Cognitive and Behavioral Practice最新文献

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Reconnecting Hope: The Treatment of Eating Disorders in Rural America 重新连接希望:美国农村饮食失调的治疗

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.08.001

Jenny E. Copeland, Jacob Hefner, Sarah E. Estep, Carolyn Black Becker

Eating disorders (EDs), a significant public health concern, impact millions of Americans every year. Many people with EDs are often overlooked for multiple reasons, including the stereotype that EDs predominantly affect thin, White, affluent young women and girls. One historically overlooked group is impoverished individuals in rural areas of the United States (U.S.), who may, in fact, be at an increased risk for EDs. The Reconnect Eating Disorders treatment program (REDTP) at Ozark Center is the first comprehensive, evidence-based, multidisciplinary ED treatment program to be developed in a Certified Community Behavioral Health Organization (CCBHO) in the U.S. CCBHOs are a unique model of financially sustainable integrated care well-suited to the treatment of biopsychosocial illnesses such as EDs because CCBHOs offer a full range of services to treat both physical and mental health. This paper details the development of REDTP, including its team, barriers, and successes. The role of Community Support Specialists/Reconnect Coaches and Healthcare Home/Medical Support is reviewed, which includes providing outpatient care and intensifying treatment for the most acute clients. Key domains of growth for REDTP included selecting core evidence-based treatments, building a team and defining team roles, and intensive training to develop evidence-based ED expertise. Persistent barriers included staffing limitations for providing intensive treatment to a small number of clients. Adult case studies of REDTP clients are presented. Recommendations for future ED and other specialized treatment programs in low resource agencies are provided.

饮食失调(EDs)是一个重大的公共卫生问题，每年影响数百万美国人。由于多种原因，许多患有急症的人经常被忽视，其中包括一种刻板印象，即急症患者主要是瘦弱、富裕的白人年轻女性和女孩。一个历来被忽视的群体是美国农村地区的贫困人群，事实上，他们患ed的风险可能会增加。Ozark中心的重新连接饮食失调治疗计划(REDTP)是美国认证社区行为健康组织(CCBHO)开发的第一个全面的，基于证据的，多学科的ED治疗计划。CCBHO是一个独特的经济可持续的综合护理模式，非常适合治疗生物心理社会疾病，如ED，因为CCBHO提供全方位的服务来治疗身体和心理健康。本文详细介绍了REDTP的开发，包括它的团队、障碍和成功。回顾了社区支持专家/重新连接教练和保健之家/医疗支持的作用，其中包括提供门诊护理和加强对最急性客户的治疗。REDTP增长的关键领域包括选择核心循证治疗，建立团队并定义团队角色，以及强化培训以发展循证ED专业知识。持续存在的障碍包括为少数病人提供强化治疗的人员配备限制。介绍了REDTP客户的成人案例研究。对未来的ED和其他专业治疗方案在低资源机构提供了建议。

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引用次数: 0

Acceptability of Men’s Externalizing Depression Constructs Among Black American Men and Middle-Aged and Older White Men 美国黑人男性和中老年白人男性外化抑郁结构的可接受性

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.08.004

Douglas Gazarian , Michael E. Addis

Research on the dissemination and implementation of gender-based care for men has rarely considered diversity within the male-identifying population. The present study evaluated the acceptability of men’s externalizing depression (MED) constructs across purposive samples of men understudied in the MED literature and at higher risk for MED-related outcomes (Black American men and middle-aged and older White men). Following brief psychoeducation, participants rated MED constructs for comprehensibility and perceived clinical value. Using a convergent mixed-methods design, we examined how attitudes varied by sample and experimentally-manipulated psychoeducational variables pertaining to different MED conceptual models. Across samples and psychoeducation conditions, we observed similarly strong levels of acceptability for MED as a gender-based conceptualization of mixed internalizing-externalizing symptoms. Small differences emerged as a function of sample-psychoeducation interactions. Quantitative and qualitative data converged to suggest race-gender intersections influence men’s construal of psychological symptoms. Overall, results supported MED as an acceptable formulation of symptoms across multiple subpopulations of men in the context of an international, online community sample.

对男性基于性别的护理的传播和实施的研究很少考虑到男性认同人口中的多样性。本研究评估了男性外化抑郁(MED)结构的可接受性，目的样本为MED文献中未被充分研究的男性和MED相关结果风险较高的男性(美国黑人男性和中老年白人男性)。经过简短的心理教育后，参与者对MED构念的可理解性和感知的临床价值进行评分。采用融合混合方法设计，我们研究了态度如何随样本和实验操纵的心理教育变量而变化，这些变量与不同的MED概念模型有关。在样本和心理教育条件下，我们观察到MED作为一种基于性别的内化-外化症状的概念化，同样具有很强的可接受性。作为样本-心理教育互动的功能，微小的差异出现了。定量和定性的数据显示，种族和性别的交集会影响男性对心理症状的解释。总体而言，在国际在线社区样本的背景下，结果支持MED在多个男性亚群中作为一种可接受的症状表述。

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引用次数: 0

Exploring Differences in Presentation and Treatment Outcomes Between Black and White American Adults With Prolonged Grief Disorder 探索患有长期悲伤障碍的美国黑人和白人成年人在表现和治疗结果上的差异

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2024.05.004

Margaret Gacheru, Christine Mauro, Natalia Skritskaya, Nicole Alston, Charles F. Reynolds III, Naomi Simon, Sidney Zisook, Barry Lebowitz, M. Katherine Shear

Prolonged grief disorder (PGD) is a condition of persistent, intense grief and PGD-targeted psychotherapy (PGDT) is an efficacious treatment. This study aimed to compare participants with PGD who self-identified as Black versus White, with respect to baseline features and response to PGDT. We performed a secondary data analysis of 55 Black and 455 White adults from two randomized clinical trials. Racial differences in baseline features were examined using Chi-squared and T-tests. We compared assessment completion and treatment response rates (PGDT vs. no PGDT) by race and evaluated posttreatment self-reported measures using linear models. There were racial differences in the cause of death, relation to the deceased, and taking comfort in religion. Black participants had similar ratings to their counterparts on impairment and grief severity at baseline. However, they had higher scores on a baseline measure of typical grief-related beliefs. Both racial groups had significantly greater response rates to PGDT than the comparison treatment. Similarly, PGDT resulted in lower posttreatment impairment than the comparison treatment for both racial groups. However, only the White participants had a difference in posttreatment grief severity between the treatment groups. This study supports the idea that PGD characteristics are similar in Black and White treatment seeking individuals, and that Black and White participants display improvement in response to PGDT.

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引用次数: 0

Development and Pilot Test of a Therapist-Assisted Self-Management Program for Completers of Trauma-Focused Therapy for Posttraumatic Stress Disorder 创伤后应激障碍创伤集中治疗完成者治疗师辅助自我管理计划的开发和试点测试

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.08.002

Shannon M. Kehle-Forbes, Tara Galovski, Melissa A. Polusny, Kyle Possemato, Sean Nugent, Eliza McManus, Allison L. Baier

Veterans who complete an evidence-based trauma-focused therapy (TFT) for posttraumatic stress disorder (PTSD) report continued treatment needs to build self-efficacy, promote continued skill application, and bolster engagement in valued activities. This paper describes the rationale, development, and treatment structure of a novel 4-session therapist-assisted self-management program, named EMPOWER, for TFT completers. A mixed methods approach was used to evaluate the acceptability and feasibility of the intervention in an open pilot trial with 12 veterans. Therapists delivered the treatment with fidelity and participants reported high acceptability and satisfaction with EMPOWER. Quantitatively, participants reported meaningful improvements in quality of life and small improvements in community engagement; however, there were no clinically meaningful changes in self-efficacy, PTSD symptoms, depression, or functioning pre- to postintervention. Qualitatively, participants noted EMPOWER met their post TFT needs and that the structure of treatment was helpful in continuing to practice TFT skills. They also noted improvements in self-efficacy for self-managing PTSD symptoms and an increase in valued activities. Findings suggest EMPOWER is feasible, acceptable, and meets veterans’ post-TFT treatment needs. A larger-scale, randomized trial of EMPOWER is warranted to evaluate the impact of EMPOWER on self-efficacy, clinical symptoms, functioning, and quality of life.

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引用次数: 0

The Impact of Exposure Therapy on Cancer-Related Future Cognitions in Severe Health Anxiety 暴露疗法对严重健康焦虑患者癌症相关未来认知的影响

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.07.001

Nora Brier, Lily A. Brown

Individuals with illness anxiety disorder (IAD) experience a preoccupation with having or acquiring a serious illness despite having mild or absent physical symptoms. Formerly hypochondriasis, individuals with IAD experience high rates of disability, contribute to elevated annual health care costs, and experience multiple comorbidities. IAD has been historically difficult to treat for both medical and mental health providers. Research suggests cognitive behavior therapy has mixed results for individuals with IAD. In this fictitious case presentation, we describe a course of successful exposure therapy for IAD drawing on the principals of inhibitory learning theory. Thus, through this example we demonstrate how to overcome common obstacles to successful treatment for IAD, such as willingness to participation, comorbid depression, and therapeutic alliance.

患有疾病焦虑障碍(IAD)的个体尽管有轻微或没有身体症状，但仍然对患有或获得严重疾病感到担忧。以前患有疑病症的IAD患者致残率高，导致年度卫生保健费用增加，并伴有多种合并症。从历史上看，对医疗和精神卫生提供者来说，IAD都是难以治疗的。研究表明，认知行为疗法对IAD患者的效果好坏参半。在这个虚构的案例介绍中，我们描述了一个成功的暴露治疗过程，利用抑制学习理论的原则。因此，通过这个例子，我们展示了如何克服成功治疗IAD的常见障碍，如参与意愿、共病抑郁症和治疗联盟。

引用次数: 0

Older Bereaved Individuals’ Experiences of Cognitive-Behavioral Therapy for Complicated Grief Reactions: A Qualitative Multistage Focus Group Approach 老年丧亲者对认知行为疗法治疗复杂悲伤反应的体验：多阶段焦点小组定性方法

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2024.06.002

Christina Buur , Thomas Mackrill, Lisbeth Hybholt , Eva Rames Nissen, Maja O’Connor

Bereavement is particularly common in old age. A small proportion of bereaved people develop complicated grief reactions (CGR) characterized by elevated symptoms of depression, prolonged grief disorder, anxiety, and/or posttraumatic stress. Cognitive-behavioral therapy for CGR (CBTgrief) is found to be an effective treatment. Detailed knowledge about older adults’ experiences of CBTgrief is needed to optimize treatment and to give recommendations to practice. To explore older adults’ experience of CBTgrief to gain insight into elements that were helpful or less helpful. Four multistage focus group interviews were conducted with nine older adults who lost a partner and received CBTgrief and three researchers. Five participants received group therapy and four individual therapy (mean age = 69.67 years, 89% women). The participants found exposure exercises, psychoeducation in grief, and letter writing particularly helpful. The participants requested options for family sessions, a combined individual/group format, and follow-up sessions. Awareness of potential memory problems and adapting to new practical tasks should receive greater focus in therapy. This study gives important insights into older adults’ experiences of CBTgrief and evaluates the helpful and less helpful elements in grief therapy. This may guide improvements in the treatment of bereaved older adults with CGR.

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引用次数: 0

Cognitive Behavioral Treatments for Prolonged Grief: Introduction to the Special Feature 长期悲伤的认知行为疗法：专题介绍

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2024.11.003

Donald J. Robinaugh, Naomi M. Simon

Over the past two decades, researchers have devoted enormous effort to developing treatments for prolonged grief disorder that are rooted in cognitive behavioral principles. There is now considerable evidence that these treatments are effective in reducing prolonged grief disorder severity. In this article, we introduce and provide an overview of a special series of articles in Cognitive and Behavioral Practice whose aim is to introduce clinicians and clinical researchers to the treatment of prolonged grief. By bringing together recent empirical research with expert clinical guidance, this special issue provides (a) further support for the efficacy of cognitive behavioral treatments for prolonged grief, (b) valuable insight into how they can be most effectively delivered, and (c) consideration for how to ensure that all individuals impacted by prolonged grief disorder can access the most effective care possible. We close with a brief discussion of paths forward for the continued advancement of cognitive behavioral treatments for prolonged grief.

引用次数: 0

Prolonged Grief Therapy

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2024.12.002

M. Katherine Shear, Naomi M. Simon

This paper provides a concise introduction to Prolonged Grief Therapy (PGT), an evidence-based treatment for the new PGD diagnosis in DSM-5 and ICD-11. PGD differs from nonclinical grief as well as major depression and PTSD. PGD symptoms show little response to treatments for depression. PGD comorbidity predicts worse treatment outcome for PTSD. Our group began describing PGD in the mid-1990s, using the terms “traumatic” or “complicated” grief, and to develop and test a treatment for this condition. The publication in 2005 of our randomized trial became the first empirically validated treatment for this condition. It is based upon the premise that grief is the natural response to loss that continues for an indefinite period of time after someone close dies. It is based upon the premise that grief is the natural response to loss that evolves and subsides as a bereaved person learns to live in a world of absence. PGD is the result of impediments to this learning process and the treatment aims to facilitate learning to live with a loss and to address impediments to this process. The recency of its inclusion in DSM-5 leaves many clinicians unfamiliar with PGD, the treatment that we validated, the studies in which the treatment was tested and the ways available to learn and use this approach. This paper provides a brief summary of each of these topics.

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引用次数: 0

Using Visual Displays in a Manualized Cognitive-Behavioral Treatment for Adults With ADHD and Comorbid Mood or Anxiety Disorders: A Pilot Study 视觉显示在成人多动症和共病情绪或焦虑障碍的人工认知行为治疗中的应用：一项初步研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.08.003

Antonio F. Pagán, Gregory H. Mumma, Andrew K. Littlefield

Attention-deficit/hyperactivity disorder (ADHD) in adults is a major health concern, often occurring with other disorders and functional, occupational, and relational deficits. Unfortunately, many treatment studies for adults with ADHD exclude comorbid mood or anxiety disorders. The present two-part study sought to identify the feasibility, acceptability, and preliminary effectiveness of a treatment for adults with ADHD and comorbid mood or anxiety disorders that used modules from evidence-based cognitive-behavioral (CB) and mindfulness interventions for adult ADHD and mood or anxiety disorders. Selection of modules for each participant’s treatment was guided by participant input (e.g., top problems) and personalized visual displays. Visual displays included a CB case formulation and intraindividual network analyses, using pretreatment ecological momentary assessment (EMA) data completed two or three times a day to assess ADHD and comorbid symptoms. All 9 (6 women) participants completed the pretreatment standardized measures—however, completion of EMA data by 6 participants provides mixed support for the feasibility of utilizing EMA with ADHD adults. Nevertheless, the results indicate feasibility for using this CB treatment combining manualized interventions with treatment personalization using complex visual displays from available EMA data. Seven of 9 (77.8%) participants achieved a reliable change and 5 (55.6%) achieved a clinically significant change in total ADHD symptoms (Barkley Adult ADHD-IV Rating Scale) at posttreatment and/or 3-month follow-up. Inattention symptoms reliably decreased in all participants.

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引用次数: 0

Challenges in Grief-Focused Cognitive Behavior Therapy for Prolonged Grief Disorder 针对长期悲伤障碍的悲伤焦点认知行为疗法所面临的挑战

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.cbpra.2023.10.002

Fiona Maccallum, Katie Dawson, Suzanna Azevedo, Richard A. Bryant

Prolonged Grief Disorder (PGD) is a potential deleterious outcome of bereavement that is associated with significant negative psychological consequences. The condition is thought to be maintained through a dynamic interplay between painful memories, maladaptive appraisal patterns, and unhelpful coping behaviors, including a persistent avoidance of reminders of the loss. Grief-focused cognitive behavior therapies (GF-CBT) targeting these mechanisms have been found to ameliorate symptoms, with treatments that include exposure-based processing of memories of the loss showing superior outcomes. However, data indicate that treatments involving exposure-based techniques are typically underutilized by mental health clinicians. In this clinical report we describe a series of cases that illustrate common challenges encountered in implementing GF-CBT and outline practical approaches to address these challenges.

长期悲伤障碍（PGD）是丧亲之痛的一种潜在有害结果，与严重的负面心理后果有关。这种情况被认为是通过痛苦回忆、不适应的评估模式和无益的应对行为（包括持续回避失去亲人的回忆）之间的动态相互作用而维持的。针对这些机制的以悲伤为重点的认知行为疗法（GF-CBT）已被发现可以改善症状，其中包括对失去亲人的记忆进行暴露式处理的疗法效果更佳。然而，有数据表明，心理健康临床医生通常没有充分利用涉及暴露技术的治疗方法。在这份临床报告中，我们描述了一系列病例，说明了在实施 GF-CBT 时遇到的常见挑战，并概述了应对这些挑战的实用方法。

引用次数: 0

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