Cognitive Behaviour Therapy最新文献

A systematic review and meta-analysis was conducted of different types of CBTs for ID in adults treated in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for studies published until January 2025. The effectiveness of CBT, methodological quality, and moderators of treatment outcomes were examined and benchmarked by meta-analytically comparing them with efficacy studies for ID. Thirty-two studies were included, comprising 5231 participants. Very large within-group effect sizes (ES; Hedges' g) were obtained for ID-severity at post-treatment (1.87), and follow-up (1.68), on average 12 months post-treatment. Remission rates were 45% post-treatment and 51% at follow-up. Attrition rate was 13.9%. Risk of bias was considerable in the majority of studies. The benchmarking analysis showed that effectiveness studies (1.83) had almost exactly the same ES as efficacy studies (1.82) at post-treatment. Furthermore, there was no significant difference between effectiveness and efficacy studies on sleep diary measures, remission rates, and self-ratings of depression and anxiety. CBTs for ID are effective when delivered in routine clinical care, with ESs comparable to those found in efficacy studies. However, the evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.Prospero registration id: CRD420251032141.

Gratitude and hope are established predictors of mental and physical health and well-being. Scarce literature investigates relevant mediators of these relationships in a single model and during the COVID-19 pandemic. The current study investigated the mediating role of health anxiety (measured three months after baseline) in the relationship of gratitude and hope at baseline with alcohol use, fatigue, pain, and well-being six months later. The sample was composed of 788 mostly male (58.1%), White (70.3%), middle-aged adults (M_age = 38.0, SD = 11.8). Structural equation models (SEM) were used to analyze the data. Gratitude at baseline's indirect effect of health anxiety three months later was both small and negative for alcohol use (ab = ‒.06, 95% CI [-.10, -.03]) and pain (ab = ‒3.01, 95% CI [-4.34, -1.68]). Health anxiety appears to be a robust mediator of the relationship between gratitude and mental and physical health outcomes. Hope was a stronger and more direct predictor of well-being compared to gratitude. The findings of this study may provide evidence for examining health anxiety levels as a risk factor when trying to promote resilience factors in individuals who report health issues, particularly during times of environmental contagion.

Implementation efforts to increase delivery of cognitive-behavioral therapy (CBT) require ongoing consultation to support the necessary skill development, intervention delivery, and sustainability of its practice in the face of common barriers. However, many ethical challenges can arise within consultation across implementation research and practice at both an individual and organizational level that are not easily resolved within current ethical guidelines. In this paper, we highlight the role of consultation in implementation science and practice and illustrate major ethical challenges that can arise in CBT consultation (i.e. role clarity, influence and power dynamics, professional differences, legal requirements), providing relevant case examples. We then offer practical suggestions for consultants to effectively and proactively address ethically challenging situations, guided by a structured problem-solving framework with reflective questions. We present an extended case example to demonstrate the utility of the proposed framework to support clinicians-particularly practitioners engaged in training and consultation-to support delivery of high-quality, evidence-based care. We conclude by discussing important future directions as they relate to ethical consultation practices to advance CBT implementation.