Pub Date : 2025-02-01DOI: 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.
{"title":"The Impact of Exposure Therapy on Cancer-Related Future Cognitions in Severe Health Anxiety","authors":"Nora Brier, Lily A. Brown","doi":"10.1016/j.cbpra.2023.07.001","DOIUrl":"10.1016/j.cbpra.2023.07.001","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 123-133"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 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.
{"title":"Older Bereaved Individuals’ Experiences of Cognitive-Behavioral Therapy for Complicated Grief Reactions: A Qualitative Multistage Focus Group Approach","authors":"Christina Buur , Thomas Mackrill, Lisbeth Hybholt , Eva Rames Nissen, Maja O’Connor","doi":"10.1016/j.cbpra.2024.06.002","DOIUrl":"10.1016/j.cbpra.2024.06.002","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 56-69"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 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.
{"title":"Cognitive Behavioral Treatments for Prolonged Grief: Introduction to the Special Feature","authors":"Donald J. Robinaugh, Naomi M. Simon","doi":"10.1016/j.cbpra.2024.11.003","DOIUrl":"10.1016/j.cbpra.2024.11.003","url":null,"abstract":"<div><div>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 <em>Cognitive and Behavioral Practice</em> 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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 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.
{"title":"Prolonged Grief Therapy","authors":"M. Katherine Shear, Naomi M. Simon","doi":"10.1016/j.cbpra.2024.12.002","DOIUrl":"10.1016/j.cbpra.2024.12.002","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 6-17"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 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.
{"title":"Using Visual Displays in a Manualized Cognitive-Behavioral Treatment for Adults With ADHD and Comorbid Mood or Anxiety Disorders: A Pilot Study","authors":"Antonio F. Pagán, Gregory H. Mumma, Andrew K. Littlefield","doi":"10.1016/j.cbpra.2023.08.003","DOIUrl":"10.1016/j.cbpra.2023.08.003","url":null,"abstract":"<div><div><span><span>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 </span>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 </span>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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 106-122"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48373638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 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.
{"title":"Challenges in Grief-Focused Cognitive Behavior Therapy for Prolonged Grief Disorder","authors":"Fiona Maccallum, Katie Dawson, Suzanna Azevedo, Richard A. Bryant","doi":"10.1016/j.cbpra.2023.10.002","DOIUrl":"10.1016/j.cbpra.2023.10.002","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 18-28"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138690071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cbpra.2024.12.004
A.A.A. Manik J. Djelantik, Mariken Spuij
The cognitive behavioral therapy (CBT) protocol for prolonged grief disorder in children and adolescents has demonstrated effectiveness in multiple studies, including a large randomized controlled trial. However, in clinical practice, we frequently encounter children with prolonged grief disorder who also present with comorbid conditions, such as other mental health disorders (e.g., posttraumatic stress disorder) and developmental disorders (e.g., autism spectrum disorder). This paper aims to describe the CBT protocol for prolonged grief in children and adolescents and to illustrate, through case vignettes and clinical observations, how this protocol may be adapted for use with children with comorbid conditions. We show that thorough clinical assessment is crucial for adapting techniques from other protocols into PGD treatment. Future research should prioritize the inclusion of detailed case studies of children with PGD and comorbidities to advance our understanding and optimize the individualization of treatment strategies.
{"title":"Cognitive Behavioral Therapy for Childhood Prolonged Grief Disorder for Bereaved Children and Adolescents With Comorbid Problems: Case Vignettes","authors":"A.A.A. Manik J. Djelantik, Mariken Spuij","doi":"10.1016/j.cbpra.2024.12.004","DOIUrl":"10.1016/j.cbpra.2024.12.004","url":null,"abstract":"<div><div>The cognitive behavioral therapy (CBT) protocol for prolonged grief disorder in children and adolescents has demonstrated effectiveness in multiple studies, including a large randomized controlled trial. However, in clinical practice, we frequently encounter children with prolonged grief disorder who also present with comorbid conditions, such as other mental health disorders (e.g., posttraumatic stress disorder) and developmental disorders (e.g., autism spectrum disorder). This paper aims to describe the CBT protocol for prolonged grief in children and adolescents and to illustrate, through case vignettes and clinical observations, how this protocol may be adapted for use with children with comorbid conditions. We show that thorough clinical assessment is crucial for adapting techniques from other protocols into PGD treatment. Future research should prioritize the inclusion of detailed case studies of children with PGD and comorbidities to advance our understanding and optimize the individualization of treatment strategies.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 70-77"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cbpra.2023.11.001
Katrine B. Komischke-Konnerup, Maja O'Connor, Herbert Hoijtink, Paul A. Boelen
In bereavement, some individuals develop complicated grief reactions (CGR), including symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Symptoms of PGD often co-occur with other complicated grief reactions, e.g., PTSD and depression, pointing to the need for a transdiagnostic understanding of CGR to inform treatment. In this paper, a transdiagnostic cognitive-behavioral therapy for CGR called “CBTgrief” is explained, including its theoretical framework and treatment content. CBTgrief is based on previous cognitive-behavioral conceptualizations of PGD, PTSD, and depression and includes 12 sessions consisting of exposure, cognitive restructuring, and behavioral activation. Preliminary findings of CBTgrief are evaluated in terms of feasibility, acceptability, and treatment satisfaction in a sample of eight older bereaved individuals treated for different types of CGR in a naturalistic clinical setting. Additionally, theory-driven hypotheses about changes in CGR and theoretical proposed core maintaining processes are evaluated using Bayesian informative hypotheses testing. Preliminary findings, limitations, implications, and future directions are discussed.
{"title":"Cognitive-Behavioral Therapy for Complicated Grief Reactions: Treatment Protocol and Preliminary Findings From a Naturalistic Setting","authors":"Katrine B. Komischke-Konnerup, Maja O'Connor, Herbert Hoijtink, Paul A. Boelen","doi":"10.1016/j.cbpra.2023.11.001","DOIUrl":"10.1016/j.cbpra.2023.11.001","url":null,"abstract":"<div><div>In bereavement, some individuals develop complicated grief reactions (CGR), including symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Symptoms of PGD often co-occur with other complicated grief reactions, e.g., PTSD and depression, pointing to the need for a transdiagnostic understanding of CGR to inform treatment. In this paper, a transdiagnostic cognitive-behavioral therapy for CGR called “CBTgrief” is explained, including its theoretical framework and treatment content. CBTgrief is based on previous cognitive-behavioral conceptualizations of PGD, PTSD, and depression and includes 12 sessions consisting of exposure, cognitive restructuring, and behavioral activation. Preliminary findings of CBTgrief are evaluated in terms of feasibility, acceptability, and treatment satisfaction in a sample of eight older bereaved individuals treated for different types of CGR in a naturalistic clinical setting. Additionally, theory-driven hypotheses about changes in CGR and theoretical proposed core maintaining processes are evaluated using Bayesian informative hypotheses testing. Preliminary findings, limitations, implications, and future directions are discussed.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 29-43"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138690307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-09DOI: 10.1016/j.cbpra.2024.11.002
Matthew J Hollocks, Jessica M Schwartzman
Autistic youth are more likely to experience both anxiety and depression than their nonautistic peers, yet treatment options are extremely limited. Clinicians working with this population lack a robust evidence base of psychological models within which to formulate and treat these enduring internalizing disorders in autistic youth. Negative self-esteem is a robust risk factor-and treatment target-for internalizing disorders in nonautistic youth that remains largely understudied in autistic youth. The Cognitive and Behavioral Model of Low Self-Esteem (Fennell, 1997) was conceived to guide the development of cognitive-behavioral interventions targeting this construct in the general population. The model highlights how low-self-esteem develops from the interacting effects of temperament and negative experiences, leading to the formation of dysfunctional assumptions, and the subsequent development and maintenance of anxiety and depression. Autistic individuals are known to have specific vulnerabilities across the core elements of this model, making it potentially pertinent for this population. In this paper, we describe a theoretical extension of the model for autistic youth. We then use a blended case example to inform case conceptualization using the model to understand how low self-esteem may develop in an autistic youth and act to maintain anxiety and depression. Future directions for research into the use of the Low Self-Esteem Model in autistic youth are also discussed.
{"title":"Conceptualizing Pathways to Depression and Anxiety in Autistic Youth Using the Cognitive and Behavioral Model of Low Self-Esteem.","authors":"Matthew J Hollocks, Jessica M Schwartzman","doi":"10.1016/j.cbpra.2024.11.002","DOIUrl":"10.1016/j.cbpra.2024.11.002","url":null,"abstract":"<p><p>Autistic youth are more likely to experience both anxiety and depression than their nonautistic peers, yet treatment options are extremely limited. Clinicians working with this population lack a robust evidence base of psychological models within which to formulate and treat these enduring internalizing disorders in autistic youth. Negative self-esteem is a robust risk factor-and treatment target-for internalizing disorders in nonautistic youth that remains largely understudied in autistic youth. The Cognitive and Behavioral Model of Low Self-Esteem (Fennell, 1997) was conceived to guide the development of cognitive-behavioral interventions targeting this construct in the general population. The model highlights how low-self-esteem develops from the interacting effects of temperament and negative experiences, leading to the formation of dysfunctional assumptions, and the subsequent development and maintenance of anxiety and depression. Autistic individuals are known to have specific vulnerabilities across the core elements of this model, making it potentially pertinent for this population. In this paper, we describe a theoretical extension of the model for autistic youth. We then use a blended case example to inform case conceptualization using the model to understand how low self-esteem may develop in an autistic youth and act to maintain anxiety and depression. Future directions for research into the use of the Low Self-Esteem Model in autistic youth are also discussed.</p>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-20DOI: 10.1016/j.cbpra.2024.05.002
Ramya Ramadurai, Jacob Gustaveson, Jeane Bosch, Mauli T. Shah
As the body of support for the usefulness of mindfulness-based practices within therapeutic intervention has grown, so has demand. To increase access to this evidence-based care, skill-building groups as well as mobile apps that deliver mindfulness training have been developed. However, evaluations of app-augmented group mindfulness interventions are lacking. This pilot study developed and implemented a protocol augmenting a virtual Veterans Affairs–Compassionate Awareness Learning Module (VA-CALM) group with the Mindfulness Coach app in a Mid-Atlantic VA health system. The 6-week app-augmented group was implemented across four cycles (n = 18) within the system’s Integrated Primary Care setting. Qualitative feedback was collected and used to improve the integrative protocol iteratively across group cycles. Feedback indicated participants found the app supported skill growth and that the group context enhanced app engagement, while others found it difficult to navigate the app and build new habits. Quantitative outcomes indicated improvements in stress, health-related quality of life, and the mindfulness skill of nonreactivity. App usage among group members ranged from none to frequent. Groups in combination with apps may be a feasible and acceptable way to support mindfulness skill growth and application to daily life for some veterans. Further study should focus on patient-level factors that are relevant to engagement and efficacy of app-augmented protocols, as well as whether engagement predicts clinical improvement.
{"title":"Augmenting Virtual Mindfulness Group With a Mindfulness App in Integrated Primary Care: Development, Feasibility, and Acceptability","authors":"Ramya Ramadurai, Jacob Gustaveson, Jeane Bosch, Mauli T. Shah","doi":"10.1016/j.cbpra.2024.05.002","DOIUrl":"10.1016/j.cbpra.2024.05.002","url":null,"abstract":"<div><div>As the body of support for the usefulness of mindfulness-based practices within therapeutic intervention has grown, so has demand. To increase access to this evidence-based care, skill-building groups as well as mobile apps that deliver mindfulness training have been developed. However, evaluations of app-augmented group mindfulness interventions are lacking. This pilot study developed and implemented a protocol augmenting a virtual Veterans Affairs–Compassionate Awareness Learning Module (VA-CALM) group with the Mindfulness Coach app in a Mid-Atlantic VA health system. The 6-week app-augmented group was implemented across four cycles (<em>n</em> = 18) within the system’s Integrated Primary Care setting. Qualitative feedback was collected and used to improve the integrative protocol iteratively across group cycles. Feedback indicated participants found the app supported skill growth and that the group context enhanced app engagement, while others found it difficult to navigate the app and build new habits. Quantitative outcomes indicated improvements in stress, health-related quality of life, and the mindfulness skill of nonreactivity. App usage among group members ranged from none to frequent. Groups in combination with apps may be a feasible and acceptable way to support mindfulness skill growth and application to daily life for some veterans. Further study should focus on patient-level factors that are relevant to engagement and efficacy of app-augmented protocols, as well as whether engagement predicts clinical improvement.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 4","pages":"Pages 557-569"},"PeriodicalIF":2.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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