Using CBT to Target Body Image Issues in Female College Smokers

A recent study showed that using CBT techniques to target body image issues among female smokers in smoking cessation intervention programs can help lower their smoking rates. High smoking rates and the health risks associated with smoking are a serious concern. An alarming twenty-two to thirty-four percent of college students smoke cigarettes. Previous research has shown that smoking rates in some female college students are related to their body image beliefs. This research used the cognitive pathway of body image and smoking to explain how females’ schemas of their body image serve as a foundation for smoking. These previous studies suggest that when females ruminate about their weight, they develop a cognitive bias about their body, which leads them to use smoking as a method for weight loss.

In the current study published in Behavior Modification researchers created two intervention programs for female college students to help them decrease the number of cigarettes they smoked. Twenty-four female college students were recruited to participate in an eight-week cognitive behavior smoking cessation program. They were placed into either an internet smoking session and body image group or an internet smoking session and exercise group. Both groups participated in a an hour long smoking cessation workshop which involved cognitive behavior therapy techniques (e.g., goal setting and skill building) followed by either a body image workshop or an exercise class. In addition, an internet site called Blackboard was used for group discussions and to distribute handouts.

Smoking, body image, and weight concerns were assessed using questionnaires following the intervention. Results showed that the smoking cessation rates for those who participated in the internet smoking session and body image group were greater than the rates for those who participated in the internet smoking session and exercise group. This research supports the hypothesis that body image schemas affect smoking habits in female college students.

In terms of limitations, the current study used a small sample size, lacked a control group, and used web-based instead of face-to-face group discussions. All of the participants involved in this research recommended the program to others, and they suggested that future studies incorporate face-to-face programs to make sure that everyone can participate and attend the sessions. The authors recommend replication studies with larger sample sizes in order to obtain more significant findings.

Napolitano, M.A., Llyod-Richardson, E.E., Marcus, B.H. (2011). Targeting body image schema for smoking cessation among college females: Rationale, program description, and pilot study results. Behavior Modification; 35(4): 323-346. PMID: 21502132.

What is Dr. Aaron Beck’s 90th birthday wish? (Students Ask Dr. Beck – Part EIGHT)

This is the eighth question from the Q&A portion of Beck Institute’s 3-Day CBT Workshop on Depression and Anxiety for students and post-doctoral fellows, held on August 15 – 17, 2011. In this video, Dr. Beck shares his 90th birthday wish with participants at Beck Institute’s annual Student and Faculty Workshop, on CBT for Depression and Anxiety. Dr. Beck discusses the dissemination of CBT by effective cognitive therapists. He also discusses the status of cognitive therapy in the US and abroad as well as the importance of increasing education of cognitive therapy within the US.

Using Pupil Dilation to Screen Depressed Patients for Remission Likelihood with CBT Treatment

Research indicates that cognitive behavior therapy (CBT) is an effective treatment for up to 60% of patients with Major Depressive Disorder (MDD). However, some patients are more likely to remit than others, depending on the severity of the disorder. It is important and beneficial to patients, clinicians, and third-party payers alike, therefore, that scientists identify those who will most likely benefit from treatment.

One facet of CBT treatment involves interrupting the “downward spiral” of automatic negative thoughts. While neuroimaging has shown that CBT influences this type of brain activity via sustained limbic activity and decreased prefrontal function, functional magnetic resonance imaging (fMRI) can be costly and time-consuming. A recent study by Siegle, et al. published in Biological Psychiatry proposes that pupillary response to negative words may be a cost-effective measure to predict the likelihood of remission for certain depressed patients treated with CBT. Previous research has shown that depressed patients have increased and sustained pupillary response to negative words and that this response reflects cognitive and emotional processes, including prefrontal control.

Patients (n=32) with recurrent MDD were recruited for the current study. Participants completed an emotion-identification task that required they identify certain words as positive, negative, or neutral.  Participants also completed a digit sorting task to assess executive control. Pupillary response was measured during these tests. Participants then received a 16-session CBT intervention. The Beck Depression Inventory (BDI) was used to determine which patients had achieved remission (i.e., a score of less than 10 on the BDI coupled with no diagnosis of MDD). To test whether pupillary response was related to limbic activity, fMRI data was used for the 20 subjects able to complete this part of the experiment.

In the current study, patients who exhibited lower pretreatment depressive severity had better remission rates. These patients also presented with increased and sustained pupillary response. These results suggest that increased pupillary response is related to higher remission rates. That is, patients with a higher level of pupillary response may be more likely to remit with CBT; those with lower scores may be less likely and might choose to pursue other, more intensive treatment options. Increased pupillary response also correlated with increased prefrontal activity, which can be linked to executive control and emotional regulation. Siegel, et al. conclude that measuring pupillary response may be a noninvasive, cost-effective, and quick (requiring less than 10 minutes) tool to help depressed patients and their providers decide on effective treatment.

Lead author, Greg Siegle, Ph.D., was selected and participated in our Beck Institute Scholars Program in 2007-2008.

Siegle, G.J., Steinhauer, S.R., Friedman, E.S., Thompson, W.S., Thase, M.E. (2011). Remission prognosis for cognitive therapy for recurrent depression using the pupil: Utility and neural correlates. Biological Psychiatry; 69: 726-733. doi:10.1016/j.biopsych.2010.12.041

CBT for Children and Adolescents

OCTOBER 2011:  Earlier this week, 43 child psychiatrists, school psychologists, school counselors, and other health and mental health professionals working with children and adolescents, came from 5 countries including: Brazil, Canada, Cayman Islands, Singapore, and South Africa; and from 11 US states to participate in our first ever CBT for Children and Adolescents workshop at Beck Institute. This 3-day workshop began with the basics of cognitive behavioral therapy and progressed to the application of CBT with complex cases. Cognitive theory, case conceptualization and CBT session structure were introduced. Then cognitive and behavioral interventions were explored and practiced.

Participants engaged in variety of role plays, to increase knowledge and ability to use CBT with children and adolescents and to experience using cognitive case conceptualization to select and implement interventions tailored for individual clients.

Participants received professional training from Aaron T. Beck, M.D., Torrey Creed, Ph.D., Luke Schultz, Ph.D. and Judith S. Beck, Ph.D.

One of the highlights of the workshop was a special question and answer session with Dr. Aaron Beck (video clip below).  Dr. Beck discussed. For more information on future CBT for Children and Adolescents workshops, visit our website.

What research is Dr. Beck presently involved in? (Students Ask Dr. Beck – Part SEVEN)

This is the seventh question from the Q&A portion of Beck Institute’s 3-Day CBT Workshop on Depression and Anxiety for students and post-doctoral fellows, held on August 15 – 17, 2011. In this video Dr. Aaron Beck discusses research he is presently involved in and/or leading at the University of Pennsylvania. Dr. Beck explains the work being done by three different teams within his unit; including clinical trials with suicidal patients, groundbreaking research on CBT treatment for schizophrenia, and a community mental health center project involving dissemination of cognitive behavior therapy.

What is the synergistic effect of medication and CBT? (Students Ask Dr. Beck – PART SIX)

This is the sixth question from the Q&A portion of Beck Institute’s 3-Day CBT Workshop on Depression and Anxiety for students and post-doctoral fellows, held on August 15 – 17, 2011. In this video Dr. Aaron Beck discusses the evolution of neurobiological research examining changes in the brain before and after cognitive therapy; in particular, Dr. Beck notes how CBT has been shown to decrease inflammatory cytokines.

Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing

It is important that veterans with Posttraumatic Stress Disorder (PTSD) have access to evidence-based treatment (EBT). A significant number (40%) of military service members leaving active duty return to rural or remote areas where access to EBT and specialized PTSD treatment is often limited or unavailable. To overcome this obstacle, the use of video conferencing is becoming a more widespread and acceptable method of providing therapy to those living in areas with limited access to EBT.

While research indicates that cognitive behavior therapy (CBT) is an effective treatment for PTSD, there are few studies that examine outcomes of group CBT with veterans.  In the current study, Morland et al. compared therapist adherence to manualized cognitive-behavioral anger management group treatment (AMT) between therapy delivered via video conference (VC) and the traditional in-person modality. The researchers also compared the equivalency of cognitive-behavioral anger management group therapy delivered via VC and the same therapy delivered in-person.

The results of this study indicate that utilizing video conferencing did not affect therapists’ adherence to CBT anger management group therapy. This study provides support for the utility of video conferencing as a method for delivering effective therapy to veterans. It also identifies video-conferencing as a potential gateway to evidence-based CBT for veterans and service members returning to remote areas following deployment. These findings encourage future research on the effectiveness of video conferencing among different populations and EBTs.

Morland, L.A., Greene, C.J., Grubbs, K., Kloezeman, K., Mackintosh, M., Rosen, C., et al. (2011). Therapist Adherence to Manualized Cognitive-Behavioral Therapy for Anger Management Delivered to Veterans with PTSD via Videoconferencing. Journal of Clinical Psychology, 67, 629-638.

Beck Spotlight on Antonette Zeiss

At a 90th birthday party for Dr. Aaron Beck, given by Pearson Assessment at the American Psychological Association annual conference in Washington, D.C., we had the opportunity to catch up with our colleague, Dr. Antonette Zeiss, Ph.D., whom we have known for many years. We are so pleased that she, a very prominent cognitive behavior therapist, has been appointed to be Chief Consultant for the Office of Mental Health Services, in the Veterans Health Administration at the Department of Veterans Affairs (VA). Dr. Zeiss was already the highest ranking psychologist in the VA, and is now the first psychologist, and first woman, to hold the role of Chief Consultant.

In 2007, Dr. Zeiss received an American Psychological Association (APA) Presidential Citation recognizing her leadership contributions both in APA and the VA. And last year, Dr. Zeiss won a Distinguished Career Award from the Association of VA Psychologist Leaders for her continued efforts to improve mental health services.

We applaud Dr. Zeiss’s accomplishments in the field of psychology and cognitive behavior therapy, and we appreciate the efforts of the tens of thousands of health and mental health professionals who treat active duty and veteran military service members and their families. To learn more about a scholarship initiative to help train these professionals in cognitive behavior therapy please visit www.soldiersuicideprevention.org.

What can neurobiology teach us about Cognitive Therapy? – (Students Ask Dr. Beck — PART FIVE)

This is the fifth question from the Q&A portion of Beck Institute’s 3-Day CBT Workshop on Depression and Anxiety for students and post-doctoral fellows, held on August 15 – 17, 2011. In this video Dr. Aaron Beck discusses the evolution of neurobiological research examining changes in the brain before and after cognitive therapy; in particular, Dr. Beck notes how CBT has been shown to decrease inflammatory cytokines.

Workshop on Cognitive Behavior Therapy for Weight Loss and Maintenance

This weekend Dr. Judith Beck and I (Deborah Beck Busis, Diet Program Coordinator) presented a workshop at the Beck Institute on Cognitive Behavior Therapy for Weight Loss and Maintenance.  We had a great time teaching dieters and maintainers, diet coaches, and health and mental health professionals how we apply CBT principles and techniques to the difficult problem of overweight and obesity. We used lecture, role play, and lots of Q and A.   

Some of the topics we covered were:

  • Overview of the Beck Diet Solution Program
  • Sabotaging Thinking
  • Assessment Initiating Treatment, and Structuring Sessions
  • Pre-Dieting Skills
  • Eating Habits
  • Hunger, Craving, and Emotional Eating
  • Dealing with deprivation, discouragement, and disappointment
  • The Long Haul and Maintenance
  • Reluctant Dieters and Real Life Compromises

On their evaluation forms, participants indicated that the workshop was very helpful and we hope they will use this knowledge to enrich their work with dieters and/or themselves.  As of now, our next diet workshop at the Beck Institute is scheduled for June 2, 2012.  Check back in with us and our website, though, because we add new workshops periodically. Below is a video of me discussing the importance of staying on track and getting back on track when mistakes happen: