Systems of Psychotherapy (Part 3)

In this video from Beck Institute’s recent CBT Workshop for Students and Faculty, Dr. Aaron Beck first explains the fundamental methodology of meditation-based therapies, including acceptance and commitment therapy and mindfulness-based therapy. Dr. Beck explains that these therapies require patients to actively experience negative, dysfunctional thoughts and accept them without trying to change them. Through acceptance, patients are able to decenter themselves, gain greater distance, and greater objectivity. Next Dr. Beck delves into relationship-based therapies. Rooted in Rogerian therapy, the main tenets of relationship-based therapies include the therapist’s total acceptance of the patient, genuine warmth, and accurate empathy. Dr. Beck describes these tenets as important qualities of every therapist.

Click here to view part 1 of this video on the Beck Institute YouTube channel.

Click here to view part 2 of this video on the Beck Institute YouTube channel.

Group CBT Helps Women with Low Self-Esteem

A recent study published in Behavioural and Cognitive Psychotherapy indicates that cognitive behavioral therapy (CBT) group intervention may be helpful for women with low self-esteem, and co-morbid depression and anxiety. In the current study, researchers used a set of CBT-based self-help workbooks, Overcoming Low Self-Esteem Self-Help Course (Fennell, 2006), to implement group therapy in a recruited sample of 37 women with low self-esteem (as indicated by the Robson Self Concept Questionnaire (RSCQ)). The group met once per week for two hours, for a total of eight sessions. Final results revealed clinically significant improvements in self-esteem and mood, including decreased depression and anxiety scores at post-intervention. While the mechanism for change is not yet clear, the researchers hypothesize that the group experience, combined with their learning adaptive skills and gaining new perspectives via CBT treatment, enhanced participants’ overall feelings of acceptance and increased confidence, both of which contribute to healthy self-esteem.

Morton, L., Roach, L., Reid, H., & Stewart, S. H. (2012). An evaluation of a CBT group for women with low self-esteem. Behavioural and Cognitive Psychotherapy, 40, 2, 221-5.

Systems of Psychotherapy (Part 2)

In this video from Beck Institute’s recent CBT Workshop for Students and Faculty, Dr. Aaron Beck discusses cognitive behavior therapy within the context of systems of psychotherapy. Dr. Beck explains that CBT is rooted in a broad theoretical framework and refined and reformulated for each disorder. Therapeutic strategies are selected based on the individual conceptualization of the patient. According to Dr. Beck, basic methods of CBT, such as cognitive reframing, can be adapted for more complex cases. He refers to his recent research on schizophrenia to demonstrate how to adapt CBT strategies within the theoretical framework.

To view part 1 of this video, visit the Beck Institute YouTube page: www.youtube.com/beckinstitute.

Systems of Psychotherapy (Part 1)

In this video from Beck Institute’s recent CBT Workshop for Students and Faculty, Dr. Aaron Beck discusses cognitive behavior therapy within the context of systems of psychotherapy. Dr. Beck explains that CBT’s rich theoretical background has been validated and systemized and that the therapy itself is derived directly from the theory. CBT is part of a system of psychotherapy; its theory guides the selection of effective treatment methods for particular patients, across various disorders.

For CBT resources, visit: https://www.beckinstitute.org/cognitive-behavioural-therapy-courses.

National Dissemination and Implementation of CBT for Depression in the Department of Veterans Affairs Health Care System Improves Patient Outcomes

According to a recent study published in the Journal of Consulting and Clinical Psychology, the implementation of CBT training for depression (CBT-D) significantly improves patient outcomes in the Veterans Affairs (VA) health care system. In the current study, 211 therapists participated in a VA CBT-D Training Program and delivered therapy to 356 patients. Therapist training included a 3-day CBT workshop followed by a 6-month consultation phase (weekly, 90-minute telephone-based consultation sessions led by an expert CBT-D clinician). Therapist competencies were assessed using the Cognitive Therapy Rating Scale (CTRS) and patient outcomes were assessed using the Beck Depression Inventory-II and World Health Organization Quality of Life-BREF. At the conclusion of the program, all of the therapists who completed training (82%) demonstrated competency in administering CBT-D, as well as higher levels of confidence, self-efficacy, and positive attitudes toward treatment. Furthermore, the implementation of CBT-D resulted in highly significant reductions in depressive symptoms and improvements in quality of life among patients treated. In fact, patient assessments revealed a 40% average decline in mean BDI-II scores recorded during the initial and later phases of treatment. This study has important implications for both therapists and veterans suffering from depression: A comprehensive CBT training program, when implemented in a realistic time-frame with follow-up consultation, significantly increases therapists’ ability to deliver effective treatment to depressed VA patients.

Karlin, B.E., Brown, G.K., Trockel, M., Cunning, D., Zeiss, A.M., & Taylor, C.B. (2012, July23). National dissemination of cognitive behavioral therapy for depression in the department of veteran affairs health care system: therapist and patient-level outcomes. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029328

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Long Term Effects of CBT for PTSD

According to a recent study published in the Journal of Consulting and Clinical Psychology, cognitive-behavior treatments (CBT) may provide long-term improvements for PTSD and related symptoms. CBTs such as Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) have already been shown to be effective and are considered some of the “first line treatments” for PTSD. However, the important question of CBT’s long term efficacy for PTSD has not been explored as deeply, as follow ups typically occur only three to six months after treatment.

The current study compares the long term outcomes of CPT and PE for PTSD in female rape survivors. The original study measured symptoms of women suffering from PTSD (n=171), before and after receiving either CPT or PE. This long term follow up, from 4.5 to 10 years later (M = 6.15), includes 73.7% of the original sample following initial treatments (n= 126) of CPT (n= 63) or PE (n=63). Researchers used the PTSD Symptom Scale (PSS), the Beck Depression Inventory (BDI), and the Clinician-Administered PTSD Scale (CAPS) to measure PTSD symptoms. Of those allocated to CPT, 46 completed the therapy, 10 received some therapy, and 7 did not start. Of those allocated to PE, 44 completed the therapy, 13 received some therapy, and 6 did not start.

Participants who received both cognitive therapies (CPT and PE) showed significant improvements in PTSD and related symptoms from pre- to post-treatment. There was no marked significance in the difference between the two samples receiving treatment. During the long term follow up, there was an impressive amount of maintenance of these improvements in symptoms. At pre-treatment assessment, 100% of participants had met criteria for PTSD; however, at the long term follow up only 22.2% of participants in the CPT group and 17.5% in the PE group met criteria for PTSD. In addition, there was no further psychotherapy or medication use reported which could have otherwise accounted for the long term efficacy of these treatments.

Female rape survivors in this study benefitted significantly from a lasting improvement in PTSD symptoms. Although further research and replication studies are needed, these findings suggest that CBT may be effective for years following initial treatment.

Resick, Patricia A., Williams, Lauren F., Suvak, Michael K., Monson, Candice M., & Gradus, Jaimie L. (2012). Long-term outcomes of cognitive–behavioral treatments for posttraumatic stress disorder among female rape survivors. Journal of Consulting and Clinical Psychology, 80(2) 201-210.

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Beck Institute will offer a 3-day workshop on CBT for PTSD on September 10-12, 2012, in Philadelphia. A limited number of spaces remain.