rigorous research that demonstrates the use of effective interventions. While cognitive behavioral therapy (CBT) has long been established as a best practice option for the general adolescent population suffering from mental health problems, knowledge about the use of CBT with SMY lags far behind. Thus, the purpose of this article is to present a clearly defined adaptation of CBT for SMY that integrates gay affirmative practices for youth (e.g., coming out, stigma and discrimination, the role of social support and community). Specifically, the authors: (a) discuss the impact of minority stress on SMY; (b) highlight the specific components of CBT that represent a good fit for SMY and also address the criticisms of using such an approach; (c) consider the importance of using gay affirmative practices with SMY; and (d) offer recommendations for incorporating gay affirmative practices into traditional CBT models to better meet the needs of SMY.     

Cognitive behavioural therapy for violent behaviour in children and adolescents: A meta-analysis

Aggressive behaviours often co-occur with other emotional, behavioural, academic, and social relationship problems. During adolescence, these children often exhibit increased rates of school dropout, depression, juvenile delinquency, substance abuse, and poor peer relationships. Some definitions focus on aggression as an emotion; according to this framework, aggressive behaviours stem from anger. Other definitions emphasise the motivational aspect of aggression, wherein intentions are thought to indicate the behavioural characteristics. Cognitive–behavioural therapy (CBT) is one of the most extensively researched forms of psychotherapy. This paper aims to review the literature on the use of CBT for treating children and adolescents who demonstrate high levels of violence. Studies were searched for using several methods. First, we used large database of literature on psychological treatments of violence in general. Studies were traced by means of several methods. A large database of 240 papers on the psychological treatment of aggression and violence in general were used. This database was developed through a comprehensive literature search (from 1997 to March 2009) in which we examined abstracts in ERIC (19 abstracts), Psycinfo (30), and Medline (23). Keywords used in computer searches were: Aggression, Violence, CBT, cognitive–behavioural therapy, cognitive therapy, behaviour therapy, and behavioural activation. The options were used in computer searches so that all relevant topics within the broader categories were searched as well. Six studies met the inclusion criteria, all of which indicated beneficial results of using CBT. A meta-analysis suggested an effect size of − 0.094 for reduced violence as a result of CBT treatment; this is considered to be a medium effect. The differential effects of cognitive–behavioural therapy and affective education were variable, although they were also generally in the medium range. In this meta-analytic study, CBT treatment proved less effective in reducing aggressive behaviour. This review tentatively suggests potential for using CBT to reduce violence in children and adolescents. However, there is only a small body of research exploring this relationship at present. Further research is needed before any solid conclusions can be drawn.     

Resolving the Therapy Culture Wars by the Pragmatic Case Study Method

Is there a therapy research paradigm that is suited to the models of clinicians who do not use a CBT approach? This article says yes, and describes that alternative: the collection into an organised database of systematic, ‘pragmatic case studies’ conducted by individual therapists. A review of this paradigm reveals that it can also serve the needs of CBT clinicians and researchers who, it turns out, are actually closet case‐study advocates.     

The Use of Computerized Self-Help Packages to Treat Adolescent Depression and Anxiety

Despite the efficacy of cognitive-behavioral therapy (CBT) in treating adolescent anxiety, few sufferers seek treatment. Barriers to accessing psychologists include a shortage of skilled therapists, long waiting lists, and affordability. The Internet is a medium possibly able to address issues of accessibility and affordability. This study aimed to assess the efficacy of online therapy in the treatment and prevention of adolescent anxiety and depression. Participants (N = 38) were randomly allocated to one of four conditions: online CBT, face-to-face CBT, combined face-to-face/online CBT, and control. Combined face-to-face/online CBT is more effective in treating symptoms of depression and anxiety compared to stand-alone online or face-to-face therapy. The present study suggests that for those who are unable to access face-to-face therapy, computerized therapy may be a viable option. This is an important finding, especially in light of current capacity to treat and accessibility problems faced in the treatment of adolescent depression and anxiety.     

Development of a New Approach to Guided Self-Help via the Internet: The Swedish Experience

ABSTRACT

This article describes the development and empirical status of guided Internet-delivered self-help. The treatment approach combines the benefits of bibliotherapy with book-length text materials and the support given online via web pages and e-mail. Interactive features such as online registrations, tests, and online discussion forums are also included. Cognitive behavior therapy (CBT) guided the research and clinical implementations of this approach, as it lends itself more easily to the self-help format compared with other presently available psychotherapy approaches. We include an overview of the research, current issues and research in service delivery, lessons learned through a program of research, and directions for future investigations.     

Attachment-based family therapy: adherence and differentiation

This study examined the fidelity of attachment-based family therapy (ABFT) for depressed adolescents. Trained observers used the therapist behavior rating scale (3rd version) to code therapist behaviors in 45 sessions of ABFT and 45 sessions each from two empirically based treatments for adolescent substance abusers: multidimensional family therapy (MDFT) and cognitive-behavioral therapy (CBT). Results indicate that ABFT therapists employed essential ABFT interventions, such as focusing on vulnerable affect, highlighting attachment-related themes, and promoting adolescent-parent reattachment through in-session enactments. In accordance with the sequential nature of the treatment, these interventions were used more extensively during the early stage of treatment, when there is a greater focus on reattachment. ABFT was perfectly discriminable from CBT, with ABFT therapists using more restructuring and reattachment interventions and CBT therapists using more signature CBT interventions, such as cognitive monitoring and homework. ABFT was also discriminable from MDFT, with ABFT therapists placing a greater emphasis on reattachment. These results suggest that ABFT is a viable and differentiated treatment. Together with prior findings supporting its efficacy, ABFT should be considered a promising new approach for working with depressed adolescents and their families.     

Telehealth for Patients with Chronic Pain: Exploring a Successful and an Unsuccessful Outcome

Abstract

Cognitive-behavioral therapy (CBT) is effective for treating chronic pain, but little is known about the mechanisms that might facilitate or hinder its utility when delivered by videoconference. In a single-case experimental design, we explored the outcomes of two adults with chronic pain who were provided with videoconference-based CBT. The goal was to examine the relationship between therapeutic alliance as well as presence felt and clinical outcomes. Therapeutic alliance was high overall for both participants; however, only the successful case’s alliance ratings significantly increased over treatment. Levels of presence felt in videoconferencing were also high, but were not related to therapy outcome.     

Treating Problem Gambling Samples with Cognitive Behavioural Therapy and Mindfulness-Based Interventions: A Clinical Trial

The problem gambling (PG) intervention literature is characterised by a variety of psychological treatments and approaches, with varying levels of evidence (PGRTC in Guideline for screening, assessment and treatment in problem and pathological gambling. Monash University, Melbourne, 2011). A recent PG systematic review (Maynard et al. in Res Soc Work Pract, 2015. doi: 10.1177/1049731515606977) and the success of mindfulness-based interventions to effectively treat disorders commonly comorbid with PG suggested mindfulness-based interventions may be effective for treating PG. The current study tested the effectiveness of three interventions to treat PGs: 1. case formulation driven Cognitive Behaviour Therapy (CBT); 2. manualised CBT; and 3. mindfulness-based treatment. All three interventions tested returned large effect size improvements in PG behaviour after seven sessions (Cohen’s d range 1.46–2.01), at post-treatment and at 3 and 6-month follow-up. All of the interventions were rated as acceptable by participants at post-treatment. This study suggests that the mindfulness-based and TAU interventions used in the current study appear to be effective at reducing PG behavior and associated distress and they also appear to generalise to improvements in other measures such as quality of life-mental functioning and certain mindfulness facets more effectively than the manualised form of CBT utilised used here. Secondly, a brief mindfulness intervention delivered after psycho-education and a brief CBT intervention may be a useful supplement to traditional CBT treatments by addressing transdiagnostic processes such as rumination and thought suppression. Thirdly, CBT interventions continue to report effectiveness in reducing PG behaviour and associated distress consistent with the prevailing literature and clinical direction.     

Cognitive-behavioral therapy for obsessive-compulsive disorder: review of treatment techniques

Obsessive-compulsive disorder (OCD) is a chronic, impairing condition with an estimated lifetime prevalence in adults of 2.5%. Controlled treatment trials have demonstrated that cognitive-behavioral therapy (CBT) is an effective intervention for OCD. However, many individuals diagnosed with OCD do not receive appropriate, empirically validated interventions, perhaps due to limited knowledge of CBT among mental health practitioners. This article provides a review of CBT for OCD. Issues related to treatment delivery and assessment are presented and highlighted by an individual example.     

Listening to Children in Care: A Review of Methodological and Theoretical Approaches to Understanding Looked after Children’s Perspectives

This article reviews 44 refereed journal articles published between 2003 and 2008. All of the articles attempt to directly uncover the experiences or perspectives of young people cared for by the state in foster, residential or kinship care homes. The review reveals that this field is developing a rich body of evidence derived from a broad range of methodological and theoretical frameworks. In this sample, research designs appeared to be influenced by placement settings, as well as theoretical orientations, but comparative and longitudinal designs were used in both quantitative and qualitative studies. Participative research designs were only present in qualitative designs within a broadly interpretive theoretical orientation. It is suggested in this article that researchers should critically reflect on the use of constructs that may negatively label young people in care. It is also suggested that there could be fuller reporting of ethical issues. Despite some identified gaps, such as the participation of young people in quantitative research designs and research with younger age groups, the article concludes that there appears to be an encouraging emergence of theoretical and methodological diversity in this research area.     

Mindful Leadership: Sind achtsame F��hrungskr?fte leistungsf?higere F��hrungskr?fte?

In the last years, mindfulness became the focus of increasing research interest in the health sciences. More than hundred studies highlight the positive impact of mindfulness based interventions on a variety of health relevant parameters. Mindfulness became a well-established intervention in clinical and non-clinical contexts such as stress prevention, substance abuse treatment or relationship counselling in couples. The concept has until now not received much attention in business contexts; implications and applications in this field are highlighted in this article. In particular, it is described how mindfulness may help leaders and managers to perform their tasks more successfully and in a much more relaxed way.     

The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others: A Pilot Randomized Controlled Trial

Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.     

Are relaxation techniques effective in relief of chronic pain?

Alternative therapies are becoming more popular in the United States despite the lack of scientific evidence supporting that they are effective treatments. Some alternative therapies used in the relief of chronic pain are relaxation techniques, guided imagery, and biofeedback. Overall, the existing research suggests that relaxation techniques are effective in reducing pain [6,8,21]. Research concerning guided imagery has also suggested that it is helpful in reducing pain [19,22,23]. Finally, most of the research concerning biofeedback and the reduction of pain in people with chronic pain has been positive [7,10,14,20]. Despite these findings, one can not conclude that relaxation techniques, guided imagery, and biofeedback are effective in reducing pain in individuals with chronic pain. There were many problems with most of the studies, including small sample sizes and unstated reliability and validity of assessments. These limitations lower the significance of the studies, which makes it impossible to draw conclusions from the research as a whole. More research needs to be conducted to determine the effectiveness of relaxation techniques, guided imagery, and biofeedback concerning chronic pain. Information regarding the transference of these learned techniques to one's roles and daily activities should also be incorporated into the research by occupational therapists.     

Mixing Apples and Oranges and Other Methodological Problems with a Meta-Analysis of Long Term Psychodynamic Psychotherapy

Current trends in mental health practice indicate that mental health practitioners, including clinical social workers, are tending to move away from psychodynamic approaches and are favoring short-term empirically supported approaches such as cognitive-behavioral therapy (CBT). Recently, the presumption that long-term psychodynamic psychotherapy (LTPP) approaches lack empirical support has been challenged, however, with the publication in major peer reviewed journals of meta-analyses that are claimed to demonstrate its equality to or superiority over empirically supported short-term therapies for some conditions. The present article examines the methodology employed in one particular meta-analysis which compared LTPP to short term therapies and the studies upon which the analysis was based. We found that major methodological and statistical flaws with the meta-analysis and with the individual studies preclude drawing any conclusions regarding the efficacy of LTPP.     

The influence of posttraumatic stress disorder, depression, and sensory processing patterns on occupational engagement: a case study

The purpose of this article is to provide a brief overview of how Posttraumatic Stress Disorder (PTSD), Depression, and Sensory Processing patterns influence occupational engagement, including work performance. Interventions and outcomes of the Sensory Modulation Program and approaches from Cognitive Behavior Therapy (CBT) are reviewed through single case exploration with a 42 year-old woman in outpatient services. The marked increase in occupational engagement and improved work performance in this single case review demonstrates the need for more research on the use of the Sensory Modulation Program and approaches from CBT with populations with PTSD, Depression, and Sensory Processing disorder.     

Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program

Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care. Treatment credibility, treatment expectancies, social support, and improvements in depression and anxiety symptoms predicted higher treatment satisfaction in the total sample. In the CBT group, only credibility and adherence with treatment predicted satisfaction. This suggests that older patients receiving CBT who believe more strongly in the treatment rationale and follow the therapist's recommendations more closely are likely to report satisfaction at the end of treatment. In addition, this study found that adherence mediated the relationship between treatment credibility and treatment satisfaction. In other words, patients’ perceptions that the treatment made sense for them led to greater treatment adherence which then increased their satisfaction with treatment.     

The Efficacy of Internal Family Systems Therapy in the Treatment of Depression Among Female College Students: A Pilot Study

College women are vulnerable to depression due to developmental and transitional life changes. Early diagnosis and effective treatment is critically important. Empirical support exists for the effectiveness of select treatment options (i.e., antidepressant medication, cognitive‐behavioral therapy [CBT], and interpersonal psychotherapy [IPT]), yet a significant percentage of those treated do not benefit. In this pilot study, Internal Family Systems (IFS) therapy was tested as an alternative approach. College women (N = 37) were randomly allocated to IFS treatment or treatment as usual (CBT or IPT). Results demonstrated a decline in depressive symptoms for both conditions and no significant differences in the magnitude or rate of change. The results provide preliminary evidence for the efficacy of IFS in the treatment of depressive symptoms.