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Klein AM, Hagen A, Mobach L, Zimmermann R, Baartmans JMD, Rahemenia J, de Gier E, Schneider S, Ollendick TH. The Importance of Practicing at Home During and Following Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Conceptual Review and New Directions to Enhance Homework Using Mhealth Technology. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00476-5. [PMID: 38616213 DOI: 10.1007/s10567-024-00476-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/16/2024]
Abstract
Practicing newly acquired skills in different contexts is considered a crucial aspect of Cognitive Behavioral Therapy (CBT) for anxiety disorders (Peris et al. J Am Acad Child Adolesc Psychiatry 56:1043-1052, 2017; Stewart et al. Prof Psychol Res Pract 47:303-311, 2016). Learning to cope with feared stimuli in different situations allows for generalization of learned skills, and experiencing non-occurrence of the feared outcome helps in developing non-catastrophic associations that may enhance treatment outcomes (Bandarian-Balooch et al. J Behav Ther Exp Psychiatry 47:138-144, 2015; Cammin-Nowak et al. J Clin Psychol 69:616-629, 2013; Kendall et al. Cogn Behav Pract 12:136-148, 2005; Tiwari et al. J Clin Child Adolesc Psychol 42:34-43, 2013). To optimize treatment outcome, homework is often integrated into CBT protocols for childhood anxiety disorders during and following treatment. Nevertheless, practicing at home can be challenging, with low motivation, lack of time, and insufficient self-guidance often listed as reasons for low adherence (Tang and Kreindler, JMIR Mental Health 4:e20, 2017). This conceptual review provides an overview of (1) how existing CBT childhood programs incorporate homework, and empirical evidence for the importance of homework practice, (2) evidence-based key elements of practice, and (3) how mHealth apps could potentially enhance practice at home, including an example of the development and application of such an app. This review therefore sets the stage for new directions in developing more effective and engaging CBT-based homework programs for childhood anxiety disorders.
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Affiliation(s)
- Anke M Klein
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands.
| | - Annelieke Hagen
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
| | - Lynn Mobach
- Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Pro Persona Institute for Integrated Mental Health Care, Wolfheze, The Netherlands
| | - Robin Zimmermann
- Mental Health Research and Treatment Center (FBZ), Ruhr University, Bochum, Germany
| | | | - Jasmin Rahemenia
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
| | | | - Silvia Schneider
- Mental Health Research and Treatment Center (FBZ), Ruhr University, Bochum, Germany
| | - Thomas H Ollendick
- Department of Psychology, Child Study Center, Virginia Tech, Blacksburg, USA
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Lawrence TI, Hong JS, Espelage DL, Voisin DR. Antecedents of sibling aggression and bullying victimization: The parallel and serial contributions of depressive symptoms and substance use. J Affect Disord 2023; 333:193-201. [PMID: 37084977 DOI: 10.1016/j.jad.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE Sibling aggression has received attention as a common form of family violence. However, further research is needed to elucidate several antecedents of sibling aggression perpetration and bullying victimization, such as substance use and depressive symptoms. Additionally, more studies are needed to identify the mediating paths of depressive symptoms and substance use, which could explain the association between bullying victimization and sibling aggression perpetration on the one hand and the association between sibling aggression victimization and bullying victimization on the other hand, while controlling for exposure to family violence and demographic variables. The current study tested two separate mediational models guided by the displaced aggression theory and self-medication hypothesis. METHOD The present study used the Bullying, Sexual, and Dating Violence Trajectories From Early to Late Adolescence in the Midwestern United States, 2007-2013 dataset. The original sample consisted of 1162 middle school students who were initially surveyed and followed into three high schools. For the current study, the first wave was used, which included a sample of 1101 adolescents. Structural equation modeling (SEM) was conducted to first examine whether bullying victimization was associated with sibling aggression perpetration. Then another model was conducted to test whether sibling aggression victimization was associated with bullying victimization. RESULTS In the first model, results suggest bullying victimization is positively associated with sibling aggression. Mediation results indicated depressive symptoms and substance use serially mediated the relation between bullying victimization and sibling aggression. In the second model, results suggest that sibling aggression victimization is positively associated with bullying victimization. Parallel mediation results indicated that depressive symptoms alone and not substance use individually explained the association between sibling aggression victimization and bullying victimization. Finally, serial mediation results indicated that depressive symptoms and substance use serially mediate the association between sibling aggression victimization and bullying victimization. LIMITATIONS Limitations include self-report measures and cross-sectional design; therefore, we could not estimate casual relationships. CONCLUSION The implications of these findings suggest the need for continued attention to school-based bully prevention efforts and family relations interventions. Such efforts might be associated with reductions in bullying victimization and sibling aggression.
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Affiliation(s)
- Timothy I Lawrence
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, Bryan, TX, USA.
| | - Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, MI, USA; Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Dorothy L Espelage
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dexter R Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Badesha K, Wilde S, Dawson DL. Mental health mobile application self-help for adolescents exhibiting psychological distress: A single case experimental design. Psychol Psychother 2023; 96:223-248. [PMID: 36345016 PMCID: PMC10098610 DOI: 10.1111/papt.12436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present demand for child and adolescent mental health services exceeds the capacity for service provision. Greater research is required to understand the utility of accessible self-help interventions, such as mobile apps. This study sought to investigate whether use of a mental health app, underpinned by CBT, led to changes in psychological distress amongst adolescents. Mechanisms of change were examined, specifically whether changes are attributable to cognitive strategies. DESIGN This study utilised a multiple-baseline single-case experimental design, tracking variables across baseline and intervention phases. Surveys assessing participant experience were also administered. METHODS Five participants with moderate-to-severe levels of psychological distress engaged with a CBT-based app over five weeks. Participants were recruited from both a well-being service and the general population. Supplementary weekly calls to participants offered clarification of app content. RESULTS A small overall effect of the intervention of psychological distress was evident; however, outcomes were dependent on the analysis conducted. The intervention appeared to promote an increase in use of adaptive cognitive strategies but not negative thinking styles. The CBT app did not promote changes in participant well-being. Participant feedback highlighted practical challenges of utilising the app. CONCLUSIONS The clinical benefits of app-based CBT were small, and a range of barriers to engagement were recognised. While further research is required, caution should be exercised in the interpretation of studies reporting on app effectiveness.
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Affiliation(s)
- Kiran Badesha
- Clinical Psychology, University of Lincoln, Lincoln, UK
| | - Sarah Wilde
- Clinical Psychology, University of Lincoln, Lincoln, UK
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Shabani F, Farvareshi M, Hamdi K, Sadeghzadeh Oskouei B, Montazeri M, Mirghafourvand M. The effect of cognitive-behavioral therapy on stress and anxiety of women with premature ovarian insufficiency: A randomized controlled trial. Post Reprod Health 2022; 28:211-221. [PMID: 36269099 DOI: 10.1177/20533691221136309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N64. Date of registration: 14/02/2021. URL: https://en.irct.ir/user/trial/52024/view; date of first registration: 17/02/2021.
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Affiliation(s)
- Fatemeh Shabani
- Faculty of Nursing and Midwifery, Department of Midwifery, Student Research Committee, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Farvareshi
- Clinical Psychologist, Razi Hospital, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kobra Hamdi
- Women's Reproductive Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behnaz Sadeghzadeh Oskouei
- Department of Midwifery, School of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Faculty of Nursing and Midwifery, Midwifery Department, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Faculty of Nursing and Midwifery, Social Determinants of Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
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Ovenstad KS, Ormhaug SM, Jensen TK. The relationship between youth involvement, alliance and outcome in trauma-focused cognitive behavioral therapy. Psychother Res 2022; 33:316-327. [PMID: 36125352 DOI: 10.1080/10503307.2022.2123719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE Research suggests that combining the trauma-specific elements with a strong alliance helps optimize treatment outcomes in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth. Building on this, we investigate whether more positive and less negative involvement behaviors during trauma narration are associated with a stronger alliance and predict fewer posttraumatic stress symptoms (PTSS). METHOD Participants were 65 youth (M age = 15.5, SD = 2.2; 77% girls) receiving TF-CBT. Both youth self-report (Child PTSD Symptom Scale and Therapeutic Alliance Scale for Children) and observer ratings (Client Involvement Rating Scale) were used, and relationships were investigated with correlations and regression analyses. RESULTS The positive involvement behaviors demonstration of treatment understanding and self-disclosure predicted fewer PTSS but were not associated with the alliance - while initiation of discussions and showing enthusiasm predicted more PTSS but were associated with a stronger alliance. The negative involvement behaviors passivity and avoidance did not predict PTSS but were negatively associated with the alliance. CONCLUSION The relationships between traumatized youths' positive and negative involvement behaviors, alliance and PTSS outcomes appear mixed. The combination of a clear understanding of why processing the trauma can be helpful, more trauma-related self-disclosure and a stronger alliance seem favorable for alleviating PTSS.Trial registration: ClinicalTrials.gov identifier: NCT00635752..
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Affiliation(s)
- Kristianne S Ovenstad
- Department of Psychology, University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Silje M Ormhaug
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tine K Jensen
- Department of Psychology, University of Oslo and Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Felton JW, Shadur JM, Havewala M, Cassidy J, Lejuez CW, Chronis-Tuscano A. Specific Pathways from Parental Distress Reactions to Adolescent Depressive Symptoms: The Mediating Role of Youths' Reactions to Negative Life Events. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022; 44:750-762. [PMID: 36189339 PMCID: PMC9523721 DOI: 10.1007/s10862-022-09954-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
Abstract
The current multimethod longitudinal study examines how parents' distress reactions to adolescents' negative emotions may shape youths' own perceptions of negative life events and subsequent increases in depressive symptomology. Ninety adolescents (41 girls, 49 boys, average age = 16.5 years old) and their parents were assessed over three timepoints. We found that greater parent-reported distress reactions to adolescents' emotions predicted subsequent increase in youths' own self-reported negative reactions to stressful experiences over a two-week period, which in turn predicted steeper increases in youth-reported depressive symptoms across this same two-week period. Moreover, youths' negative reactions mediated the relation between parent emotion socialization and increases in adolescent depressive symptoms. These findings support the use of interventions that simultaneously target parent and child distress to prevent the onset of adolescent depression.
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Affiliation(s)
- Julia W. Felton
- Center for Health Policy & Health Services Research, Henry Ford Health Systems, Detroit, MI 48202, USA
| | - Julia M. Shadur
- School of Integrative Studies (Childhood Studies) and Human Development & Family Science, George Mason University, Fairfax, VA, USA
| | - Mazneen Havewala
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, USA
| | - Jude Cassidy
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Carl W. Lejuez
- Office of the Provost and Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Feldmann L, Zsigo C, Piechaczek C, Schröder PT, Wachinger C, Schulte-Körne G, Greimel E. Visual attention during cognitive reappraisal in adolescent major depression: Evidence from two eye-tracking studies. Behav Res Ther 2022; 153:104099. [DOI: 10.1016/j.brat.2022.104099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/08/2022] [Accepted: 04/10/2022] [Indexed: 11/02/2022]
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How Can We Make a Sustainable Workplace? Workplace Ostracism, Employees’ Well-Being via Need Satisfaction and Moderated Mediation Role of Authentic Leadership. SUSTAINABILITY 2022. [DOI: 10.3390/su14052869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ostracism in the workplace is a common phenomenon in modern society that impairs employees’ well-being. This study suggests that workplace ostracism reduces subjective well-being by examining the effect of workplace ostracism on subjective well-being. Based on self-determination theory and resource conservation theory, this study explores the underlying processes and their contingent factors in the relationship between workplace ostracism and employee well-being. Specifically, this study hypothesizes that workplace ostracism decreases employees’ well-being by enhancing employees’ need satisfaction. Furthermore, the perception of a direct supervisor’s authentic leadership positively moderates the relationship between workplace ostracism and employees’ need satisfaction. This study used moderated mediation analysis to evaluate our predictions using a two-time online survey of 485 Korean employees. The findings revealed that workplace ostracism has a detrimental impact on employee well-being via need satisfaction. However, perceptions of a direct supervisor’s authentic leadership positively moderate the association between workplace ostracism and need satisfaction. Our results have important practical and theoretical implications in the workplace ostracism literature.
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Méndez J, Sánchez-Hernández Ó, Garber J, Espada JP, Orgilés M. Psychological Treatments for Depression in Adolescents: More Than Three Decades Later. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094600. [PMID: 33926111 PMCID: PMC8123571 DOI: 10.3390/ijerph18094600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 12/29/2022]
Abstract
Depression is a common and impairing disorder which is a serious public health problem. For some individuals, depression has a chronic course and is recurrent, particularly when its onset is during adolescence. The purpose of the current paper was to review the clinical trials conducted between 1980 and 2020 in adolescents with a primary diagnosis of a depressive disorder, excluding indicated prevention trials for depressive symptomatology. Cognitive behavioral therapy (CBT) is the pre-eminent treatment and is well established from an evidence-based treatment perspective. The body of research on the remaining treatments is smaller and the status of these treatments is varied: interpersonal therapy (IPT) is well established; family therapy (FT) is possibly effective; and short-term psychoanalytic therapy (PT) is experimental treatment. Implementation of the two treatments that work well-CBT and IPT-has more support when provided individually as compared to in groups. Research on depression treatments has been expanding through using transdiagnostic and modular protocols, implementation through information and communication technologies, and indicated prevention programs. Despite significant progress, however, questions remain regarding the rate of non-response to treatment, the fading of specific treatment effects over time, and the contribution of parental involvement in therapy.
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Affiliation(s)
- Javier Méndez
- Department of Personality, Assessment and Psychological Treatment, University of Murcia, 30100 Murcia, Spain
- Correspondence:
| | - Óscar Sánchez-Hernández
- Department of Developmental and Educational Psychology, University of Murcia, 30100 Murcia, Spain;
| | - Judy Garber
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN 37302, USA;
| | - José P. Espada
- Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain; (J.P.E.); (M.O.)
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain; (J.P.E.); (M.O.)
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Takeda S, Matsuo R, Ohtsuka M. Effects of a Classroom-Based Stress Management Program by Cognitive Reconstruction for Elementary School Students. Yonago Acta Med 2020; 63:198-204. [PMID: 32884439 DOI: 10.33160/yam.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/04/2020] [Indexed: 11/05/2022]
Abstract
Background The present study evaluates the effects of a classroom-based universal program for stress management among elementary school students. Methods The participating children (aged 11-12 years) were assigned to either an intervention (n = 172) or a control group (n = 100). The program involved one 45-minute session during school hours. The program taught students about cognitive distortions and trained them using cognitive reconstruction. Cognitive distortions were characterized so that children could easily understand them. Students were asked to complete the Children's Stress Response Test, comprised of five questions about self-efficacy about cognitive reconstruction before and after the program, to assess the program's effects. Results The results as observed in the intervention group were as follows: (a) stress responses decreased, (b) self-efficacy in the awareness about one's feelings and thinking improved, (c) understanding how thinking affects feelings was prompted, (d) self-efficacy to review one's thinking improved when they felt uncomfortable, and (e) self-efficacy to change one's negative thinking to adaptive thinking improved. Conclusion These results suggest that the program was useful for reducing stress responses and improving self-efficacy in cognitive reconstruction among children.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
| | - Risa Matsuo
- Department of Child studies, College of Humanities, Okinawa University, Naha 902-8521, Japan
| | - Minako Ohtsuka
- Hyogo Earthquake Memorial 21st Century Research Institute, Hyogo Institute for Traumatic Stress, Kobe 651-0073, Japan
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Calderon A, Schneider C, Target M, Midgley N. 'Interaction structures' between depressed adolescents and their therapists in short-term psychoanalytic psychotherapy and cognitive behavioural therapy. Clin Child Psychol Psychiatry 2019; 24:446-461. [PMID: 30400758 DOI: 10.1177/1359104518807734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Identify the core 'interaction structures' between therapists and depressed adolescents within and across two common forms of psychotherapy. METHOD A total of 70 audio-recorded psychotherapy sessions representing short-term psychoanalytic psychotherapy (STPP) and cognitive behavioural therapy (CBT) with youth aged 12-18 years old were coded with the Adolescent Psychotherapy Q-set (APQ), a newly developed instrument. Data included different therapist-patient dyads and stages in treatment and were analysed with cluster analysis. RESULTS Three distinct interaction structures between therapists and depressed adolescents: two influenced by the therapists' techniques and one more influenced by the young people's attitude to therapy. CONCLUSION When there is a collaborative working relationship between therapists and depressed young people, the therapy process is influenced by the therapists' techniques; while when there is a poor working relationship, the techniques used by therapists of different theoretical orientation become more similar with the aim of engaging the young person in the process.
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Affiliation(s)
- Ana Calderon
- 1 Department of Clinical, Educational and Health Psychology, University College London, London, UK.,2 Anna Freud National Centre for Children and Families, London, UK
| | | | - Mary Target
- 1 Department of Clinical, Educational and Health Psychology, University College London, London, UK.,2 Anna Freud National Centre for Children and Families, London, UK
| | - Nick Midgley
- 1 Department of Clinical, Educational and Health Psychology, University College London, London, UK.,2 Anna Freud National Centre for Children and Families, London, UK
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Effectiveness Trial of Brief Indicated Cognitive-Behavioral Group Depression Prevention in French-Canadian Secondary Schools. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09316-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hedemann ER, Frazier SL. Leveraging After-School Programs to Minimize Risks for Internalizing Symptoms Among Urban Youth: Weaving Together Music Education and Social Development. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 44:756-770. [PMID: 27544670 DOI: 10.1007/s10488-016-0758-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined a university-community partnership, focusing on mental health promotion within an after-school music program. We pursued two goals: (a) supporting staff around student engagement and behavior management; (b) integrating social-emotional activities into the curriculum. We assessed youth's mental health needs and examined feasibility of social-emotional activities delivered. One-hundred sixty-two youth participated in activities, while a subset of youth (n = 61) and their parents provided information on mental health need. Rates of anxiety and depression symptoms were high, and youth reported high satisfaction with the activities. Results suggest promise of this model for mental health promotion for urban youth.
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Affiliation(s)
- Erin R Hedemann
- Florida International University, AHC-1 Room 140, 11200 S.W. 8th St., Miami, FL, 33199, USA.
| | - Stacy L Frazier
- Florida International University, AHC-1 Room 140, 11200 S.W. 8th St., Miami, FL, 33199, USA
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Zilcha-Mano S. Major developments in methods addressing for whom psychotherapy may work and why. Psychother Res 2018; 29:693-708. [DOI: 10.1080/10503307.2018.1429691] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Homework in Cognitive Behavioral Therapy: A Systematic Review of Adherence Assessment in Anxiety and Depression (2011-2016). Psychiatr Clin North Am 2017; 40:625-639. [PMID: 29080590 DOI: 10.1016/j.psc.2017.08.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Treatment adherence has posed a substantial challenge not only for patients but also for the health profession for many decades. The last 5 years has witnessed significant attention toward adherence with cognitive behavioral therapy (CBT) homework for anxiety and depressive disorders, and adherence assessment methods have diversified. However, there remains a large component of the adherence process not assessed in CBT, with patient effort, engagement, and the known role for treatment appraisals and beliefs necessitating the pursuit of improved adherence assessment methods.
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Orkibi H, Azoulay B, Regev D, Snir S. Adolescents’ dramatic engagement predicts their in-session productive behaviors: A psychodrama change process study. ARTS IN PSYCHOTHERAPY 2017. [DOI: 10.1016/j.aip.2017.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Orkibi H, Ronen T. Basic Psychological Needs Satisfaction Mediates the Association between Self-Control Skills and Subjective Well-Being. Front Psychol 2017. [PMID: 28638362 PMCID: PMC5461363 DOI: 10.3389/fpsyg.2017.00936] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Although studies have shown that self-control skills (SCSs) are positively linked to both personal and interpersonal outcomes in adolescent students, studies on the putative mechanisms underlying this relationship are scarce. Drawing on Self-Determination Theory and previous studies, we theorized that the association between students’ SCSs and their subjective well-being (SWB) in school may be mediated by students’ perceived satisfaction of their basic psychological needs for competence, relatedness, and autonomy. The sample consisted of 1576 Israeli adolescent students (54% girls) in grades 10–12 (mean age 16) enrolled in 20 schools. A mediation model was tested with structural equation modeling and a robust bootstrap method for testing indirect effects, controlling for school-level variance. The findings supported the hypothesized model and a post hoc multi-group comparison analysis yielded gender invariance in the model. The findings suggest that both girls and boys with high SCSs may perceive themselves as having greater needs satisfaction in school and consequently higher school-related SWB. Implications for policy and practice are discussed.
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Affiliation(s)
- Hod Orkibi
- School of Creative Arts Therapies, University of HaifaHaifa, Israel
| | - Tammie Ronen
- Renata Adler Memorial Research Center for Child Welfare and Protection, Gershon Gordon Faculty of Social Sciences, Tel-Aviv UniversityTel-Aviv, Israel
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Fradkin C. Janina Scarlet: Superhero Therapy: A Hero’s Journey Through Acceptance and Commitment Therapy. J Youth Adolesc 2017. [DOI: 10.1007/s10964-017-0658-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kazantzis N, Whittington C, Zelencich L, Kyrios M, Norton PJ, Hofmann SG. Quantity and Quality of Homework Compliance: A Meta-Analysis of Relations With Outcome in Cognitive Behavior Therapy. Behav Ther 2016; 47:755-772. [PMID: 27816086 DOI: 10.1016/j.beth.2016.05.002] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 04/27/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022]
Abstract
Homework assignments have been shown to produce both causal and correlational effects in prior meta-analytic reviews of cognitive behavior therapy (CBT), but this research area has been characterized by a focus on the amount of compliance (i.e., quantity), and little is known about the role of skill acquisition (i.e., quality). A landmark study by Neimeyer and Feixas (1990) showed stronger homework-outcome relations when quality was assessed, but previous reviews have not considered whether the same pattern is evident across studies. Seventeen studies of CBT (N = 2,312 clients) published following calls for research on homework quality were included in the current meta-analysis. In the present review, homework compliance relations were demonstrated when outcome was assessed at posttreatment (quality Hedges' g = 0.78, 95% Confidence Interval [CI] = 0.03 to 1.53, k = 3, n = 417; quantity g = 0.79, 95% CI = 0.57 to 1.02, k = 15, n = 1537) and at follow-up (quality g = 1.07, 95% CI = 0.06 to 2.08, k = 3, n = 417; quantity g = 0.51, 95% CI = 0.28 to 0.74, k = 7, n = 1291). All effect sizes were different from 0, ps < .05. Differences that were obtained in homework-outcome relations among sources of compliance data (client, therapist, objective) were tentative due to overlapping CIs, but suggest a potential moderating effect. If confirmed by further research, the present findings would suggest that trial methods capable of assessing both quantity and quality have been an important omission in research on homework-outcome relations in CBT.
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Changes in causal attributions and relationship representations: Are they specific or common mechanisms in the treatment of depression? J Affect Disord 2016; 193:73-80. [PMID: 26771947 PMCID: PMC4744572 DOI: 10.1016/j.jad.2015.12.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/29/2015] [Accepted: 12/30/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND The goal of the study was to examine two central theory-driven mechanisms of change, causal attributions and relational representations, to account for symptomatic improvement in psychodynamic treatment and supportive clinical management, combined with either pharmacotherapy or placebo, in a randomized control trial (RCT) for depression. METHOD We used data from an RCT for depression, which reported non-significant differences in outcome among patients (N=149) who received supportive-expressive psychotherapy (SET), clinical management combined with pharmacotherapy (CM+MED), or clinical management with placebo pill (CM+PBO) (Barber et al., 2012). Mechanism and outcome measures were administered at intake, mid-treatment, end of treatment, and at a 4-month follow-up. RESULTS Improvements in causal attributions and in relational representations were found across treatments. Changes in causal attributions did not predict subsequent symptomatic level when controlling for prior symptomatic level. In contrast, decrease in negative relational representations predicted subsequent symptom reduction across all treatments, and increase in positive relational representations predicted subsequent symptom reduction only in SET. LIMITATIONS The study is limited by its moderate sample size. Additional studies are needed to examine the same questions using additional treatment orientations, such as cognitive treatments. CONCLUSIONS Findings demonstrate that changes in negative relational representations may act as a common mechanism of change and precede symptom reduction across psychodynamic therapy and supportive case management combined with either pharmacotherapy or placebo, whereas an increase in positive relational representation may be a mechanism of change specific to psychodynamic therapy.
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Lomholt JJ, Thastum M, Christensen AE, Leegaard A, Herlin T. Cognitive behavioral group intervention for pain and well-being in children with juvenile idiopathic arthritis: a study of feasibility and preliminary efficacy. Pediatr Rheumatol Online J 2015; 13:35. [PMID: 26293657 PMCID: PMC4546223 DOI: 10.1186/s12969-015-0032-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/06/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pain is still a part of everyday living for several children with juvenile idiopathic arthritis (JIA) despite improvement in treatment. Psychological interventions may contribute to diminish pain complaints and improve well-being in children with JIA. Only few studies have investigated the efficacy of psychological therapy in children with arthritis and with mixed results. The aim of the study was to evaluate the feasibility and preliminary efficacy of a cognitive behavioral therapy group intervention for children with JIA and their parents. METHODS Nineteen children with JIA and their parents were allocated to six sessions' group cognitive-behavioral therapy (n = 9) or a waitlist control condition (n = 10). Results were measured from self-reported scales and one-week pain diaries. Clinical data was collected by a rheumatologist. RESULTS The participation rate was low; 33 % of the invited families participated. However, the participants rated the intervention's credibility and satisfaction with the intervention as high. The dropout rate was low and attendance rate high. Increased quality of life and improvements in adaptive pain cognitions was reported in the intervention condition compared to the waitlist condition, whereas no differences were found for pain and functional disability. The disease activity increased in the treatment condition but not in the control condition. CONCLUSIONS The feasibility of this study seemed high with regards to the acceptability of the families participating in the intervention. However, the feasibility in general was challenged by implementation problems with a low participation rate. A reduction in pain after the intervention was not found even though pain management was the main target in the intervention. Preliminary analysis showed that although the severity of the disease status increased, an increase in quality of life, reduction in pain catastrophizing, and an improvement in adaptive pain cognitions (the beliefs in controlling pain and self-efficacy) were seen in the intervention condition. The study highlights the importance of considering the disease status when evaluating the efficacy of a psychological intervention in children with arthritis. Conclusions on the strength of the efficacy require further research in a large, randomized controlled trial.
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Affiliation(s)
- Johanne Jeppesen Lomholt
- Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 9, 8000, Aarhus, Denmark.
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 9, 8000, Aarhus, Denmark.
| | - Anne Estmann Christensen
- Department of Pediatrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Anne Leegaard
- Department of Pediatrics, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark.
| | - Troels Herlin
- Department of Pediatrics, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark.
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Homework Adherence and Cognitive Behaviour Treatment Outcome for Children and Adolescents with Anxiety Disorders. Behav Cogn Psychother 2015; 44:225-35. [DOI: 10.1017/s1352465815000429] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Homework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders. Aims: The study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents. Method: The treatment program was completed by 98 children and adolescents (ages 7–16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up. Results: Results did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity. Conclusions: The study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.
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It's complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression. Clin Psychol Rev 2014; 41:3-15. [PMID: 25595660 PMCID: PMC10080251 DOI: 10.1016/j.cpr.2014.12.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/29/2014] [Accepted: 12/10/2014] [Indexed: 11/23/2022]
Abstract
Many attempts have been made to discover and characterize the mechanisms of change in psychotherapies for depression, yet no clear, evidence-based account of the relationship between therapeutic procedures, psychological mechanisms, and symptom improvement has emerged. Negatively-biased thinking plays an important role in the phenomenology of depression, and most theorists acknowledge that cognitive changes occur during successful treatments. However, the causal role of cognitive change procedures in promoting cognitive change and alleviating depressive symptoms has been questioned. We describe the methodological and inferential limitations of the relevant empirical investigations and provide recommendations for addressing them. We then develop a framework within which the possible links between cognitive procedures, cognitive change, and symptom change can be considered. We conclude that cognitive procedures are effective in alleviating symptoms of depression and that cognitive change, regardless of how it is achieved, contributes to symptom change, a pattern of findings that lends support to the cognitive theory of depression.
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