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Cognitive Behavior Therapy Workshop for Professionals at Beck Institute: September 27 – 29, 2010

Aaron T. Beck, M.D.SEPTEMBER 2010: Psychologists, psychiatrists, social workers, professors, school counselors, nurse practitioners, and other professionals from mental health, medical, and related fields traveled from 18 states and 10 countries, including Australia, Brazil, Canada, Germany, Hong Kong, Jamaica, Japan, Netherlands, Pakistan and United Kingdom. Pictured above-left, Aaron T. Beck, M.D. answers questions after conducting a live patient session that was viewed (via closed-circuit television) by participants in the Cognitive Behavior Therapy workshop at Beck Institute.

Aaron T Beck, M.D., also met with scholarship winners Ellen Driessen, MSc, Jordana Muroff, Ph.D., LICSW, and Scott Ries, MSW, who were all granted full tuition scholarships to attend one of our 3-Day workshops.  They represent three out of ten winners from our Scholarship Competition held in March 2010, which received over 880 entries from around the world!

Participants received professional training in Cognitive Behavior Therapy from Aaron T. Beck, M.D., Judith S. Beck, Ph.D., Leslie Sokol, Ph.D., and Norman Cotterell, Ph.D. Trainees participated in seminars and case discussions, reviewed videos of therapy sessions, and observed demonstration roleplays among other activities. More event highlights:

Beck Institute Participants (1)Beck Institute Participants (2)Judith S. Beck, Ph.D. and Aaron T. Beck, M.D.Leslie Sokol, Ph.D.Norman Cotterell, Ph.D.Judith S. Beck, Ph.D.

The Relationship between Interpersonal Self-Concept and Paranoia in Patients with Schizophrenia

newstudy-graphic-66x60.jpgA recent study published in Behavior Therapy examined the relationship between interpersonal self-concept and global self-worth, and psychotic and depressive symptoms in patients with psychosis. The participants consisted of 83 patients, all of whom had diagnoses on the schizophrenia spectrum, and 33 healthy individuals. The researchers measured each participant’s global self-worth, interpersonal self-concept, dysfunctional beliefs, positive and negative symptoms, delusions, paranoia, and depressive symptoms.

Results showed that (1) Global self-worth is related more to depression than it is to paranoia, (2) the perception of not being accepted by others is more related to psychotic symptoms, (3) individuals who believe that others evaluate them positively have lower levels of paranoia, regardless of their dysfunctional beliefs levels, and (4) negative self-concept (i.e., not being respected , trusted, loved, and accepted by others) is most closely related to positive symptoms, paranoia, and psychosis.

The significant correlation between dysfunctional interpersonal self-concept, dysfunctional attitudes, and paranoia reinforces the formulation-based cognitive approach to delusions and the importance of eliminating dysfunctional self-concepts. The results of this study suggest that cognitive therapy may be successful in treating persecutory delusions and paranoia by focusing on interpersonal and threat-related self-concepts.

Lincoln, T.M., Mehl, S., Ziegler, M. Kesting, M.L., Exner, C., & Rief, W. (2010). Is fear of others linked to an uncertain sense of self? The relevance of self-worth, interpersonal self-concepts, and dysfunctional beliefs to paranoia. Behavior Therapy, 41, 187-197.

Special Cognitive Behavior Therapy Workshop for Students and Post-Doctoral Fellows: August 9 – 11, 2010

Aaron T. Beck, M.D. AUGUST 2010: Post-doctoral fellows, psychiatry residents, social work interns, nurses, and other graduate students from mental health, medical, and related fields traveled from 20 states and 8 countries, including Brazil, Canada, Denmark, Hong Kong, Ireland, Lebanon, Mexico, Turkey, and United Kingdom. Pictured above-left, Aaron T. Beck, M.D. answers questions from students in the Cognitive Behavior Therapy workshop hosted by Beck Institute. (Below/Right) Torrey Creed, Ph.D., conducts a roleplay demonstrating techniques in Cognitive Behavior Therapy for children and adolescents. Participants received professional training in Cognitive Behavior Therapy from Aaron T. Beck, M.D., Judith S. Beck, Ph.D., Leslie Sokol, Ph.D., and Torrey Creed, Ph.D. Trainees participated in seminars and case discussions, reviewed videos of therapy sessions, and observed demonstration roleplays among other activities. More event highlights: Aaron T. Beck, M.D. and Judith S. Beck, Ph.D.Judith S. Beck, PhDLeslie Sokol, Ph.D.Leslie Sokol, Ph.D. (lecture)Judith S. Beck, Ph.D.

CBT is Effective for Tourette’s Syndrome

researchlogo72x65bl-new.jpgA new study is the first to show that CBT (cognitive behavioral therapy) is effective in patients with Tourette’s syndrome and tic disorders, regardless of their medication status or symptom severity. 76 adult participants, all of whom had been diagnosed with the aforementioned conditions, were divided into two groups; those who were prescribed medication and those who were not. All of the participants underwent four months of individualized, manual-based CBT. Before and after receiving CBT, measures were taken to assess depression, anxiety, obsessive-compulsive symptoms, and planning style. Also, the Tourette Syndrome Global Scale was employed to assess various factors, including severity and treatment outcome.

 The results demonstrated that both groups—medicated and unmedicated—greatly improved from the CBT. The unmedicated group improved in terms of anxiety, while both groups’ depressive symptoms decreased.

CBT is Effective for Irritable Bowel Syndrome

researchlogo72x65bl.jpgA recent study posted in Clinical Gastroenterology and Hepatology, a journal publishing clinical articles on all aspects of the digestive system, shows evidence that cognitive behavioral therapy (CBT) is an effective treatment for irritable bowl syndrome (IBS).

The study included 71 participants, with moderately severe IBS symptoms, who were randomly assigned to one of two conditions; they either received 10 weekly 1-hour sessions of CBT, or 4 1-hour sessions over 10 weeks.

Results showed that “rapid responders”, those who began to see improvements in their IBS symptoms within the first 4 weeks, had maintained the improvements at both immediate and 3-month check ups after treatment had ended. No difference was observed between the patients who received 4 sessions and those who received 10 sessions during the 10 weeks.

Lackner, J. M., Gudleski, G. D., Keefer, L., Powell, C., & Katz, L. A. (2010). Rapid response to    cognitive behavior therapy predicts treatment outcome in patients with irritable bowel syndrome, Clinical Gastroenterology and Hepatology, 8, 426-432.

CBT Found to Be Clinically Effective for Depressed Older Adults in Primary Care

NewStudy-Graphic-72x72_edited-3A new study published in the Archives of General Psychiatry investigated the clinical effectiveness of cognitive behavior therapy (CBT) for older adults in primary care. A total of 204 men and women aged 65 years or older with geriatric depression were randomly assigned to one of three groups: treatment as usual (TAU), TAU plus a talking control (TC), and TAU plus CBT. The CBT and TC treatments were offered over a period of four months and participants were followed up at 10 months. Depressive levels were measured with the Beck Depression Inventory-II (BDI-II) at baseline, at four months (the end of therapy), and again at 10 months. Based on BDI-II scores per session, a significant benefit of CBT versus the TAU and TC was observed, pointing to CBT as an effective treatment for depression in older adults.

This study was the largest CBT study conducted by general practitioner of their patients.

Generalizing Cognitive Behavior Therapy for Anxiety Disorders to Clinical Practice

NewStudy-Graphic-72x72_edited-3 Studies conducted at the University of Pennsylvania add to a growing body of research that supports the use of cognitive behavior therapy (CBT) in clinical practice. In their meta-analysis review of 56 studies, Stewart and Chambless (2009) examined CBT treatments for social anxiety disorder, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD), panic disorder, and posttraumatic stress disorder (PTSD), and found significant support for each treatment within the clinical setting. When CBT treatments were compared to control conditions, 78% of participants improved with CBT treatment as compared to 22% of participants in control groups. Additional analyses also indicated lower effect sizes for treatment outcomes when therapists were not trained, when treatment manuals were not used, and when treatment fidelity was not monitored. This data points to the importance of training, the use of treatment protocols, and the monitoring of treatment fidelity.

Reference

Stewart R.E. & Chambless, D.L. (2009). Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77, 595-606.

CBT and CBT Plus Medication for the Treatment of OCD in Children

NewStudy-Graphic-72x72_edited-3 A recent study published in Child and Adolescent Mental Health found both Cognitive Behavior Therapy (CBT) and CBT in combination with medication to be effective in the treatment of Obsessive Compulsive Disorder (OCD) in children. During a ten-year period, 75 children were evaluated and treated for OCD in an outpatient setting. Investigators later contacted a subset of that sample to investigate the long-term maintenance of their therapeutic gains. Treatment groups in this follow up investigation included, (1) those treated with medication before beginning CBT, (2) those treated with CBT only, and (3) those treated with CBT and medication, simultaneously. Participants in each group had all met diagnostic criteria for OCD as determined by their Children’s Yale Brown Obsessive-Compulsive Scale (CYBOCS) scores. Long term maintenance was assessed by comparing post-treatment and pre-treatment CYBOCS scores. Results showed significant improvement for each group, yielding further support for the use of CBT and CBT plus medication (SSRIs) in the treatment of OCD.

Reference

Nakatani, E. (2009). Outcomes of cognitive behaviour therapy for obsessive compulsive disorder in a clinical setting: A 10-year experience from a specialist OCD service for children and adolescents. Child and Adolescent Mental Health, 14, 133-139.

Repeat Suicide Attempts Reduced by CBT

NewStudy-Graphic-72x72_edited-3A randomized control study in the Journal of the American Medical Association found cognitive behavioral therapy (CBT) to be effective in reducing the number of repeat suicide attempts in adults.

Past research had focused on intensive follow-up treatment or intensive case management, interpersonal psychotherapy, or cognitive behavioral therapy for the preventative treatment of suicide attempts, but empirical evidence for the efficacy of these therapies has been limited. The current study aimed to examine the efficacy of cognitive behavioral therapy as a preventative therapy for suicide, by performing a randomized control study adequate in power to detect treatment differences.

Participants consisted of patients who had attempted suicide and received a medical or psychological evaluation within 48 hours of the attempt. Participants were randomly assigned to follow-up care of either CBT or usual care (UC). Those placed in the CBT group received outpatient CBT sessions that were specifically designed for preventing future suicide attempts. The CBT aimed to address and identify the thoughts, images, and core beliefs that activated the previous suicide attempt, and to teach cognitive and behavioral strategies as better ways of coping with these thoughts and stressors.

The authors found that participants in the CBT group were 50% less likely to reattempt suicide than the participants in the UC group. In addition, the CBT group measured significantly lower for depression as well as hopelessness than the UC group. The authors concluded that “the short-term feature of cognitive therapy would make it particularly applicable for the treatment of suicide attempters at community mental health centers, which typically provide relatively short-term therapy.”

Reference: Brown, G. K, Have, T. T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association, 294, 563-570

CBT Meta-Analysis Review is Most Downloaded Article in CPR

It looks as if the research efficacy of Cognitive Therapy is becoming more well-known. Clinical Psychology Review is a peer-reviewed journal that publishes substantive reviews of topics relevant to clinical psychology. The most downloaded article from this important journal is The empirical status of cognitive-behavioral therapy: A review of meta-analyses (Volume 26, Issue 1, January 2006, Pages 17-31), authored by Andrew C. Butler, Jason E. Chapman, Evan M. Forman and Aaron T. Beck.

This 2006 review summarizes CBT treatment outcomes for a wide array of psychiatric disorders and includes sixteen methodologically rigorous meta-analyses. Findings are consistent with previous review methodologies and demonstrate the efficacy of CBT for many disorders. Specifically, unipolar depression, generalized anxiety disorder, panic disorder (with or without agoraphobia), social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders all showed large effect sizes. Marital distress, anger, childhood somatic disorders, and chronic pain showed moderate effect sizes.

CBT was also shown to be somewhat superior to antidepressants in the treatment of adult depression and as effective as behavior therapy in the treatment of both adult depression and obsessive-compulsive disorder. Bulimia nervosa and schizophrenia showed large, uncontrolled effect sizes.