Cognitive and Behavioral Practice最新文献

Mental and physical health disparities for transgender and gender diverse (TGD) communities have been well-documented. While advancements have been made in the development of guidelines when providing mental health care to TGD clients, gaps remain, particularly related to concrete applications of cognitive behavior therapy (CBT) approaches to address the unique mental health needs of TGD people. Such gaps leave many mental health professionals inadequately prepared to assess and treat clinical distress in TGD people, which in turn maintains health disparities. Utilizing case vignettes reflecting diverse TGD identities, this paper discusses minority stress and intersectional stigma frameworks and demonstrates their integration with CBT principles in the delivery of culturally tailored assessment, case conceptualization, and treatment of TGD clients.

Body dissatisfaction is a robust risk factor for eating disorders (EDs) and body dysmorphic disorder (BDD) and is associated with decreased quality of life. Current gold-standard ED treatments often do not fully address body dissatisfaction, which may leave patients vulnerable to relapse following treatment. Mirror exposure (ME) is one evidence-based strategy shown to reduce body dissatisfaction in EDs and BDD. However, the potential of integrating this strategy with other interventions demonstrated to reduce body dissatisfaction, such as focusing on the body’s functionality, remains unexplored in ED samples. This article describes the development of a novel body functionality-focused ME (FME). We describe the development and structure of the novel ME, and a pilot test for its benefits in treatment through a clinical case series of four individuals with clinically elevated body dissatisfaction and/or EDs who were receiving concurrent cognitive behavioral therapy. All four patients demonstrated clinically meaningful improvements in state body satisfaction, body checking, and body image avoidance from pretreatment to posttreatment, with nonsignificant improvements evident at longer follow-up durations (which varied across patients). Additional randomized controlled treatment research is needed to determine whether FME may improve efficacy or reduce relapse rates compared to traditional cognitive behavior therapy for body dissatisfaction and EDs.

Mindfulness-based interventions (MBIs) have been adapted for use with a variety of populations, but empirical research on their use with residents of long-term care facilities (LTCFs) is lacking. This case report demonstrates successful implementation of an individual MBI with a Native American male who participated in an 8-week study at a LTCF. Measures of mindfulness, depression, rumination, and pain were administered at pre- and posttreatment. The participant showed improvements on all measures, particularly depression. Follow-up interviews indicated that the participant was still engaging in the mindfulness techniques and found them to be helpful 1 month and 1 year following completion of the program. Recommendations for implementing the program in LTCFs are provided. Despite the limitations of an individual MBI (I-MBI) approach in LTCF populations (e.g., understaffing), several positive implications exist, including greater access for LTCF residents with physical and other limitations, as well as flexibility in tailoring the I-MBI to meet each resident’s unique needs.

Conversion practices include a range of efforts that attempt to change or suppress LGBTQA+ individuals’ sexual or gender identity. Formal versions of these practices are occurring less frequently in Western settings, yet informal versions and the ideology underpinning them continue to cause psychological and spiritual harm to people who are subjected to them. As evidence for the harmful nature of conversion practices increases, and some governments and professional bodies are responding with measures that restrict their use, there is a growing need for the mental health sector to be engaged with these issues so that practitioners are appropriately prepared to recognize and support survivors in ways that are effective and affirming of sexual and gender diversity. In this paper, we review the state of the evidence concerning associated harms and their lack of efficacy in changing sexuality or gender identity, and highlight the changing nature of research in this space to focus on the negative impacts of conversion practices on survivors. We then discuss the evidence around mental health practitioners’ knowledge and support capacity for conversion practices survivors. We close by commenting on specific features of therapeutic practices that can guide practitioners as they support survivors through the recovery process.