Cognitive and Behavioral Practice最新文献_第8页

Adapting a Behavioral Activation Intervention for Opioid Use Disorder and Methadone Treatment Retention for Peer Delivery in a Low-Resource Setting: A Case Series 在低资源环境中对阿片类药物使用障碍和美沙酮治疗保留进行行为激活干预以进行同伴递送：一个案例系列

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-03-09 DOI: 10.1016/j.cbpra.2023.01.003

While methadone treatment (MT) is effective in treating opioid use disorder (OUD), retention remains an issue nationwide, especially among low-income, minoritized populations. Peer recovery specialists (PRSs), individuals with lived substance use experience, are particularly well suited to support vulnerable populations, though often are not trained in delivering evidence-based interventions. Thus, our team developed a Type 1 hybrid effectiveness-implementation open-label pilot trial to evaluate the effectiveness of PRS-delivered BA (Peer Activate) in improving MT retention and establish feasibility, acceptability and PRS fidelity of the intervention. In this case series, we provide a more in-depth depiction of the adaption of Peer Activate and present three cases to illustrate how Peer Activate can be implemented among patients in routine MT care and adapted to meet the needs of varying clinical presentations. We include descriptive data on participant substance use and MT outcomes to supplement the narrative discussion. While varying participant presentations and needs presented challenges to the PRS interventionist, the PRS utilized his shared, lived substance use and recovery experiences and met participants where they were at, as well as successfully used BA techniques, ultimately leading to intervention success.

虽然美沙酮治疗（MT）对治疗阿片类药物使用障碍（OUD）很有效，但在全国范围内，特别是在低收入和少数民族人群中，保留率仍然是一个问题。朋辈康复专家（PRSs）是具有药物使用经验的个人，他们特别适合为弱势群体提供支持，尽管他们往往没有接受过提供循证干预措施的培训。因此，我们的团队开发了一个 1 类混合有效性-实施开放标签试点试验，以评估同伴康复专家提供的 BA（同伴激活）在改善 MT 保持率方面的有效性，并确定干预的可行性、可接受性和同伴康复专家的忠诚度。在本病例系列中，我们对同伴激活法的适应性进行了更深入的描述，并通过三个病例说明了同伴激活法如何在常规 MT 护理的患者中实施，以及如何进行调整以满足不同临床表现的需求。我们纳入了关于参与者药物使用和 MT 治疗结果的描述性数据，以补充叙述性讨论。虽然不同的参与者表现和需求给同伴激励干预者带来了挑战，但同伴激励干预者利用其共同的药物使用和康复经验，满足了参与者的需求，并成功地使用了心理辅导技术，最终取得了干预的成功。

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引用次数: 0

Impulsive Decision Reduction Training for Youth With a Patterned History of Making Risky and Impulsive Decisions: A Case Report 针对有冒险和冲动决策模式的青少年的冲动决策减少训练：一个案例报告

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-02-14 DOI: 10.1016/j.cbpra.2023.01.002

Impulsive, risky decision-making has been associated with harmful behaviors and negative outcomes across the lifespan. Targeting maladaptive decision-making during adolescence could prevent adverse consequences in adulthood. However, few interventions directly address decision-making biases and promote adaptive decision-making skills in youth. Impulsive Decision Reduction Training for Youth (IDRT-Y) was developed to address this need by adapting an existing adult intervention. IDRT-Y is an 8-session, manualized cognitive behavioral therapy approach in which youth learn to change their maladaptive decision-making habits, increase their future orientation when making decisions, and learn more adaptive decision-making strategies to reduce risky, impulsive decisions. This article describes IDRT-Y and its application by presenting a case study of a 16-year-old boy with a history of impulsive and risky decision-making patterns who was treated with IDRT-Y. Pretreatment, posttreatment, and 24-week follow-up assessments were conducted. Both the youth and parent reported high satisfaction with IDRT-Y. The youth demonstrated reductions in impulsivity, substance use, internalizing and externalizing symptoms, and improvement in his consideration of future consequences when making decisions. The case study illustrates how IDRT-Y is delivered and shows IDRT-Y was an acceptable and effective intervention for addressing risky, impulsive decision-making in this adolescent. We discuss the implications of these findings and future directions to study the acceptability and effectiveness of IDRT-Y in larger youth samples.

冲动、冒险的决策与人一生中的有害行为和负面结果有关。针对青少年时期的不适应决策可以避免成年后的不良后果。然而，很少有干预措施能直接解决青少年的决策偏差并提高其适应决策的技能。为了满足这一需求，我们对现有的成人干预措施进行了改编，开发出了青少年冲动决策减少训练（IDRT-Y）。IDRT-Y 是一种为期 8 个疗程、手册化的认知行为治疗方法，通过这种方法，青少年可以学习改变其不适应决策的习惯，在做决定时增加对未来的定位，并学习更多适应性决策策略，以减少冲动决策的风险。本文介绍了 IDRT-Y 及其应用，通过对一名 16 岁男孩的案例研究，该男孩曾有冲动和冒险决策模式的历史，并接受了 IDRT-Y 的治疗。对他进行了治疗前、治疗后和 24 周的跟踪评估。青少年和家长都对 IDRT-Y 表示非常满意。该青少年在冲动、药物使用、内化和外化症状方面都有所减少，而且在做决定时对未来后果的考虑也有所改善。该案例研究说明了 IDRT-Y 的实施方法，并表明 IDRT-Y 是一种可接受的、有效的干预方法，可用于解决该青少年的危险、冲动决策问题。我们讨论了这些发现的意义，以及在更大的青少年样本中研究 IDRT-Y 的可接受性和有效性的未来方向。

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引用次数: 0

We’re in This Together: A Case Study of the Concurrent Delivery of Prolonged Exposure Therapy to Intimate Partners With PTSD 我们在一起：对患有创伤后应激障碍的亲密伴侣同时进行长期暴露治疗的案例研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-05-04 DOI: 10.1016/j.cbpra.2023.03.002

Research on the links between intimate relationships and PTSD and the treatments for PTSD tend to be limited to couples in which only one partner within the dyad has PTSD. No investigations, to our knowledge, have empirically examined the simultaneous provision of evidence-based PTSD treatment to both partners in an intimate relationship diagnosed with PTSD. The current case study describes two partners in a different-sex relationship, both diagnosed with current PTSD, who received individual Prolonged Exposure (PE) therapy at the same time as part of a larger randomized clinical trial. Each partner received ten, 90-minute individual sessions of PE therapy by two separate clinicians trained in PE followed by a 1-month follow-up. The findings demonstrated significant pre- to posttreatment reductions in PTSD symptoms as measured by the Clinician Administered PTSD Scale-5 (CAPS-5) for the male partner (Δ = 18) and the female partner (Δ = 24). Both partners achieved diagnostic remission of PTSD by end of treatment. In addition, both partners expressed enhancements in relationship functioning that they experienced while receiving PE therapy concurrently. Clinical considerations for the provision of concurrent PE to partners in an intimate relationship are discussed. The positive findings from this case study may inform future research in this much-needed area of treatment for couples where both partners are suffering from PTSD.

有关亲密关系与创伤后应激障碍之间的联系以及创伤后应激障碍治疗方法的研究，往往局限于只有一方患有创伤后应激障碍的情侣。据我们所知，还没有任何调查对亲密关系中被诊断出患有创伤后应激障碍的双方同时提供以证据为基础的创伤后应激障碍治疗进行过实证研究。本案例研究描述了异性关系中的两位伴侣，他们都被诊断出患有创伤后应激障碍，并同时接受了个体延长暴露（PE）疗法，这是一项大型随机临床试验的一部分。每对伴侣分别接受了由两名受过 PE 培训的临床医生进行的 10 次 90 分钟的个人 PE 治疗，然后进行为期 1 个月的随访。研究结果表明，从治疗前到治疗后，男性伴侣（Δ = 18）和女性伴侣（Δ = 24）的创伤后应激障碍症状均有明显减轻，这是由临床医师管理的创伤后应激障碍量表-5（CAPS-5）测量的结果。在治疗结束时，双方的创伤后应激障碍都得到了诊断性缓解。此外，双方都表示在同时接受创伤后应激障碍治疗的过程中，他们的人际关系功能得到了改善。本文讨论了为亲密关系中的伴侣同时提供 PE 治疗的临床注意事项。本病例研究的积极发现可能会为今后针对双方都患有创伤后应激障碍的情侣进行治疗这一急需领域的研究提供参考。

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引用次数: 0

Developing an Implementation Model for ADHD Intervention in Community Clinics: Leveraging Artificial Intelligence and Digital Technology 利用人工智能和数字技术开发社区诊所ADHD干预的实施模型

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-03-03 DOI: 10.1016/j.cbpra.2023.02.001

Implementation of behavior therapy for ADHD faces challenges in community settings. We describe development of a community-based implementation model for adolescent ADHD behavior therapy (Supporting Teens’ Autonomy Daily; STAND) blended with Motivational Interviewing (MI). A stakeholder-engaged development approach is used based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Resulting model features include: (a) task-shifting supervision from experts to agency supervisors, (b) holding bi-weekly technical assistance drop-ins to provide training and implementation supports, (c) MI integrity monitoring and feedback by artificial intelligence (AI), (d) AI-generated metrics for STAND content fidelity, (e) digitizing resources (manual, worksheets, tips, videos) on a clinician dashboard, (f) creating visual displays of feedback using badges and graphs, and (g) adding a rapport-building session prior to manualized content. We conducted stakeholder focus groups (N = 32) and two pilot studies to evaluate the new STAND AI measurement tool and revised service-delivery model (N = 6 therapists, 7 youth and parents, 3 agency supervisors). Results revealed advantages and disadvantages of the model, supported the promise of a STAND AI fidelity measurement tool, and indicated initial feasibility, acceptability, and agency engagement in STAND’s community-based implementation model. We discuss future directions for continued iterative development and testing. Video examples are included as supplementary material.

在社区环境中实施多动症行为疗法面临挑战。我们介绍了青少年多动症行为疗法（Supporting Teens' Autonomy Daily; STAND）与动机访谈法（MI）相结合的社区实施模式的发展情况。在探索、准备、实施、持续（EPIS）框架的基础上，我们采用了利益相关者参与的开发方法。由此产生的模式特点包括(a) 将专家监督任务转移给机构监督员；(b) 每两周举行一次技术援助活动，以提供培训和实施支持；(c) 人工智能（AI）对 MI 的完整性进行监控和反馈；(d) 人工智能生成 STAND 内容保真度指标；(e) 在临床医生仪表板上将资源（手册、工作表、提示、视频）数字化；(f) 使用徽章和图表创建可视化反馈显示；(g) 在手册内容之前增加一个建立融洽关系的环节。我们开展了利益相关者焦点小组（N = 32）和两项试点研究，以评估新的 STAND AI 测量工具和修订后的服务提供模式（N = 6 名治疗师、7 名青少年和家长、3 名机构主管）。研究结果揭示了该模式的优缺点，支持 STAND AI 忠实度测量工具的前景，并表明了 STAND 社区实施模式的初步可行性、可接受性和机构参与度。我们讨论了继续迭代开发和测试的未来方向。视频示例作为补充材料提供。

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引用次数: 0

Novel Application of Skills for Psychological Recovery as an Early Intervention for Posttraumatic Stress Disorder, Depression, and Alcohol Misuse in Survivors of Recent Sexual Assault: A Case Series 心理康复技能在近期性侵幸存者创伤后应激障碍、抑郁和酗酒早期干预中的新应用：一系列案例

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-07-11 DOI: 10.1016/j.cbpra.2023.05.003

Skills for Psychological Recovery (SPR) is an evidence-informed, early intervention for teaching survivors coping skills in the aftermath of recent disasters. Although SPR has not been tested following recent sexual assault, there is theoretical support for applying SPR to the needs of recent sexual assault survivors. The current study is the first to describe the application of SPR among survivors of recent sexual assault. SPR was administered by two master-level clinicians over the telephone to five people who experienced a sexual assault in the last month. Clients completed up to five SPR sessions. Mean scores of measures of Posttraumatic Stress Disorder (PTSD; PTSD Primary Care Screen), depression (Patient Health Questionnaire–2), and alcohol misuse (Alcohol Use Disorders Identification Test–Concise) were calculated pre- and post-intervention. Clients reported a reduction in PTSD symptoms (pre-intervention mean = 4.4; post-intervention mean = 2.8), depression (pre-intervention mean = 3.6; post-intervention mean = 2.2), and alcohol misuse (pre-intervention mean = 4.5; post-intervention mean = 3.2) at post-intervention. Results are presented using a case series approach. Findings suggest that SPR may be an effective strategy for reducing early trauma-related symptoms among recent survivors of sexual assault. Future investigations should explore the feasibility, acceptability, and efficacy of delivering SPR with larger, multiculturally diverse samples of recent sexual assault survivors.

心理恢复技能 (SPR) 是一种有实证依据的早期干预方法，用于向幸存者传授应对近期灾难的技能。虽然 SPR 尚未在近期性侵犯后进行测试，但理论上支持将 SPR 应用于满足近期性侵犯幸存者的需求。本研究首次描述了 SPR 在近期性侵犯幸存者中的应用。SPR 由两名硕士水平的临床医生通过电话对五名在上个月经历过性侵犯的人实施。客户最多完成了五次 SPR 治疗。干预前和干预后的创伤后应激障碍（PTSD；PTSD 初级护理筛查）、抑郁（患者健康问卷-2）和酒精滥用（酒精使用障碍识别测试--Concise）测量的平均分进行了计算。客户报告称，干预后创伤后应激障碍症状（干预前平均值=4.4；干预后平均值=2.8）、抑郁（干预前平均值=3.6；干预后平均值=2.2）和酒精滥用（干预前平均值=4.5；干预后平均值=3.2）均有所减轻。研究结果以案例系列的方式呈现。研究结果表明，SPR 可能是减少近期性侵犯幸存者早期创伤相关症状的有效策略。未来的调查应探索在更大规模、多元文化的近期性侵犯幸存者样本中实施 SPR 的可行性、可接受性和有效性。

{"title":"Novel Application of Skills for Psychological Recovery as an Early Intervention for Posttraumatic Stress Disorder, Depression, and Alcohol Misuse in Survivors of Recent Sexual Assault: A Case Series","authors":"","doi":"10.1016/j.cbpra.2023.05.003","DOIUrl":"10.1016/j.cbpra.2023.05.003","url":null,"abstract":"<div><div>Skills for Psychological Recovery (SPR) is an evidence-informed, early intervention for teaching survivors coping skills in the aftermath of recent disasters. Although SPR has not been tested following recent sexual assault, there is theoretical support for applying SPR to the needs of recent sexual assault survivors. The current study is the first to describe the application of SPR among survivors of recent sexual assault. SPR was administered by two master-level clinicians over the telephone to five people who experienced a sexual assault in the last month. Clients completed up to five SPR sessions. Mean scores of measures of Posttraumatic Stress Disorder (PTSD; PTSD Primary Care Screen), depression (Patient Health Questionnaire–2), and alcohol misuse (Alcohol Use Disorders Identification Test–Concise) were calculated pre- and post-intervention. Clients reported a reduction in PTSD symptoms (pre-intervention mean = 4.4; post-intervention mean = 2.8), depression (pre-intervention mean = 3.6; post-intervention mean = 2.2), and alcohol misuse (pre-intervention mean = 4.5; post-intervention mean = 3.2) at post-intervention. Results are presented using a case series approach. Findings suggest that SPR may be an effective strategy for reducing early trauma-related symptoms among recent survivors of sexual assault. Future investigations should explore the feasibility, acceptability, and efficacy of delivering SPR with larger, multiculturally diverse samples of recent sexual assault survivors.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"31 4","pages":"Pages 498-510"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45685803","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}

引用次数: 0

Single-Session Telehealth Booster for Youth Experiencing a Return of Anxiety After CBT: A Case Series 青少年经历CBT后焦虑回归的单次远程医疗助推器:一个案例系列

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-05-02 DOI: 10.1016/j.cbpra.2023.04.001

There is a subset of youth who, despite responding well to CBT, experience a return of anxiety in the years after treatment ends. Although empirical research and clinical recommendations have described approaches to prevent a return of anxiety following CBT, to our knowledge, no empirical or clinical articles have evaluated approaches to help youth who have experienced such a return. In this article, we take an initial step toward providing clinical guidance on addressing recurrence in youth with anxiety disorders by describing the development of an approach, a booster session delivered remotely using telehealth, and by presenting promising preliminary data in a case series among three youths who experienced a return of anxiety following CBT. Participants were N = 3 youths ages 10 to 15 years (M = 12 years; 33% male, 33% female, 33% nonbinary) who previously completed a full CBT protocol for anxiety disorders as part of outpatient clinical services in an urban area of the southeastern United States. Parent- and youth-report on youth anxiety severity were assessed pretreatment and posttreatment. Clinical response to the booster among these three families was mixed and varied by informant source, with an overall positive response according to parent ratings and a smaller response according to youth ratings. This case series represents an important first step toward addressing the return of anxiety in youth following CBT, and findings provide the impetus for further development and evaluation work of single session boosters. Limitations and implications of the findings are discussed.

有一部分青少年尽管对 CBT 反应良好，但在治疗结束后的几年里，他们的焦虑症又复发了。尽管实证研究和临床建议都介绍了如何预防 CBT 治疗后焦虑症复发，但据我们所知，还没有任何实证或临床文章对帮助焦虑症复发青少年的方法进行过评估。在本文中，我们介绍了一种方法的开发过程，即利用远程医疗技术远程提供强化治疗，并通过对三名在接受 CBT 治疗后焦虑症复发的青少年进行病例系列研究，展示了令人鼓舞的初步数据，从而为解决焦虑症青少年复发问题提供临床指导迈出了第一步。参与者为 N = 3 名 10 至 15 岁的青少年（M = 12 岁；33% 为男性，33% 为女性，33% 为非二元性），他们之前在美国东南部城市地区的门诊临床服务中完成了针对焦虑症的完整 CBT 方案。在治疗前和治疗后，评估了家长和青少年对青少年焦虑严重程度的报告。这三个家庭对助推器的临床反应不一，且因信息来源而异，根据家长的评价，总体反应积极，而根据青少年的评价，反应较小。本系列病例是解决 CBT 治疗后青少年焦虑症复发问题的重要第一步，研究结果为单次治疗增强剂的进一步开发和评估工作提供了动力。本文还讨论了研究结果的局限性和影响。

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引用次数: 0

Low-Cost Virtual Reality to Support Imaginal Exposure Within PTSD Treatment: A Case Report Study Within a Community Mental Healthcare Setting 低成本虚拟现实支持创伤后应激障碍治疗中的图像暴露:社区精神卫生保健环境中的案例报告研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-05-24 DOI: 10.1016/j.cbpra.2023.03.003

Revisiting what happened during (or after) a traumatic event is an important part of the treatment process in trauma-focused cognitive therapy (TF-CT). However, clinicians may have difficulty helping patients to intentionally retrieve these memories in order to engage with their content. As such, clinical tools to support the access and delivery of imaginal exposure content within treatment may prove to be particularly useful for therapists. This case report introduces work undertaken with Mr. A, a 38-year-old male, who 2 years prior had experienced a city centre assault. Initial assessment revealed a PCL-5 score of 64 and he met DSM-5 criteria for posttraumatic stress disorder (PTSD). Mr. A received 10 sessions of TF-CT wherein the traditional imaginal exposure components were implemented via a newly developed virtual reality (VR) development workflow called “VR Photoscan.” After 10 sessions, results showed PCL-5 scores decreased from 64 to 19 and Mr. A no longer met DSM-5 PTSD criteria. VR Photoscan was used during 4/10 sessions and included (1) reliving, (2) memory updating, and (3) stimulus discrimination activities. Mr. A also reported VR Photoscan as helpful regarding preparation for site visits. In conclusion, VR Photoscan technology provided a more visceral exposure experience which supported Mr. A to revisit the trauma memory. He reported high levels of satisfaction with the quality of the virtual environment and no issues using the VR technology. Produced with lower costs and shorter development times than typical computer-generated environments, VR Photoscan may be more easily implemented within routine care, although further research is required.

重温创伤事件中（或之后）发生的事情是创伤认知治疗（TF-CT）治疗过程中的一个重要部分。然而，临床医生可能很难帮助患者有意识地检索这些记忆，以参与其内容。因此，支持在治疗过程中获取和传递意象暴露内容的临床工具可能对治疗师特别有用。本病例报告介绍了对 38 岁的男性 A 先生进行的治疗，他在两年前曾在市中心遭遇袭击。初步评估显示，他的 PCL-5 得分为 64 分，符合 DSM-5 的创伤后应激障碍（PTSD）标准。A 先生接受了 10 次 TF-CT 治疗，通过新开发的名为 "VR Photoscan "的虚拟现实（VR）开发工作流程实施了传统的意象暴露部分。10 次治疗后，结果显示 PCL-5 分数从 64 分降至 19 分，A 先生不再符合 DSM-5 PTSD 标准。VR Photoscan 在 4/10 次疗程中使用，包括（1）重温、（2）记忆更新和（3）刺激辨别活动。A 先生还表示，VR Photoscan 对准备实地考察很有帮助。总之，VR 照片扫描技术提供了更直观的暴露体验，有助于 A 先生重温创伤记忆。他对虚拟环境的质量非常满意，而且在使用 VR 技术时没有遇到任何问题。与典型的计算机生成环境相比，VR Photoscan 的制作成本更低，开发时间更短，可能更容易在日常护理中使用，但仍需进一步研究。

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引用次数: 0

A Transdiagnostic Treatment to Improve Biomedical and Syndemic Outcomes in People Living With HIV 一种改善HIV感染者生物医学和综合征结果的转诊治疗

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-05-09 DOI: 10.1016/j.cbpra.2023.04.002

People living with HIV (PLWH) experience a range of co-occurring psychosocial stressors, mental health symptoms, and structural barriers (e.g., “syndemics”) that can impair their ability to adhere to medical recommendations for treatment. This has consequences for their health and the health of others as nonadherence increases the likelihood of unsuppressed HIV viral load, and therefore the ability to transmit HIV to others. Transdiagnostic treatment, or treatment not focused on a single mental health condition, can efficiently address a range of mental health problems by skills training to reduce symptoms. Additionally, cognitive behavioral and problem-solving approaches can be used to address larger, structural factors by helping individuals navigate systemic challenges using evidence-based skills. This article describes the development of a transdiagnostic treatment for PLWH and illustrates the application of the treatment through case examples. This treatment might be appropriate for integration into an HIV clinic or within an outpatient setting when working with a patient who is experiencing syndemic conditions and living with HIV.

艾滋病病毒感染者（PLWH）会遇到一系列并发的社会心理压力、精神健康症状和结构性障碍（如 "综合症"），这些都会影响他们坚持按照医疗建议进行治疗的能力。这对他们和其他人的健康都有影响，因为不坚持治疗会增加艾滋病毒病毒载量未得到抑制的可能性，从而增加向他人传播艾滋病毒的能力。跨诊断治疗，或不专注于单一心理健康问题的治疗，可以通过技能培训来减少症状，从而有效地解决一系列心理健康问题。此外，认知行为和问题解决方法也可用于解决更大的结构性因素，通过循证技能帮助个人应对系统性挑战。本文介绍了一种针对 PLWH 的跨诊断治疗方法，并通过案例说明了该治疗方法的应用。这种治疗方法可能适合整合到 HIV 诊所或门诊环境中，用于治疗患有综合症并携带 HIV 的病人。

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引用次数: 0

Exploring the Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders With Latinxs: A Record-Review Study at a Culturally Specific Clinic for Latinxs 探索拉丁裔情绪障碍跨诊断治疗统一方案的有效性:一项针对拉丁裔文化特异性诊所的记录回顾研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-11-01 Epub Date: 2023-07-28 DOI: 10.1016/j.cbpra.2023.06.001

The Unified Protocol (UP) is a transdiagnostic cognitive behavioral therapy that targets the core affective processes underlying anxiety, depression, and other emotional disorders. Given the high rates of anxiety and depression and comorbidity among Latinxs, transdiagnostic treatments are a potentially effective intervention for this group. This record review study examined treatment outcomes for 20 Spanish-speaking Latinxs with an anxiety disorder receiving the UP at a community clinic. Six participants dropped out of treatment (30%) and 14 (70%) completed and responded to treatment. An intent-to treat analysis revealed a statistically significant improvement between pre- and posttreatment scores on the PHQ-9 (95% CI, 5.26, 11.04, t [19] = 5.894, p < .001) and the GAD-7 (95% CI, 4.49, 9.11, t [19] = 6.17, p < .001). We also included an in-depth case study, illustrating how the UP can be used with Spanish-speaking Latinxs. Our results provide preliminary support for the UP for use with a subset of Latinx adults with anxiety (with or without comorbid depression).

统一方案（UP）是一种跨诊断认知行为疗法，针对焦虑、抑郁和其他情绪障碍的核心情感过程。鉴于拉美裔焦虑症、抑郁症和合并症的高发率，跨诊断治疗对这一群体来说是一种潜在的有效干预措施。这项记录回顾研究考察了 20 名患有焦虑症的讲西班牙语的拉美人在社区诊所接受 UP 治疗的结果。6名参与者退出了治疗（30%），14名参与者（70%）完成了治疗并对治疗做出了反应。治疗意向分析显示，PHQ-9（95% CI，5.26，11.04，t [19] = 5.894，p <.001）和GAD-7（95% CI，4.49，9.11，t [19] = 6.17，p <.001）的治疗前和治疗后评分之间有显著的统计学改善。我们还进行了一项深入的案例研究，说明如何将 UP 应用于讲西班牙语的拉美人。我们的研究结果初步证明，UP 可用于患有焦虑症（合并或不合并抑郁症）的拉丁裔成年人。

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引用次数: 0

Culturally Responsive CBT for Psychological and Physical Symptoms in Pakistani Youth: Role of Religious and Cultural Attunement 针对巴基斯坦青少年心理和生理症状的文化适应性 CBT：宗教和文化调适的作用

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-08-01 Epub Date: 2024-01-18 DOI: 10.1016/j.cbpra.2023.12.007

Tania Nadeem, Nargis Asad, Sahar Nadeem Hamid, Pinar Farooq, Fauzia Mahr

Cognitive Behavioral Therapy (CBT) is used widely throughout the world in diverse populations for successful treatment of a wide range of psychiatric and comorbid conditions. Over the years clinicians have been making efforts to culturally adapt CBT to various groups. This paper discusses the assessment and treatment of a young female from Pakistan with depression and anxiety with comorbid headache. After ruling out all organic causes, the treatment continued over 20 sessions with the initial phase consisting of introduction to CBT, risk assessment, and identification of treatment goals. Following this, the patient was helped in identifying automatic thoughts, feelings, and behaviors. Finally, tools such as thought substitutions, reappraisals, and positive diversions were used effectively to decrease automatic negative thoughts. A focus on the patient’s religio-cultural identity was maintained throughout. Understanding of contextual factors like religio-cultural values and family dynamics helped to bring about favorable therapy outcomes. A case conceptualization that cohesively addressed factors relating to ethnicity, class, and gender yielded a positive result in our case. Involvement of the family and psychoeducation regarding neurobiological causes also proved to be helpful. Such an approach can facilitate a culturally responsive application of CBT in Pakistani youth experiencing comorbid medical and psychiatric disorders.

认知行为疗法（CBT）在世界各地广泛应用于不同人群，成功治疗了多种精神疾病和合并症（Pearce 等人，2015 年）。多年来，临床医生一直在努力使 CBT 疗法适应不同群体的文化。本文讨论了对一名患有抑郁和焦虑并伴有头痛的巴基斯坦年轻女性的评估和治疗。在排除了所有器质性病因后，治疗持续了 20 个疗程，初始阶段包括介绍 CBT、风险评估和确定治疗目标。随后，帮助患者识别自动思维、情感和行为。最后，有效使用思想替代、重新评估和积极转移等工具来减少自动的消极想法。在整个过程中，始终关注患者的宗教文化身份。对宗教文化价值观和家庭动态等背景因素的了解有助于取得良好的治疗效果。在我们的病例中，针对种族、阶级和性别因素的病例概念化取得了积极的效果。事实证明，家庭的参与和有关神经生物学原因的心理教育也很有帮助。这种方法可以促进 CBT 在巴基斯坦青少年中的文化适应性应用，这些青少年同时患有内科和精神科疾病。

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引用次数: 0