Cognitive Behaviour Therapist最新文献

{"title":"Addressing therapist concerns about religion in cognitive behavioural therapy: why, when, and how?","authors":"Hibah Hassan, Katherine E Wakelin, Graham R Thew","doi":"10.1017/S1754470X26100646","DOIUrl":"https://doi.org/10.1017/S1754470X26100646","url":null,"abstract":"<p><p>Despite religion being an important part of some patients' identity and value systems, therapists report finding it challenging to discuss religion in therapy. Avoiding religion for these patients can have detrimental effects on the therapeutic alliance, treatment outcomes, and parity of access for minoritised groups. Therefore, this clinical guidance paper aims to support therapists to bring religion into the therapy room by addressing six key concerns: (1) difficulties raising the topic, (2) 'getting it wrong' when discussing religion, (3) therapist and patient differences, (4) managing negative or ambivalent beliefs about religion, (5) perceptions of insufficient knowledge, and (6) a lack of time for meaningful discussions. These barriers are explored by drawing on empirical evidence, clinical experience, and illustrative case examples. The paper aims to provide suggestions and next steps for how therapists can reflect on and address these concerns, aiming to enhance confidence and competence in integrating religion into CBT.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"19 ","pages":"e27"},"PeriodicalIF":2.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of BRAVE, a CBT intervention to reduce violence risk in early psychosis.","authors":"Stephanie Alexia Rolin, Samantha E Jankowski, Megan G Flores, Ilana Nossel, Iruma Bello, Milton L Wainberg, Leah G Pope, Michael T Compton, Lisa B Dixon, Paul S Appelbaum","doi":"10.1017/s1754470x26100816","DOIUrl":"10.1017/s1754470x26100816","url":null,"abstract":"<p><p>Violence risk is elevated during the early phase of psychosis and can have significant consequences for engagement, recovery, and safety. BRAVE (Behavioral Response Against Violence Engagement) is a cognitive-behavioural intervention adapted from the PICASSO model for use in early intervention services (EIS) that targets dynamic, modifiable mechanisms associated with psychosis-related violence. This open pilot trial evaluated the feasibility, acceptability, fidelity, and preliminary target engagement of BRAVE when delivered by clinicians within routine EIS care. Seven clinician-client dyads were enrolled across OnTrackNY sites; five completed the intervention, with a mean of 11.4 sessions. Feasibility and acceptability were high: clinicians rated BRAVE as useful and deliverable within standard visit structures. Fidelity ratings were high across both clinician and client checklists. Although violent behaviour was infrequent at baseline, exploratory clinical outcomes suggested reductions in violent ideation over time. The primary hypothesized mechanistic target, impulsivity, remained stable but secondary mechanistic outcomes showed directionally positive movement across the affective, cognitive, behavioural, and physiological domains expected to shift with BRAVE, including reductions in hostility, negative self-appraisal, persecutory thinking, substance use, and sleep disturbance, alongside increased coping self-efficacy. Overall, findings indicate that BRAVE can be implemented with high fidelity and strong acceptability within participating clinician-client dyads in EIS settings, and offer preliminary descriptive patterns consistent with the hypothesized mechanistic model.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"19 ","pages":"e37"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing your delivery of cognitive therapy for PTSD: a celebration of the work of Hannah Murray.","authors":"Graham R Thew, Emma Warnock-Parkes, Sharif El-Leithy, Kerry Young, Nick Grey, Kirsten V Smith, Gabriella Tyson, Firoozeh Daraei, Jennifer Wild, Belinda Graham, Richard Thwaites, Sophie Grant, Alice Kerr, David M Clark, Anke Ehlers","doi":"10.1017/S1754470X24000370","DOIUrl":"10.1017/S1754470X24000370","url":null,"abstract":"","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"17 ","pages":"s1754470x24000370"},"PeriodicalIF":2.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding mental health service needs and treatment characteristics for Latin American immigrants and refugees: A focus on CBT strategies for reducing acculturative stress.","authors":"Gabriela A Nagy, Chanel Zhan, Stephanie Salcedo Rossitch, Allison M Stafford, Andrea Mendoza, Norma F Reyes, Rosa Gonzalez-Guarda","doi":"10.1017/s1754470x24000138","DOIUrl":"https://doi.org/10.1017/s1754470x24000138","url":null,"abstract":"<p><p>Acculturative stress is a key social driver of health impacting the mental health of immigrants and refugees from Latin America, which contributes to inequities experienced by them. While there is a robust scientific literature describing and evaluating evidence-based treatments targeting a range of psychiatric disorders, these treatments often do not primarily target acculturative stress. Thus, the present study examined how psychotherapists ought to treat acculturative stress directly in their clinical practice. Ten therapists were interviewed using a qualitative descriptive approach. Rapid contemporary content analysis was used to describe Latino/Hispanic immigrants' most common presenting problems, the context in which they provide care for these problems, and the psychotherapeutic approaches currently utilized or considered effective in mitigating acculturative stress. Findings revealed that common mental health conditions that therapists addressed among this population, including depression, anxiety and trauma-related somatization, including the unique context in which therapy was delivered. Additionally, specific strategies for addressing acculturative stress such as the importance of acknowledging this stressor, drawing out immigration journey narratives, and behavioural activation approaches were shared. The results from this study can be used to improve the effectiveness of mental health interventions addressing acculturative stress among immigrant and refugee populations.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"17 ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender- and Sexuality-Minoritised Adolescents in DBT: A Reflexive Thematic Analysis of Minority-Specific Treatment Targets and Experience.","authors":"J Camp, A Morris, H Wilde, P Smith, K A Rimes","doi":"10.1017/S1754470X23000326","DOIUrl":"10.1017/S1754470X23000326","url":null,"abstract":"<p><p>Gender- and sexuality-minoritised (GSM) adolescents are at increased risk of self-harm and suicidal behaviours compared to their cisgender and heterosexual peers. This increased risk is thought to be explained in part by exposure to stigma and societal oppression. Dialectical Behaviour Therapy (DBT) is an evidence-based intervention for self-harm and suicidal behaviour that may have advantages for supporting GSM young people in distress. No study has yet sought to understand what GSM-associated difficulties may be important to consider in DBT for adolescents, or the experiences of GSM young people in a standard DBT programme. Therefore, this study aimed to understand the experiences of GSM young people in DBT and what difficulties and dilemmas associated with their gender and sexuality diversity were thought by them to be important to target in DBT. Qualitative interviews were conducted with 14 GSM young people in a comprehensive DBT programme and were analysed using Reflexive Thematic Analysis. The analysis was supported by two further GSM young people who had finished DBT. The findings were split into three overarching themes (Identity, Impact of Others, and Space for Sexual and Gender Identity in DBT), each with themes within. The identity-based theme included \"identity confusion and acceptance\"; the relationship-based themes included \"cis-Heterosexism\" and \"community connectedness\"; and the space within DBT themes included \"negotiating focus and targeting in DBT\" and \"creating safety in DBT\". Findings are discussed in relation to implications and recommendations for therapists working with GSM young people within and outside of DBT.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"16 ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving forward with the loss of a loved one: treating PTSD following traumatic bereavement with cognitive therapy.","authors":"Jennifer Wild, Michael Duffy, Anke Ehlers","doi":"10.1017/S1754470X23000041","DOIUrl":"10.1017/S1754470X23000041","url":null,"abstract":"<p><p>Traumatic loss is associated with high rates of post-traumatic stress disorder (PTSD) and appears to inhibit the natural process of grieving, meaning that patients who develop PTSD after loss trauma are also at risk of experiencing enduring grief. Here we present how to treat PTSD arising from traumatic bereavement with cognitive therapy (CT-PTSD; Ehlers <i>et al</i>., 2005). The paper describes the core components of CT-PTSD for bereavement trauma with illustrative examples, and clarifies how the therapy differs from treating PTSD associated with trauma where there is no loss of a significant other. A core aim of the treatment is to help the patient to shift their focus from loss to what has not been lost, from a focus on their loved one being gone to considering how they may take their loved one forward in an abstract, meaningful way to achieve a sense of continuity in the present with what has been lost in the past. This is often achieved with imagery transformation, a significant component of the memory updating procedure in CT-PTSD for bereavement trauma. We also consider how to approach complexities, such as suicide trauma, loss of a loved one in a conflicted relationship, pregnancy loss and loss of life caused by the patient.</p><p><strong>Key learning aims: </strong>To be able to apply Ehlers and Clark's (2000) cognitive model to PTSD arising from bereavement trauma.To recognise how the core treatment components differ for PTSD associated with traumatic bereavement than for PTSD linked to trauma where there is no loss of life.To discover how to conduct imagery transformation for the memory updating procedure in CT-PTSD for loss trauma.</p>","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"16 ","pages":"e12"},"PeriodicalIF":2.1,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10160000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘I almost felt like I can be a little bit more honest’: experiences of a telehealth group for bipolar disorder","authors":"Tania Perich, Kelly Kakakios, Isabel Fraser","doi":"10.1017/s1754470x2300020x","DOIUrl":"https://doi.org/10.1017/s1754470x2300020x","url":null,"abstract":"Abstract Despite the increasing use of telehealth platforms to deliver cognitive behavioural group therapy programs, few studies have been conducted that explore the experience of using telehealth platforms for those living with bipolar disorder. The present study aimed to explore the impact of the telehealth platform on the delivery of a recovery-orientated well-being plan group program for participants living with bipolar disorder. A total of 19 participants completed the qualitative interviews (3 male, 16 female). Using content analysis, data were deductively coded in line with pre-existing codes and matrix categories with unexpected data that discussed the telehealth experience being coded using an inductive content analysis framework. Two themes were identified: (1) Social inclusion, which included the subthemes of (a) connection to others via telehealth and (b) feeling safe using telehealth; and (2) Barriers and engagement, which included the subthemes of (a) removing barriers by using telehealth and (b) symptom impacts to engagement using the telehealth platform. Participants reported increased connection with others using telehealth and feeling greater safety overall when using the telehealth platform; however, some noted that dominant personalities could contribute to feeling unsafe within the group at times. Overall, the platform reduced barriers and was easy to use with this being a convenient way to attend, even if in some instances the platform highlighted differences between the members. Key learning aims (1) Telehealth platforms provide a unique opportunity for connection for those living with bipolar disorder. (2) Telehealth platforms may increase feelings of personal safety but may also increase feelings of difference between group members. (3) Symptoms may impact on engagement with anxiety and mood symptoms playing a role; however, telehealth may also decrease barriers to engagement.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135954896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician experiences on training and awareness of sexual orientation in NHS Talking Therapies Services for Anxiety and Depression","authors":"Jason Kai Yu Ho, Christopher O’Rouke, Allán Laville, Marie Chellingsworth, Patrick Callaghan","doi":"10.1017/s1754470x23000181","DOIUrl":"https://doi.org/10.1017/s1754470x23000181","url":null,"abstract":"Abstract Previous research that explored sexual minority service users’ experiences of accessing NHS Talking Therapies for Anxiety and Depression Services highlighted the need for specific sexual orientation training. Inconsistent or lack of training may contribute to disparities in treatment outcomes between sexual minority service users and heterosexual service users. The aim of the study was to explore clinicians’ competencies working with sexual minority service users, their experiences of sexual orientation training, their view of current gaps in training provision, and ways to improve training. Self-reported sexual orientation competency scales and open-ended questions were used to address the aims of the study. Participants ( n =83) included Psychological Wellbeing Practitioners (PWPs) and high-intensity CBT therapists (HITs). Responses on competency scales were analysed using Kruskal–Wallis tests and thematic analysis was used to analyse qualitative responses. Participants who identified as 25–29 years old had higher scores on the knowledge scale than 45+-year-olds. Bisexual participants also had higher scores on the knowledge subscale than heterosexual participants. Three over-arching themes were identified: (a) training received on sexual minority issues by Talking Therapies clinicians, (b) clinicians’ experiences of accessing and receiving sexual minority training, and (c) perceived gaps in current sexual minority training and ways to improve training. Findings were linked to previous literature and recommendations to stakeholders are made throughout the Discussion section with the view of improving sexual orientation training. Key learning aims (1) To understand current training provision of sexual orientation training across NHS Talking Therapies courses and services in England. (2) To consider clinicians’ experiences of challenges and barriers that may prevent them from accessing or implementing sexual orientation training in clinical practice. (3) To understand clinicians’ views of the current gaps in training and ways to improve training provision. (4) To make recommendations to NHS Talking Therapies for Anxiety and Depression courses and services in ways to improve training on sexual orientation to better meet the learning needs of clinicians and service users.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135440831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do patients want from therapy? Understanding treatment goals of patients with long-term conditions referred for cognitive behavioural therapy in primary care","authors":"Vilas Sawrikar, Christopher Newton, Leeanne Nicklas","doi":"10.1017/s1754470x23000272","DOIUrl":"https://doi.org/10.1017/s1754470x23000272","url":null,"abstract":"Abstract Integrating cognitive behavioural therapy (CBT) into primary care for patients with long-terms conditions (LTCs) is a priority for the National Health Service (NHS) in the United Kingdom (UK). To inform delivery of cognitive behavioural interventions for this clinical population, the aim of this study was to evaluate the major treatment goal themes of patients with LTCs. A single group mixed-methods design was used to analys treatment goals and their association with patient characteristics. A total of n =222 patients (86 males; 132 females) who participated in a service development evaluation of the Accessible Depression and Anxiety Psychological Therapies for Individuals with Long-Term Conditions in Scotland (UK) were selected for inclusion if they reported at least one treatment goal at assessment. Data were drawn from routine outcome measures that recorded information in relation to client demographics, physical conditions, mental health, functioning and treatment goals. Participants freely reported up to three goals as part of assessment. Thematic analysis identified four major goal themes ranked in the following order of frequency: functioning, emotional health, condition management, and self-appraisal. Wanting to improve functioning was positively associated with age and depression, and negatively associated with anxiety. No other patient characteristics were associated with any of the major themes. Patients with LTCs referred to CBT in primary care can have wide-ranging goals that only partially correspond with their mental health status. Practitioners and service providers need to flexibly deliver CBT to enhance the individual relevance of therapy which is tailored to patient’s goals. Key learning aims (1) Treatment goals are fundamental to a better understanding of how best to assess and plan treatments that meet the needs of patients with long-term conditions. (2) We highlight the need to enhance practitioner competencies in aligning treatment with patient’s goals to ensure goal-based decision-making is achieved in practice. (3) Key areas of goal-oriented therapy for patients with long-term conditions include integrating aspects of wanting to improve functioning, emotional health, condition management, and self-appraisal. These aspects should represent primary outcomes of treatment.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance and commitment therapy (ACT) for post-stroke adjustment difficulties via telerehabilitation in a working-age man","authors":"Jinnie Ooi, Tom Steverson","doi":"10.1017/s1754470x23000260","DOIUrl":"https://doi.org/10.1017/s1754470x23000260","url":null,"abstract":"Abstract Adjustment difficulties following a stroke are common and associated with poorer outcomes. Current systematic reviews suggest insufficient evidence for the efficacy of psychological interventions for post-stroke anxiety and/or depression. However, a recent randomised controlled trial (Majumdar and Morris, 2019) of group-based acceptance and commitment therapy (ACT) showed promise in reducing depression and increasing hopefulness and perceived health status in stroke survivors. The present case study describes the assessment, formulation, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using ACT delivered via telerehabilitation. At the end of treatment (six sessions over 2 months), the client no longer met clinical cut-off for psychological distress and depression. Furthermore, reported levels of psychological flexibility were comparable to non-clinical norms. These gains were maintained at 3- and 6-month follow-up. Outcomes from this case study support emerging evidence indicating that ACT may be an efficacious intervention for post-stroke adjustment difficulties, even when delivered via telerehabilitation. Further research investigating the mediating and moderating effects of different cognitive behavioural processes such as values and acceptance on psychological adjustment to stroke is recommended. Key learning aims (1) Current evidence on the efficacy of psychological interventions for stroke survivors is limited. (2) This case study describes the assessment, treatment and outcomes of post-stroke adjustment difficulties in a working-aged man using an ACT approach. (3) Following six sessions of ACT delivered via telerehabilitation, the client no longer met clinical cut-off for psychological distress and depression. Moreover, his levels of psychological flexibility were comparable to non-clinical norms. (4) Further exploration of psychological processes that facilitate post-stroke adjustment difficulties is recommended.","PeriodicalId":45163,"journal":{"name":"Cognitive Behaviour Therapist","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135505485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}