Research Results: CBT is Effective for Seasonal Affective Disorder

Need help getting through the winter? This week’s NY Times article says that Cognitive Behavior Therapy (CBT) is effective for Seasonal Affective Disorder (SAD) with or without light therapy, and that CBT is actually better than light therapy in preventing relapse among SAD sufferers.

The NY Times article refers to Dr. Kelly Rohan’s initial pilot study of 23 individuals with SAD. Dr. Rohan conducted a larger randomized controlled trial of 61 patients with SAD in 2005, and again found CBT to be effective in SAD treatment and relapse prevention. This later study is described in Science Daily, although the results have not yet been published. You can also read an interview with Dr. Rohan, in which she discusses her research on CBT for SAD.

What does Cognitive Therapy have to do with Nursing?

As Advanced Practice Nurses (APNs) interact with patients who have health problems, many of them find that their patients also suffer from mental health problems, including depression, anxiety, and other illnesses. So how can APNs best address the mental health needs of their patients? Two articles published this fall in Medscape’s Advanced Practice Nursing ejournal discuss how Cognitive Therapy (CT), also referred to as Cognitive Behavior Therapy (CBT), is an effective, time-limited, clinically tested treatment that is ideal for nursing settings. (To view these articles, you have to be registered with Medscape – registration is free.)

In Cognitive Behavioral Therapy in Advanced Practice Nursing: An Overview, Dr. Sharon Morgillo Freeman, a psychologist and certified Cognitive Therapist, discusses how CBT meets APNs’ need for effective, empirically based treatment — it’s a great overview for any APN interested in CBT, and includes a case example of a depressed patient treated with CBT. In Nurses Integrate Cognitive Therapy Treatment Into Primary Care: Description and Clinical Application of a Pilot Program, Dr. Judith Beck and Dr. Christine Reilly describe a pilot program that trained 12 APNs in CT, and monitored their success in implementing CT with low-income, underserved patients. This pilot program, conducted by the Beck Institute and the National Nursing Centers Consortium (NNCC), showed that APNs were able to integrate CT techniques in their primary care practices, with better patient results. We expect that in the future, we’ll see more and more integration of CT in nurse settings…

Research Results: CBT plus Medication is Effective for Gambling

An initial randomized, controlled trial shows that Cognitive Behavior Therapy (CBT) plus Selective Serotonin Reuptake Inhibitor (SSRI) can improve pathological gambling. For this study, 34 patients were randomly assigned to either medication alone, CBT plus medication, or CBT plus placebo for 16 weeks. Patients who received CBT plus medication improved the fastest. Further study is needed to assess long-term outcomes and other variables. Results were presented at the November, 2006 Canadian Psychiatric Association’s annual meeting.

CT Worldwide: Australian Government Provides Universal Mental Health Care Rebates


The Australian public health care system, Medicare, has just taken an important step in recognizing that mental health care is just as important as medical care. As of November 1st of this year, Australian patients suffering from mental health problems will be able to receive Medicare rebates for evidence-based treatment, including Cognitive-Behavior Therapy (CBT).

Patients can receive Medicare rebates for 12 annual individual or group consultations (or up to 18 in special cases) from approved mental health providers who practice evidence-based therapy (therapy that has been demonstrated in clinical trials to be effective). Patients must be referred to a mental health provider by a general practitioner, psychiatrist or pediatrician in order to receive the rebates, which can be used for the treatment of depression, anxiety, eating disorders, schizophrenia, and other illnesses.

This new Medicare rebate program was prompted in part by a highly successful pilot initiative called “Better Outcomes in Mental Health,” which aimed to integrate mental health care and primary care, and which specified that CBT or Interpersonal Therapy were the best evidence-based treatments. For more information about Cognitive Behavior Therapists in Australia, please visit The Australian Association of Cognitive and Behavior Therapy. Congratulations to Australia for helping to make mental health treatment more affordable to its citizens!

Research Results: Having Trouble Sleeping? Experts Recommend CBT for Insomnia

The American Academy of Sleep Medicine recently published updated guidelines for treating Insomnia and recommended Cognitive Behavior Therapy (CBT) as an effective, evidence-based treatment. The Academy’s new guidelines are based on a large review of 37 sleep studies that examined the effectiveness of various treatments for 2,246 insomnia patients. This review showed that Cognitive Behavioral Therapy (CBT), among other behavioral/psychological interventions, is an effective treatment for insomnia, and that sleep improvements last over time.

Research Results: CBT May Reduce Depression Relapse after ECT


Many studies have demonstrated that Cognitive Therapy (CT) is effective for depression, and twice as effective as medication in preventing relapse among depressed patients. So what’s new in CT for Depression research? A recent initial study shows that Cognitive Behavior Therapy (CBT) may decrease the risk of relapse specifically for depressed patients who are undergoing electroconvulsive therapy (ECT). For this study, six patients received 12 weeks of CBT following a course of ECT-only treatment. At follow up, five of the six patients had “much improved” or “very much improved” scores on depression measures, as compared to their measures after ECT treatment. Results indicate that CBT may prolong improvement among depressed patients who have received ECT.

Aaron Beck Video Clips

People often ask us for video footage of Aaron T. Beck, especially students. Here is a list of all the video footage we are aware of:

Brief Video Clips of Aaron T. Beck:
2006 Lasker Foundation Interview Clips with Aaron Beck (Free)
Aaron Beck speaks about origins of CT, how psychological treatments affect physiology, and widening use of CT, plus a clip of Beck and the Dalai Lama. If you have trouble viewing the clips on your computer, try selecting a different video player or speed.

2006 Aaron Beck Appears on the Charlie Rose Show (Free)

2001 Aaron Beck Accepts the Heinz Award (Free)
Brief video clip of Beck’s acceptance speech for the Heinz Award for the Human Condition. The full text of his speech is also available on the Heinz Awards website.

When the Mind Causes Pain (scroll down to view)
As part of this Video/DVD, Aaron T. Beck provides treatment strategies to reduce the symptoms of anxiety and depression.

Full Videotapes & DVDs of  Aaron T. Beck:
(2005) A Meeting of Minds: Aaron T. Beck and the Dalai Lama
A phenomenal DVD of Dr. Beck and the Dalai Lama engaging in conversation in front of a live audience at the International Congress of Psychotherapy in Sweden on June 13, 2005.

(2005) Recent Advances in CT: An Interview with Aaron T. Beck
Created for the European Association for Behavioural and Cognitive Therapies, September 21st, 2005.

(1979) Cognitive Therapy of Depression (scroll down to view)
A classic recording of an actual therapy session between Aaron T. Beck and a depressed patient.

(1977) Demonstration of CT of Depression (scroll down to view)
In this seminal Video/DVD, Dr. Beck demonstrates Cognitive Therapy (CT) while roleplaying with a depressed, suicidal woman.

One Therapist Writes In: Switching to CBT

Last week, we received the following in an email from a therapist in Arizona who began using CBT with his clients, and for his own battle with Multiple Sclerosis. Here’s what he experienced, in his own words:

I am a Licensed Associate Counselor in Arizona currently working toward independent status.  I have had supervisors of various theoretical orientations.  A few months into my M. A. internship it became apparent that very few had any real insight into client problems and psychopathology.  While some were very gifted, others seemed clueless.  I found this discouraging.

About 2 years ago I began to read everything I could on CBT.  I have read many works from the UK, works from both Drs. Beck, and a host of works on OCD, chronic depression, etc. etc.  Imagine my surprise when a good number of my clients suddenly began completing homework and actually GETTING BETTER!! Interestingly, I now find that practitioners from around my area now refer clients to me with depression and anxiety disorders, in spite of the fact that I am not independently licensed (of course, I continue to practice under direct supervision in a state funded community agency, though I hope to enter private practice one day).  I don’t think this would be happening had I not embraced CBT.  I work in rural southwestern AZ.  Many people here claim to use CBT, but after conversation it becomes obvious to me that most of them simply use one or two cognitive techniques here and there and really don’t utilize any type of case conceptualization.

In May of 2006 I received some bad news and was diagnosed with Multiple Sclerosis.  Looking back, my disease probably began to present around 1999, but I did not recognize it at the time.  I have found the techniques set forth in Padesky’s “Mind over mood“, along with antidepressant medication, extremely helpful for coming to grips with the uncertain future that characterizes MS.  While complete disability is a real possibility for me, I have been able to really look at things from a realistic point of view, and avoid catastrophizing.  I recently began walking with a cane (something I should have begun doing about 6 months ago) and was surprised when two of my clients told me that their doctors have been hounding them for a long time to use a mobility aid.  When I told them how much more energy it gave me they seemed interested and seemed to make the connection that walking with a cane does not automatically mean that one is weak (especially when they see how fast I can move with it!!). Anyway, wanted to share this information.  I anticipate taking a formal training course in CT once I can get the tuition saved and looking into certification with the Academy once I hit independent licensure.

— Kevin L. Benbow, MA, LAC

Research Results: Group CBT Reduces Anxiety among Women with Breast Cancer

A new study published in the American Journal of Psychiatry shows that group Cognitive Behavior Therapy (CBT) can reduce unwanted thoughts, anxiety and stress among women who have recently had breast cancer surgery. For this study, 199 women who had recently had breast cancer surgery were randomly assigned to one of two groups — they received either 10 weeks of group CBT, or a one-day seminar following surgery. The University of Miami, Florida team that conducted the study observed the women for one year, and found that those who had received group CBT had significantly less anxiety, intrusive cancer-related thoughts, emotional distress, and overall life stress than those in the control group. These improvements were maintained during the year post-treatment.

Aaron T. Beck Writes In: Early Response to CT, and Current Success

The following is a direct email excerpt from Dr. Beck’s conversation with an interviewer. [In response to a question about meeting resistance in publishing articles about Cognitive Therapy (CT) when Dr. Beck was first developing CT.] Dr. Beck: I did not have any resistance at all in publishing articles in psychiatric journals at the very beginning of my description of the theory and therapy. My first two articles in 1963 and 1964 were published in the prestigious Archives of General Psychiatry. The second article was also the subject of an editorial in the Journal of the American Medical Association. Having said that, the major phenomenon that I noticed (until there was a critical mass of empirical studies supporting cognitive therapy) was more or less disregard. That is, articles on depression in the mainstream professional journals occasionally mentioned cognitive therapy, although they generally emphasized psychodynamic therapy as well as the biological studies and pharmacological treatment. Cognitive therapy was totally ignored in the psychoanalytic journals; it was not perceived until fairly recently as a competitor of psychodynamic therapy. Certain individuals from the psychoanalytic field, however, ranged from skepticism to hostility in comments that they made to other people, which were brought to my attention. One psychoanalyst said that cognitive therapy was dangerous because it treated the symptoms instead of the causes, and eventually the patient would get worse because the causes were not addressed. Other criticisms were that it was superficial; it was like treating meningitis with mood music. Even today, a prominent British psychoanalyst said that cognitive therapy is like aspirin rather than an antibiotic. Also, the guidelines for depression published by the American Psychiatric Association tended to emphasize drug therapy and psychodynamic therapy, and cognitive therapy was addressed in a secondary way. The problem still exists today in that most of the training programs in psychiatry have a much larger load of training in psychodynamic therapy than in cognitive therapy and the other empirically based therapies largely (I suppose) because the instructors have been trained only in psychoanalytic therapy. This has become a self-perpetuating phenomenon. [In response to a question about why Cognitive Therapy (CT) has been successful.] Dr. Beck: I believe that success of cognitive therapy has been based on the following: a. With each disorder, the investigators (including myself) first made a careful phenomenological study of the disorder and created a cognitive model that fit the disorder. There is a generic cognitive model which needs to be adapted to each disorder. Thus, there are significant variations in the formulation of the specific disorder and also in the treatment. Based on the formulation, the treatment for obsessive-compulsive disorder is totally different from the treatment for panic disorder, which is totally different from the treatment for depression. b. The investigators validated the theory through research and then developed treatment manuals based on the formulations. c. I also believe the success has been based not only on the careful understanding of each disorder using the generic cognitive model, but on the strategies of cognitive therapy itself, which involves a number of features such as “guided discovery” and “collaborative empiricism.” The technique includes skills training, a reasonable degree of structure in the interviews (agenda setting), and homework assignments. d. The therapy has been validated in hundreds of clinical trials of numerous disorders.