The Relationship Between CBT and Neuroscience

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck discusses the relationship between CBT and neuroscience. Dr. Beck explains that various biological findings have been associated with successful CBT treatment and that preliminary and future research will seek to determine whether certain genomes respond better to different CBT techniques.

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Emotional Management Training CBT in Social Settings May Reduce Children’s Anxiety

A recent study published in the Journal of Research in Childhood Education, investigated the effect of using Cognitive Behavior Therapy (CBT) in a social setting on children’s anxiety levels. Typically, children with anxiety have the most difficulty with evaluating and managing emotions, which may lead to poor peer relationships and maladaptive coping strategies. Because anxiety disorders are the most common mental health conditions in children, research on early intervention is warranted. Emotional Management Training (EMT) is a form of CBT that helps children learn to regulate anxious emotions. Participants in the current study were primarily recruited from a New York City mental health clinic and included 58 children, ages 5-14, diagnosed with anxiety disorders. The program included social and therapeutic group activities, as well as CBT skills to help children manage anxious emotions. Specifically, the EMT CBT intervention consisted of psychoeducation about emotional and physical anxiety symptoms, relaxation and meditation therapy, cognitive restructuring, and exposure activities. Results demonstrated overall improvement in anxiety symptoms measured by the Multidimensional Anxiety Scale for Children, program satisfaction surveys, self-reports, and therapist and parent reports. These findings suggest that EMT may be a helpful alternative for anxious children in social settings.

Kearny, R., Pawlukewicz, J., & Guardino, M. (2014). Children with anxiety disorders: Use of a cognitive behavioral therapy model within a social milieu. Journal of Research in Childhood Education, 28, 59-68. doi: 10.1080/02568543.2013.850130

Assessing Therapist Competence in CBT

At a recent Beck Institute Workshop, Dr. Aaron Beck discusses how psychotherapists can use self-monitoring tools to measure their competence in CBT. Recording sessions is one way to evaluate and self-reflect on key CBT skills. Dr. Beck also discusses the use of the Cognitive Therapy Rating Scale (CTRS) which is a tool designed to measure competency and can highlight a therapist’s specific strengths and weaknesses in a session.

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CBT Improves Adherence and Depression in Patients with Uncontrolled Type 2 Diabetes

According to a new study published in Diabetes Care, cognitive behavior therapy (CBT) may be an effective intervention for medication adherence, depressive symptoms, and glycemic control in adults with type 2 diabetes and depression.  In the current study, 87 adults with unipolar depression and uncontrolled type 2 diabetes were randomized to receive either enhanced treatment as usual (ETAU) (medication adherence, self-monitoring of blood glucose, and lifestyle counseling) or ETAU plus 9 to 11 sessions of CBT for adherence and depression (CBT-AD). At four months, immediately following treatment, the CBT-AD group showed greater improvements in medication adherence, depressive symptoms, and glycemic control than the ETAU group.  At 8- and 12-month follow ups, CBT-AD remained superior to ETAU on adherence and glycemic control. There was no between group difference on depression, though some evidence of continued improvement was noted for both groups. These findings suggest that CBT is an effective intervention for medication adherence, glycemic control, and depression with lasting benefits for self-management and control among patients with type 2 diabetes and depression.

Safren, S. A., Gonzalez, J. S., Wexler, D. J., Psaros, C., Delahanty, L. M., Blashill, A. J., Margolina, A. I., … Cagliero, E. (January 01, 2014). A Randomized Controlled Trial of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in Patients With Uncontrolled Type 2 Diabetes. Diabetes Care, 37, 3, 625-33.

Early Views of Cognitive Therapy

In this video from a recent Beck Institute workshop, Dr. Aaron Beck discusses the psychoanalytic community’s early views of cognitive therapy. A common misconception about cognitive therapy was that it could only provide symptomatic relief. Dr. Beck explains, however, that even early in his career, he followed his patients for as long as 5 years and most of them improved and maintained their improvements. Today there are many similarities between cognitive therapy and modern psychodynamic therapy, which Dr. Beck briefly describes here.

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Cognitive Therapy Improves Symptoms in Schizophrenia Spectrum Disorder Patients not Taking Antipsychotic Drugs

According to a new study published in The Lancet, Cognitive Therapy (CT) has been shown to reduce the severity of psychiatric symptoms among schizophrenia spectrum disorder patients not taking antipsychotic drugs. In this first study of its kind, researchers performed a single-blind randomized control trial at two UK Centers between 2010 and 2013. Participants included 74 schizophrenia spectrum disorders patients, aged 16-65 years, who had chosen not to take antipsychotic medication. They were randomly assigned to receive either CT plus treatment as usual (n=37) or the control, treatment as usual (n=37). In the CT group, participants received 26 weekly sessions for a maximum of 9 months, plus up to four boosters in the subsequent 9 months that followed. Therapy focused on normalization and evaluation of patients’ own appraisals, behavioral experiments to test appraisals, and helping patients to identify and modify unhelpful cognitive and behavioral responses. The Positive and Negative Syndrome Scale (PANSS), the primary outcome measure, was utilized to evaluate treatment at baseline, and at 3, 6, 9, 12, 15, and 18 months. Results showed that PANSS total scores were significantly and consistently less in the cognitive therapy group than in the control group. On secondary outcomes, CT was also shown to improve personal and social functioning, and some dimensions of delusional beliefs and voice hearing. These findings offer hope for individuals who decline pharmacological treatment, and while further research is necessary, evidence based treatment should be available to this population.

Morrison, A. P., Turkington, D., Pyle, M., Spencer, H., Brabban, A., Dunn, G., Christodoulides, T., … Hutton, P. (February 01, 2014). Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial. The Lancet.

CBT with Depressed Caregivers

In this video from a recent Beck Institute workshop, Dr. Aaron Beck discusses how to structure treatment with depressed caregivers under a limited number of sessions. Dr. Beck explains that depressed caregivers often have negative beliefs about illness, and that they often withdraw from others and from pleasurable activities. When time is limited to just a few sessions with this type of client, it may be helpful to spend time explaining and teaching the client to use a Thought Record, to engage in Activity Scheduling, and to develop a plan to continue to use these tools into the future.

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