{"title":"Therapist factors associated with intent to use exposure therapy: a systematic review and meta-analysis.","authors":"Diane Langthorne, Jessica Beard, Glenn Waller","doi":"10.1080/16506073.2023.2191824","DOIUrl":"https://doi.org/10.1080/16506073.2023.2191824","url":null,"abstract":"<p><p>Exposure therapy is effective but widely underused. Numerous studies indicate therapist factors that might explain this pattern of underuse. This systematic review and meta-analysis synthesised those previous research findings, to identify which therapist factors are clearly associated with their intent to use exposure therapy. A systematic review and six random-effects meta-analyses synthesised studies identified in three databases (Scopus, PsychINFO, Web of Science) and through reference lists and citation searches. Most studies relied on a survey design, resulting in weak quality of research. Twenty-six eligible studies were included in the narrative synthesis, (including 5557 participants), while 21 studies yielded sufficient data to enter the meta-analysis. Medium to large pooled effect sizes indicated that therapists with more positive beliefs, a CBT orientation, and training in exposure therapy were significantly more likely to use exposure. Small pooled effect sizes indicated that older and more anxious therapists were less likely to use exposure. Therapist years of experience was not significantly associated with exposure use. There was no evidence of publication bias. Therapist characteristics clearly play a role in the use of exposure therapy, and future clinical and research work is required to address this limitation in the delivery of this effective therapy.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10054013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rathod, A. Javed, Rehmina Iqbal, Ayaat Al-Sudani, Akansha Vaswani-Bye, I. Haider, P. Phiri
{"title":"Results of a qualitative study of patient, carer and clinician views on the experience of caring for individuals with psychosis in Pakistan","authors":"S. Rathod, A. Javed, Rehmina Iqbal, Ayaat Al-Sudani, Akansha Vaswani-Bye, I. Haider, P. Phiri","doi":"10.1017/S1754470X23000077","DOIUrl":"https://doi.org/10.1017/S1754470X23000077","url":null,"abstract":"Abstract Cultural relevance is a core element of effective psychological interventions like cognitive behaviour therapy (CBT) or family intervention (FI), which can be considered Eurocentric. There have been few studies that have examined explanatory models of mental illness and its management in Pakistan to date. This study elicited patient- and carer-related health beliefs on psychosis including attributions to illness, and help-seeking behaviours to inform development of culturally sensitive treatment and improve outcomes in a unit in Lahore (Pakistan). The study group completed 45 semi-structured qualitative interviews at a mental health rehabilitation centre in Lahore. Data were analysed thematically using emerging themes and content analysis. Participants’ explanatory models for psychosis included religion or faith-driven beliefs, like previous wrong-doing and supernatural ideas such as black magic. Social factors that impacted families included high expectations, social stigma, and discriminations. Families first sought help from faith leaders and then medical or psychological sources of care. Participants had generally positive attitudes about their experience of psychological interventions. Key learning aims (1) The need to consider cultural influences to ensure relevance of interventions like cognitive behaviour therapy (CBT) or family interventions (FI) in different countries. (2) The need for cultural adaptation of interventions like CBT and FI in different countries to make them accessible and acceptable. (3) When adapting therapy to a particular culture or country, recognizing the importance of engaging the local cultural population in the adaptation process.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88900811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"To (i)B or not to i(B), that is the question: on the differences between Ellis’ REBT and Beck’s CT","authors":"P. Young, M. Turner","doi":"10.1017/S1754470X23000090","DOIUrl":"https://doi.org/10.1017/S1754470X23000090","url":null,"abstract":"Abstract Far from being a monolithic approach to psychotherapy, cognitive behavioural therapy (CBT) is in fact an umbrella term to describe a family of psychological therapies that share many common features but also have nuanced differences. Of the CBTs, two are often conflated under the ‘CBT’ moniker, namely cognitive therapy (CT) and rational emotive behaviour therapy (REBT). In this article, we explore some of the key differences and similarities between CT and REBT, touching on philosophy, practical implementation, and literature. We provide a brief hypothetical case study to demonstrate the different ways a therapist using CT and REBT might tackle the same client problem. We do not declare either approach superior, but suggest each might have their advantages in certain contexts and acknowledge that skilful practitioners could, and often do, integrate both approaches. As CBT continues to evolve and move into new areas, it is important that psychology practitioners and researchers are clear about which specific approach to CBT they are delivering, measuring and/or reporting on.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79389379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The relationship between therapist experiential avoidance and observed CBT competence during training: a preliminary investigation","authors":"Vickie L. Presley, Gwion Jones, Magda Marczak","doi":"10.1017/S1754470X23000089","DOIUrl":"https://doi.org/10.1017/S1754470X23000089","url":null,"abstract":"Abstract The psychological literature highlights experiential avoidance as a transdiagnostic maintenance factor for a number of psychopathologies. Some attention has been given to therapist experiential avoidance, with the suggestion that this interferes with the acquisition and execution of CBT skills; there is, however, a paucity of research directly examining this relationship. This study aimed to measure experiential avoidance in trainee cognitive behavioural therapists, and establish any relationships with observed clinical competence. Twenty-nine trainee therapists took part in the study; levels of experiential avoidance were measured using the Multidimensional Experiential Avoidance Questionnaire and were analysed in relation to observed CBT skills assessed using the Cognitive Therapy Scale (Revised). No overall relationship between therapist experiential avoidance and clinical competency was observed. However, a number of significant associations were observed between individual dimensions of therapist experiential avoidance and CBT skills in collaboration, guided discovery, conceptual integration and homework setting. Aspects of therapist experiential avoidance during training may therefore be associated with the acquisition of key CBT skills. Tentative interpretations and recommendations for CBT training and supervision have been made, although further investigation is required. Key learning aims (1) To understand the role of experiential avoidance in psychopathology. (2) To understand the relevance of client experiential avoidance as part of CBT treatment. (3) To examine the potential impact of therapist experiential avoidance on the development and execution of key CBT skills. (4) To consider implications for CBT training, supervision and clinical practice.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83737674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A qualitative exploration of black psychotherapists’ personal experience of racism and the challenges that exist for black therapists who work with clients in therapy who have also experienced racism. A pilot study using interpretive phenomenological analysis","authors":"Michelle Brooks-Ucheaga","doi":"10.1017/S1754470X23000065","DOIUrl":"https://doi.org/10.1017/S1754470X23000065","url":null,"abstract":"Abstract The impact of racism to the individual is arguably immeasurable; however, the impact on psychotherapists who themselves have personally had either one or multiple experiences of racism and work with clients in therapy who have also experienced racism is an area with very little research. Semi-structured interviews were conducted with black cognitive behavioural therapists who have personally experienced racism and have also worked with clients who have experienced racism; data were analysed using interpretive phenomenological analysis. As this was a pilot study, only two participants were recruited to the study. Superordinate and subordinate themes were identified from the data and explored. The study highlighted that the impact of racism, racist experiences and microaggressions can lead to mental health problems, and there is need for further support for therapists, especially within the contexts of clinical supervision and from their organisation leadership. In addition, the need for further research was also identified, as well as improved training in working with disclosures of racism, and racial trauma within a therapeutic context was considered as important to the therapists of this pilot study. Key learning aims (1) To explore and understand the personal experiences of black therapists who have personally experienced racism. (2) To identify some of the challenges that exist for black therapists who work with clients who have experienced racism and to explore possible solutions to overcome such challenges.","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80342416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pim Cuijpers, Clara Miguel, Marketa Ciharova, Soledad Quero, Constantin Yves Plessen, David Ebert, Mathias Harrer, Annemieke van Straten, Eirini Karyotaki
{"title":"Psychological treatment of depression with other comorbid mental disorders: systematic review and meta-analysis.","authors":"Pim Cuijpers, Clara Miguel, Marketa Ciharova, Soledad Quero, Constantin Yves Plessen, David Ebert, Mathias Harrer, Annemieke van Straten, Eirini Karyotaki","doi":"10.1080/16506073.2023.2166578","DOIUrl":"https://doi.org/10.1080/16506073.2023.2166578","url":null,"abstract":"<p><p>Most people with a mental disorder meet criteria for multiple disorders. We conducted a systematic review and meta-analysis of randomized trials comparing psychotherapies for people with depression and comorbid other mental disorders with non-active control conditions. We identified studies through an existing database of randomized trials on psychotherapies for depression. Thirty-five trials (3,157 patients) met inclusion criteria. Twenty-seven of the 41 interventions in the 35 trials (66%) were based on CBT. The overall effect on depression was large (g = 0.65; 95% CI: 0.40 ~ 0.90), with high heterogeneity (I<sup>2</sup> = 78%; 95% CI: 70 ~ 83). The ten studies in comorbid anxiety showed large effects on depression (g = 0.90; 95% CI: 0.30 ~ 1.51) and anxiety (g = 1.01; 95% CI: 0.28 ~ 1.74). For comorbid insomnia (11 comparisons) a large and significant effect on depression (g = 0.99; 95% CI: 0.16 ~ 1.82) and insomnia (g = 1.38; 95% CI: 0.38 ~ 2.38) were found. For comorbid substance use problems (12 comparisons) effects on depression (g = 0.25; 95% CI: 0.06 ~ 0.43) and on substance use problems (g = 0.25; 95% CI: 0.01 ~ 0.50) were significant. Most effects were no longer significant after adjustment for publication bias and when limited to studies with low risk of bias. Therapies are probably effective in the treatment of depression with comorbid anxiety, insomnia, and substance use problems.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9328367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura J Lambe, Fakir Md Yunus, Mackenzie Moore, Matthew T Keough, Kara Thompson, Marvin Krank, Patricia Conrod, Sherry H Stewart
{"title":"Inhibited personality traits, internalizing symptoms, and drinking to cope during the COVID-19 pandemic among emerging adults.","authors":"Laura J Lambe, Fakir Md Yunus, Mackenzie Moore, Matthew T Keough, Kara Thompson, Marvin Krank, Patricia Conrod, Sherry H Stewart","doi":"10.1080/16506073.2022.2152726","DOIUrl":"https://doi.org/10.1080/16506073.2022.2152726","url":null,"abstract":"<p><p>Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9384663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lydia Morris, Karina Lovell, Phil McEvoy, Richard Emsley, Lesley-Anne Carter, Dawn Edge, Rachel Bates, Tanya Wallwork, Warren Mansell
{"title":"A brief transdiagnostic group (the take control course) compared to individual low-intensity CBT for depression and anxiety: a randomized non-inferiority trial.","authors":"Lydia Morris, Karina Lovell, Phil McEvoy, Richard Emsley, Lesley-Anne Carter, Dawn Edge, Rachel Bates, Tanya Wallwork, Warren Mansell","doi":"10.1080/16506073.2022.2143418","DOIUrl":"https://doi.org/10.1080/16506073.2022.2143418","url":null,"abstract":"<p><p>Few studies have examined brief transdiagnostic groups. The Take Control Course (TCC) was developed for patients with mild to moderate common mental health problems. We examined whether TCC is non-inferior to individual low-intensity cognitive behaviour therapy (CBT) in a single-blind individually randomised parallel non-inferiority trial. The primary outcomes were depression (PHQ9) and anxiety (GAD7) at 6-month follow-up (primary outcome point) and 12-month follow-up. The non-inferiority margin that we set, based on previous trials, corresponds to approximately 3 points on the PHQ9 and approximately 2.5 points on the GAD7. Intention-to-treat (ITT) and per-protocol (PP) analyses of 6-month data of 156 randomised patients indicated that TCC was non-inferior to individual low-intensity CBT on anxiety (ITT Coefficient = 0.24; 95% CI: -1.45 to 1.92; <i>d</i> = 0.04; <i>p</i> = .79), and depression (ITT Coefficient = 0.82; 95% CI: -1.06 to 2.69; <i>d</i> = 0.14; <i>p</i> = .39) outcomes, and functioning (ITT Coefficient = 0.69; 95% CI: -2.56 to 3.94; <i>d</i> = 0.08; <i>p</i> = .68). The findings at 12 months were inconclusive and require further testing. This randomised trial provides preliminary support that TCC is not less effective than short-term individual CBT within Improving Access to Psychological Therapies (IAPT) services.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}