Men Have Eating Disorders – Cognitive Therapy Can Help

Anorexia and bulimia are not just affecting women. A recent Harvard Medical School survey showed that nationally, 25% of those with anorexia or bulimia and 40% of those who binge eat are male. The reported prevalence of eating disorders among men was much higher than previously expected.

This article in the Washington Post discusses the survey, and notes that, “Treatment for males and females involves cognitive therapy to overcome a distorted body image, which is at the core of eating disorders.”

Cognitive Restructuring Group

We recently received the following update from Kevin Benbow about the positive effects of teaching Cognitive Restructuring in a group format:

About six months ago I came up with the idea to create a group based on the premises of Greenberger and Padesky’s “Mind Over Mood.”  This was a pilot program, and the intention of the group was to solely teach the basics of cognitive restructuring to the participants.   This was done via handouts, movie clips, and a power point presentation. The group ran for 12 sessions and we systematically taught all participants to make the connection between situations, moods and automatic thoughts.  The BDI* and BAI* were administered prior to beginning group and were also administered at the last session.

It should be noted that in addition to the teaching of CR techniques these clients would also receive individual therapy as well as psychotropic medication if needed.

While I have seen the power and utility of CR before, I was pleasantly surprised to see how group dynamics can be used to reinforce the completion of homework and normalize symptoms of depression and anxiety.  Once the basic concepts were taught, we would complete thought records on the white board using actual stressors from the clients’ lives.  Read more

CBT for Smoking Cessation among Cancer Patients

Smoking, alcohol use and depression often co-exist at high rates among patients with head and neck cancer. Researchers recently designed a randomized, controlled study to see whether patients with head and neck cancer and at least one of the above traits improved with integrated Cognitive Behavior Therapy (CBT) that addressed all of the above factors.

184 patients were randomly assigned to either usual care or 9-11 CBT phone sessions plus optional medications over a period of six months. At the end of the trial, those in the CBT group had significantly improved their smoking cessation rate as compare to those in the usual care group (47% compared to 31%).

The study suggests that an integrated CBT approach, which treats smoking cessation, alcohol and depression simultaneously, may improve smoking cessation rates and provide a more practical means of addressing these co-morbid factors.

Using Cognitive Therapy to treat Delusions

Dr. Aaron Beck recently responded to an interviewer’s questions about addressing delusions among Schizophrenic patients. One of the central tenets of Cognitive Therapy is that individuals learn to evaluate their thinking and look for evidence that supports and/or contradicts their perceptions. The interviewer asked Dr. Beck how this pursuit of evidence plays out when individuals are having delusions and literally ‘seeing’ objects/people that aren’t really there.

Interviewer: How… do you persuade someone to ignore the evidence of their own eyes and believe you? 

Dr. Aaron Beck: The treatment of delusions and schizophrenia is a very tricky one. One of the definitions of delusions is that they do not yield to corrective feedback from other people. Consequently, attempting to persuade an individual that the delusion is incorrect is obviously self-defeating. There is a whole body of literature on how to address delusions. In brief, questioning the patient like a journalist without indicating disbelief is one way. This tends to get the patient into a questioning mode. Read more

Homework

I often tell therapists and patients that the way people get better is to make small changes in their thinking and behavior every day. That’s why it’s important for patients to do homework – just talking to a therapist for an hour a week is unlikely to be of much help to most people with psychiatric disorders. Homework frequently involves having patients change their distorted thinking so they see reality more clearly, doing “experiments” to change their behavior in small ways to see what happens, and implementing solutions to problems they’ve discussed in session.

I set up homework assignments very carefully and make sure patients are overwhelmingly likely to do them. When an Australian graduate student contacted me a few weeks ago about the role of homework in cognitive therapy, I told him that I think the reason some patients fail to do homework is because of mistakes their therapist makes. Read more

Can’t leave home? Phone therapy can help

A new study shows that Cognitive Behavior Therapy (CBT) delivered entirely by phone can help depressed patients – with lasting results.

393 mildly depressed patients already on antidepressants received either standard care, or antidepressants plus CBT. Those in the CBT group received 10-12 phone sessions over the course of a year. At the end of the study, the CBT group had improved more than those who received standard care (77% improved compared to 63% in the standard care group) – and the benefits lasted for at least six months after CBT treatment had ended. Read more