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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.

Recalling Recent Experiences in Session

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I do many things at the beginning of therapy sessions, one of which is to ask patients about their experiences since I last saw them. Depressed patients routinely report only negative incidents. I then ask them what positive things happened, or what was going on during the better parts of their week. One reason I do this is to collect data that may be contrary to their globally negative thinking. (“No one likes me.” “It isn’t worth doing anything.” “Everything is terrible.”)


Another reason I do this is to allow the session to be a little more conversational, a little lighter in tone. I also find that having patients recall positive experience lightens their mood and makes it easier for them to take a more realistic (less negative) view of their problems. A recent study confirms the importance of doing so. When people are depressed, their thinking is more rigid and ruminative when stimuli are negative, which translates into greater difficulty in solving problems.  

-Judith S. Beck, Ph.D.

Cognitive-Behavioral Therapy Shows Promise for Children with Mental Illness – JAMA Article

 

The numbers are astonishing:

20% of children in the U.S. have some form of mental illness.

Only 1 in 5 receives treatment. Read more

What Cognitive Therapy does to your brain…

Cognitive Therapy is well known for being effective for depression (it’s twice as effective as medication in preventing relapse) and it’s also been shown to work for many other disorders — but why? How does it work?

A major clue to how Cognitive Therapy affects the brain came out in this study two years ago — researchers were interested in seeing how Cognitive Behavior Therapy affected the brains of depressed people as compared to medication. They hypothesized that since both CBT and medication were effective for depression, both treatments would affect the same part of the brain. Using brain imaging technology, they scanned participants’ brains before and after the course of treatment.

And they were in for a surprise. Researchers found that antidepressants affected one part of the brain among depressed patients, and CBT treatment affected another part altogether. Antidepressants dampened activity in the limbic system — the emotional center of the brain. Conversely, CBT calmed activity in the cortex — the brain’s seat of reason.

In other words, antidepressants reduced emotions, whereas CBT helped patients process their emotions in a healthier manner.

Which explains why those on antidepressants have a much higher likelihood of relapse if they go off of their meds — negative emotions can flood back in. But with CBT, patients gain the skills to respond to their emotions more effectively — for long-term benefits.

Alternatives to Drugs for Hyperactive Children? Psychotherapy Can Help

 

A recent NY Times article talks about the prevalence of ADHD in children, and parents who want to avoid drugs like Ritalin. The American Psychological Association in fact recommends that parents consider non-drug treatment first for children. The article discusses one family that used new parenting techniques to help with their son’s ADHD, and also says that Cognitive Behavior Therapy has been demonstrated to help teach children how to improve their anger, frustration, depression, and anxiety. We actually just posted on how nurses used Cognitive therapy to help children ages 7-18 — see below…

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 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.