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

Forbes Magazine: Patient Fix Thyself… Cognitive Behavior Therapy… may be better than Prozac

 

“Dump the Couch! And ditch the Zoloft. A new therapy revolution is here,” says the cover of the April, 2007 issue of Forbes Magazine.

Forbes is referring to Cognitive Behavior Therapy (CBT), which has “been shown to be surprisingly effective in quelling an ever expanding array of mental maladies: depression, anxiety, panic attacks, obsessive-compulsive disorder, post-traumatic stress syndrome, bulimia, hypochondria–even insomnia. Now almost 150 clinical trials are under way to learn whether CBT also can help patients with Tourette’s syndrome, gambling addiction, obesity, irritable bowel syndrome and more; one trial studies the therapy in children who have been sexually abused.”

The Forbes article highlights patients who improved with CBT, and includes commentary from leaders in the field, including Dr. Aaron Beck.

Cognitive Behavior Therapist – How to Find One

Two days ago, we received a great comment that said, “This is *not* what I experienced when I saw a cognitive-behavioral therapist… I wish cognitive-behavioral therapy as described on this site was available. Too many CBT therapists are not well-trained and refuse to think!” (you can read Sam’s full comments about the kind of ‘CBT’ that he and his friend received on this post – his is the fourth comment down).

We thought it was important to highlight his experience because we think many consumers may not know about the vast differences in training and approach among people who call themselves Cognitive Therapists or Cognitive Behavior Therapists. Read more

HBO Film on Cognitive Behavior Therapy for Addiction

HBO is launching a new addiction project, and one of its films features Cognitive Behavior Therapy (CBT) as the “most effective treatment for stimulant addiction.” The film follows a group of individuals undergoing CBT treatment for addiction at the Matrix Institute in California.   Read more

Cognitive Behavioral Aspects of Irritable Bowel Syndrome

recent study followed 620 patients with gastroenteritis (an infection or inflammation of the stomach area) to see if they went on to develop Irritable Bowel Syndrome (IBS) (a more chronic bowel disorder). Researchers wanted to evaluate whether those who developed IBS had any psychological factors in common. And in fact, they did. Read more

Most influential therapists of the past 25 years

A 2006 survey of 2,598 therapists showed that the 2nd most influential therapist was Aaron T. Beck, M.D. (the 1st most influential was Carl Rogers…). What’s more, 68.7% of the therapists surveyed say that they practice Cognitive Behavior Therapy (CBT)! This is quite a change from 40 years ago.

Setting the Agenda in session

A frequent question I’m asked by clinicians who are not cognitive therapists is why we set agendas toward the beginning of sessions with patients. They often think that doing so will result in their missing out on important information. I tell them that we’ve found the opposite to be generally true.


We ask patients, “What problems do you want my help in solving today?” and guide them into naming the problems (as opposed to giving us a full description at that moment). Then we ask them to prioritize the problems and let us know roughly about how much of the session they’d like to devote to each one. When clinicians don’t set agendas, they deprive the patient of the opportunity to think through what is most important to them to spend time on in session.

-Judith S. Beck, Ph.D.