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Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures. A mixed-model analysis of variance revealed a Group × Time interaction on peak oxygen consumption change, F(1, 14) = 10.1, p =.007, and EX increased peak oxygen consumption (p =.03, g′ = −0.41) and reduced ISI (p =.001, g′ = 0.82) compared with RE (p =.49, g = 0.16) post-8 weeks. Post-16 weeks, there was a significant Group × Time interaction (p =.014) driven by RE + CBTiEX yielding a larger improvement in ISI (p =.023, g′ = 1.48) than EX + EX (p =.88, g′ < 0.1). Objective sleep was unchanged. This study showed promising effects of regular EX alone and combined with cognitive-behavioral therapy for insomnia on ISI in comorbid insomnia and obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral therapies and related approaches are highly prevalent within sport psychology practice. Traditionally, these approaches are delivered across interventions comprising multiple sessions. However, in the fast-paced environments in which many applied sport psychologists operate, practitioners are sometimes required to provide fast, effective, and impactful interventions to athletes at their point of need within a single session. Single-session integrated cognitive-behavioral therapy presents a potentially effective approach for practice wherein time is often at a premium, and there is frequently pressure to make an impact quickly to improve performance. In this article, we put forward a stimulus piece that contextualizes single-session integrated cognitive-behavioral therapy and overviews how sport psychology practitioners may use such techniques with athletes. We also put forth a call for more practitioners to report more idiographic case studies that feature the use of brief or single-session interventions to further build the evidence base for such approaches. [ABSTRACT FROM AUTHOR]

"Why Has Nobody Told Me This Before?" by Julie Smith is a book that addresses the increasing incidents of mental health issues among students, faculty, and staff at universities, particularly exacerbated by the COVID-19 pandemic. The book aims to provide practical advice and concepts to individuals who may not have access to psychotherapy or mental health services. It covers various topics such as sleep, diet, exercise, motivation, emotional pain, grief, self-doubt, fear, and stress, offering a balanced approach between resilience and self-compassion. The book's accessible tone and structure make it a useful resource for both faculty and students in managing mental health and well-being. [Extracted from the article]

Major depressive disorder (MDD) represents a sizable economic burden in Spain. Pharmacogenetic (PGx) screening to guide the choice of antidepressant medication (ADM) in MDD patients yields higher response and remission rates, which could reduce both healthcare and indirect costs. We built a cost-effectiveness probabilistic Markov model with microsimulation using Tree Age Pro 2022, simulating a patient cohort from the SNHS starting ADM for MDD, and comparing PGx screening before starting ADM versus no screening (No PGx). We carried out a probabilistic sensitivity analysis using the Monte Carlo simulation with microsimulation, set for 1000 iterations and 1000 microsimulation trials, both from societal and healthcare provider perspectives, for a time horizon of 3 years. From a societal perspective, the model estimated a mean cost of 3172.85€ and effectiveness of 2.64 quality-adjusted life years (QALYs) for the No PGx strategy, and a mean cost of 1687.02€ and effectiveness of 2.84 QALYs for the PGx strategy. The mean ICER was −7820.56 €/QALY. From a healthcare provider perspective (no indirect costs considered), the mean cost was 662.62€ for the No PGx strategy, and 446.60€ for the PGx strategy. The mean ICER was −1130.16 €/QALY. The heterogeneity of input data from the literature, the need for assumptions of homogeneous distribution of variables and events across population and time, and the inherent limitations of cost-effectiveness analysis should be considered. The model omits combined therapies (ADMs with mood stabilizers, antipsychotics, cognitive behavioral therapy...). PGx screening in MDD prior to ADM start is a dominant strategy in the SNHS. • Treatment failure rates in major depressive disorder are high and contribute to its economic impact • Pharmacogenetics-guided choice of antidepressants lower failure rates, which could reduce the associated economic burden • We analyzed the cost-effectiveness of this strategy with a Markov model • Microsimulation allows for a more accurate simulation of individual patients' characteristics • Pharmacogenetic screening when starting antidepressants is a dominant strategy [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD) is a high-prevalence mental disorder among children and adolescents. The aim of this study is to compare and rank the effectiveness of several psychotherapies for SAD among children and adolescents. Only randomized controlled trials (RCTs) were utilized by searching PubMed, Embase, Cochrane Library, and Web of Science. We used network meta-analysis in the Bayesian framework to analyze the data. This study is registered with PROSPERO, number CRD42023476829. In total, 30 RCTs with 1547 individuals were included, and nine psychotherapies with three control conditions were compared and ranked in this study. The findings revealed that internet-delivered cognitive behavioural therapy (surface under the cumulative ranking curve [SUCRA: 71.2 %]), group cognitive behavioural therapy (SUCRA: 68.4 %), and individual cognitive behavioural therapy (SUCRA: 66.0 %) significantly reduced social anxiety symptoms; internet-delivered cognitive behavioural therapy also significantly decreased depression symptoms in these patients (SUCRA: 92.2 %). In addition, group cognitive behavioural therapy can enhance functioning in these patients (SUCRA: 89.6 %). These results suggest that internet-delivered cognitive behavioural therapy is the optimal type of psychotherapy for reducing social anxiety and depression symptoms in children and adolescents with SAD, internet-delivered parent-child interaction therapy and cognitive bias modification of interpretation have relatively poor treatment effects on social anxiety symptoms in children than other psychological interventions, and group cognitive behavioural therapy has better benefits in enhancing the functioning among children and adolescents with SAD. Further studies are needed to ascertain these results due to the limited number of included studies. • Network meta-analysis examines interventions for social anxiety disorder. • Internet-delivered CBT is an optimal psychotherapy for social anxiety disorder. • Group CBT has better benefits in enhancing the functioning. • Findings can provide recommendations for health care professionals and patients. [ABSTRACT FROM AUTHOR]

Super Skills for Life is a structured intervention rooted in cognitive-behavioral therapy and a transdiagnostic approach, aimed at preventing childhood emotional problems. Over the past decade, it has demonstrated positive outcomes in various formats and countries. This study evaluated the comparative effectiveness of two individual modalities: the computerized and the traditional version enriched with multimedia content, through a comparative randomized effectiveness trial. 109 children (55.24 % female) aged 8–12 years participated, randomly assigned to either the traditional (n = 54) or computerized (n = 51) groups. Pre- and post-intervention assessments involved emotional problem measures completed by children and parents. Both groups exhibited significant reductions in all outcomes according to parent reports, including depression, anxiety, and anxiety-related life interference. Children's self-reports indicated improvements across all general measures. Generalized Estimating Equations indicated marginally better improvements in the traditional group. Limitations included the absence of follow-up assessment, variability in participant regions across Spain, and input from other informants like teachers. This study pioneers the examination of short-term effects of the program in both a fully computerized format supervised by a specialized therapist and an enriched traditional individual format, and the promising results suggest their potential for indicated prevention of childhood emotional problems. • First study to evaluate short-term effects of fully computerized Super Skills intervention supervised by therapists. • Results show the fully computerized Super Skills format is as effective as the traditional one-to-one version. • Streamlined materials and shorter application times enhance cost-effectiveness of computerized format. • Promising results suggest transdiagnostic CBT interventions as effective tools for preventing children's emotional problems. [ABSTRACT FROM AUTHOR]

To evaluate the effects of different interventions on adolescent internet addiction, a meta-analysis and network meta-analysis were performed to determine the possible intervention effects of these interventions. Computer searches of the China National Knowledge Network, Wanfang, VIP, EMBASE, PubMed, Web of Science, EBSCO, and Cochrane Library databases were performed. The relevant randomized controlled trials were designed to assess the effects of interventions on adolescent internet addiction. The retrieval period ranged from the establishment of the database to January 31, 2024. Literature screening, data extraction, and bias risk assessment were carried out independently by two researchers. CMA 3.3, Stata 17.0 software and Review Manager 5.3 were used for the data analysis. A total of 89 studies with 6876 samples were included. A traditional meta-analysis of 51 single interventions and controlled studies revealed that sports intervention, cognitive behavior therapy, family therapy, mindfulness intervention, attention bias training and group counseling significantly improved adolescent Internet addiction [standardized mean difference (SMD) = −1.75, 95 % CI (−2.07, −1.44), p < 0.01; I2 = 94 %] compared to no-treatment groups. A network meta-analysis showed that combined intervention (Sucra = 93.5) had the highest probability of being the best intervention for adolescent Internet addiction, and acupuncture interventions showed the most promise as a single intervention modality; however, due to the limited number of studies, we believe that sports intervention could be the most appropriate single intervention. The evidence provided by existing studies shows that compared with other single interventions, combined interventions have the greatest effect on adolescent IA, and sports may be the best single intervention. However, because of the limitations of sample size and quality of individual studies, the strength of the evidence still needs to be further verified by additional standardized and high-quality studies. • To evaluate the effects of different interventions on adolescent Internet addiction, and to rank their possible intervention effects. • A total of 89 RCTs with 6876 samples were included. • Combined intervention had the highest probability of being the best intervention for adolescent Internet addiction, and sports intervention could be the most appropriate single intervention. [ABSTRACT FROM AUTHOR]

Background: Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to timely and targeted mental health intervention for children at significant risk for poor outcomes. The present paper will describe our planned protocol to evaluate the efficacy of CoolTaCo via randomized control trial (RCT). Methods/design: We will recruit 60 children (ages 8–12) with ADHD who will be randomized to either immediate (n = 30) or delayed (n = 30) treatment (i.e., a waitlist control group). Among those randomized to immediate treatment, half will be assigned to DHI (delivered via a smartwatch and smartphone application), the other half to an active control treatment as usual (TAU). Unlike the DHI group, the TAU group will receive the smartwatch with no assigned activities, applications, or interventions on the devices. The intervention period will last 16 weeks; after a participant has been in the delayed treatment group for 16 weeks and has completed the post-waiting period assessment, they will be randomly assigned to either the intervention or active control group. Thus, 30 participants will complete the intervention, and 30 will complete the active control, with half of the total sample completing a waitlist period. Discussion: Individuals with ADHD have complex needs. Despite improvement in outcomes following cognitive behavioral therapies (CBT) and pharmaceutical treatment, long-term maintenance is a challenge often not addressed by traditional medical approaches, and, as we described, ineffective approaches to information sharing across points of care create further barriers to progress. Our research will fill a significant gap in translating early treatment investments and gains into long-term, sustainable outcomes. This study was registered as a clinic trial at ClinicalTrials.gov (Digital Health Intervention for Children With ADHD, ID# NCT06456372) on 06/13/2024. [ABSTRACT FROM AUTHOR]

The current medical model has transitioned from the original biomedical treatment model to a bio-psycho-social model, where patients now have higher demands for service awareness. Consequently, doctor–patient relationships have become a crucial aspect of the contemporary medical process. Currently, psychological resilience among medical students in China tends to be at a moderately lower level. Medical students often exhibit poor psychological qualities in handling contradictions in doctor–patient relationships. Moreover, there is a lack of emphasis on the education of corresponding psychological qualities for medical students during the teaching process. This deficiency is highly disadvantageous for medical students in their future management of doctor–patient relationships. The article explores how to cultivate psychological resilience in medical students and enhance their ability to handle conflicts in doctor–patient relationships from the perspective of doctor–patient relationships. The author suggests that schools should place greater emphasis on the psychological resilience of medical students, change teaching methods, incorporate online education to enhance the mentalization level of medical students, and propose an eight-week mindfulness cognitive therapy program to improve psychological resilience. The intervention process should consider establishing positive coping mechanisms, promoting good interpersonal relationships among medical students, and regulating individual negative emotions. Through simulating doctor–patient scenarios, teachers should consciously train the psychological resilience of medical students, improve their cognition and thinking abilities, and accelerate their psychological health recovery. [ABSTRACT FROM AUTHOR]

Background: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain its constitution and development. Method: A review of theoretical models and empirical research on TRD was conducted in major databases. Results: The model reflects how patients with TRD are more susceptible to becoming trapped in their condition by seeking to avoid discomfort through avoidance and escape behaviors, which increasingly drives them away from sources of positive reinforcement. Based on this model, a BA-based intervention protocol is suggested for the treatment of TRD. Through six phases (in a total of thirteen sessions), the protocol guides the intervention towards the reestablishment of personalized routines to increase the probability of reinforcement and reduce avoidance behaviors. Conclusions: Although the model holds significant potential to become an effective intervention in TRD, future research will allow the evaluation of the efficacy of the protocol as a standalone intervention. [ABSTRACT FROM AUTHOR]

The Body Advocacy Movement (BAM) is a novel, cognitive-dissonance-based intervention designed to target fatphobia and anti-fat bias as mechanisms to drive reductions in eating disorder (ED) risk. Previous dissonance-based programs (i.e. the Body Project; BP) have successfully targeted thin-ideal internalization as an intervention mechanism. As burgeoning research indicates that fatphobia and anti-fat bias may play a central role in the maintenance of ED pathology, a focused intervention designed to target these constructs could bolster prevention efforts. The aims of this pilot study include confirming acceptability and feasibility of BAM and developing preliminary estimates of its effects on intervention targets, along with benchmarking these effects against the BP intervention. BAM was found to be accepted by participants and feasible to facilitate in a peer-led model. Preliminary results from 50 participants (BAM: N = 26; BP: N = 24) reveal small-to-moderate pre-to-post intervention effects on fatphobia, anti-fat bias, thin-ideal internalization, and eating pathology, which dissipated at 8-week follow-up. The BAM intervention has the potential to supplement the existing suite of ED prevention programs by specifically targeting anti-fat bias, though additional testing in larger and more diverse samples is necessary to clarify its impact on both hypothesized risk mechanisms and ED outcomes. [ABSTRACT FROM AUTHOR]

Objective: Blended cognitive behavioral therapy (bCBT) combines face-to-face therapy with digital elements, such as digital health apps. This pilot study aimed to explore the effectiveness and safety of a novel bCBT application for treating unipolar depression in adults combined with cognitive behavioral therapy (CBT) compared to CBT alone in routine care. Methods: Patients (N = 82) were randomly assigned to bCBT (n = 42) or CBT (n = 40) over 12 weeks. bCBT consisted of weekly CBT sessions accompanied by the elona therapy depression module (a bCBT application for unipolar depression) for use between sessions. Standard CBT consisted of weekly CBT sessions. Outcomes (6,12 weeks) were analyzed with linear mixed models. Results: Improvements in depressive symptoms (BDI-II, PHQ-9) were descriptively larger for the bCBT group. Yet, this difference did not reach statistical significance. bCBT was superior to standard CBT in secondary outcome measures of psychological health (d =.50) and generalized anxiety symptoms (d = -.45). In other secondary outcomes (BAI, PSWQ, GSE, WHOQOL-BREF), improvements were descriptively larger for bCBT compared to CBT. Conclusion: This pilot study provided preliminary evidence that bCBT might be advantageous in comparison to CBT alone in the treatment of depression, but larger RCTs of the bCBT application are needed. [ABSTRACT FROM AUTHOR]

Objective: The role of affective experiences (AE) in cognitive–behavioral therapy (CBT) has rarely been investigated. We examined between- and within-person effects of AE on coping in CBT for family caregivers and interactions with therapeutic alliance and resource activation. Methods: 67 family caregivers rated AE, therapeutic alliance, resource activation, and coping after each of 12 sessions of telephone-based CBT. We examined direct session-to-session effects of AE on coping in structural equation modeling and interactions of AE with therapeutic alliance and resource activation in multilevel models. Results: AE did not directly predict coping. Instead, within-person effects of AE interacted with simultaneous within-person emotional bond. Given strong emotional bond, AE positively predicted coping, whereas given weak emotional bond, AE negatively predicted coping. Further, cross-level interactions of between-person AE and within-person agreement on collaboration and resource activation indicated that these positively predicted coping only in dyads with high between-person AE. Conclusion: AE may enhance coping when complemented with strong emotional bond. Further, within-person effects of agreement on collaboration and resource activation seem to rely on a certain degree of between-person AE. Results are discussed in relation to current findings on emotional processing in CBT. [ABSTRACT FROM AUTHOR]

Objective: To develop two prediction algorithms recommending person-centered experiential therapy (PCET) or cognitive–behavioral therapy (CBT) for patients with depression: (1) a full data model using multiple trial-based and routine variables, and (2) a routine data model using only variables available in the English NHS Talking Therapies program. Method: Data was used from the PRaCTICED trial comparing PCET vs. CBT for 255 patients meeting a diagnosis of moderate or severe depression. Separate full and routine data models were derived and the latter tested in an external data sample. Results: The full data model provided the better prediction, yielding a significant difference in outcome between patients receiving their optimal vs. non-optimal treatment at 6- (Cohen's d =.65 [.40,.91]) and 12 months (d =.85 [.59, 1.10]) post-randomization. The routine data model performed similarly in the training and test samples with non-significant effect sizes, d =.19 [−.05,.44] and d =.21 [−.00,.43], respectively. For patients with the strongest treatment matching (d ≥ 0.3), the resulting effect size was significant, d =.38 [.11, 64]. Conclusion: A treatment selection algorithm might be used to recommend PCET or CBT. Although the overall effects were small, targeted matching yielded somewhat larger effects. [ABSTRACT FROM AUTHOR]

Dysfunctional attitudes – a cornerstone to cognitive psychotherapy – vary with both psychological and pharmacological interventions. Post-acute changes in these cognitions appear to covary with the acute reactions to psychedelics that often precede improved outcomes. An examination of post-acute changes in dysfunctional attitudes could support targeting them in psychedelic-assisted therapy. Screened participants (N = 400+) reported the acute, subjective experiences associated with their most significant psychedelic response as well as post-acute changes in dysfunctional attitudes and subsequent alterations in wellbeing. Dysfunctional attitudes, emotional breakthroughs, and challenging experiences accounted for significant, unique variance in wellbeing. The effects of dysfunctional attitudes generally exceeded those of acute reactions. Comparisons among those acute responses revealed that the effect of emotional breakthroughs exceeded challenging experiences, which exceeded mystical experiences. Nevertheless, the indirect effects through post-acute changes in dysfunctional attitudes did not account for all the impact of acute effects nor interact with them. These results emphasize the import of both acute and post-acute reactions, suggesting that strategies for optimizing each might maximize outcomes for psychedelic-assisted interventions. Furthermore, standard cognitive interventions that alter these cognitions could combine with psychedelics in straightforward ways. The results also support the use of multiple multivariate approaches to address the relative importance of multicollinear predictors. [ABSTRACT FROM AUTHOR]

Background: Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. Objective: To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. Methods: A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. Results: 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. Conclusion: While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress. [ABSTRACT FROM AUTHOR]

The Global ECT MRI Research Collaboration (GEMRIC) has collected clinical and neuroimaging data of patients treated with electroconvulsive therapy (ECT) from around the world. Results to date have focused on neuroimaging correlates of antidepressant response. GEMRIC sites have also collected longitudinal cognitive data. Here, we summarize the existing GEMRIC cognitive data and provide recommendations for prospective data collection for future ECT-imaging investigations. We describe the criteria for selection of cognitive measures for mega-analyses: Trail Making Test Parts A (TMT-A) and B (TMT-B), verbal fluency category (VFC), verbal fluency letter (VFL), and percent retention from verbal learning and memory tests. We performed longitudinal data analysis focused on the pre-/post-ECT assessments with healthy comparison (HC) subjects at similar timepoints and assessed associations between demographic and ECT parameters with cognitive changes. The study found an interaction between electrode placement and treatment number for VFC (F(1,107) = 4.14, p = 0.04). Higher treatment was associated with decreased VFC performance with right unilateral electrode placement. Percent retention showed a main effect for group, with post-hoc analysis indicating decreased cognitive performance among the HC group. However, there were no significant effects of group or group interactions observed for TMT-A, TMT-B, or VFL. We assessed the current GEMRIC cognitive data and acknowledge the limitations associated with this data set including the limited number of neuropsychological domains assessed. Aside from the VFC and treatment number relationship, we did not observe ECT-mediated neurocognitive effects in this investigation. We provide prospective cognitive recommendations for future ECT-imaging investigations focused on strong psychometrics and minimal burden to subjects. • GEMRIC has amassed clinical & MRI data from ECT-treated patients worldwide, emphasizing neuroimaging correlates and cognitive data collection. • Analysis showed electrode placement & treatment number impacted verbal fluency, but no significant effects were found for other cognitive tasks. • Future ECT-imaging studies should use robust cognitive measures with strong psychometrics and minimal subject burden. [ABSTRACT FROM AUTHOR]

Scholars and practitioners have attended to and shown support for the promotion of a culturally sensitive approach within applied sport psychology. Yet, a cultural competence knowledge-behavior gap among sport psychology practitioners (SPPs) remains prevalent along with a lack of practical guidance on how SPPs can engage in a cultural praxis. In order to ensure that SPPs are helping all clients (e.g., athletes) thrive—not merely cope with forms of social identity oppression (e.g., racism) and other sources of harm that pervade sport—there is a need for empirical research that explores how current SPPs fully account for identity, privilege/power and oppression in their work. This qualitative study aimed to help close this gap by offering practical insights from SPPs that can serve as direction for other practitioners to strengthen their cultural praxis. This study adopted a cultural praxis agenda. Semi-structured interviews were conducted with 27 current SSPs working in the United States who identified as making efforts to account for social identity, privilege/power and oppression in their practice. Reflexive thematic analysis of interviews with SPPs was carried out at the semantic level. Results highlight four key themes that reflect SPPs approach: (a) acknowledging the self, (b) learning about the client as a whole person in context, (c) shifting power to the client for collaboration, and (d) taking individual-level and/or organizational-level action. Findings provide guidance for how SPPs can engage in a cultural praxis that goes beyond cultural competence promotion in order to ensure that sport is an empowering context for all. Lay summary: This study explored how SPPs account for social identity, privilege/power and oppression in their practice. Four themes characterized their approach: acknowledging the self, learning about the client as a whole person in context, shifting power to the client for collaboration, and individual-level and organizational-level action to promote inclusion, belonging, and equity. Findings provide guidance for how SPPs can work to ensure that sport is an empowering context for all. IMPLICATIONS FOR PRACTICE: SPPs accounted for social identity, privilege/power and oppression in their applied work by first building and exercising their awareness of themselves (and their positionality) along with their client as a whole person in context. Practitioners used this awareness to shift power to their client for collaboration by honoring their expertise and making individualized considerations. SPPs took individual-level and/or organizational level action to promote inclusion, belonging, and equity within the context of the client-practitioner relationship and broader sport environment. In order to ensure that sport is an empowering context for all, SPPs can consider what organizational-level actions they might take alongside individual-level actions in order to effect wholescale social justice change. [ABSTRACT FROM AUTHOR]

People high in depressive or anxious symptom severity show repetitive negative thinking, including worry and rumination. They also show various cognitive phenomena, including probability, cost, and interpretation biases. Since there is conceptual overlap between these cognitive biases and repetitive negative thinking – all involve thinking about potential threats and misfortunes – we wondered whether repetitive negative thinking could account for (mediate) these cognitive biases' associations with depressive and anxious symptom severity. In three studies, conducted in two languages and cultures, cost bias and (in two studies) interpretation bias only predicted symptom severity via worry and repetitive negative thinking; this suggests these biases are actually associated with repetitive negative thinking, rather than with symptoms. In contrast, probability bias showed direct relationships with depressive (all studies) and anxious (two studies) symptom severity, suggesting its relationships with symptoms are partly independent of repetitive negative thinking. These results show the value of studying relationships among the various cognitive features of psychopathology. Furthermore, new interventions which target cognitive biases in depression or anxiety must show that they can improve upon cognitive behavioural therapy, which is already widely available, targets both repetitive negative thinking and probability bias, and is highly effective. [ABSTRACT FROM AUTHOR]

Background: Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait‐like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within‐person processes of elevated risk in clinically meaningful time periods. Methods: The present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self‐report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Results: Overall, two‐thirds of variance in weekly irritable mood was accounted for by between‐person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Conclusions: Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression. [ABSTRACT FROM AUTHOR]

Little is known about the nature of social anxiety in autistic people: What is similar and different about factors contributing to social anxiety in autistic and non-autistic people? There is also very limited research about autistic people's experiences of therapy for social anxiety in current routine clinical practice. This study investigated these issues by analysing responses to an online questionnaire for 308 adults with elevated social anxiety (232 autistic people and 76 non-autistic people) using mixed-methods approaches. Distinct factors influenced social anxiety in autistic participants, including individual and environmental factors relating to autistic experiences in the social world. We propose a 'distinct' model of social anxiety in autism. In addition, many participants had not had helpful experiences in therapy, especially cognitive behaviour therapy, for social anxiety: They thought therapists did not always acknowledge the basis of their social fears, did not adapt the therapy process in an individualised way and did not understand neurodiversity or recognise neurodivergence. Our results suggest that social anxiety needs to be understood specifically in the context of autism, and if this is neglected, therapy is unlikely to be helpful. Based on participants' comments, this article makes some practical recommendations for therapists supporting autistic adults with social anxiety. The nature of social anxiety has been widely researched in non-autistic people. This existing research has allowed therapists to develop effective therapy for social anxiety in non-autistic people. Meanwhile, some research suggests that autistic people may have different experiences of anxiety compared to non-autistic people. In addition, there is some evidence that modified therapy may help autistic people with social anxiety, although we also know that many autistic people feel failed by existing mental health services. This article provides a detailed picture of social anxiety in autistic people. This includes similarities and differences compared to non-autistic people. In terms of similarities, people often described feeling afraid that others would judge them, and this would have negative consequences. In terms of differences, autistic people commonly reported a clash between their traits and their social environment, which caused them distress and discomfort. This included factors only rarely reported by non-autistic people (such as struggling with too much sensory stimulation or inaccessible forms of communication and encountering discrimination for these problems). Based on this, we propose a 'distinct' model of social anxiety with particular relevance to autistic people. In addition, many participants reported negative experiences in therapy for social anxiety. They thought therapists wrongly viewed their fears of social situations as irrational and ungrounded. They thought therapists did not adapt the therapy process in an individualised way and did not understand neurodiversity or recognise neurodivergence. Standard approaches for social anxiety may not always suit autistic people, so this needs further exploration. We highlight several practical recommendations for therapists offering therapy for social anxiety to autistic people. [ABSTRACT FROM AUTHOR]

Neurodegenerative disorders involve progressive dysfunction and loss of synapses and neurons and brain atrophy, slowly declining memories and cognitive skills, throughout a long process. Alzheimer's disease (AD), the leading neurodegenerative disorder, suffers from a lack of effective therapeutic drugs. Decades of efforts targeting its pathologic hallmarks, amyloid plaques and neurofibrillary tangles, in clinical trials have produced therapeutics with marginal benefits that lack meaningful clinical improvements in cognition. Delivering meaningful clinical therapeutics to treat or prevent neurodegenerative disorders thus remains a great challenge to scientists and clinicians. Emerging evidence, however, suggests that dysfunction of various synaptogenic signaling pathways participates in the neurodegenerative progression, resulting in deterioration of operation/structure of the synaptic networks involved in cognition. These derailed endogenous signaling pathways and disease processes are potential pharmacological targets for the therapies. Therapeutics with meaningful clinical benefit in cognition may depend on the effectiveness of arresting and reversing the neurodegenerative process through these targets. In essence, promoting neuro-regeneration may represent the only option to recover degenerated synapses and neurons. These potential directions in clinical trials for AD therapeutics with meaningful clinical benefit in cognitive function are summarized and discussed. [ABSTRACT FROM AUTHOR]

• Grief-focused CBTs have the strongest evidence to support their use in treating PGD. • Effects of PGD psychotherapies for racially/ethnically diverse populations are unclear. • Uniform diagnoses/measures of grief will support efforts to improve PGD treatments. Prolonged grief disorder (PGD) is a distinct diagnostic entity that has recently garnered considerable attention as it describes an intense, enduring, distressing and disabling bereavement reaction experienced by a small minority of community-based mourners. In recent decades, research has exploded to address how best to treat PGD with different psychotherapeutic interventions. In this state-of-the-science review, the strength of the evidence will be discussed regarding common psychotherapeutic interventions used to treat grief. Specifically, we focus on the most commonly used interventions, cognitive behavioral (CB)-based therapies, bereavement and support groups, and brief contact interventions (BCIs), in an effort to summarize the relevant clinical takeaways of the current available research. A discussion of the use of these therapies in specific clinical populations is also included, with a focus on those traumatically bereaved, pediatric populations, communities of color, and underserved communities. Important foci and directions for future research are also discussed. [ABSTRACT FROM AUTHOR]

The scope and burdens of mental health challenges in today's world are staggering. Among the available psychological treatment approaches, cognitive and behavioral therapies, and their combinations, have garnered the strongest evidence base. That said, progress has not always been linear and most of the work is still ahead of us. Against this backdrop, Behavior Therapy has launched its State of the Science series—an exciting new journal feature offering a curated set of authoritative reviews of research in major areas of relevance to applied cognitive-behavioral science, written by distinguished scientists in each area and peer-reviewed. The vision for the Behavior Therapy State of the Science series is to launch with an initial set of articles that make up this special journal issue, with continued publication of additional State of the Science articles in future journal issues. The current article launches the State of the Science series, providing a brief summary of progress in cognitive and behavioral practice and related areas, as well as various missteps and harmful legacies that remind us that the state of the science for research focused on mental health and the alleviation of human suffering is always in flux and evolving. The 16 inaugural reviews in this special issue are then introduced one by one. Collectively, these State of the Science reviews take stock of what has been learned across key areas in the field, highlight critical knowledge gaps in need of research, and provide expert guidance for improving the effectiveness and reach of care, particularly for marginalized and underserved populations. [ABSTRACT FROM AUTHOR]

• Cognitive processing therapy is highly recommended in all PTSD treatment guidelines. • This paper reviews the scope of CPT and its effects on PTSD and comorbid disorders. • CPT with diverse populations and dissemination efforts are also described. This state of the science review provides an overview of the history and findings of cognitive processing therapy (CPT), one of the most recommended treatments for posttraumatic stress disorder, acute stress disorder, and comorbid conditions. After an introduction to CPT and the randomized controlled trials that have been conducted, the effects of CPT on comorbid conditions are reviewed, as well as new combination treatments. Cognitive mediators of change are described. Different formats for CPT that have been developed are described, as well as patient, therapy, and therapist factors in outcome; applicability across diverse populations; efforts to disseminate CPT; and ongoing studies into the future. [ABSTRACT FROM AUTHOR]

• Though data on youth is limited, face-to-face CBT for BDD is effective across ages. • Digital treatments show efficacy, with sustained benefits and potential scalability. • Current evidence lacks diversity and may overlook underserved groups' experiences. • New therapies for visual deficits are being explored as potential treatment options. • Studies needed on long-term treatment effects and predictors of treatment response. Body dysmorphic disorder (BDD) is an underrecognized, challenging illness with severe comorbidities, demanding urgent advancements in treatment strategies. This state-of-the-science review describes current research on existing BDD treatments, beginning with a detailed discussion of cognitive-behavioral therapy (CBT), the primary psychosocial intervention for BDD, and its foundational theories. We emphasize the significant progress in the field, including the efficacy of face-to-face CBT, the promising outcomes of digital interventions for broadening access to care, and emerging treatments that warrant further exploration. The review also addresses the critical gap of targeted interventions for youth, considering the diseases' typical onset during adolescence. Our review also sheds light on the significant gap in research dedicated to testing these treatments in underserved communities, stressing the importance of including these populations in research and culturally informed and adapted, if necessary, care. The review concludes with recommendations for future directions, outlining areas for ongoing treatment development and research to expand the scope and efficacy of interventions for BDD. [ABSTRACT FROM AUTHOR]

• This review summarizes the history and science of LGBTQ-affirmative psychotherapy. • This review outlines a future research agenda for LGBTQ-affirmative psychotherapy. • Research is needed on LGBTQ-affirmative psychotherapy mechanisms and moderators. • Research is needed on therapy orientations beyond CBT and with diverse populations. • Future implementation efforts should embed therapy within structural interventions. Sexual and gender minority (SGM) individuals experience significantly higher levels of depression, anxiety, and behavioral comorbidities (i.e., substance use, suicide) compared to heterosexual and cisgender individuals. LGBTQ-affirmative psychotherapy aims to ameliorate the adverse psychosocial processes, ultimately caused by stigma, that underlie this disparity. Over the past two decades, the mental health field has introduced professional guidelines and treatment protocols for LGBTQ-affirmative psychotherapy, and established their efficacy across distinct SGM populations, delivery modalities, and settings. This state of the science review outlines the history, current evidence, and future directions of LGBTQ-affirmative psychotherapy. It provides an historical account of clinically relevant research for SGM populations and outlines the factors that moved the field from pathologizing perspectives to affirmative approaches. It then discusses the current evidence for LGBTQ-affirmative psychotherapy, as well as studies identifying treatment moderators, including race/ethnicity and stigma exposure, as well as potential treatment mechanisms, including hypervigilance, shame, negative self-schemas, unassertiveness, and emotion dysregulation. SGM individuals can only benefit from LGBTQ-affirmative psychotherapy if protocols are widely available and used by therapists. To this end, the article presents current findings on implementation and dissemination, such as therapist training, and different treatment delivery modalities. Finally, the article outlines an agenda for future research to advance the field of LGBTQ-affirmative psychotherapy, including identifying treatment mechanisms, successfully implementing and disseminating treatment protocols, determining which contexts and client characteristics warrant adaptations to current protocols, and understanding how LGBTQ-affirmative psychotherapy can interact with structural and systemic conditions to exert the strongest possible impact on SGM mental health. [ABSTRACT FROM AUTHOR]

• Sleep and circadian problems are often comorbid with mental disorders. • Sleep and circadian problems are mechanistic contributors to mental disorders. • TranS-C treats sleep and circadian problems across mental disorders via one protocol. • TranS-C is grounded in basic sleep and circadian science and existing EBPTs. • TranS-C includes cognitive-behavioral therapy for insomnia (CBT-I) The transdiagnostic intervention for sleep and circadian dysfunction (TranS-C) was developed to provide one protocol that treats a range of sleep and circadian problems across a range of mental disorders. The focus of TranS-C includes, and goes beyond, categorically defined sleep and circadian disorders to facilitate healthy sleep along empirically derived "sleep health" dimensions. In this State of the Science review, we highlight key advantages of a transdiagnostic approach to sleep and circadian problems, including (a) the potential to better understand and treat comorbidity between various sleep and circadian problems and mental disorders, as well as the potential to better understand and treat the heterogeneous sleep and circadian problems that are present within a specific mental disorder; (b) the opportunity to explore the hypothesis that sleep and circadian problems are an important transdiagnostic mechanism in the multifactorial maintenance of mental disorders; (c) the potential to transfer breakthroughs made across siloed areas of research and practice; (d) its suitability for dissemination into a broad range of settings, particularly lower resource settings; and (e) the opportunity to improve a range of important outcomes. We also explain the theoretical underpinnings of TranS-C, including the two-process model of sleep regulation and the Sleep Health Framework. TranS-C includes cognitive-behavioral therapy for insomnia (CBT-I) and we offer recommendations for when to use CBT-I versus TranS-C. The process for developing TranS-C is discussed along with outcome data, applications to underserved communities, and future directions for research. [ABSTRACT FROM AUTHOR]

• Emerging literature has increasingly implicated disgust in certain anxiety-related disorders. • Research has accumulated evidence identifying processes linking disgust to these disorders. • Processes include trait-level vulnerabilities, cognitive processes, and learning mechanisms. • Research is needed that leverages a guiding framework that informs treatment development. Anxiety disorders have long been conceptualized as disorders of fear, while other emotions have largely been overlooked. However, an emerging literature has increasingly implicated disgust in certain anxiety-related disorders, including obsessive–compulsive disorder, specific phobias (e.g., spider phobia), health anxiety, and posttraumatic stress disorder. Roughly two decades of research has accumulated evidence identifying various mechanisms linking disgust-related phenomena to these disorders. In the present "State of the Science" review, we sought to summarize the current state of the literature with respect to disgust-related mechanisms in anxiety disorders, including trait-level vulnerabilities (e.g., disgust proneness), cognitive processes (e.g., biases of attention and memory), and associated learning mechanisms (e.g., evaluative conditioning). Research in these areas has revealed important ways in which disgust differs from fear-related phenomena, which have important treatment implications. From there, we sought to summarize research on laboratory interventions that attempt to target and attenuate disgust, as well as the early research on formal cognitive-behavioral treatments that integrate disgust-related interventions for anxiety disorders. Although the past two decades of research have revealed important insights related to the role of disgust in psychopathology, much remains to be learned in this area. We propose some future directions, emphasizing the importance of a guiding framework that highlights studying disgust-related mechanisms across different levels of analysis. [ABSTRACT FROM AUTHOR]

Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18–88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p <.001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics. [ABSTRACT FROM AUTHOR]

Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up. [ABSTRACT FROM AUTHOR]

Fatigue is one of the most disabling symptoms reported by people with multiple sclerosis. Although behavioural and pharmacological interventions might be partly beneficial, their combined effects have not been evaluated for multiple sclerosis fatigue, or examined with sufficient consideration of characteristics that might affect treatment response. In this comparative effectiveness research trial, we compared the effectiveness of cognitive behavioural therapy (CBT), modafinil, and their combination for treating multiple sclerosis fatigue. This randomised, analyst-blinded, parallel-arm, comparative effectiveness trial was done at two universities in the USA. Adults (aged ≥18 years) with multiple sclerosis and problematic fatigue (Fatigue Severity Scale [FSS] score ≥4) were randomly assigned (1:1:1), using a web-based treatment assignment system with minimisation, to receive CBT, modafinil, or both for 12 weeks. Statisticians were masked to group assignment, but participants, study neurologists, CBT interventionalists, and coordinators were not masked to treatment assignment. The primary outcome was the change in Modified Fatigue Impact Scale (MFIS) from baseline to 12 weeks, assessed using multiple linear regression, adjusted for age, sex, study site, anxiety, pain, baselines MFIS score, and physical activity. Analyses were done by intent to treat. The trial was registered with clinicaltrials.gov , NCT03621761 , and is completed. Between Nov 15, 2018, and June 2, 2021, 336 participants were randomly assigned treatment (114 assigned to CBT, 114 assigned to modafinil, and 108 assigned to combination therapy). At 12 weeks, CBT (n=103), modafinil (n=107), and combination therapy (n=102) were associated with clinically meaningful within-group MFIS reductions of 15·20 (SD 11·90), 16·90 (15·90), and 17·30 (16·20) points, respectively. Change in MFIS scores from baseline to 12 weeks did not differ between groups: relative to combination therapy, the adjusted total mean difference in MFIS change score was 1·88 (95% CI –2·21 to 5·96) for CBT and 1·20 (–2·83 to 5·23) for modafinil. Most common adverse events for modafinil-containing treatment groups included insomnia (eight [7%] for modafinil and eight [7%] for combination therapy) and anxiety (three [3%] for modafinil and nine [8%] for combination therapy). Modafinil, CBT, and combination therapy were associated with similar reductions in the effects of multiple sclerosis fatigue at 12 weeks. Combination therapy was not associated with augmented improvement compared with the individual interventions. Further research is needed to determine whether effects of these interventions on multiple sclerosis-related fatigue is influenced by sleep hygiene and sleepiness. No serious adverse events related to the study drug were encountered. Patient-Centered Outcomes Research Institute and National Multiple Sclerosis Society. [ABSTRACT FROM AUTHOR]

Objectives: Research in adults suggests that intrusive memories and intrusive thoughts (often referred to as intrusive cognitions) are common in members of the general population and are often seen in clinical disorders. However, little is known about the experience of intrusive cognitions in adolescents, particularly in adolescents with major depressive disorder (MDD) and post‐traumatic stress disorder (PTSD). The present study sought to gather fundamental data on these phenomena (i.e., frequency, characteristics and appraisals of intrusive cognitions) in adolescents with MDD and PTSD. Methods: Adolescents aged 11–18 with MDD (n = 11), PTSD (n = 13) and a non‐clinical control group (n = 25) completed structured interviews concerning their intrusive memories and thoughts. Results: Intrusive thoughts were common in all three groups but were particularly frequently experienced in the MDD group. Intrusive memories were expectedly very common in the PTSD group but also experienced by over half of the adolescents with MDD. Both clinical groups reported more negative emotions in response to their intrusive thoughts or memories and appraised these cognitions more negatively than the non‐clinical group. Conclusion: Intrusive memories and thoughts are common experiences in adolescents with MDD and PTSD. Emotions and appraisals relating to these cognitions may be targets for psychological intervention in this age group. However, small sample sizes limit the conclusions that can be drawn. Replication is needed with larger numbers of clinical participants. [ABSTRACT FROM AUTHOR]

Objective: Generalized anxiety disorder (GAD) is a chronic mental health condition that results in significant individual and societal burden. Cognitive‐behaviour therapy (CBT) therapy is an effective treatment for GAD, however, many individuals experience logistical barriers when accessing evidence‐based care. Remote treatments may help to reduce these barriers, however, currently, there are few studies examining the efficacy of high‐intensity remote methods for GAD treatment. The current study aims to examine the efficacy of CBT delivered via videoconferencing (VCBT) for GAD using a randomized controlled trial design comparing an immediate treatment group to a waitlist control. Method: Seventy‐eight adults (Mage = 36.92; SD = 12.92; 84.4% female) with GAD were enrolled in the study. Results: Those in the treatment group demonstrated a statistically significant reduction in GAD symptoms from pre‐treatment to post‐treatment (d = 1.03) and pre‐treatment to 3‐month follow‐up (d = 1.50). Large between‐group effect sizes were also observed at post‐treatment (d =.80). Twenty‐five participants (64.10%) in the VCBT group no longer met diagnostic criteria for GAD at post‐treatment, and 26/39 (66.67%) no longer met criteria at 3‐month follow‐up. Ninety‐six per cent of participants were satisfied with the treatment. Conclusion: The results contribute towards advancing our knowledge on the efficacy and acceptability of VCBT for patients with GAD. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) patients often experience non-motor symptoms like depression and anxiety, significantly impacting their quality of life. With the limited effectiveness of pharmacological treatments, effective non-pharmacological interventions are needed. This systematic review and meta-analysis aimed to evaluate the efficacy of cognitive-behavioral therapy (CBT) in reducing depression and anxiety symptoms in PD patients. Methods: Randomized controlled trials (RCTs) exploring CBT's effectiveness for depression and anxiety in PD patients were included. Studies published until April 2023 were identified from PubMed, Web of Science, and Scopus. Methodological quality was assessed using the Risk of Bias-2 (ROB-2) tool. Statistical analysis involved calculating the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) using Review Manager 5.4.1. Results: The systematic review included 12 studies involving 241 PD patients. CBT led to a substantial reduction in anxiety (SMD -0.95, 95% CI [-1.15 to -0.74], P < 0.00001) and depression (SMD -1.02, 95% CI [-1.39 to -0.65], P < 0.0001). Both traditional CBT and tele-CBT (administered over the phone or internet) were effective in treating depression and anxiety. Traditional CBT improved depression (SMD -1.16, 95% CI [-1.83 to -0.49], P < 0.00001), while tele-CBT showed comparable results (SMD -0.90, 95% CI [-1.31 to -0.48], P < 0.00001). For anxiety, both traditional CBT (SMD -0.94, 95% CI [-1.25 to -0.63], P < 0.00001) and tele-CBT (SMD -0.95, 95% CI [-1.22 to -0.67], P < 0.00001) significantly reduced symptoms. In conclusion, this systematic review and meta-analysis demonstrated the efficacy of CBT in reducing depression and anxiety in PD patients. Healthcare providers are encouraged to integrate CBT into their treatment protocols. However, additional high-quality studies with longer-term follow-up assessments are needed to further enhance understanding in this area. Prospero Registration: CRD42023424758. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the feasibility and acceptability of a newly developed online psychoeducation intervention on childhood anxiety for school staff using a within groups pre‐post design. The intervention is informed by cognitive behavioural therapy principles. Seventy six participants volunteered to attend a brief online training, and complete two brief questionnaires pre and post the training. Following the intervention, school staff reported that they were significantly less likely to respond to children's anxious behaviours with anxiety‐promoting responses (i.e., sanctions, avoidance reinforcement and overprotection), and were more likely to respond with autonomy‐promoting responses in line with cognitive behavioural theory (i.e., problem‐solving, reward and encouragement). On average, participants found the intervention engaging, useful, suitable, appropriate and easy‐to‐access. Participants also reported that they felt more confident in understanding childhood anxiety and implementing anxiety strategies in their work following the intervention. Areas of development were noted regarding the drop‐out rates of the online intervention. Overall, the novel, online intervention appears to be a feasible and acceptable method for those who participated. In addition, the preliminary outcomes show promise and warrant further investigation. Limitations of the study are discussed with suggestions for future research and areas for improvement. Practitioner points: School staff reported that they were significantly more likely to respond with actions in line with Cognitive‐Behavioural Theory following the psychoeducation training.School staff felt more confident in understanding childhood anxiety and implementing anxiety strategies in their work following the psychoeducation training.The novel, online psychoeducation training appears to be a feasible and acceptable method for those who participated. [ABSTRACT FROM AUTHOR]

Anxiety is commonly experienced by autistic people and impacts on quality of life and social participation. New anxiety interventions are required to effectively meet the needs of autistic people. Personalised Anxiety Treatment-Autism (PAT-A©) is a bespoke, modular approach to treating anxiety in up to 12 sessions. This study explored the feasibility and acceptability of delivering PAT-A© in the UK National Health Service (NHS). A single-blind randomised controlled trial design. Thirty-four autistic adults were recruited via clinical services and randomised to receive either PAT-A© or enhanced treatment as usual (CCSP). Outcome assessments relating to anxiety, quality of life and related constructs were completed at baseline, immediately post intervention; and at 3 and 12 months. Seventy-one percent of the PAT-A© group and 65% of the CCSP met diagnostic threshold for at least three anxiety disorders. Retention was good across both groups, with 82% (N = 14/17) completing the full course of PAT-A© and 71% (N = 12/17) attending both psychoeducational sessions in CCSP. 94% in PAT-A© and 82% in CCSP completed some follow up assessment 3 months post-intervention. Thematic analysis of interview data revealed that many participants valued the personalised approach, developed transferable skills and experienced positive changes to their anxiety. Participants were willing to be recruited and randomised, PAT-A© was feasible to deliver in the NHS and the trial methods and materials were acceptable. Our findings indicate that a fully powered clinical and cost-effectiveness trial of PAT-A© is warranted. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet just 10% receive evidence‐based care. This randomized controlled trial aimed to determine if a synchronous online 9‐week group cognitive‐behavioral therapy (CBT) intervention delivered by mothers who have recovered from postpartum depression (i.e., peers) could effectively improve PPD and its comorbidities. Methods: Participants (n = 183) in this study lived in Ontario, Canada, were ≥18 years‐old, had an infant <12 months, were fluent in English, and scored ≥10 on the Edinburgh Postnatal Depression Scale (EPDS). They were randomized to experimental (received intervention plus treatment as usual (TAU)) or waitlist control (TAU plus the intervention after a 9‐week wait) groups. Depression, anxiety, social support, mother‐infant bonding, and infant temperament were assessed at baseline and 9 weeks later. Outcomes were assessed in the experimental group 3 months post‐intervention to assess stability. Results: Statistically significant reductions were observed in EPDS (B = 5.99; p < 0.001; d = 1.32) and Generalized Anxiety Disorder Questionnaire‐7 scores (B = 5.94; p < 0.001; d = 1.22), improvements that remained stable 3 months post‐intervention in the experimental group. Maternal social support (p = 0.02; d = 0.40), infant‐focused anxiety (p = 0.02; d = 0.54), and infant negative emotionality (p < 0.01; d = 0.23) also improved post‐intervention and remained stable 3 months later. Conclusion: Online peer‐delivered group CBT for PPD can effectively treat PPD and anxiety, and improve social support, infant‐focused anxiety, and negative emotionality in infants. This intervention could provide the means to increase access to treatment for those experiencing PPD and improve outcomes for mothers, birthing parents, and families. [ABSTRACT FROM AUTHOR]

The "Healthy Mother Healthy Baby" (HMHB) study is a phase three, single-blind randomized clinical trial conducted at Holy Family Hospital (HFH) in association with Rawalpindi Medical University (RMU). We aimed to examine the mediators of a specialized psychosocial approach based on Cognitive Behavioural Therapy principles, targeting pregnant women experiencing anxiety. The HMHB intervention was effective in treating perinatal anxiety symptoms and preventing future depressive episodes. The trial randomized participants into two arms: the HMHB intervention or Enhanced Usual Care (EUC), following World Health Organization guidelines. The HMHB intervention comprised strategies to strengthen social support networks, improving mother-baby bonding and strategies to deal with interpersonal conflicts, economic challenges, and societal gender preferences using cognitive and behavioural techniques and culturally resonant illustrations. Participants underwent rigorous data collection at three pivotal timepoints: baseline, third trimester, and 6-weeks postnatal. The primary outcome was anxiety symptom severity scores using the Hospital Anxiety and Depression Scale (HADS) at 6-weeks post-childbirth. Four potential mediators – social support, behavioural activation, perceived stress, and pregnancy experience – were assessed in the third trimester of pregnancy. A total of 1200 participants were randomized to the HMHB and EUC arms. In the six-week follow-up time point, 379 participants remained in the EUC group, and 387 continued in the HMHB group. Post-intervention, HMHB participants displayed significant improvements in postnatal anxiety and depression scores. Mediation analyses revealed social support and pregnancy hassles as significant mediators of the intervention's effect on postnatal anxiety outcomes, while only social support emerged as a significant mediator for depression outcomes. The HMHB intervention showed promising results in improving anxiety and depression scores among pregnant women. Significant mediation effects suggest the importance of targeting social support and managing pregnancy-related hassles for optimal intervention effectiveness. • There's limited evidence on psychosocial interventions for perinatal anxiety in low- and middle-income countries. • "Healthy Mother Healthy Baby" (HMHB) uses CBT principles to help pregnant women with anxiety. • HMHB effectively treats perinatal anxiety and prevents future depressive episodes. • Mediation analysis shows social support and reduced pregnancy hassles are key to HMHB's impact on postnatal anxiety. [ABSTRACT FROM AUTHOR]

• The UP is a promsing treatment for Latinx adults who have anxiety, including those who have both anxiety and depression. • Transdiagnostic treatments represent a promising treatment for the Latinx population. • Organic incorporation of cultural variables may enhance treatment outcomes. The Unified Protocol (UP) is a transdiagnostic cognitive behavioral therapy that targets the core affective processes underlying anxiety, depression, and other emotional disorders. Given the high rates of anxiety and depression and comorbidity among Latinxs, transdiagnostic treatments are a potentially effective intervention for this group. This record review study examined treatment outcomes for 20 Spanish-speaking Latinxs with an anxiety disorder receiving the UP at a community clinic. Six participants dropped out of treatment (30%) and 14 (70%) completed and responded to treatment. An intent-to treat analysis revealed a statistically significant improvement between pre- and posttreatment scores on the PHQ-9 (95% CI, 5.26, 11.04, t [19] = 5.894, p <.001) and the GAD-7 (95% CI, 4.49, 9.11, t [19] = 6.17, p <.001). We also included an in-depth case study, illustrating how the UP can be used with Spanish-speaking Latinxs. Our results provide preliminary support for the UP for use with a subset of Latinx adults with anxiety (with or without comorbid depression). [ABSTRACT FROM AUTHOR]

• VR Photsoscan environments were created in under 48 hours and were created between sessions. • High levels of satisfaction with VR Photoscan environment. • VR technology successfully implemented within a standard treatment protocol for PTSD. • Implemented within a routine community mental healthcare setting. • VR assisted with imaginal reliving, memory updating, and stimulus discrimination. Revisiting what happened during (or after) a traumatic event is an important part of the treatment process in trauma-focused cognitive therapy (TF-CT). However, clinicians may have difficulty helping patients to intentionally retrieve these memories in order to engage with their content. As such, clinical tools to support the access and delivery of imaginal exposure content within treatment may prove to be particularly useful for therapists. This case report introduces work undertaken with Mr. A, a 38-year-old male, who 2 years prior had experienced a city centre assault. Initial assessment revealed a PCL-5 score of 64 and he met DSM-5 criteria for posttraumatic stress disorder (PTSD). Mr. A received 10 sessions of TF-CT wherein the traditional imaginal exposure components were implemented via a newly developed virtual reality (VR) development workflow called "VR Photoscan." After 10 sessions, results showed PCL-5 scores decreased from 64 to 19 and Mr. A no longer met DSM-5 PTSD criteria. VR Photoscan was used during 4/10 sessions and included (1) reliving, (2) memory updating, and (3) stimulus discrimination activities. Mr. A also reported VR Photoscan as helpful regarding preparation for site visits. In conclusion, VR Photoscan technology provided a more visceral exposure experience which supported Mr. A to revisit the trauma memory. He reported high levels of satisfaction with the quality of the virtual environment and no issues using the VR technology. Produced with lower costs and shorter development times than typical computer-generated environments, VR Photoscan may be more easily implemented within routine care, although further research is required. [ABSTRACT FROM AUTHOR]

• People living with HIV experience "syndemics." • Transdiagnostic treatment can address multiple psychiatric and medical problems. • Developed a transdiagnostic CBT treatment to address the needs of people living with HIV. • Treatment description and case examples are provided as a guide for clinicians. People living with HIV (PLWH) experience a range of co-occurring psychosocial stressors, mental health symptoms, and structural barriers (e.g., "syndemics") that can impair their ability to adhere to medical recommendations for treatment. This has consequences for their health and the health of others as nonadherence increases the likelihood of unsuppressed HIV viral load, and therefore the ability to transmit HIV to others. Transdiagnostic treatment, or treatment not focused on a single mental health condition, can efficiently address a range of mental health problems by skills training to reduce symptoms. Additionally, cognitive behavioral and problem-solving approaches can be used to address larger, structural factors by helping individuals navigate systemic challenges using evidence-based skills. This article describes the development of a transdiagnostic treatment for PLWH and illustrates the application of the treatment through case examples. This treatment might be appropriate for integration into an HIV clinic or within an outpatient setting when working with a patient who is experiencing syndemic conditions and living with HIV. [ABSTRACT FROM AUTHOR]

• This case series describes PRS-delivered behavioral activation to support MT. • Three cases were chosen to depict intervention adaption for varying presentations. • The PRS worked with each participant to implement value-driven, rewarding activities. • PRS shared experiences and intervention flexibility played key roles in pilot success. While methadone treatment (MT) is effective in treating opioid use disorder (OUD), retention remains an issue nationwide, especially among low-income, minoritized populations. Peer recovery specialists (PRSs), individuals with lived substance use experience, are particularly well suited to support vulnerable populations, though often are not trained in delivering evidence-based interventions. Thus, our team developed a Type 1 hybrid effectiveness-implementation open-label pilot trial to evaluate the effectiveness of PRS-delivered BA (Peer Activate) in improving MT retention and establish feasibility, acceptability and PRS fidelity of the intervention. In this case series, we provide a more in-depth depiction of the adaption of Peer Activate and present three cases to illustrate how Peer Activate can be implemented among patients in routine MT care and adapted to meet the needs of varying clinical presentations. We include descriptive data on participant substance use and MT outcomes to supplement the narrative discussion. While varying participant presentations and needs presented challenges to the PRS interventionist, the PRS utilized his shared, lived substance use and recovery experiences and met participants where they were at, as well as successfully used BA techniques, ultimately leading to intervention success. [ABSTRACT FROM AUTHOR]

• Addressing risky decision-making may prevent negative outcomes for youth. • Few interventions directly focus on modifying decision-making processes. • Impulsive decision reduction training for youth (IDRT-Y) may fill this gap. • This case report describes and provides preliminary support for IDRT-Y. Impulsive, risky decision-making has been associated with harmful behaviors and negative outcomes across the lifespan. Targeting maladaptive decision-making during adolescence could prevent adverse consequences in adulthood. However, few interventions directly address decision-making biases and promote adaptive decision-making skills in youth. Impulsive Decision Reduction Training for Youth (IDRT-Y) was developed to address this need by adapting an existing adult intervention. IDRT-Y is an 8-session, manualized cognitive behavioral therapy approach in which youth learn to change their maladaptive decision-making habits, increase their future orientation when making decisions, and learn more adaptive decision-making strategies to reduce risky, impulsive decisions. This article describes IDRT-Y and its application by presenting a case study of a 16-year-old boy with a history of impulsive and risky decision-making patterns who was treated with IDRT-Y. Pretreatment, posttreatment, and 24-week follow-up assessments were conducted. Both the youth and parent reported high satisfaction with IDRT-Y. The youth demonstrated reductions in impulsivity, substance use, internalizing and externalizing symptoms, and improvement in his consideration of future consequences when making decisions. The case study illustrates how IDRT-Y is delivered and shows IDRT-Y was an acceptable and effective intervention for addressing risky, impulsive decision-making in this adolescent. We discuss the implications of these findings and future directions to study the acceptability and effectiveness of IDRT-Y in larger youth samples. [ABSTRACT FROM AUTHOR]

Criminal justice stakeholders have increasingly relied on probation supervision as an alternative to incarceration and yet, probation revocations often result in incarceration. As such, increased understanding of the mechanisms behind revocations and strategies to reduce them is critical. We conduct a rapid review of the literature on factors associated with probation revocations. Specifically, we review 50 articles on how probation officer behavior, officer-client relationships, caseload size, supervision intensity, monetary sanctions, probation client characteristics, or programming and services are associated with probation revocations. Though the literature is limited, and findings are mixed, the most consistent findings indicate that officer-client relationships involving trust, support, respect, and empathy as well as reduced caseload sizes and cognitive behavioral therapy programs are associated with probation success while intensive supervision programs; greater monetary sanctions and nonpayment of those sanctions; and being Black and less educated are associated with poorer supervision outcomes. Implications for future research, policy, and practice are discussed. [ABSTRACT FROM AUTHOR]