Cognitive and Behavioral Practice最新文献

Evaluating the Relationship Between Therapist Negative Beliefs About Exposure Therapy and Delivery Behavior 评估治疗师对暴露治疗的负面信念与传递行为的关系。

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.06.003

Joshua Kemp, Lesley A. Norris, Alicia Fenley, Anna Kidd, Erin Mamaril, Jennifer Herren, Jennifer Freeman, Kristen Benito

Therapist negative beliefs about exposure have been identified as a key contributor to underutilization and suboptimal delivery of exposure—however, supporting evidence is derived from laboratory analogue studies and therapist self-report. Benito and colleagues (2021b) completed a training trial that included rigorous coding of videotaped in-session delivery behavior among a sample of therapists (N = 16) who received workshop training followed by ongoing consultation. The present study is a secondary analysis evaluating the relationship between Therapist Beliefs About Exposure Scale (TBES) scores and actual delivery behavior with anxious children/adolescents in the community. Marginally significant findings suggested that lower pretraining TBES scores (i.e., fewer negative beliefs about exposure) were associated with more frequent exposure usage, and that increased use of anxiety-increasing behaviors was related to greater reduction in therapist negative beliefs about exposure over the course of training. Belief levels did not demonstrate a statistically significant difference based on setting (community mental health vs. private practice). Although future studies with larger samples are needed, current findings extend growing evidence highlighting therapist beliefs about exposure as a potential influence on exposure utilization and delivery quality in real-world settings. Dissemination efforts involving the development of training strategies to promote exposure use in community settings are discussed.

治疗师对暴露的消极信念已被确定为暴露未充分利用和不理想交付的关键因素-然而，来自实验室模拟研究和治疗师自我报告的支持证据。Benito及其同事（2021b）完成了一项培训试验，其中包括在接受工作坊培训后进行持续咨询的治疗师样本（N = 16）中对会议中交付行为的视频进行严格编码。本研究是对社区中焦虑儿童/青少年的心理治疗师关于暴露量表（TBES）得分与实际分娩行为之间关系的二次分析。轻度显著的研究结果表明，较低的训练前TBES分数（即关于暴露的负面信念较少）与更频繁的暴露使用有关，并且在训练过程中，增加焦虑增加行为的使用与治疗师对暴露的负面信念的更大减少有关。信念水平没有显示出基于环境（社区心理健康与私人诊所）的统计显着差异。虽然未来需要更大样本的研究，但目前的研究结果扩展了越来越多的证据，强调了治疗师关于暴露对现实环境中暴露利用和传递质量的潜在影响的信念。讨论了传播工作，包括制定培训战略以促进在社区环境中使用暴露疗法。

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引用次数: 0

Feasibility, Safety, and Acceptability of Cognitive Processing Therapy for PTSD Following a Recent Suicide Attempt: A Case Study 认知加工疗法治疗近期自杀未遂后创伤后应激障碍的可行性、安全性和可接受性：案例研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.06.001

Deidre A. Marsh

While cognitive processing therapy (CPT) has been found to be highly effective in the treatment of posttraumatic stress disorder (PTSD) and comorbid suicidal ideation, it is unknown how soon after a suicide attempt this treatment may be safe and effective. This case study investigates the effectiveness of weekly, telehealth-delivered CPT for a client with PTSD following a suicide attempt on the anniversary of a traumatic event. Results indicate a clinically meaningful reduction in PTSD symptoms and loss of PTSD diagnosis, as measured by the PTSD Checklist for DSM-5 (PCL-5), and a lack of further suicidal ideation or attempts. These results were maintained at long-term follow-ups at 1-, 3-, and 12-month periods. Qualitative data from the client further supported the effectiveness and acceptability of treatment. This case study suggests the potential of CPT as a valuable intervention for individuals with PTSD recovering from suicide attempts and highlights the importance of further research in this area. In support of this, the case study also suggests the use of nuanced suicide risk assessments, such as the fluid vulnerability theory (FVT), to respond to fluctuations in suicide risk in high-risk clients.

虽然认知加工疗法（CPT）已被发现在治疗创伤后应激障碍（PTSD）和共病自杀意念方面非常有效，但尚不清楚在自杀未遂后多久这种治疗可能是安全有效的。本案例研究调查了每周的有效性，远程医疗交付的创伤后应激障碍的客户继自杀未遂创伤事件的周年纪念日。根据DSM-5 （PCL-5）的PTSD检查表，结果显示PTSD症状和PTSD诊断的丧失在临床上有意义的减少，并且没有进一步的自杀意念或企图。这些结果在1个月、3个月和12个月的长期随访中保持不变。来自患者的定性数据进一步支持了治疗的有效性和可接受性。本案例研究表明，CPT作为一种有价值的干预措施，可以帮助PTSD患者从自杀企图中恢复过来，并强调了该领域进一步研究的重要性。为了支持这一点，该案例研究还建议使用细微差别的自杀风险评估，如流体脆弱性理论（FVT），以应对高风险客户自杀风险的波动。

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引用次数: 0

Mapping Dialectical Behavior Therapy Skills to Clinical Domains Implicated in Contemporary Addiction Research: A Conceptual Synthesis and Promise for Precision Medicine 将辩证行为疗法技能映射到当代成瘾研究中涉及的临床领域：概念综合与精准医学的前景

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.07.002

Jeremy W. Luk, Matthew F. Thompson

Recent addiction research has identified clinical domains that are central to the development and maintenance of alcohol use disorder (AUD). Yet existing psychotherapy approaches are not typically organized around these clinical domains and are often limited in scope. Dialectical behavior therapy (DBT) is an intensive, multicomponent cognitive behavioral treatment that includes individual psychotherapy, group-based skills training, phone coaching, and consultation team for DBT therapists. Despite its efficacy on various mental health conditions, access to full DBT is often a challenge. In this paper, we describe how the skills training component of DBT can be flexibly applied to target clinical domains that underlie the three stages of the addiction cycle or impair quality of life during recovery from AUD. Using three clinical case vignettes, we illustrate how DBT skills can be mapped onto addiction clinical domains (e.g., Dialectical Abstinence and Clear Mind on executive function, STOP and TIP skills on incentive salience, Check the Facts and Opposite Action on negative emotionality, and ABC PLEASE skill on quality of life). Based on this integrated framework, we offer practical recommendations for case conceptualization, stigma reduction, and implementation through multiple delivery options. Implications on precision medicine are also discussed. Together, this conceptual synthesis serves as a bridge for practitioners to learn about contemporary addiction theories and for addiction researchers to appreciate the value of DBT in substance use treatment. The promotion of DBT skills training as a stand-alone or adjunctive intervention may help address the significant treatment gap in alcohol and substance use behaviors.

最近的成瘾研究已经确定了对酒精使用障碍（AUD）的发展和维持至关重要的临床领域。然而，现有的心理治疗方法通常不是围绕这些临床领域组织的，而且范围往往有限。辩证行为疗法（DBT）是一种强化的、多成分的认知行为治疗，包括个体心理治疗、团体技能培训、电话指导和DBT治疗师咨询团队。尽管它对各种心理健康状况有效，但获得全面的DBT往往是一个挑战。在本文中，我们描述了DBT的技能训练部分如何灵活地应用于成瘾周期三个阶段的目标临床领域或损害AUD恢复期间的生活质量。通过三个临床案例，我们说明了DBT技能如何映射到成瘾的临床领域（例如，辩证戒断和清晰思维在执行功能上，STOP和TIP技能在激励突出性上，检查事实和相反行动在消极情绪上，ABC PLEASE技能在生活质量上）。在这一综合框架的基础上，我们为案例概念化、减少污名以及通过多种交付方案实施提供了切实可行的建议。对精准医疗的启示也进行了讨论。总之，这一概念综合为从业者学习当代成瘾理论和成瘾研究人员欣赏DBT在物质使用治疗中的价值提供了一座桥梁。促进DBT技能培训作为独立或辅助干预可能有助于解决酒精和物质使用行为的显著治疗差距。

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引用次数: 0

Acknowledgment to 2025 Reviewers 感谢2025位审稿人

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2026.01.001

引用次数: 0

Development and Pilot Testing of an Internet-Based Version of the Unified Protocol That Targets Positive Affect Regulation: A Treatment Development Report 针对积极影响监管的统一协议的基于互联网版本的开发和试点测试：治疗发展报告

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.07.003

Elizabeth H. Eustis, Maya Nauphal, Brittany Jaso, Daniella Spencer-Laitt, Lauren Woodard, Todd J. Farchione, David H. Barlow

Anxiety and depressive disorders are common and continue to increase in prevalence. However, most individuals who meet the criteria for these disorders do not receive any treatment, and only a small portion receive evidence-based care. Digital mental health interventions (DMHIs) are one way to increase access to evidence-based psychological treatments. Evidence supports the efficacy of disorder-specific and transdiagnostic DMHIs based on cognitive-behavioral therapy for anxiety and depression. Most of these interventions focus on reducing symptoms and negative affect. However, research indicates that deficits in positive affect, a related yet distinct construct, are common across these disorders. The current study reports on the development of an Internet-based version of the unified protocol that also targets positive affect regulation. We also report results from a small initial pilot study (N = 4) on the acceptability of the intervention, preliminary outcomes, and participant feedback used to inform refinements to the program. Participants generally found the program to be acceptable. In terms of preliminary outcomes, there was a statistically significant reduction in anxiety symptoms at the group level from pre- to posttreatment. There were no other statistically significant results at the group level from pre- to posttreatment on stress, depression, savoring, or well-being. However, individual participants reported clinically significant changes in various outcomes. Results also highlight the importance of receiving participant feedback early in the development process.

焦虑和抑郁障碍很常见，并且患病率在不断增加。然而，大多数符合这些疾病标准的人没有接受任何治疗，只有一小部分接受循证治疗。数字心理健康干预（DMHIs）是增加获得循证心理治疗的途径之一。证据支持基于认知行为疗法的障碍特异性和跨诊断DMHIs对焦虑和抑郁的疗效。这些干预措施大多侧重于减轻症状和负面影响。然而，研究表明，积极情绪的缺陷（一种相关但独特的结构）在这些疾病中很常见。目前的研究报告了基于互联网的统一协议版本的开发，该协议也针对积极影响监管。我们还报告了一项小型初步试点研究（N = 4）的结果，该研究涉及干预的可接受性、初步结果和用于通知程序改进的参与者反馈。参与者普遍认为这个项目是可以接受的。就初步结果而言，从治疗前到治疗后，在组水平上焦虑症状有统计学上显著的减少。从治疗前到治疗后，在组水平上，在压力、抑郁、品味或幸福感方面没有其他统计学上显著的结果。然而，个别参与者报告了各种结果的临床显着变化。结果还强调了在开发过程早期接收参与者反馈的重要性。

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引用次数: 0

Tailoring Interoceptive Exposure for Patients With Medical Comorbidities 为有医疗合并症的患者量身定制内感受性暴露

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.11.001

Samantha G. Farris, Mindy M. Kibbey, Lilly Derby, Brittany Keller, Danielle Hoyt, Hannah R. Brinkman, Brandon L. Alderman, Teresa M. Leyro

Interoceptive exposure (IE) is an evidence-based cognitive-behavioral intervention strategy that involves eliciting physical sensations in a safe and controlled manner to reduce negative emotion (typically anxiety) associated with the sensations. The somatic focus of IE has transdiagnostic relevance to targeting anxiety in the context of medical comorbidities. Yet IE exercises are often overlooked as an intervention strategy and (incorrectly) perceived as unsafe for use, especially in patients with physical health conditions. In this article, we discuss the rationale and procedures for the use of IE in patients with medical comorbidities, with a particular focus on clinical assessment and medical consultation, safety guidelines, and strategies for safe modification of IE. Several clinical examples are provided to increase clinician understanding of tailored IE planning.

内感受性暴露（IE）是一种基于证据的认知行为干预策略，涉及以安全和可控的方式引发身体感觉，以减少与感觉相关的负面情绪（典型的焦虑）。在医学合并症的背景下，IE的躯体焦点与靶向焦虑具有跨诊断相关性。然而，IE练习作为一种干预策略经常被忽视，并且（错误地）认为不安全，特别是在有身体健康状况的患者中。在这篇文章中，我们讨论了在有医疗合并症的患者中使用IE的基本原理和程序，特别关注临床评估和医疗咨询、安全指南和安全修改IE的策略。提供了几个临床实例，以增加临床医生对量身定制的IE计划的理解。

引用次数: 0

Treating the Trauma-Based Psychological Sequelae of a COVID-19-Related Hospitalization: Two Case Studies of Patients Who Experienced Delirium 治疗covid -19相关住院治疗的创伤性心理后遗症：两例谵妄患者的病例研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.08.003

Kendra E. Hinton-Froese, Victoria A. Powers, Samantha R. Richards, Michelle L. Miller

Since the onset of the COVID-19 pandemic there has been a surge in hospitalizations. Emerging data indicates that after being discharged from the hospital, many individuals experience mental health concerns such as depression, anxiety, and posttraumatic stress disorder. This population may present with unique psychological features and treatment needs that differ from individuals hospitalized for other reasons. For example, these patients experience delirium at higher rates than those of comparable respiratory illnesses. Two case studies are presented to demonstrate how psychotherapy can be used to address the unique needs of patients who have a COVID-19-related hospitalization, experience delirium, and develop trauma-related symptoms. While existing psychotherapy interventions can be used, there are important considerations for working with this population. It is critical to address delirium experiences, ongoing fears about contracting COVID-19, and medical sequelae. A multidisciplinary approach is likely essential for addressing the complex needs of this population.

自2019冠状病毒病大流行爆发以来，住院人数激增。新出现的数据表明，出院后，许多人都会出现精神健康问题，如抑郁、焦虑和创伤后应激障碍。这一人群可能表现出独特的心理特征和治疗需求，与因其他原因住院的个体不同。例如，这些患者谵妄的发生率高于患有类似呼吸道疾病的患者。介绍了两个案例研究，以展示如何使用心理治疗来解决与covid -19相关的住院治疗、经历谵妄和出现创伤相关症状的患者的独特需求。虽然可以使用现有的心理治疗干预措施，但在与这些人群一起工作时，有一些重要的考虑因素。解决谵妄经历、对感染COVID-19的持续恐惧和医疗后遗症至关重要。多学科方法对于解决这一人群的复杂需求可能是必不可少的。

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引用次数: 0

Provider Perspectives: Feasibility, Acceptability, and Appropriateness of Online Parent Training With Therapist Coaching in a Community Practice Setting 提供者的观点：可行性，可接受性，和适当的在线父母培训与治疗师辅导在社区实践设置

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.08.005

Heather A. MacPherson, Tommy Chou, Emma DeMartino, Sydney Velotta, A. Rani Elwy, Jennifer Wolff

A considerable body of evidence documents the detrimental impact of disruptive behavior disorders (DBDs) in childhood and their longstanding effects across development and into adulthood. While research has yielded evidence-based interventions for DBDs, such as parent management training, disparities in access to care persist. The growing ubiquity of consumer technologies underscores the potential to provide evidence-based treatments through online programs; however, structural barriers continue to impede dissemination in community settings. This paper examines clinic staff’s perspectives on the implementation of an online parent management program in a community mental health center (CMHC) to integrate novel programming with existing therapeutic care to maximize resource efficiency in treatment delivery and increase family adherence and engagement. Quantitative and qualitative data were collected from 16 staff members who were trained to deliver the intervention at a CMHC. Quantitative data indicated positive perceptions across various domains, while qualitative findings highlighted feasibility, acceptability, and appropriateness. Facilitators to feasibility included program ease, integration into sessions, and flexible access. Time constraints and technology access were barriers. Acceptability was high, with videos reinforcing therapy and promoting family connection. The program’s structure and psychoeducation were appreciated, while quiz format and time constraints were concerns. Appropriateness was positive, with broad relevance, insight-building impact, comprehensive coverage, evidence-based strategies, and support. Barriers existed for specific patient characteristics. Implications for implementation in practice and future directions of research are discussed.

大量证据证明了破坏性行为障碍（DBDs）在儿童时期的有害影响及其在整个发育和成年期的长期影响。虽然研究已经为dbd提供了基于证据的干预措施，如父母管理培训，但在获得护理方面的差距仍然存在。日益普及的消费技术强调了通过在线项目提供循证治疗的潜力；然而，结构性障碍继续阻碍在社区环境中传播。本文研究了诊所工作人员对社区精神卫生中心（CMHC）实施在线家长管理计划的看法，该计划将新计划与现有治疗护理相结合，以最大限度地提高治疗提供的资源效率，并增加家庭依从性和参与度。从16名工作人员那里收集了定量和定性数据，这些工作人员接受了在CMHC提供干预措施的培训。定量数据表明了各个领域的积极看法，而定性研究结果强调了可行性、可接受性和适当性。促进可行性的因素包括程序简化、集成到会议和灵活访问。时间限制和技术获取是障碍。接受度高，视频强化治疗，促进家庭联系。节目的结构和心理教育受到赞赏，而测验形式和时间限制则令人担忧。适当性是积极的，具有广泛的相关性、建立洞察力的影响、全面的覆盖、基于证据的战略和支持。患者的特定特征存在障碍。最后讨论了该方法在实践中的应用及未来的研究方向。

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引用次数: 0

TEAM-CBT for Adolescents and Young Adults With Depression and Anxiety: Testing Short-Term Impact and Within-Session Change 针对患有抑郁症和焦虑症的青少年的 TEAM-CBT：测试短期影响和疗程内变化

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.05.005

Elise Bourgeois-Munoz, Jacqueline Corcoran

The prevalence of mental health disorders has shown a notable rise in adolescents and young adults (Parodi et al., 2022). These developmental stages, adolescence and young adulthood, are peak periods for emerging mental health disorders, affecting around 49.5% of young individuals. Anxiety and depression have significant adverse and long-term effects that interfere with developmental tasks if not successfully treated (Merikangas, 2010).

An evidence-based model, TEAM-CBT, incorporates the following treatment components: testing, empathy, agenda setting, and methods. The model’s impact on depression and anxiety was tested in a naturalistic study of adolescent and young adult clients in a group practice setting. T-tests and ANOVAs were used to test treatment effects, including changes between the first and final sessions, within-session changes, and the treatment response pattern.

A total of N = 116 patients’ data was included in the analysis. Both depression and anxiety scores were significantly lower at posttest compared to pretest. The majority of adolescents and young adults achieved clinically significant improvement: 80% of youth no longer met criteria for clinically significant symptoms of depression symptoms, and 87% of youth for anxiety symptoms. No correlation was found between the number of sessions received and the treatment outcome. Within-session symptom reduction was clinically significant in each of the 10 sessions. The largest symptom reductions occurred over the first five sessions. Findings, recommendations, and implications are discussed.

青少年和年轻成年人的精神疾病发病率明显上升（Parodi et al.）青春期和青年期是心理健康疾病的高发期，约有 49.5%的年轻人会受到影响。焦虑症和抑郁症如果得不到成功治疗，会产生严重的不良和长期影响，从而干扰发展任务（Merikangas，2010 年）。

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引用次数: 0

Disorders in Disguise: Proposed Clinical Competencies in Eating Disorders for All Child and Adolescent Mental Health Providers 伪装中的失调：为所有儿童和青少年心理健康服务提供者提出的饮食失调症临床能力建议

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2026-02-01 DOI: 10.1016/j.cbpra.2024.07.001

Leslie Sim, Jocelyn Lebow, Afton Koball, Stephen P. Whiteside, Abigail Matthews

Early detection and treatment of child and adolescent eating disorders is strongly linked to positive outcomes and can be achieved by recognizing the diverse and often concealed ways in which these conditions commonly present within mental health care settings. In particular, eating disorders are frequently disguised by the appearance of more familiar presenting problems, such as symptoms of anxiety, depression, and emotion or behavioral dysregulation. As a primer for child and adolescent mental health therapists seeking to provide efficient and effective treatment to young patients who may be presenting for mental health care with an undetected eating disorder, we present six cases of patients from differing child and adolescent mental health settings who presented for the treatment of psychiatric symptoms that ultimately were related to an eating disorder. In each case, the detection and treatment of an underlying eating disorder was paramount to improving the presenting problems. Within this context, we discuss key concepts and basic clinical competencies in child and adolescent eating disorders that are essential for all mental health providers, including those who do not consider eating disorder treatment as within their scope of practice.

儿童和青少年饮食失调症的早期发现和治疗与积极的治疗效果密切相关，而要做到这一点，就必须认识到这些疾病在心理健康护理环境中通常会以多种多样且往往被掩盖的方式出现。尤其是，饮食失调常常会被一些更常见的问题所掩盖，如焦虑、抑郁、情绪或行为失调等症状。作为儿童和青少年心理健康治疗师的入门读物，我们介绍了六例来自不同儿童和青少年心理健康机构的患者，他们因精神症状前来就诊，最终发现与进食障碍有关，从而寻求高效、有效的治疗。在每个病例中，发现并治疗潜在的进食障碍对于改善目前的问题至关重要。在此背景下，我们讨论了儿童和青少年饮食失调的关键概念和基本临床能力，这些对于心理健康服务提供者（包括那些并不认为饮食失调治疗属于其执业范围的人员）来说至关重要。

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引用次数: 0