Pub Date : 2023-08-01DOI: 10.1016/j.cbpra.2022.04.004
Kris L. Morris, Carey Schwartz, Tara E. Galovski, Katherine A. Dondanville, Jennifer Schuster Wachen
Despite consistent evidence that Cognitive Processing Therapy (CPT) is an efficacious treatment for posttraumatic stress disorder (PTSD), the effects among active-duty service members and veterans have been smaller than for civilians. Modifications to standard delivery may be needed to increase treatment engagement and completion, which could improve outcomes in this population. Delivering CPT in a massed format may reduce barriers to care and enable more rapid symptom reduction, yet clinicians and patients may have concerns about the tolerability and practicality of such interventions. This case series describes a course of CPT delivered in 5 days in a mixed group and individual format among 4 active-duty military service members as part of a larger randomized clinical trial. Although the pattern of symptom change differed between patients, most demonstrated clinically significant reductions in PTSD and depression symptoms during the 5-day treatment. Patients reported that the pace was tolerable and that the mixed group and individual format was beneficial. Although further research is needed to understand the longer-term outcomes of massed CPT, this therapy format has important implications for the future delivery of treatments for PTSD.
{"title":"Massed Cognitive Processing Therapy in Active-Duty Military: A Case Series","authors":"Kris L. Morris, Carey Schwartz, Tara E. Galovski, Katherine A. Dondanville, Jennifer Schuster Wachen","doi":"10.1016/j.cbpra.2022.04.004","DOIUrl":"10.1016/j.cbpra.2022.04.004","url":null,"abstract":"<div><p>Despite consistent evidence that Cognitive Processing Therapy (CPT) is an efficacious treatment for posttraumatic stress disorder (PTSD), the effects among active-duty service members and veterans have been smaller than for civilians. Modifications to standard delivery may be needed to increase treatment engagement and completion, which could improve outcomes in this population. Delivering CPT in a massed format may reduce barriers to care and enable more rapid symptom reduction, yet clinicians and patients may have concerns about the tolerability and practicality of such interventions. This case series describes a course of CPT delivered in 5 days in a mixed group and individual format among 4 active-duty military service members as part of a larger randomized clinical trial. Although the pattern of symptom change differed between patients, most demonstrated clinically significant reductions in PTSD and depression symptoms during the 5-day treatment. Patients reported that the pace was tolerable and that the mixed group and individual format was beneficial. Although further research is needed to understand the longer-term outcomes of massed CPT, this therapy format has important implications for the future delivery of treatments for PTSD.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45356041","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.01.006
Mariah M. Stickley, Kelly S. Sopchak, Carly E. McCord
Cognitive Processing Therapy (CPT) has been thoroughly investigated as an efficacious treatment for posttraumatic stress disorder (PTSD). However, for many, the barriers to receiving treatment in the traditional weekly, in-person format prevent engagement. Recent evidence suggests alternative modalities, such as telehealth, and condensed administration of treatment protocols may reduce barriers, increasing treatment completion. This case study reports the treatment of a gay-identifying adolescent Latino male who received 10 sessions of CPT over the course of 5 consecutive days (CPT-5). The patient experienced significant reduction in PTSD symptoms over the course of treatment, dropping below the clinical threshold for PTSD diagnosis by the 10th session. Treatment gains were maintained, and continued, 6 weeks posttreatment. Further, the patient reported marked reduction in suicidality and substance use. In conclusion, the administration of CPT-5 via telehealth holds promise as an effective evidence-based treatment for adolescents with PTSD, including those holding multiple historically marginalized identities, though further investigation through clinical trials is warranted.
{"title":"Cognitive Processing Therapy Delivered in 5 Days via Telehealth to a Gay Latino Adolescent: A Clinical Case Study","authors":"Mariah M. Stickley, Kelly S. Sopchak, Carly E. McCord","doi":"10.1016/j.cbpra.2022.01.006","DOIUrl":"10.1016/j.cbpra.2022.01.006","url":null,"abstract":"<div><p>Cognitive Processing Therapy (CPT) has been thoroughly investigated as an efficacious treatment for posttraumatic stress disorder (PTSD). However, for many, the barriers to receiving treatment in the traditional weekly, in-person format prevent engagement. Recent evidence suggests alternative modalities, such as telehealth, and condensed administration of treatment protocols may reduce barriers, increasing treatment completion. This case study reports the treatment of a gay-identifying adolescent Latino male who received 10 sessions of CPT over the course of 5 consecutive days (CPT-5). The patient experienced significant reduction in PTSD symptoms over the course of treatment, dropping below the clinical threshold for PTSD diagnosis by the 10th session. Treatment gains were maintained, and continued, 6 weeks posttreatment. Further, the patient reported marked reduction in suicidality and substance use. In conclusion, the administration of CPT-5 via telehealth holds promise as an effective evidence-based treatment for adolescents with PTSD, including those holding multiple historically marginalized identities, though further investigation through clinical trials is warranted.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46850894","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}
Tokophobia is a debilitating, relatively prevalent, and undertreated anxiety disorder, which can lead to prenatal, natal, and postpartum adverse effects. This article provides an outline of the Dual-Session Tokophobia Intervention (DSTI), an ultrashort exposure-based cognitive behavioral therapy (CBT) protocol that can be delivered by non-mental-health professionals to women in the third term of pregnancy. The detailed description of the intervention is illustrated by a case study that is part of an ongoing clinical trial, targeting the specific needs of women suffering from Tokophobia near term. DSTI is carried out in two sessions (for a total of 4 hours) with a 1-week interval in between. The intervention protocol presented in this article, to the best of our knowledge, is the first to offer treatment specifically for women near term. It aims to decrease anxiety and provide women and their newborns with better obstetric and psychiatric outcomes. The patient presented was screened by the Fear of Birth Scale and a Structured Clinical Interview for DSM Disorders. She indicated her Subjective Units of Distress on a list of specific fears related to childbirth, before and after the intervention. Following treatment, the patient showed a 70% decrease in SUDS, a cessation of avoidance and information seeking behaviors, a short labor duration and a subjective experience of being able to calm herself during a difficult birth and concentrate on the delivery process. Six weeks postpartum there were no signs of depression or PTSD.
{"title":"Dual-Session Tokophobia Intervention, a Novel Ultrashort Cognitive Behavioral Therapy Protocol for Women Suffering From Tokophobia in the Third Term of Pregnancy","authors":"Sharon Ben-Rafael, Miki Bloch, Gabi Aisenberg-Romano","doi":"10.1016/j.cbpra.2022.02.015","DOIUrl":"10.1016/j.cbpra.2022.02.015","url":null,"abstract":"<div><p>Tokophobia is a debilitating, relatively prevalent, and undertreated anxiety disorder, which can lead to prenatal, natal, and postpartum adverse effects. This article provides an outline of the Dual-Session Tokophobia Intervention (DSTI), an ultrashort exposure-based cognitive behavioral therapy (CBT) protocol that can be delivered by non-mental-health professionals to women in the third term of pregnancy. The detailed description of the intervention is illustrated by a case study that is part of an ongoing clinical trial, targeting the specific needs of women suffering from Tokophobia near term. DSTI is carried out in two sessions (for a total of 4 hours) with a 1-week interval in between. The intervention protocol presented in this article, to the best of our knowledge, is the first to offer treatment specifically for women near term. It aims to decrease anxiety and provide women and their newborns with better obstetric and psychiatric outcomes. The patient presented was screened by the Fear of Birth Scale and a Structured Clinical Interview for DSM Disorders. She indicated her Subjective Units of Distress on a list of specific fears related to childbirth, before and after the intervention. Following treatment, the patient showed a 70% decrease in SUDS, a cessation of avoidance and information seeking behaviors, a short labor duration and a subjective experience of being able to calm herself during a difficult birth and concentrate on the delivery process. Six weeks postpartum there were no signs of depression or PTSD.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44579383","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.05.004
Harrison R. Weinstein, Erika M. Roberge, Suzanne C. Parker
Cognitive Processing Therapy (CPT) is an empirically supported psychotherapy for posttraumatic stress disorder (PTSD). The complex issue of treatment attrition is a frequently cited concern regarding CPT and other evidence-based psychotherapies for PTSD. The current study investigated the feasibility and effectiveness of “intensive” CPT, a treatment-consistent modification of CPT in which sessions are conducted more frequently than standard protocol. Fifty-four military veterans (20% female; Mage = 46; 80% Caucasian) seeking outpatient treatment for PTSD were included in this study. Patients who elected to receive intensive CPT (n = 27) were matched with archival records of individuals who received standard CPT (n = 27). Patients across treatment conditions were matched based on baseline symptom severity as measured by the PTSD Checklist for DSM-5 (PCL-5; MPCL-5 = 52.61). Treatment outcomes were compared and longitudinal multilevel modeling was used to compare rate of symptom change over time. Patients who elected to engage in intensive CPT were twice as likely to complete treatment (88.9%) as those who received standard CPT (44.4%), X2(1, N = 54) = 12.00, p = .001. On average, intensive CPT patients completed treatment in about 25% of the time as standard CPT patients (33.8 days vs. 125.7 days). Patients in intensive CPT also demonstrated greater benefit: 81.4% reported a clinically significant improvement in PCL-5 scores compared to 51.8% of those in standard CPT, X2(1, N = 54) = 5.33, p = .020, φ = −0.314. Intensive and standard CPT performed comparably in regard to final PCL-5 score, change over time, and screening cutoff. In addition, there were no differences in treatment outcomes based on licensure status of the provider nor whether treatment was delivered in person or virtually. Intensive CPT represents a novel, treatment-consistent adaptation that was utilized to treat a group of veterans with PTSD with minimal treatment dropout. Patients who elected to engage in more frequent treatment were more likely to complete treatment, did so in one quarter of the time, and reported similar to better treatment outcomes. Providers may consider encouraging their patients to participate in treatment as frequently as they are able. However, preliminary findings are based on a nonrandom sample and design limitations temper conclusions.
认知加工疗法(CPT)是一种经验支持的创伤后应激障碍(PTSD)心理治疗方法。治疗损耗的复杂问题是CPT和其他基于证据的PTSD心理疗法经常被提及的问题。目前的研究调查了“强化”CPT的可行性和有效性,这是一种治疗一致的CPT修改,其中进行的次数比标准方案更频繁。54名退伍军人(20%为女性;法师= 46;80%的白种人)寻求PTSD门诊治疗纳入本研究。选择接受强化CPT的患者(n = 27)与接受标准CPT的患者(n = 27)的档案记录相匹配。不同治疗条件的患者根据DSM-5的PTSD检查表(PCL-5;mpcl-5 = 52.61)。对治疗结果进行比较,并使用纵向多水平模型来比较症状随时间的变化率。选择强化CPT的患者完成治疗的可能性(88.9%)是接受标准CPT的患者(44.4%)的两倍,X2(1, N = 54) = 12.00, p = 0.001。平均而言,强化CPT患者完成治疗的时间约为标准CPT患者的25%(33.8天对125.7天)。强化CPT患者也表现出更大的获益:81.4%的患者报告临床显着改善PCL-5评分,而标准CPT患者的这一比例为51.8%,X2(1, N = 54) = 5.33, p = 0.020, φ =−0.314。强化和标准CPT在最终PCL-5评分、随时间变化和筛查截止时间方面表现相当。此外,基于提供者的许可状态以及治疗是亲自提供还是虚拟提供,治疗结果没有差异。强化CPT代表了一种新颖的,治疗一致的适应,用于治疗一组患有创伤后应激障碍的退伍军人,治疗退出率最低。选择更频繁治疗的患者更有可能在四分之一的时间内完成治疗,并报告了类似的更好的治疗结果。提供者可以考虑鼓励他们的病人尽可能频繁地参与治疗。然而,初步研究结果是基于非随机样本和设计限制的结论。
{"title":"Intensive Cognitive Processing Therapy Associated With Reduced PTSD Treatment Dropout in a Case-Controlled Study of Treatment-Seeking Veterans","authors":"Harrison R. Weinstein, Erika M. Roberge, Suzanne C. Parker","doi":"10.1016/j.cbpra.2022.05.004","DOIUrl":"10.1016/j.cbpra.2022.05.004","url":null,"abstract":"<div><p>Cognitive Processing Therapy (CPT) is an empirically supported psychotherapy for posttraumatic stress disorder (PTSD). The complex issue of treatment attrition is a frequently cited concern regarding CPT and other evidence-based psychotherapies for PTSD. The current study investigated the feasibility and effectiveness of “intensive” CPT, a treatment-consistent modification of CPT in which sessions are conducted more frequently than standard protocol. Fifty-four military veterans (20% female; <em>M</em><sub>age</sub> = 46; 80% Caucasian) seeking outpatient treatment for PTSD were included in this study. Patients who elected to receive intensive CPT (<em>n</em> = 27) were matched with archival records of individuals who received standard CPT (<em>n</em> = 27). Patients across treatment conditions were matched based on baseline symptom severity as measured by the PTSD Checklist for DSM-5 (PCL-5; <em>M</em><sub>PCL-5</sub> = 52.61). Treatment outcomes were compared and longitudinal multilevel modeling was used to compare rate of symptom change over time. Patients who elected to engage in intensive CPT were twice as likely to complete treatment (88.9%) as those who received standard CPT (44.4%), <em>X</em><sup>2</sup>(1, <em>N</em> = 54) = 12.00, <em>p</em> = .001. On average, intensive CPT patients completed treatment in about 25% of the time as standard CPT patients (33.8 days vs. 125.7 days). Patients in intensive CPT also demonstrated greater benefit: 81.4% reported a clinically significant improvement in PCL-5 scores compared to 51.8% of those in standard CPT, <em>X</em><sup>2</sup>(1, <em>N</em> = 54) = 5.33, <em>p</em> = .020, <em>φ</em> = −0.314. Intensive and standard CPT performed comparably in regard to final PCL-5 score, change over time, and screening cutoff. In addition, there were no differences in treatment outcomes based on licensure status of the provider nor whether treatment was delivered in person or virtually. Intensive CPT represents a novel, treatment-consistent adaptation that was utilized to treat a group of veterans with PTSD with minimal treatment dropout. Patients who elected to engage in more frequent treatment were more likely to complete treatment, did so in one quarter of the time, and reported similar to better treatment outcomes. Providers may consider encouraging their patients to participate in treatment as frequently as they are able. However, preliminary findings are based on a nonrandom sample and design limitations temper conclusions.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48295754","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.06.005
Edward C. Wright, Jennifer Schuster Wachen, Cynthia Yamokoski, Tara Galovski, Kris Morris, Elizabeth M. Goetter, Brian Klassen, Vanessa Jacoby, Liza Zwiebach, Jo Sornborger, Katherine A. Dondanville, Brooke A. Fina, Sheila A.M. Rauch
Despite strong evidence of their effectiveness in reducing symptoms of posttraumatic stress disorder (PTSD), prolonged exposure therapy (PE) and cognitive processing therapy (CPT) remain challenging for some service members and veterans to access and complete. Delivering PE and CPT in time-condensed or “massed” formats may reduce barriers to receiving care. PE and CPT have now been implemented across a range of tempos (e.g., multiple sessions per day across 1 week, one session per day for 3 weeks) and to multiple target populations, in a variety of contexts from individual therapy alone to full intensive outpatient programs. A massed format of treatment delivery has advantages for both patients and providers, including quicker time to recovery, less opportunity for avoidance, and improved treatment completion rates. The time-limited nature of massed treatment also creates accompanying challenges, such as less time to practice homework and greater impact when factors delay or disrupt progress. This paper discusses lessons learned from providers across diverse settings who are experienced in both delivering massed PE and CPT and managing such programs, primarily with military populations.
{"title":"Clinical and Administrative Insights From Delivering Massed Trauma-Focused Therapy to Service Members and Veterans","authors":"Edward C. Wright, Jennifer Schuster Wachen, Cynthia Yamokoski, Tara Galovski, Kris Morris, Elizabeth M. Goetter, Brian Klassen, Vanessa Jacoby, Liza Zwiebach, Jo Sornborger, Katherine A. Dondanville, Brooke A. Fina, Sheila A.M. Rauch","doi":"10.1016/j.cbpra.2022.06.005","DOIUrl":"10.1016/j.cbpra.2022.06.005","url":null,"abstract":"<div><p>Despite strong evidence of their effectiveness in reducing symptoms of posttraumatic stress disorder (PTSD), prolonged exposure therapy (PE) and cognitive processing therapy (CPT) remain challenging for some service members and veterans to access and complete. Delivering PE and CPT in time-condensed or “massed” formats may reduce barriers to receiving care. PE and CPT have now been implemented across a range of tempos (e.g., multiple sessions per day across 1 week, one session per day for 3 weeks) and to multiple target populations, in a variety of contexts from individual therapy alone to full intensive outpatient programs. A massed format of treatment delivery has advantages for both patients and providers, including quicker time to recovery, less opportunity for avoidance, and improved treatment completion rates. The time-limited nature of massed treatment also creates accompanying challenges, such as less time to practice homework and greater impact when factors delay or disrupt progress. This paper discusses lessons learned from providers across diverse settings who are experienced in both delivering massed PE and CPT and managing such programs, primarily with military populations.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42249314","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.02.020
Katherine A. Buckheit, Eileen Barden, Rachael Shaw, Kyle Possemato, Nadine R. Mastroleo, Sheila A.M. Rauch
Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.
{"title":"Primary Care Treatment Integrating Motivation and Exposure for PTSD Symptoms and Hazardous Alcohol Use: A Case Series","authors":"Katherine A. Buckheit, Eileen Barden, Rachael Shaw, Kyle Possemato, Nadine R. Mastroleo, Sheila A.M. Rauch","doi":"10.1016/j.cbpra.2022.02.020","DOIUrl":"10.1016/j.cbpra.2022.02.020","url":null,"abstract":"<div><p>Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159065","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.02.021
Julie M. Petersen, Carter H. Davis, Tyler L. Renshaw, Michael E. Levin, Michael P. Twohig
Anxiety disorders are one of the most prevalent diagnoses in youth, often resulting in impaired social and school functioning. Research on treatments for youth anxiety is primarily based in traditional clinical settings. However, integrating youth psychotherapies into the school environment improves access to evidence-based care. The present study is a pilot, randomized waitlist-controlled trial of a school-based, group Acceptance and Commitment Therapy–based (ACT) intervention for adolescents with anxiety. Students at two separate schools (N = 26) with elevated anxiety were randomized to a 12-week waitlist or to immediate treatment. Participants in the immediate treatment condition reported statistically significant decreases in anxiety and class absences at posttreatment and follow-up compared to the waitlist group. No statistically significant differences were found between groups for depression, psychological flexibility, positive mental health, and student well-being. However, medium within-condition effect sizes were seen in the treatment group for all outcomes. Participants reported the treatment as favorable with good acceptance ratings. Overall, this study supports ACT as a viable intervention for schools and other clinical settings providing services to adolescents with anxiety.
{"title":"School-Based Acceptance and Commitment Therapy for Adolescents With Anxiety: A Pilot Trial","authors":"Julie M. Petersen, Carter H. Davis, Tyler L. Renshaw, Michael E. Levin, Michael P. Twohig","doi":"10.1016/j.cbpra.2022.02.021","DOIUrl":"10.1016/j.cbpra.2022.02.021","url":null,"abstract":"<div><p>Anxiety disorders are one of the most prevalent diagnoses in youth, often resulting in impaired social and school functioning. Research on treatments for youth anxiety is primarily based in traditional clinical settings. However, integrating youth psychotherapies into the school environment improves access to evidence-based care. The present study is a pilot, randomized waitlist-controlled trial of a school-based, group Acceptance and Commitment Therapy–based (ACT) intervention for adolescents with anxiety. Students at two separate schools (<em>N</em> = 26) with elevated anxiety were randomized to a 12-week waitlist or to immediate treatment. Participants in the immediate treatment condition reported statistically significant decreases in anxiety and class absences at posttreatment and follow-up compared to the waitlist group. No statistically significant differences were found between groups for depression, psychological flexibility, positive mental health, and student well-being. However, medium within-condition effect sizes were seen in the treatment group for all outcomes. Participants reported the treatment as favorable with good acceptance ratings. Overall, this study supports ACT as a viable intervention for schools and other clinical settings providing services to adolescents with anxiety.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49557011","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 : 2023-08-01DOI: 10.1016/j.cbpra.2022.04.006
Sarah M. Kennedy, Daniel P. Wilkie, Lauren Henry, Jami Moe-Hartman, Kayin President, Kaila Townson, Laura G. Anthony, Jessica L. Hawks
Partial hospitalization programs (PHPs) and other acute mental health treatment programs, which are becoming increasingly common, may help divert children and adolescents from inpatient psychiatric care and provide a concentrated dose of intervention to individuals living in low-resource areas. However, there have been relatively few examinations of the effectiveness of PHPs in addressing emotional concerns (e.g., anxiety, depression, irritability) and functional impairment in youth. Further, evidence-based treatments originally designed for delivery in an outpatient weekly format may require significant adaptation to be appropriate for delivery in acute mental health settings, which differ significantly from weekly outpatient care in program structure, patient acuity, and staffing. In this intervention development and adaptation report, we present the rationale for adapting a transdiagnostic approach to treating emotional disorders—the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A)—for a hospital-based, general psychiatric partial hospitalization program. We use implementation science frameworks to describe our iterative approach to treatment adaptation and testing and to describe in detail proactive, planned adaptations to the UP-C/A for partial hospitalization that occurred prior to initial implementation and pilot testing. Three case examples (child, preadolescent, adolescent) are presented to illustrate how a transdiagnostic approach to care such as the UP-C/A can be used intensively in an acute mental health setting to address emotional and behavioral concerns, including safety.
{"title":"The Unified Protocols for Children and Adolescents in Partial Hospitalization: Using Implementation Science Frameworks to Guide Adaptation","authors":"Sarah M. Kennedy, Daniel P. Wilkie, Lauren Henry, Jami Moe-Hartman, Kayin President, Kaila Townson, Laura G. Anthony, Jessica L. Hawks","doi":"10.1016/j.cbpra.2022.04.006","DOIUrl":"https://doi.org/10.1016/j.cbpra.2022.04.006","url":null,"abstract":"<div><p>Partial hospitalization programs (PHPs) and other acute mental health treatment programs, which are becoming increasingly common, may help divert children and adolescents from inpatient psychiatric care and provide a concentrated dose of intervention to individuals living in low-resource areas. However, there have been relatively few examinations of the effectiveness of PHPs in addressing emotional concerns (e.g., anxiety, depression, irritability) and functional impairment in youth. Further, evidence-based treatments originally designed for delivery in an outpatient weekly format may require significant adaptation to be appropriate for delivery in acute mental health settings, which differ significantly from weekly outpatient care in program structure, patient acuity, and staffing. In this intervention development and adaptation report, we present the rationale for adapting a transdiagnostic approach to treating emotional disorders—the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A)—for a hospital-based, general psychiatric partial hospitalization program. We use implementation science frameworks to describe our iterative approach to treatment adaptation and testing and to describe in detail proactive, planned adaptations to the UP-C/A for partial hospitalization that occurred prior to initial implementation and pilot testing. Three case examples (child, preadolescent, adolescent) are presented to illustrate how a transdiagnostic approach to care such as the UP-C/A can be used intensively in an acute mental health setting to address emotional and behavioral concerns, including safety.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49730997","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 : 2023-07-01DOI: 10.1016/j.cbpra.2023.05.003
Emily L. Tilstra-Ferrell, A. Rheingold, Katherine Mai, Christine K. Hahn
{"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":"Emily L. Tilstra-Ferrell, A. Rheingold, Katherine Mai, Christine K. Hahn","doi":"10.1016/j.cbpra.2023.05.003","DOIUrl":"https://doi.org/10.1016/j.cbpra.2023.05.003","url":null,"abstract":"","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-07-01","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}
Pub Date : 2023-07-01DOI: 10.1016/j.cbpra.2023.06.001
L. Benuto, T. Farchione, Nicole D. Cardona
{"title":"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","authors":"L. Benuto, T. Farchione, Nicole D. Cardona","doi":"10.1016/j.cbpra.2023.06.001","DOIUrl":"https://doi.org/10.1016/j.cbpra.2023.06.001","url":null,"abstract":"","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43608995","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}