scholarly journals Exposure utilization and completion of cognitive behavioral therapy for PTSD in a “real world” clinical practice

2005 ◽  
Vol 18 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Claudia Zayfert ◽  
Jason C. DeViva ◽  
Carolyn B. Becker ◽  
Julie L. Pike ◽  
Karen L. Gillock ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioral Therapy ◽  
Real World ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

scholarly journals Blended Care-Cognitive Behavioral Therapy for Depression and Anxiety in Real-World Settings: Pragmatic Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Anita Lungu ◽  
Janie Jihee Jun ◽  
Okhtay Azarmanesh ◽  
Yan Leykin ◽  
Connie E-Jean Chen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Real World ◽  
Behavioral Therapy ◽  
Anxiety Symptoms ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Care Intervention ◽  
Blended Care ◽  
Over Time

BACKGROUND The past few decades saw considerable advances in research and dissemination of evidence-based psychotherapies, yet available treatment resources are not able to meet the high need for care for individuals suffering from depression or anxiety. Blended care psychotherapy, which combines the strengths of therapist-led and internet interventions, can narrow this gap and be clinically effective and efficient, but has rarely been evaluated outside of controlled research settings. OBJECTIVE This study evaluated the effectiveness of a blended care intervention (video-based cognitive behavior therapy and internet intervention) under real-world conditions. METHODS This is a pragmatic retrospective cohort analysis of 385 participants with clinical range depression and/or anxiety symptoms at baseline, measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), who enrolled in blended care psychotherapy treatment. Participants resided in the United States and had access to the blended care intervention as a mental health benefit offered through their employers. Levels of depression and anxiety were tracked throughout treatment. Hierarchical linear modeling was used to examine the change in symptoms over time. The effects of age, gender, and providers on participants’ symptom change trajectories were also evaluated. Paired sample t-tests were also conducted, and rates of positive clinical change and clinically significant improvement were calculated. RESULTS The average depression and anxiety symptoms at 6 weeks after the start of treatment were 5.94 and 6.57, respectively. There were significant linear effects of time on both symptoms of depression and anxiety (β=–.49, <i>P</i>&lt;.001 and β=–.64, <i>P</i>&lt;.001). The quadratic effect was also significant for both symptoms of depression and anxiety (β=.04, P&lt;.001 for both), suggesting a decelerated decrease in symptoms over time. Approximately 73% (n=283) of all 385 participants demonstrated reliable improvement, and 83% (n=319) recovered on either the PHQ-9 or GAD-7 measures. Large effect sizes were observed on both symptoms of depression (Cohen d=1.08) and of anxiety (d=1.33). CONCLUSIONS Video blended care cognitive behavioral therapy interventions can be effective and efficient in treating symptoms of depression and anxiety in real-world conditions. Future research should investigate the differential and interactive contribution of the therapist-led and digital components of care to patient outcomes to optimize care.

Supportive Therapy Techniques Part I

2019 ◽  
pp. 179-191
Author(s):  
Brian A. Sharpless
Keyword(s):  
Clinical Practice ◽  
Cognitive Behavioral Therapy ◽  
Treatment Approach ◽  
Behavioral Therapy ◽  
Supportive Therapy ◽  
Cognitive Behavioral ◽  
Adaptive Skills ◽  
Patient Knowledge ◽  
Reality Testing ◽  
Number Of Patients

A number of patients seen in contemporary clinical practice are not appropriate for traditional insight-oriented therapy (i.e., expressive approaches). These may include sicker patients or those who are not interested in exploratory work. Supportive therapy refers to a flexible treatment approach that is intended to be responsive to the particular needs of these patients. Supportive therapy also benefits from the integration of techniques from other orientations (e.g., cognitive-behavioral therapy). After discussing supportive therapy more generally and differentiating it from the expressive approaches, this chapter focuses on two sets of supportive techniques. The first focuses on ways to support and enhance realistic patient self-esteem. The second set consists of techniques used to increase patient knowledge and build adaptive skills (e.g., psychoeducation, reality testing).

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