Margaret Gacheru, Christine Mauro, Natalia Skritskaya, Nicole Alston, Charles F. Reynolds III, Naomi Simon, Sidney Zisook, Barry Lebowitz, M. Katherine Shear
{"title":"Exploring Differences in Presentation and Treatment Outcomes Between Black and White American Adults With Prolonged Grief Disorder","authors":"Margaret Gacheru, Christine Mauro, Natalia Skritskaya, Nicole Alston, Charles F. Reynolds III, Naomi Simon, Sidney Zisook, Barry Lebowitz, M. Katherine Shear","doi":"10.1016/j.cbpra.2024.05.004","DOIUrl":"10.1016/j.cbpra.2024.05.004","url":null,"abstract":"<div><div>Prolonged grief disorder (PGD) is a condition of persistent, intense grief and PGD-targeted psychotherapy (PGDT) is an efficacious treatment. This study aimed to compare participants with PGD who self-identified as Black versus White, with respect to baseline features and response to PGDT. We performed a secondary data analysis of 55 Black and 455 White adults from two randomized clinical trials. Racial differences in baseline features were examined using Chi-squared and T-tests. We compared assessment completion and treatment response rates (PGDT vs. no PGDT) by race and evaluated posttreatment self-reported measures using linear models. There were racial differences in the cause of death, relation to the deceased, and taking comfort in religion. Black participants had similar ratings to their counterparts on impairment and grief severity at baseline. However, they had higher scores on a baseline measure of typical grief-related beliefs. Both racial groups had significantly greater response rates to PGDT than the comparison treatment. Similarly, PGDT resulted in lower posttreatment impairment than the comparison treatment for both racial groups. However, only the White participants had a difference in posttreatment grief severity between the treatment groups. This study supports the idea that PGD characteristics are similar in Black and White treatment seeking individuals, and that Black and White participants display improvement in response to PGDT.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 44-55"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141943633","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}
Shannon M. Kehle-Forbes, Tara Galovski, Melissa A. Polusny, Kyle Possemato, Sean Nugent, Eliza McManus, Allison L. Baier
{"title":"Development and Pilot Test of a Therapist-Assisted Self-Management Program for Completers of Trauma-Focused Therapy for Posttraumatic Stress Disorder","authors":"Shannon M. Kehle-Forbes, Tara Galovski, Melissa A. Polusny, Kyle Possemato, Sean Nugent, Eliza McManus, Allison L. Baier","doi":"10.1016/j.cbpra.2023.08.002","DOIUrl":"10.1016/j.cbpra.2023.08.002","url":null,"abstract":"<div><div>Veterans who complete an evidence-based trauma-focused therapy (TFT) for posttraumatic stress disorder (PTSD) report continued treatment needs to build self-efficacy, promote continued skill application, and bolster engagement in valued activities. This paper describes the rationale, development, and treatment structure of a novel 4-session therapist-assisted self-management program, named EMPOWER, for TFT completers. A mixed methods approach was used to evaluate the acceptability and feasibility of the intervention in an open pilot trial with 12 veterans. Therapists delivered the treatment with fidelity and participants reported high acceptability and satisfaction with EMPOWER. Quantitatively, participants reported meaningful improvements in quality of life and small improvements in community engagement; however, there were no clinically meaningful changes in self-efficacy, PTSD symptoms, depression, or functioning pre- to postintervention. Qualitatively, participants noted EMPOWER met their post TFT needs and that the structure of treatment was helpful in continuing to practice TFT skills. They also noted improvements in self-efficacy for self-managing PTSD symptoms and an increase in valued activities. Findings suggest EMPOWER is feasible, acceptable, and meets veterans’ post-TFT treatment needs. A larger-scale, randomized trial of EMPOWER is warranted to evaluate the impact of EMPOWER on self-efficacy, clinical symptoms, functioning, and quality of life.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 91-105"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47540332","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}
{"title":"The Impact of Exposure Therapy on Cancer-Related Future Cognitions in Severe Health Anxiety","authors":"Nora Brier, Lily A. Brown","doi":"10.1016/j.cbpra.2023.07.001","DOIUrl":"10.1016/j.cbpra.2023.07.001","url":null,"abstract":"<div><div>Individuals with illness anxiety disorder (IAD) experience a preoccupation with having or acquiring a serious illness despite having mild or absent physical symptoms. Formerly hypochondriasis, individuals with IAD experience high rates of disability, contribute to elevated annual health care costs, and experience multiple comorbidities. IAD has been historically difficult to treat for both medical and mental health providers. Research suggests cognitive behavior therapy has mixed results for individuals with IAD. In this fictitious case presentation, we describe a course of successful exposure therapy for IAD drawing on the principals of inhibitory learning theory. Thus, through this example we demonstrate how to overcome common obstacles to successful treatment for IAD, such as willingness to participation, comorbid depression, and therapeutic alliance.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 123-133"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348088","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}
Christina Buur , Thomas Mackrill, Lisbeth Hybholt , Eva Rames Nissen, Maja O’Connor
{"title":"Older Bereaved Individuals’ Experiences of Cognitive-Behavioral Therapy for Complicated Grief Reactions: A Qualitative Multistage Focus Group Approach","authors":"Christina Buur , Thomas Mackrill, Lisbeth Hybholt , Eva Rames Nissen, Maja O’Connor","doi":"10.1016/j.cbpra.2024.06.002","DOIUrl":"10.1016/j.cbpra.2024.06.002","url":null,"abstract":"<div><div>Bereavement is particularly common in old age. A small proportion of bereaved people develop complicated grief reactions (CGR) characterized by elevated symptoms of depression, prolonged grief disorder, anxiety, and/or posttraumatic stress. Cognitive-behavioral therapy for CGR (CBTgrief) is found to be an effective treatment. Detailed knowledge about older adults’ experiences of CBTgrief is needed to optimize treatment and to give recommendations to practice. To explore older adults’ experience of CBTgrief to gain insight into elements that were helpful or less helpful. Four multistage focus group interviews were conducted with nine older adults who lost a partner and received CBTgrief and three researchers. Five participants received group therapy and four individual therapy (mean age = 69.67 years, 89% women). The participants found exposure exercises, psychoeducation in grief, and letter writing particularly helpful. The participants requested options for family sessions, a combined individual/group format, and follow-up sessions. Awareness of potential memory problems and adapting to new practical tasks should receive greater focus in therapy. This study gives important insights into older adults’ experiences of CBTgrief and evaluates the helpful and less helpful elements in grief therapy. This may guide improvements in the treatment of bereaved older adults with CGR.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 56-69"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190627","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}
{"title":"Cognitive Behavioral Treatments for Prolonged Grief: Introduction to the Special Feature","authors":"Donald J. Robinaugh, Naomi M. Simon","doi":"10.1016/j.cbpra.2024.11.003","DOIUrl":"10.1016/j.cbpra.2024.11.003","url":null,"abstract":"<div><div>Over the past two decades, researchers have devoted enormous effort to developing treatments for prolonged grief disorder that are rooted in cognitive behavioral principles. There is now considerable evidence that these treatments are effective in reducing prolonged grief disorder severity. In this article, we introduce and provide an overview of a special series of articles in <em>Cognitive and Behavioral Practice</em> whose aim is to introduce clinicians and clinical researchers to the treatment of prolonged grief. By bringing together recent empirical research with expert clinical guidance, this special issue provides (a) further support for the efficacy of cognitive behavioral treatments for prolonged grief, (b) valuable insight into how they can be most effectively delivered, and (c) consideration for how to ensure that all individuals impacted by prolonged grief disorder can access the most effective care possible. We close with a brief discussion of paths forward for the continued advancement of cognitive behavioral treatments for prolonged grief.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528728","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}
{"title":"Prolonged Grief Therapy","authors":"M. Katherine Shear, Naomi M. Simon","doi":"10.1016/j.cbpra.2024.12.002","DOIUrl":"10.1016/j.cbpra.2024.12.002","url":null,"abstract":"<div><div>This paper provides a concise introduction to Prolonged Grief Therapy (PGT), an evidence-based treatment for the new PGD diagnosis in DSM-5 and ICD-11. PGD differs from nonclinical grief as well as major depression and PTSD. PGD symptoms show little response to treatments for depression. PGD comorbidity predicts worse treatment outcome for PTSD. Our group began describing PGD in the mid-1990s, using the terms “traumatic” or “complicated” grief, and to develop and test a treatment for this condition. The publication in 2005 of our randomized trial became the first empirically validated treatment for this condition. It is based upon the premise that grief is the natural response to loss that continues for an indefinite period of time after someone close dies. It is based upon the premise that grief is the natural response to loss that evolves and subsides as a bereaved person learns to live in a world of absence. PGD is the result of impediments to this learning process and the treatment aims to facilitate learning to live with a loss and to address impediments to this process. The recency of its inclusion in DSM-5 leaves many clinicians unfamiliar with PGD, the treatment that we validated, the studies in which the treatment was tested and the ways available to learn and use this approach. This paper provides a brief summary of each of these topics.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 6-17"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528851","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}
Antonio F. Pagán, Gregory H. Mumma, Andrew K. Littlefield
{"title":"Using Visual Displays in a Manualized Cognitive-Behavioral Treatment for Adults With ADHD and Comorbid Mood or Anxiety Disorders: A Pilot Study","authors":"Antonio F. Pagán, Gregory H. Mumma, Andrew K. Littlefield","doi":"10.1016/j.cbpra.2023.08.003","DOIUrl":"10.1016/j.cbpra.2023.08.003","url":null,"abstract":"<div><div><span><span>Attention-deficit/hyperactivity disorder (ADHD) in adults is a major health concern, often occurring with other disorders and functional, occupational, and relational deficits. Unfortunately, many treatment studies for adults with ADHD exclude comorbid mood or anxiety disorders. The present two-part study sought to identify the feasibility, acceptability, and preliminary effectiveness of a treatment for adults with ADHD and comorbid mood or anxiety disorders that used modules from evidence-based cognitive-behavioral (CB) and mindfulness interventions for </span>adult ADHD and mood or anxiety disorders. Selection of modules for each participant’s treatment was guided by participant input (e.g., top problems) and personalized visual displays. Visual displays included a CB case formulation and intraindividual network analyses, using pretreatment ecological momentary assessment (EMA) data completed two or three times a day to assess ADHD and comorbid symptoms. All 9 (6 women) participants completed the pretreatment standardized measures—however, completion of EMA data by 6 participants provides mixed support for the feasibility of utilizing EMA with ADHD adults. Nevertheless, the results indicate feasibility for using this </span>CB treatment combining manualized interventions with treatment personalization using complex visual displays from available EMA data. Seven of 9 (77.8%) participants achieved a reliable change and 5 (55.6%) achieved a clinically significant change in total ADHD symptoms (Barkley Adult ADHD-IV Rating Scale) at posttreatment and/or 3-month follow-up. Inattention symptoms reliably decreased in all participants.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 106-122"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48373638","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}
Fiona Maccallum, Katie Dawson, Suzanna Azevedo, Richard A. Bryant
{"title":"Challenges in Grief-Focused Cognitive Behavior Therapy for Prolonged Grief Disorder","authors":"Fiona Maccallum, Katie Dawson, Suzanna Azevedo, Richard A. Bryant","doi":"10.1016/j.cbpra.2023.10.002","DOIUrl":"10.1016/j.cbpra.2023.10.002","url":null,"abstract":"<div><div>Prolonged Grief Disorder (PGD) is a potential deleterious outcome of bereavement that is associated with significant negative psychological consequences. The condition is thought to be maintained through a dynamic interplay between painful memories, maladaptive appraisal patterns, and unhelpful coping behaviors, including a persistent avoidance of reminders of the loss. Grief-focused cognitive behavior therapies (GF-CBT) targeting these mechanisms have been found to ameliorate symptoms, with treatments that include exposure-based processing of memories of the loss showing superior outcomes. However, data indicate that treatments involving exposure-based techniques are typically underutilized by mental health clinicians. In this clinical report we describe a series of cases that illustrate common challenges encountered in implementing GF-CBT and outline practical approaches to address these challenges.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 18-28"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138690071","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}
{"title":"Cognitive Behavioral Therapy for Childhood Prolonged Grief Disorder for Bereaved Children and Adolescents With Comorbid Problems: Case Vignettes","authors":"A.A.A. Manik J. Djelantik, Mariken Spuij","doi":"10.1016/j.cbpra.2024.12.004","DOIUrl":"10.1016/j.cbpra.2024.12.004","url":null,"abstract":"<div><div>The cognitive behavioral therapy (CBT) protocol for prolonged grief disorder in children and adolescents has demonstrated effectiveness in multiple studies, including a large randomized controlled trial. However, in clinical practice, we frequently encounter children with prolonged grief disorder who also present with comorbid conditions, such as other mental health disorders (e.g., posttraumatic stress disorder) and developmental disorders (e.g., autism spectrum disorder). This paper aims to describe the CBT protocol for prolonged grief in children and adolescents and to illustrate, through case vignettes and clinical observations, how this protocol may be adapted for use with children with comorbid conditions. We show that thorough clinical assessment is crucial for adapting techniques from other protocols into PGD treatment. Future research should prioritize the inclusion of detailed case studies of children with PGD and comorbidities to advance our understanding and optimize the individualization of treatment strategies.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 70-77"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528852","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}
Katrine B. Komischke-Konnerup, Maja O'Connor, Herbert Hoijtink, Paul A. Boelen
{"title":"Cognitive-Behavioral Therapy for Complicated Grief Reactions: Treatment Protocol and Preliminary Findings From a Naturalistic Setting","authors":"Katrine B. Komischke-Konnerup, Maja O'Connor, Herbert Hoijtink, Paul A. Boelen","doi":"10.1016/j.cbpra.2023.11.001","DOIUrl":"10.1016/j.cbpra.2023.11.001","url":null,"abstract":"<div><div>In bereavement, some individuals develop complicated grief reactions (CGR), including symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Symptoms of PGD often co-occur with other complicated grief reactions, e.g., PTSD and depression, pointing to the need for a transdiagnostic understanding of CGR to inform treatment. In this paper, a transdiagnostic cognitive-behavioral therapy for CGR called “CBTgrief” is explained, including its theoretical framework and treatment content. CBTgrief is based on previous cognitive-behavioral conceptualizations of PGD, PTSD, and depression and includes 12 sessions consisting of exposure, cognitive restructuring, and behavioral activation. Preliminary findings of CBTgrief are evaluated in terms of feasibility, acceptability, and treatment satisfaction in a sample of eight older bereaved individuals treated for different types of CGR in a naturalistic clinical setting. Additionally, theory-driven hypotheses about changes in CGR and theoretical proposed core maintaining processes are evaluated using Bayesian informative hypotheses testing. Preliminary findings, limitations, implications, and future directions are discussed.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"32 1","pages":"Pages 29-43"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138690307","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}