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Background: Chronic low back pain (CLBP) is a significant problem affecting millions of people worldwide. Three widely implemented psychological techniques used for CLBP management are cognitive therapy (CT), mindfulness meditation (MM), and behavioral activation (BA). This study aimed to evaluate the relative immediate (pre- to post-treatment) and longer term (pre-treatment to 3- and 6-month follow-ups) effects of group, videoconference-delivered CT, BA, and MM for CLBP. Methods: This is a secondary analysis of a three-arm, randomized clinical trial comparing the effects of three active treatments—CT, BA, and MM—with no inert control condition. Participants were N = 302 adults with CLBP, who were randomized to condition. The primary outcome was pain interference, and other secondary outcomes were also examined. The primary study end-point was post-treatment. Intent-to-treat analyses were undertaken for each time point, with the means of the changes in outcomes compared among the three groups using an analysis of variance (ANOVA). Effect sizes and confidence intervals are also reported. Results: Medium-to-large effect size reductions in pain interference were found within BA, CT, and MM (ds from −.71 to − 1.00), with gains maintained at both follow-up time points. Effect sizes were generally small to medium for secondary outcomes for all three conditions (ds from −.20 to −.71). No significant between-group differences in means or changes in outcomes were found at any time point, except for change in sleep disturbance from pre- to post-treatment, improving more in BA than MM (d = −.49). Conclusions: The findings from this trial, one of the largest telehealth trials of psychological treatments to date, critically determined that group, videoconference-delivered CT, BA, and MM are effective for CLBP and can be implemented in clinical practice to improve treatment access. The pattern of results demonstrated similar improvements across treatments and outcome domains, with effect sizes consistent with those observed in prior research testing in-person delivered and multi-modal psychological pain treatments. Thus, internet treatment delivery represents a tool to scale up access to evidence-based chronic pain treatments and to overcome widespread disparities in healthcare. Trial registration: Clinicaltrials.gov, NCT03687762. [ABSTRACT FROM AUTHOR]

Background. The global prevalence of depression and anxiety disorders underscores the need for a more profound comprehension of effective treatments. Mindfulness has shown promise in enhancing treatment outcomes and preventing relapse in these conditions, but the underlying mechanisms remain poorly understood. Methods. This study examined the role of emotion regulation as a mediator in the relationship between changes in mindfulness and the reduction of depression and anxiety symptoms during individual cognitive-behavioral therapy (CBT). We tracked longitudinal changes in mindfulness, emotion regulation, depression, and anxiety at baseline (pre), early treatment (session 5), midtreatment (session 15), and posttreatment (session 25) in 162 patients with depression and anxiety disorders. Further, we examined whether the effects of mindfulness on emotion regulation could be enhanced by introducing a brief mindfulness intervention at the beginning of each CBT session, as compared to progressive muscle relaxation and individual psychotherapy without any standardized session-introducing interventions. Results. Multilevel structural equation modeling indicated that decreases in rumination and increases in reappraisal and acceptance mediated the relationship between mindfulness and reductions in depressive symptoms. In contrast, reductions in avoidance explained the association between mindfulness and changes in anxiety symptoms. These links remained unchanged when adding a mindfulness intervention into individual CBT. Conclusion. Results support emotion regulatory properties of mindfulness and highlight distinct pathways of symptom reduction in depression and anxiety. These findings have important implications for understanding the mechanisms of mindfulness and tailoring treatment to individual patient needs. This trial is registered with NTC02270073. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome causes a decrease in sexual function and health-promoting behaviors. The present study compared the effectiveness of emotionally focused therapy and cognitive-behavioral therapy on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. Method: This semi-experimental study was carried out on women with polycystic ovary syndrome referred to the infertility clinic of Afzalipur Hospital in Kerman, in 2022. For this purpose, 45 patients were selected using convenience sampling and were then randomly placed into two experimental groups and one control group (15 people in each group). The experimental groups were subjected to the interventions of emotionally focused therapy and cognitive-behavioral therapy. The questionnaires on sexual function and promoting lifestyle were used. Data were analyzed using SPSS21 software and variance analysis. Results: Findings revealed that the cognitive-behavioral therapy of emotionally focused therapy had significant effects on sexual function and health-promoting behaviors (P<0.05). The comparison of two therapies revealed that the effectiveness of cognitive-behavioral therapy on sexual function and health promoting behaviors is more than emotionally focused therapy. Moreover, there was no statistically significant difference between post-test and follow-up scores (P>0.05), which shows the lasting effect of the interventions on sexual function and health promoting behaviors in mothers with polycystic ovary syndrome. Conclusion: According to the results, the use of cognitive-behavioral therapy can be more effective on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. [ABSTRACT FROM AUTHOR]

This document discusses the relationship between mental stress and cognitive deficits, highlighting the importance of understanding this connection for effective management strategies. Research has shown that chronic stress can lead to changes in brain structures and neurotransmitters, resulting in cognitive impairments. Stress management techniques, such as cognitive behavioral therapy, have been effective in mitigating mental stress and improving cognitive deficits. Various interventions, including cognitive behavioral therapies, mindfulness-based approaches, and pharmacological interventions, have shown promise in managing stress-induced cognitive impairments. The document also mentions specific studies that explore the assessment and mitigation of mental stress and cognitive deficiency, as well as the potential use of technologies like neurofeedback and virtual reality in stress management. Future research should focus on refining intervention methods, investigating the long-term impact of stress management, and exploring the relationship between mental stress and other mental health issues. The integration of wearable devices, the Internet of Things, and artificial intelligence could enhance the management of mental stress and cognitive deficits. [Extracted from the article]

Functional neurological symptom disorder (FND) is associated with complex specialist investigations and poor prognosis. The theoretical understanding of FND posits that functional symptoms are predisposed by both psychological factors, including attachment disturbances and childhood trauma, and biological factors such as neuroplasticity and epigenetics. Current treatment recommendations include psychological therapy, with moderate effects observed with cognitive-behavioural therapy and psychodynamic therapy modalities, however, psychological understanding is key to success. The current case report describes cognitive analytic therapy (CAT) with a 68 year-old woman presenting to services with diagnoses of FND and borderline personality disorder (BPD). The target problem for therapy was integration of fragmented self-states (dissociative and driven) pertinent to both FND and BPD. 16 session CAT was delivered, with four follow up sessions, exploring unhelpful patterns of relating with self and others, based on an unconscious repertoire of internalised patterns and procedures from early life. CAT tools were used to facilitate change; reformulation and ending letters, mapping and the therapeutic relationship. Scores on the personality structure questionnaire (PSQ) and an idiosyncratic measure of state-shifting indicated positive outcomes, sustained at 3 month follow up. This shows modest early acceptability and feasibility of CAT for working with comorbid BPD and FND, providing a validating and blame free formulation of the development and maintenance of symptoms. Additional measures would have improved the ability to comment on the effectiveness of the treatment and future research implications are discussed. [ABSTRACT FROM AUTHOR]

(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components. [ABSTRACT FROM AUTHOR]

Copyright of Sucht is the property of Hogrefe AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Approximately half of patients who seek care at Emergency Departments due to chest pain are diagnosed with Non-Cardiac Chest Pain (NCCP). Concerns for heart disease and misinterpretation of the symptoms increase cardiac anxiety and have a negative impact on patients' lives. Psychological interventions such as internet-delivered cognitive behavioral therapy (iCBT) are effective in treating psychological conditions such as anxiety, by helping patients to learn how to manage chest pain. Aims: To evaluate the effects of a nurse-led iCBT program on cardiac anxiety and secondary outcomes, as bodily sensations, depressive symptoms, health-related quality of life and chest pain frequency in patients with NCCP at 6- and 12-month follow-up, and to explore predictors that can have impact on the effects of the iCBT program on psychological distress. Methods: A longitudinal study of a Randomized Controlled Trial (RCT) evaluating the long-term effects of an iCBT program (n = 54) in patients with NCCP, compared to psychoeducation (n = 55). The primary outcome, cardiac anxiety was measured using the Cardiac Anxiety Questionnaire (CAQ), and the secondary outcomes were measured with The Body Sensations Questionnaire (BSQ), Patient Health Questionnaire-9 (PHQ-9), The EuroQol Visual Analog Scale (EQ-VAS) and a self-developed question to measure chest pain frequency. All measurements were performed before and after the intervention, and 3, 6 and 12 months after the intervention. Linear mixed model was used to test between-group differences in primary and secondary outcomes and multiple regression analysis was used to explore factors that may have an impact on the treatment effect of iCBT on cardiac anxiety. Results: A total of 85% (n = 93/109) participants completed the 12-month follow-up. Mixed model analysis showed no statistically significant interaction effect of time and group between the iCBT and psychoeducation groups regarding cardiac anxiety over the 12-month follow-up. However, there was a statistically significant interaction effect of time and group (p =.009) regarding chest pain frequency favouring the iCBT group. In addition, we found a group effect in health-related quality of life (p =.03) favouring the iCBT group. The regression analysis showed that higher avoidance scores at baseline were associated with improvement in cardiac anxiety at 12-month follow-up. Conclusions: Cardiac anxiety was reduced in patients with NCCP, but iCBT was not more effective than psychoeducation. Patients with a high tendency to avoid activities or situations that they believe could trigger cardiac symptoms may benefit more from psychological interventions targeting cardiac anxiety. Trial Registration: The trial was registered at ClinicalTrials.gov NCT03336112 on 08/11/2017. [ABSTRACT FROM AUTHOR]

Introduction: Chronic back pain is a widespread medical condition associated with high socioeconomic costs and increasing prevalence. Despite the advanced implementation of multidisciplinary approaches, providing a satisfactory treatment offer for those affected is often not possible. Exposure therapy (EXP) promises to be an effective and economical form of treatment and in a previous pilot study showed to be superior to cognitive behavioral therapy (CBT) in reducing perceived limitations of movement. The current study aims to further compare the efficacy of both treatment methods and identify those patient groups that particularly benefit from EXP. Methods: The general objective of this randomized multicenter clinical trial (targeted N = 380) is to improve and expand the range of treatments available to patients with chronic back pain. As the primary objective of the study, two different psychological treatments (EXP and CBT) will be compared. The primary outcome measure is a clinically significant improvement in pain-related impairment, measured by the QPBDS, from baseline to 6-month follow-up. Secondary outcome measures are absolute changes and clinically significant improvements in variables coping, psychological flexibility, depressiveness, catastrophizing, exercise avoidance and fear of exercise, and intensity of pain. Participants are recruited in five psychological and medical centers in Germany and receive ten sessions of manualized therapy by trained licensed CBT therapists or clinical psychologists, who are currently in their post-gradual CBT training. Potential predictors of each treatment's efficacy will be explored with a focus on avoidance and coping behavior. Conclusion: This study will be the first RCT to compare CBT and EXP in chronic back pain in a large sample, including patients from different care structures due to psychological and medical recruitment centers. By identifying and exploring potential predictors of symptom improvement in each treatment group, this study will contribute to enable a more individualized assignment to treatment modalities and thus improves the care situation for chronic back pain and helps to create a customized treatment program for subgroups of pain patients. If our findings confirm EXP to be an efficacious and efficient treatment concept, it should gain more attention and be further disseminated. Trial registration: ClinicalTrials.gov NCT05294081. Registered on 02 March 2022. [ABSTRACT FROM AUTHOR]

First-line treatments for post-traumatic stress disorder (PTSD) encompass a wide range of pharmacotherapies and psychotherapies. However, many patients fail to respond to such interventions, highlighting the need for novel approaches. Due to its ability to modulate cortical activity, non-invasive brain stimulation (NIBS) could represent a valuable therapeutic tool. Therefore, the aim of this systematic review is to summarize and discuss the existing evidence on the ameliorative effects of NIBS on PTSD and comorbid anxiety and depressive symptoms. Our goal is also to debate the effectiveness of an integrated approach characterized by the combination of NIBS and psychotherapy. This search was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines in the PubMed, PsycINFO, PsycARTICLES, PSYINDEX, MEDLINE, and ERIC databases. Overall, 31 studies met the eligibility criteria, yielding a total of 26 clinical trials employing transcranial magnetic stimulation (TMS) and 5 making use of transcranial direct-current stimulation (tDCS). From these studies, it emerged that NIBS consistently reduced overall PTSD symptoms' severity as well as comorbid anxiety and depressive symptoms. Moreover, we speculate that combining NIBS with prolonged exposure or cognitive processing therapy might represent a promising therapeutic approach for consistently ameliorating subjects' clinical conditions. [ABSTRACT FROM AUTHOR]

Cultural bridging may alleviate and catalyze the therapeutic process and help to match therapeutic interventions and patient preferences. In this article, we propose to enhance Western-originated prevention and treatment of depression (behavioral activation) with an Eastern-originated cultural concept of the purpose of living (ikigai). Behavioral activation (BA) is an effective standard method (within cognitive-behavior therapy) to treat depression, whereas ikigai is a Japanese life philosophy attitude. Both approaches share the fundamental idea that the reflection of personal values guides the individual's everyday decisions. In the present narrative review, we try to explain and systematically compare both approaches to explore the possibilities of their meaningful integration. While the literature underscored the striking similarity between the fundamental ideas of both concepts, the main difference is that ikigai, as a traditional, non-psychotherapeutic approach, refers more to intuition and metaphorical heuristics. We introduce when and how the practice of ikigai could enhance behavioral activation interventions in psychotherapy and its transfer into everyday life. [ABSTRACT FROM AUTHOR]

Non-Suicidal Self-Injury (NSSI) involves deliberately causing harm to one's body without the intention of suicide. As the numbers of adolescents presenting NSSI have been steadily increasing during the last years, we intended to investigate adolescent patients exhibiting NSSI, admitted to our clinic—a Romanian child psychiatry inpatient clinic, over the course of five years. A total of 100 adolescents (80 females, 20 males, mean age: 14.9 years) hospitalized for various neuropsychiatric disorders and engaging in self-harm were studied. The self-harm methods most frequently used in our sample were, for the female group: cutting (all), skin tearing (76%), scratching/pinching (72%), and for males: cutting (all), wound-healing hindrance (85%), striking objects (80%). The initial motivations for NSSI were represented by distress (females 89%, males 90%) and seeking pleasure (females 84%). In terms of the roles of NSSI, it was primarily used for emotional regulation (females 89%) and anger management (males 90%). This study highlights the prevalence of self-harm in hospitalized adolescents, differences in methods and motivations between genders, and the need for more targeted therapy interventions. By documenting trends, investigating underlying motivations and functions, and proposing hypotheses for further research, our findings offer valuable insights on adolescent NSSI and have the potential to increase awareness among various clinicians and specialists who interact with adolescents, thus addressing the escalating prevalence of self-harm behaviours among teenagers. [ABSTRACT FROM AUTHOR]

This review is structured to systematically study the currently known evidence about Virtual Reality Exposure Therapy (VRET) pertaining to phobias and to analyze important combinations and comparisons of VRET with other psychological interventions. Randomized Control Trial testing studies published in English and peer-reviewed journals with clinically diagnosed patients of phobia were included. PubMed, Scopus, and ResearchGate along with other databases from January 2000 to October 2022 were utilized. Bias like randomization, blinding, allocation sequence concealment, discriminatory result reporting, and others were evaluated. Forty-four research using VRET were included in this review, 11 research were on social phobia, 8 were on agoraphobia, 20 were on different specific phobias and 5 other research had combinations of phobias. VRET proved to be effective as a standalone treatment for phobias and its efficacy increased when combined with pharmacological, cognitive, or augmented reality interventions. This review also discussed the high efficacy of inexpensive gears and the difference in efficacy created by session specifications. The cumulative evidence is now conclusive that the addition of medications or cognitive behavioral therapy to VRET for multiple sessions reduces phobic symptoms among patients with phobias. The potential of person-focused interventions in clinics with VRET depends on its long-term outcome and the knowledge of the technician, further research and modules should be created for the same. [ABSTRACT FROM AUTHOR]

Medicine faces challenges that indicate that it may not be sustainable. A descriptive disease concept is apt to what philosopher of science Ian Hacking called "looping effects", which can explain why health care is faced with insatiable demands. Diseases are not only indifferent objects with an objective existence in the biology of individuals. They are often interactive identities that have attractive properties. We suggest a shift in medical practice where descriptive perspectives are complemented with functional perspectives to enable clinicians better to help people from merging with dysfunctional disease identities. [ABSTRACT FROM AUTHOR]

Introduction: High variability in response and retention rates for posttraumatic stress disorder (PTSD) treatment highlights the need to identify "personalized" or "precision" medicine factors that can inform optimal intervention selection before an individual commences treatment. In secondary analyses from a noninferiority randomized controlled trial, behavioral and physiological emotion regulation were examined as non-specific predictors (that identify which individuals are more likely to respond to treatment, regardless of treatment type) and treatment moderators (that identify which treatment works best for whom) of PTSD outcome. Methods: There were 85 US Veterans with clinically significant PTSD symptoms randomized to 6 weeks of either cognitive processing therapy (CPT; n = 44) or a breathing-based yoga practice (Sudarshan kriya yoga; SKY; n = 41). Baseline selfreported emotion regulation (Difficulties in Emotion Regulation Scale) and heart rate variability (HRV) were assessed prior to treatment, and self-reported PTSD symptoms were assessed at baseline, end-of-treatment, 1-month follow-up, and 1-year follow-up. Results: Greater baseline deficit in self-reported emotional awareness (similar to alexithymia) predicted better overall PTSD improvement in both the short- and long-term, following either CPT or SKY. High self-reported levels of emotional response non-acceptance were associated with better PTSD treatment response with CPT than with SKY. However, all significant HRV indices were stronger moderators than all self-reported emotion regulation scales, both in the short-and long-term. Veterans with lower baseline HRV had better PTSD treatment response with SKY, whereas Veterans with higher or average-to-high baseline HRV had better PTSD treatment response with CPT. Conclusions: To our knowledge, this is the first study to examine both selfreported emotion regulation and HRV, within the same study, as both nonspecific predictors and moderators of PTSD treatment outcome. Veterans with poorer autonomic regulation prior to treatment had better PTSD outcome with a yoga-based intervention, whereas those with better autonomic regulation did better with a trauma-focused psychological therapy. Findings show potential for the use of HRV in clinical practice to personalize PTSD treatment. [ABSTRACT FROM AUTHOR]

It is important to be able to differentiate mindfulness-based programs in terms of their model, therapeutic elements, and supporting evidence. This article compares mindfulness-based cognitive therapy (MBCT), developed for relapse prevention in depression, and mindfulness-integrated cognitive behavior therapy (MiCBT), developed for transdiagnostic applications, on: (1) origins, context and theoretical rationale (why), (2) program structure, practice and, professional training (how), and (3) evidence (what). While both approaches incorporate behavior change methods, MBCT encourages behavioral activation, whereas MiCBT includes various exposure procedures to reduce avoidance, including a protocol to practice equanimity during problematic interpersonal interactions, and a compassion training to prevent relapse. MBCT has a substantial research base, including multiple systematic reviews and meta-analyses. It is an endorsed preventative treatment for depressive relapse in several clinical guidelines, but its single disorder approach might be regarded as a limitation in many health service settings. MiCBT has a promising evidence base and potential to make a valuable contribution to psychological treatment through its transdiagnostic applicability but has not yet been considered in clinical guidelines. While greater attention to later stage dissemination and implementation research is recommended for MBCT, more high quality RCTs and systematic reviews are needed to develop the evidence base for MiCBT. [ABSTRACT FROM AUTHOR]

Leaders of small and medium-sized enterprises (SMEs) are often confronted with specific burdens, which frequently result in increased levels of stress. Leadership behaviour, in turn, has a significant impact on employees' health and performance. Using the Population, Intervention, Comparison, Outcome (PICO) method, we conducted a systematic literature search covering publications from 2002 to 2023 using PubMed, PsycInfo and Business Source Premier on stress-reducing and well-being-improving interventions for SME leaders. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess the methodological quality and risk of bias of the included studies regarding selection bias, study design, confounders, blinding, data collection, withdrawal and drop-out. Of the 3150 identified publications, 6 were included after screening. The studies varied in content (cognitive behavioural therapy [CBT]-based, psychoeducation, and mixed interventions) and approach (individual- and organisation-centred). Not all of the examined interventions provided significant outcomes. However, CBT-based and individualised approaches showed a positive trend in reducing SME leaders' psychosocial stress and improving their well-being. Despite the limited data, it can be concluded that such interventions are beneficial for leaders and their specific needs. Future research should focus on tailored approaches, derived from well-founded theories and integrative interventions addressing SME leaders. [ABSTRACT FROM AUTHOR]

Background: Systemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an established treatment for children and adolescents with mental disorders. As methodologically rigorous systematic reviews on ST in this population are lacking, we conducted a systematic review and meta-analysis to compare the benefit and harm of ST (and ST as an add-on to CBT) with CBT in children and adolescents with mental disorders. Methods: We searched MEDLINE, Embase, PsycINFO and other sources for randomised controlled trials in 14 mental disorder classes for the above comparisons in respect of effects on patient-relevant outcomes (search date: 7/2022). Where possible, meta-analyses were performed and results were graded into 3 different evidence categories: "proof", "indication", or "hint" (or none of these categories). PRISMA standards were followed. Results: Fifteen studies in 5 mental disorder classes with usable data were identified. 2079 patients (mean age: 10 to 19 years) were analysed. 12/15 studies and 29/30 outcomes showed a high risk of bias. In 2 classes, statistically significant and clinically relevant effects in favour of ST were found, supporting the conclusion of a hint of greater benefit of ST for mental and behavioural disorders due to psychoactive substance use and of ST as an add-on to CBT for obsessive-compulsive disorders. In 2 other classes (eating disorders; hyperkinetic disorders), there was no evidence of greater benefit or harm of ST. For affective disorders, a statistically significant effect to the disadvantage of ST was found for 1 outcome, supporting the conclusion of a hint of lesser benefit of ST. Conclusions: Our results show a hint of greater benefit of ST (or ST as an add-on to CBT) compared with CBT for 2 mental disorder classes in children and adolescents (mental and behavioural disorders due to psychoactive substance use, obsessive compulsive disorders). Given the importance of CBT as a control intervention, ST can therefore be considered a beneficial treatment option for children and adolescents with certain mental disorders. Limitations include an overall high risk of bias of studies and outcomes and a lack of data for several disorders. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a severe mental disorder that significantly impairs the daily functioning of patients that causes substantial societal and economic burden. While drug therapy is crucial for schizophrenia treatment, relying solely on antipsychotic drugs does not yield the most favorable therapeutic outcomes. Current Concepts: Integrating psychosocial interventions could result in maximized therapeutic effects for individuals living with schizophrenia. Evidence-based psychosocial interventions for schizophrenia management include cognitive behavioral therapy, family involvement, psychoeducation, supported employment programs, lifestyle adjustments for physical health, and coordinated and comprehensive early intervention services. Incorporating peer support, allowing both service users and care providers to share knowledge and their illness-related personal experiences, facilitates mutual assistance along the path to recovery. Moreover, growing interest follows in using digital interventions, such as wearable technology and smartphone applications, as effective therapeutic tools for illness management. Discussion and Conclusion: The above-mentioned psychosocial interventions empower individuals with schizophrenia, helping them improve their functioning, enhance their life quality, and adapt more effectively to society. Combining early medication with comprehensive psychosocial interventions, including digital technology, is crucial for the best outcomes. This approach should begin as soon as schizophrenia is diagnosed, aiming to promote recovery and overall well-being in affected individuals. [ABSTRACT FROM AUTHOR]

Background: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs). Method: Quality assurance data from 359 patients prescribed the Sadness Program in Australia from October 2010 to November 2011 were included. Results: Intent-to-treat marginal model analyses demonstrated significant reductions in depressive symptoms (PHQ9), distress (K10), and impairment (WHODAS-II) with medium-large effect sizes (Cohen's d = .51–1.13.), even in severe and/or suicidal patients (Cohen's d = .50–1.49.) Secondary analyses on patients who completed all 6 lessons showed levels of clinically significant change as indexed by established criteria for remission, recovery, and reliable change. Conclusions: The Sadness Program is effective when prescribed by primary care practitioners and is consistent with a cost-effective stepped-care framework. [ABSTRACT FROM AUTHOR]

Questions underpin all aspects of therapeutic assessment and intervention and are a vital component of the clinical process. Over recent years frameworks have started to be applied to obtain a greater understanding of questioning formats and processes. Method: This paper examines the use of questions in cognitive therapy (CT). An overview of the main types of questions identified in the literature is presented. In addition, we examine a range of client and therapist characteristics that may impact on the questioning process. Conclusions: Asking questions in therapy is a complex, yet under-taught, skill. This paper provides a set of frameworks to assist in identifying helpful and unhelpful questioning skills. Thus the article has implications for further training and research. [ABSTRACT FROM AUTHOR]

The article presents the author's response to the paper about the future of transference-based therapies written by Lesley Murdin. It states that the possible reason Murdin wrote the paper is her knowledge that those practicing dialectical or dialogical cognitive behavior therapy (CBT) claim that they work with therapy relationship. The author believes that psychoanalytic leadership has indulged in the so called trahison des clercs, a term used in the Middle Ages to castigate the priests or clerics who are against the Pope.

Objectives: Despite some encouraging outcomes and shared components of psychological therapies specific to bipolar disorders, not all studies found conclusively that the addition of a psychosocial intervention to pharmacological interventions improves outcomes. There was some tentative evidence from post hoc analyses that patients with more than 12 previous episodes did not benefit from psychoeducation or cognitive therapy. This paper presents a systematic review and meta-analysis which examines the overall efficacy of bipolar disorder-specific psychological therapies and the impact of the number of previous episodes on the efficacy of psychological therapies in relapse prevention. Methods: Systematic literature searches of electronic databases and reference lists of existing reviews were carried out. The number of participants experiencing relapse in randomized, controlled studies was combined in a meta-analysis to determine the overall treatment effect in relapse prevention. Metaregression modeling was used to examine whether the number of previous episodes confounded the number of relapses experienced by participants by the end of treatment. Results: Meta-analysis of relapse calculated an overall relative risk of 0.74 [95% confidence interval (CI): 0.64–0.85] with some heterogeneity present (I2 = 43.3%). Metaregression of six studies showed no relationship between number of episodes and number of relapses by endpoint. Conclusion: Psychological therapy specifically designed for bipolar disorder is effective in preventing or delaying relapses in bipolar disorders, and there is no clear evidence that the number of previous episodes moderated the effect. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to promote thought and discussion around how and why we treat patients in chosen ways. In the present climate practitioners are required to treat patients following NICE guidelines in which cognitive behavioural therapy (CBT) is the treatment of choice in the majority of diagnoses. This paper raises concerns that this may lead to an homogenization of treatment, loss of invaluable skills and understanding from other treatment approaches, and loss to the patient who may be best cared for by a combination of treatments and approaches, most notably patients presenting with complex pathology. This paper aims to present this as a general principle, and by way of example, will focus on coupling two specific treatment orientations, cognitive behavioural therapy with psychodynamic psychotherapy, with the specific diagnosis of obsessive compulsive disorder (OCD). Methods: Clinical material is drawn from case studies from practice in secondary adult mental health care services within the NHS. All patients were referred to the psychological services for treatment for OCD and provided with 1:1 therapy with UKCP-registered therapists. Details have been anonymized by describing fictitious cases re-constructed from clinical material. A theoretical understanding is included which provides both an overview for integrating treatment for the specific example of OCD and is intended by extension to other diagnoses. Results: Working with the commonalities of therapeutic approaches, and integrating specific skills of CBT and psychodynamic psychotherapy, appears to offer a viable mode of treatment for cases resistant to single-orientation therapies. Conclusions: Coupling the skills of different therapies can be effective in treating complex patients that are referred to the secondary mental health services. Conversely, restricting practice to single orientation therapies can lead to an impoverished care for patients and diminution of invaluable therapeutic skills which may become underused, undervalued and lost in the practice of mental health care within the NHS. Acknowledgement of the skills of others, valuing these and learning from each other can help to avoid the defensive reactions of practitioners, where each may defensively retreat to their corners of specialism. Respecting and sharing skills from different orientations, and acknowledging this in the NICE guidelines, is good for both mental health services and patient care and addresses the concerns raised by practitioners exemplified by Bateman (2000, p. 147) that 'psychotherapy continues to be bedeviled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions'. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including "The essence of cognitive behavioural therapy: Past, present and future," by John Lees, and one "Considering the dialogic potentials of cognitive therapy," by Tom Strong, Mishka Lysack and Olga Sutherland.

This is the second of two papers that present a small, randomized control trial of cognitive behavioural therapy (CBT) within a group setting for the treatment of auditory hallucinations. In the previous paper, a method was described for an eight-session CBT group. Assessments were undertaken measuring control, power, frequency, and symptoms of distress and anxiety on commencement and on completion of the group. This second paper details the experience of the group and reports on the outcomes of the assessment measures. The study concludes that group CBT was helpful in the treatment of auditory hallucinations. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Compassionate mind training (CMT) was developed for people with high shame and self-criticism, whose problems tend to be chronic, and who find self-warmth and self-acceptance difficult and/or frightening. This paper offers a short overview of the role of shame and self-criticism in psychological difficulties, the importance of considering different types of affect system (activating versus soothing) and the theory and therapy process of CMT. The paper explores patient acceptability, understanding, abilities to utilize and practice compassion focused processes and the effectiveness of CMT from an uncontrolled trial. Six patients attending a cognitive–behavioural-based day centre for chronic difficulties completed 12 two-hour sessions in compassionate mind training. They were advised that this was part of a research programme to look at the process and effectiveness of CMT and to become active collaborators, advising the researchers on what was helpful and what was not. Results showed significant reductions in depression, anxiety, self-criticism, shame, inferiority and submissive behaviour. There was also a significant increase in the participants' ability to be self-soothing and focus on feelings of warmth and reassurance for the self. Compassionate mind training may be a useful addition for some patients with chronic difficulties, especially those from traumatic backgrounds, who may lack a sense of inner warmth or abilities to be self-soothing. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental syndrome that persists into adulthood for the majority of children with ADHD. Other individuals may not experience the full negative effects of undiagnosed ADHD until they face the demands of adult life. College counseling centers in particular are seeing a rise in the number of students seeking therapeutic services for issues related to ADHD. The purpose of this paper is to provide background information about the prevalence of ADHD on college campuses, its impact on affected students, and to induce a cognitive behavior therapy approach for college students with ADHD. [ABSTRACT FROM AUTHOR]

Background: This paper is intended to contribute to the current debate in relation to persistent stuttering and evidence‐based clinical practice. Aims: The paper will describe the authors' intervention framework for persistent stuttering, which is guided by evidence from the fields of stuttering and clinical psychology. It supports the opinion that the components of therapy should be grounded in empirically based theories that offer an explanation for the nature of stuttering, its persistence and its individual complexity. It will argue that the goals of therapy should reflect the client's personal values and experience of stuttering, as well as the knowledge and skills of the therapist. Main contribution: The paper maintains that therapy for this disorder needs to account for the highly individual nature of the overt and covert dimensions of persistent stuttering and identify the formal and informal methods that measure progress and outcome. Current research and future directions will be touched on briefly. [ABSTRACT FROM AUTHOR]

Teasdale, Segal and Williams (2003) present the combination of mindfulness and cognitive-behavioural therapy as “one of the most exciting and potentially productive avenues for future exploration.” (p. 160). In the same paper they also recommend moving beyond the current general-purpose, non-case-specific applications of mindfulness (p. 157). By integrating mindfulness interventions more closely with cognitive behavioural theories, clinicians should be in a better position to administer tailor-made mindfulness-based interventions in response to specific case formulations. This paper examines important similarities and differences between mindfulness and Rational-Emotive Behaviour Therapy (REBT), in view of integrating the two practices closely within a one-on-one counselling environment. The latter half of the paper then presents recommendations of how such integration might be achieved in practice. This is illustrated with examples of three new interventions that combine mindfulness with three specific types of cognitive dysfunction as per REBT. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although cases of posttraumatic stress disorder (PTSD) with comorbid disorders are common, the first generation of PTSD treatment approaches, including exposure and cognitive-behavioral therapy, generally ignore symptoms beyond those specific to PTSD. Optimum PTSD treatment outcome requires more comprehensive strategies, and the development and empirical testing of broader approaches is the focus of the articles that follow in this special issue. After providing some background on PTSD and PTSD treatment, this paper gives an overview of these treatment and prevention papers, which represent second-generation strategies to help trauma-exposed individuals. [ABSTRACT FROM AUTHOR]

Objective: Meta‐analyses of psychotherapies usually report effects sizes, while clinicians and patients need to know the proportion of patients who benefit from therapy. We conducted a meta‐analysis of therapies for depression reporting the rates of response (50% symptom reduction), remission (HAM‐D <7), clinical significant deterioration for psychotherapy, and control conditions (CAU, waitlist, and pill placebo), as well as the relative risk of these outcomes and the numbers‐needed‐to‐be‐treated (NNTs). Methods: We searched bibliographic databases and included 228 randomized trials comparing psychotherapy for depression against control conditions (75 with low risk of bias). Only therapies with at least 10 trials were included. We extracted outcomes from the studies, and for those studies not reporting the outcomes, we used a validated method to estimate the rates. Results: The overall response rate in psychotherapies at 2 (±1) months after baseline was 41% (95% CI: 38~43), 17% (15~20) for usual care (CAU), and 16% (95% CI: 14~18) for waitlist. No significant differences between types of therapy were found. The NNT for therapy versus CAU was 5.3 and versus waitlist 3.9. About one third of patients remitted after therapy compared with 7%–13% in control conditions. The rates of deterioration were 5% versus 12%–13%, respectively. Most sensitivity analyses supported the general findings. Conclusion: Psychotherapies for depression may be effective compared with control conditions, but more than half of patients receiving therapy do not respond and only one third remitted. More effective treatments and treatment strategies such as sequencing and combining treatments are clearly needed. [ABSTRACT FROM AUTHOR]

Cognitive therapy was originally formulated as a way of helping clients by applying rational thinking to the appraisal of their realities. The expectation was that this would undo ways of thinking that cause distress and maladaptive behaviours. However this model has been called into question by recent experimental data. This paper argues from a philosophical perspective that empirical rationality has significant shortcomings as a method of promoting self-understanding in the therapeutic situation. However, rational thinking forms the basis of one of the major schools of moral theory, formulated by the philosopher Immanuel Kant. The present paper argues that his ideas have important applications to cognitive therapy. It suggests that therapy might use rationality not only to appraise reality more accurately but also to generate precepts for personal behaviour. This idea is illustrated using an example of a client receiving cognitive therapy. The paper concludes with a discussion of the applicability of moral theory to clinical practice and a suggestion that cognitive therapy might be viewed as a form of applied ethics. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The author comments on the study paper "Psychological Treatments for Psychosis: History and Overview," by Silke Bachmann, Franz Resch and Christoph Mundt. Topics he covered include a brief overview of the history of the International Society for Psychological and Social Approaches to Psychiatry (ISPS), the views of ISPS leader Ann Louise Silver on psychodynamic reflection on psychopathology and a description of the contributions of the 19th century sociotherapists according to the study.

Copyright of Psico-USF is the property of Universidade Sao Francisco, Programa de Pos-Graduacao Stricto Sensu em Psicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose Of Review: This paper reviews the empirical literature on psychosocial factors relating to children with disabilities in the context of disaster or terrorism.Recent Findings: Research indicates adults with disabilities experience increased exposure to hazards due to existing social disparities and barriers associated with disability status. However, studies on the psychological effects of disaster/terrorism on children with pre-existing disabilities are exceedingly few and empirical evidence of the effectiveness of trauma-focused therapies for this population is limited. Secondary adversities, including social stigma and health concerns, also compromise the recovery of these children post-disaster/terrorism. Schools and teachers appear to be particularly important in the recovery of children with disabilities from disaster. Disasters, terrorism, and war all contribute to increased incidence of disability, as well as disproportionately affect children with pre-existing disabilities. Disaster preparedness interventions and societal changes are needed to decrease the disproportionate environmental and social vulnerability of children with disabilities to disaster and terrorism. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Psychiatry & Clinical Psychology / Psychiatria i Psychologia Kliniczna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cognitive behavioral therapy (CBT) is recommended as a psychological intervention for those diagnosed with schizophrenia. The prevalence of auditory hallucinations is high among this group, many of whom are cared for by community mental health teams that may not have easy access to qualified CBT practitioners. This systematic review examined the evidence for the superiority of CBT compared to non-specialized therapy in alleviating auditory hallucinations in community patients with schizophrenia. Two RCTs met the inclusion criteria totaling 105 participants. The Positive and Negative Syndrome Scale (PANSS)-Positive Scale was the outcome measure examined. A meta-analysis revealed a pooled mean difference of −0.86 [95 % CI −2.38, 0.65] in favor of CBT, although this did not reach statistical significance. This systematic review concluded there is no clinically significant difference in the reduction of positive symptoms of schizophrenia when treated by CBT compared to a non-specialized therapy for adults experiencing auditory hallucinations. [ABSTRACT FROM AUTHOR]

By considering the etiological similarities of depression and anxiety disorders with high lifetime coexistence rates, recent research has introduced a transdiagnostic approach applicable to a range of emotional disorders with these common features. This paper reviews empirical studies examining the effects of transdiagnostic intervention programs on depression and anxiety disorders. The literature search identified 18 randomized controlled and 12 non-randomized studies. These were examined in terms of their sample characteristics, methodological approaches, and findings. Overall, the reviewed transdiagnostic psychological intervention programs treat various anxiety disorders and depression effectively. In cases where anxiety and depressive symptoms are comorbid, the transdiagnostic approach has significant advantages over diagnosis-specific protocols. Future studies should investigate the effect of the transdiagnostic approach in different diagnostic groups compared to diagnosis-specific treatments. In Turkey specifically, it is important to investigate the effectiveness of transdiagnostic interventions and potential clinical and economic advantages compared to diagnostic specific protocols. [ABSTRACT FROM AUTHOR]

Experimental psychopathology researchers are devoted to understanding the causes and mechanisms of psychological disorders, with the central goal of developing and improving effective interventions. Indeed, cognitive behavioural therapy (CBT) arose from experiments identifying key mechanisms that clinicians can target to reduce their clients' symptoms. Despite the well-documented efficacy of CBT for diverse problems, many people continue to live with psychopathology, even after CBT. In this paper, we reflect on ways in which experimental psychopathology has advanced CBT (i.e. Where have we been?), areas that are fruitful for continued progress (i.e. Where are we now?), and crucial areas for improvement (i.e. Where are we going?). In particular, we contend that improving the science of psychopathology via open and transparent practices, prioritising diverse samples, testing the effects of specific CBT techniques, and focusing on problems that our clients identify will enable experimental psychopathology research to serve as the foundation for evidence-based practice. [ABSTRACT FROM AUTHOR]

In considering therapeutic approaches to anger and violence in the family, it is important to base our methods on both clinical experience and research on the control of aggression. Baron (1983) has recently summarized this research, addressing himself to the view that aggression is a learned response to a wide variety of personal, social, situational, and environmental conditions. Given this assumption, this paper takes a closer look at six ways that research has demonstrated aggression can be controlled: Punishment, catharsis, exposure to non-aggressive models, cognitive interventions, induction of incompatible responses, and social skills training. Research is summarized, conditions limiting its applicability are discussed, and clinical implications are described in working with individuals, couples, and families. [ABSTRACT FROM AUTHOR]

It is a pleasure and a challenge to provide commentary on the foregoing papers which, collectively, contain insightful clarifications and provocative extensions of the role of cognition in cognitive therapy and other therapeutic modalities. Before I begin my comments, I should inform the reader that I tend to be a "splitter," not a "lumper," when I attempt to understand psychotherapies. My tendency is to search for and clarify meaningful distinctions between psychotherapeutic approaches as well as among the phenomena that might mediate the effects of therapies, such as cognitions, behaviors, and neurotransmitters. [ABSTRACT FROM AUTHOR]

This paper discusses problems in case conceptualization in Cognitive Therapy, particularly in relation to the concept of a ‘core belief’. It is argued that this concept is ill-defined and that its ambiguity can create problems for the clinician. Changes in core beliefs should be associated with the most therapeutic leverage, thus it becomes vital to have reliable ways of identifying them. An illustrative case example is presented of the treatment of a young woman for depression. In our formulation, she held a number of self-referent beliefs which appeared to be differentially responsive to challenge. For example, her doubts about competence at work were much more easily modified than her belief that she was unattractive. This suggested that the latter belief was more central or ‘core’ to our client's view of herself. This approach, together with the charting of how modification of beliefs was related to the alleviation of depression, was taken in the current paper in order to highlight the need for clinical tools to aid conceptualization in distinguishing between core and peripheral processes. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]