CPT is Effective for Military-Related PTSD

According to a recent study published in the Journal of Anxiety Disorders, cognitive processing therapy (CPT) may have a greater effect on military-related PTSD than other usual treatments. CPT is a form of trauma-focused cognitive behavior therapy (CBT) that focuses on key themes such as safety, control, power, self-esteem, and intimacy. The present study examines the efficacy of CPT for PTSD among treatment seeking veterans (n=59) within a naturalistic setting compared to other treatments typically used for PTSD (a variety of non-trauma focused symptom management intervention, psycho-education, supportive counseling, and CBT with elements of exposure.) At post-treatment and 3 month follow up, participants in the CPT condition (n=30) showed significantly lower levels of PTSD symptoms than those who received other treatments (n=29) according to self -reporting and clinical ratings.  Additionally, there were larger reductions in comorbid depression and anxiety for participants receiving CPT than treatment as usual. These results suggest that CPT is an effective, evidence based treatment for military-related PTSD in real world environments and situations.

Forbes, D., Llyod, D., Nixon, R. D. V., Elliot, P., Varker, T., Perry, D., Bryant, R. A., & Creamer, M. (2012). A multisite randomized controlled effectiveness trial of cognitive processing therapy for military-related posttraumatic stress disorder. Journal of Anxiety Disorders, 26(3), 442-452.

CBT plus Medication is Effective for Treatment Resistant Depression

According to a new study published online in The Lancet (December 7, 2012) and Contemporary Clinical Trials, cognitive behavior therapy (CBT) as an adjunct to usual care has shown to be an effective treatment for reducing depression and improving quality of life in patients with treatment resistant depression. Although pharmacotherapy is often used as a first-line treatment for depression, only one-third of patients fully respond to anti-depressants and only half receive up to a fifty percent decrease in symptoms. The current study employed a large-scale CoBalT (two parallel-group) randomized controlled trial to investigate the effectiveness of combining CBT and usual care (including pharmacotherapy) versus usual care, alone, for treatment resistant depression. Participants (n=469) ranged from age 18 to 75 and were already taking anti-depressants. They were randomly assigned to receive either CBT plus usual care (n=234) or usual care alone (n=235).

At the 6 month follow up, 46% of  participants (n=95) in the CBT plus usual care group met criteria for response to treatment, as compared to only 22% of participants (n=46)  in the usual care group. Those who received CBT were more likely to experience remission, received lower scores on the Beck Depression Inventory (BDI), and experienced fewer symptoms of anxiety and panic. At the 12-month follow up, these improvements were maintained.

This study is the first large-scale randomized control trial investigating CBT treatment as an adjunct to usual care in patients showing treatment resistance to anti-depressants.  Findings suggest that CBT in combination with usual care can be extremely effective for treating depressive symptoms and improving the quality of life of patients suffering from depression.

Wiles, N., Thomas, L., Abel, A., Ridgway, N., Turner, N., Campbell, J., Garland, A, Hollinghurst, S., Jerrom, B., Kessler, D., Kuyken, W., Morrison, J., Turner, K., Williams, C., Peters, T., & Lewis, G. (2012). Cognitivebehavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial. Lancet. Published online 7th December 2012.

Symptom Change in CBT for Generalized Anxiety Disorder

According to a recent study published in the Journal of Consulting and Clinical Psychology, cognitive behavior therapy (CBT) may have a greater effect on symptom change in generalized anxiety disorder (GAD) than applied relaxation (AR). The current study sought to determine if change in worry accounts for change over time in somatic anxiety to the same degree in CBT and AR. Participants (treatment-seeking adults with GAD) were assigned to receive 12 weeks of either CBT (n=31) or AR (n=26).

At post-treatment, participants in both treatment groups experienced significant reductions in somatic anxiety and time spent worrying. On average, worrying was reduced from 5-6 hours per day to 3 hours per day. However, change in worry accounted for subsequent change in somatic anxiety to a much greater extent in the CBT group than the AR group. When treatment focused on reducing worry, 49.95% of somatic anxiety was also reduced among participants in the CBT Group, and just 25.87% among participants in the AR group. These results suggest that although two treatments may have similar efficacies at post treatment, the mechanisms of change may differ. Further, these results demonstrate that CBT produces symptom change in a manner that is consistent with the theoretical underpinnings on which treatment is based.

Donegan, E., and Dugas, M. (2012) Generalized anxiety disorder: A comparison of adults receiving cognitive behavioral therapy or applied relaxation. Journal of Consulting and Clinical Psychology, 80(3), 490-496.

Neurobiology and Cognitive Behavior Therapy

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck discusses  correlates between neurobiology and the cognitive model of depression. Dr. Beck explains the reflexive and reflective systems of cognitive processing and how these systems are impacted by depression. He then summarizes the effects of cognitive behavior therapy on the brain, highlighting the corrective nature of CBT.

For more information on CBT workshops and training, visit our website.