scholarly journals Cognitive–behavioural therapy and motivational intervention for schizophrenia and substance misuse

2003 ◽  
Vol 183 (5) ◽  
pp. 418-426 ◽  
Author(s):  
Gillian Haddock ◽  
Christine Barrowclough ◽  
Nicholas Tarrier ◽  
Jan Moring ◽  
Robert O'Brien ◽  
...  
Keyword(s):  
Service Use ◽  
Substance Misuse ◽  
Controlled Trial ◽  
Routine Care ◽  
Control Treatment ◽  
Health Economy ◽  
Motivational Intervention ◽  
Behavioural Treatment ◽  
Cognitive Behavioural

BackgroundComorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits.AimsTo investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive–behavioural treatment (CBT) programme.MethodPatients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months.ResultsThere were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes.ConclusionsThe treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.

Cognitive Behavioural Therapy for Medically Unexplained Physical Symptoms: A Pilot Study

1996 ◽  
Vol 24 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Anne E. M. Speckens ◽  
Philip Spinhoven ◽  
Keith E. Hawton ◽  
Jan H. Bolk ◽  
Albert M. van Hemert
Keyword(s):  
Controlled Trial ◽  
Physical Symptoms ◽  
Small Sample ◽  
Social Consequences ◽  
Behavioural Treatment ◽  
Medically Unexplained Physical Symptoms ◽  
Cognitive Behavioural ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms

The aim of the study was to develop a cognitive behavioural treatment model for medically unexplained physical symptoms and assess its feasibility and effect in a small sample of patients. This study was the first step in the realization of a randomized controlled trial. The study population consisted of consecutive patients presenting at a general medical outpatient clinic, whose symptoms could not be explained by objective abnormal findings. The treatment was based on a general model of the disorder, consisting of the physical symptoms, the patient's attribution and perceived control and the cognitive, behavioural, physical and social consequences. It incorporated record keeping concerning physical symptoms and emotions, identification of cognitions about the symptoms, challenging dysfunctional thoughts and behavioural experiments. At 6–months follow-up, four of the five treated patients were improved with regard to frequency and intensity of the symptoms, psychological distress and functional impairment. The improvement was sustained at 1–year follow-up.

A Trial of Two Cognitive-Behavioural Methods of Treating Drug-Resistant Residual Psychotic Symptoms in Schizophrenic Patients: I. Outcome

1993 ◽  
Vol 162 (4) ◽  
pp. 524-532 ◽  
Author(s):  
Nicholas Tarrier ◽  
Richard Beckett ◽  
Sue Harwood ◽  
Amanda Baker ◽  
Lawrence Yusupoff ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Controlled Trial ◽  
Psychotic Symptoms ◽  
Behavioural Treatment ◽  
Treatment Benefit ◽  
Residual Symptoms ◽  
Cognitive Behavioural ◽  
Schizophrenic Patients ◽  
Demand Condition

Despite neuroleptic medication, many schizophrenic patients continue to experience residual positive psychotic symptoms. These residual symptoms cause distress and disability. We report a controlled trial of two cognitive-behavioural treatments to alleviate residual hallucinations and delusions. Forty-nine patients were recruited into the trial, of whom 27 entered the trial and completed post-treatment assessment, and 23 were reassessed at six-month follow-up. Patients were randomly allocated to either coping strategy enhancement (CSE) or problem solving (PS). Half the patients were allocated to a high-expectancy positive demand condition and half to a counterdemand condition to evaluate expectation of improvement. Patients receiving either cognitive-behavioural treatment showed significant reductions in pyschotic symptoms compared with those in the waiting period, who showed no improvement. There was some evidence, although equivocal, that patients receiving CSE improved more than those receiving PS. There was no evidence that improvements generalised to negative symptoms or social functioning, nor was there evidence that expectancy of treatment benefit contributed to the treatment effect.

scholarly journals Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

2017 ◽  
Vol 211 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Patricia Cooney ◽  
Catherine Jackman ◽  
David Coyle ◽  
Gary O'Reilly
Keyword(s):  
Intellectual Disability ◽  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Primary Outcome Measure ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDespite the evidence base for computer-assisted cognitive–behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.AimsTo evaluate the utility of a CBT computer game for adults who have an intellectual disability.MethodA 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.ResultsA significant group x time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.ConclusionsAs the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1131-1135
Author(s):  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Alcohol Use ◽  
Contraceptive Use ◽  
Controlled Trial ◽  
Counseling Session ◽  
Community Settings ◽  
Motivational Intervention ◽  
Effective Contraception

Objectives. To test the feasibility and impact of a motivational intervention in reducing drinking and/or increasing effective contraception in women who are at risk for an alcohol-exposed pregnancy. Methods. A multisite single-arm pilot study was conducted in 6 community settings in 3 large cities. A total of 2384 women were screened for eligibility; 230 were eligible on the basis of their alcohol use and lack of contraception. Of the eligible women, 190 consented and were enrolled, and 143 (75.3%) completed the 6-month follow-up. The intervention consisted of 4 manual-guided motivational counseling sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. Outcome measures include intervention completion rates, alcohol use (frequency, quantity, and bingeing), contraceptive use and effectiveness, and risk for alcohol-exposed pregnancy. Results. Among women who completed the 6-month follow-up, 68.5% were no longer at risk of having an alcohol-exposed pregnancy; 12.6% of women who completed the program reduced drinking only; 23.1% used effective contraception only; and 32.9% reported both. Results were consistent across the 6 diverse high-risk settings. Conclusions. This study provides evidence that providing 4 sessions of motivational interviewing plus a contraception counseling session is feasible and strongly suggests that this intervention can decrease the risk of alcohol-exposed pregnancy in women in high-risk settings. Additional investigation in a randomized controlled trial is warranted.

Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial

2020 ◽  
pp. 1-14
Author(s):  
Harald Baumeister ◽  
Sarah Paganini ◽  
Lasse Bosse Sander ◽  
Jiaxi Lin ◽  
Sandra Schlicker ◽  
...  
Keyword(s):  
Care Setting ◽  
Chronic Back Pain ◽  
Controlled Trial ◽  
Work Capacity ◽  
Routine Care ◽  
Randomized Controlled ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> There is neither strong evidence on effective treatments for patients with chronic back pain (CBP) and depressive disorder nor sufficiently available mental health care offers. <b><i>Objective:</i></b> The aim is to assess the effectiveness of internet- and mobile-based interventions (IMI) as a scalable approach for treating depression in a routine care setting. <b><i>Methods:</i></b> This is an observer-masked, multicenter, pragmatic randomized controlled trial with a randomization ratio of 1:1.<b><i></i></b>Patients with CBP and diagnosed depressive disorder (mild to moderate severity) were recruited from 82 orthopedic rehabilitation clinics across Germany. The intervention group (IG) received a guided depression IMI tailored to CBP next to treatment-as-usual (TAU; including medication), while the control group (CG) received TAU. The primary outcome was observer-masked clinician-rated Hamilton depression severity (9-week follow-up). The secondary outcomes were: further depression outcomes, pain-related outcomes, health-related quality of life, and work capacity. Biostatistician blinded analyses using regression models were conducted by intention-to-treat and per protocol analysis. <b><i>Results:</i></b> Between October 2015 and July 2017, we randomly assigned 210 participants (IG, <i>n</i> = 105; CG, <i>n</i> = 105), mostly with only a mild pain intensity but substantial pain disability. No statistically significant difference in depression severity between IG and CG was observed at the 9-week follow-up (β = –0.19, 95% CI –0.43 to 0.05). Explorative secondary depression (4/9) and pain-related (4/6) outcomes were in part significant (<i>p</i> &#x3c; 0.05). Health-related quality of life was significantly higher in the IG. No differences were found in work capacity. <b><i>Conclusion:</i></b> The results indicate that an IMI for patients with CBP and depression in a routine care setting has limited impact on depression. Benefits in pain and health-related outcomes suggest that an IMI might still be a useful measure to improve routine care.

Importance of knowledge in the behavioural treatment of panic disorder

2019 ◽  
Vol 47 (5) ◽  
pp. 611-615
Author(s):  
Kathleen M. Grubbs ◽  
James D. Broussard ◽  
Emily L. Hiatt ◽  
Melissa A. Beason-Smith ◽  
Ellen J. Teng
Keyword(s):  
Panic Disorder ◽  
Intensive Therapy ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Knowledge Domains ◽  
Cognitive Behavioural ◽  
Severity Scores ◽  
Good Internal Consistency ◽  
Knowledge Scale

AbstractBackground:Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.Aims:The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.Method:Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.Results:The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.Conclusions:In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.

Sign in / Sign up

Export Citation Format

Share Document