Cognitive and Behavioral Practice最新文献

{"title":"A Transdiagnostic Treatment to Improve Biomedical and Syndemic Outcomes in People Living With HIV","authors":"","doi":"10.1016/j.cbpra.2023.04.002","DOIUrl":"10.1016/j.cbpra.2023.04.002","url":null,"abstract":"<div><div>People living with HIV (PLWH) experience a range of co-occurring psychosocial stressors, mental health symptoms, and structural barriers (e.g., “syndemics”) that can impair their ability to adhere to medical recommendations for treatment. This has consequences for their health and the health of others as nonadherence increases the likelihood of unsuppressed HIV viral load, and therefore the ability to transmit HIV to others. Transdiagnostic treatment, or treatment not focused on a single mental health condition, can efficiently address a range of mental health problems by skills training to reduce symptoms. Additionally, cognitive behavioral and problem-solving approaches can be used to address larger, structural factors by helping individuals navigate systemic challenges using evidence-based skills. This article describes the development of a transdiagnostic treatment for PLWH and illustrates the application of the treatment through case examples. This treatment might be appropriate for integration into an HIV clinic or within an outpatient setting when working with a patient who is experiencing syndemic conditions and living with HIV.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"31 4","pages":"Pages 423-436"},"PeriodicalIF":2.9,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47856753","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":"We’re in This Together: A Case Study of the Concurrent Delivery of Prolonged Exposure Therapy to Intimate Partners With PTSD","authors":"","doi":"10.1016/j.cbpra.2023.03.002","DOIUrl":"10.1016/j.cbpra.2023.03.002","url":null,"abstract":"<div><div>Research on the links between intimate relationships and PTSD and the treatments for PTSD tend to be limited to couples in which only one partner within the dyad has PTSD. No investigations, to our knowledge, have empirically examined the simultaneous provision of evidence-based PTSD treatment to both partners in an intimate relationship diagnosed with PTSD. The current case study describes two partners in a different-sex relationship, both diagnosed with current PTSD, who received individual Prolonged Exposure (PE) therapy at the same time as part of a larger randomized clinical trial. Each partner received ten, 90-minute individual sessions of PE therapy by two separate clinicians trained in PE followed by a 1-month follow-up. The findings demonstrated significant pre- to posttreatment reductions in PTSD symptoms as measured by the Clinician Administered PTSD Scale-5 (CAPS-5) for the male partner (Δ = 18) and the female partner (Δ = 24). Both partners achieved diagnostic remission of PTSD by end of treatment. In addition, both partners expressed enhancements in relationship functioning that they experienced while receiving PE therapy concurrently. Clinical considerations for the provision of concurrent PE to partners in an intimate relationship are discussed. The positive findings from this case study may inform future research in this much-needed area of treatment for couples where both partners are suffering from PTSD.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"31 4","pages":"Pages 548-562"},"PeriodicalIF":2.9,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47497276","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":"Single-Session Telehealth Booster for Youth Experiencing a Return of Anxiety After CBT: A Case Series","authors":"","doi":"10.1016/j.cbpra.2023.04.001","DOIUrl":"10.1016/j.cbpra.2023.04.001","url":null,"abstract":"<div><div>There is a subset of youth who, despite responding well to CBT, experience a return of anxiety in the years after treatment ends. Although empirical research and clinical recommendations have described approaches to <em>prevent</em> a return of anxiety following CBT, to our knowledge, no empirical or clinical articles have evaluated approaches to help youth who have experienced such a return. In this article, we take an initial step toward providing clinical guidance on addressing recurrence in youth with anxiety disorders by describing the development of an approach, a booster session delivered remotely using telehealth, and by presenting promising preliminary data in a case series among three youths who experienced a return of anxiety following CBT. Participants were <em>N</em> = 3 youths ages 10 to 15 years (<em>M</em> = 12 years; 33% male, 33% female, 33% nonbinary) who previously completed a full CBT protocol for anxiety disorders as part of outpatient clinical services in an urban area of the southeastern United States. Parent- and youth-report on youth anxiety severity were assessed pretreatment and posttreatment. Clinical response to the booster among these three families was mixed and varied by informant source, with an overall positive response according to parent ratings and a smaller response according to youth ratings. This case series represents an important first step toward addressing the return of anxiety in youth following CBT, and findings provide the impetus for further development and evaluation work of single session boosters. Limitations and implications of the findings are discussed.</div></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"31 4","pages":"Pages 539-547"},"PeriodicalIF":2.9,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48986572","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":"How to Conduct Research in Your Private Practice","authors":"Jacqueline B. Persons","doi":"10.1016/j.cbpra.2021.11.004","DOIUrl":"10.1016/j.cbpra.2021.11.004","url":null,"abstract":"<div><p>Mental health professionals who work in private practice and other clinical settings have huge opportunities to contribute to the science of our field. But they rarely do so. This article describes ways that practitioners who have research training can capitalize on recent developments in practice, science, and technology to conduct research in their private practice. I describe a model for conducting research as a practitioner that entails tightly integrating the research into clinical practice, and I point out why conducting research in your private practice is worth doing. The remainder of the paper provides a primer, describing strategies for implementing in a clinical setting all the elements of the research enterprise: addressing ethical and legal issues, keeping up to date with the scientific literature, selecting a good research question, conducting a single-case experimental design, finding collaborators and assistants, collecting the data, analyzing the data, writing the paper and getting it published, and handling time and money. Although this paper focuses on research in a solo or group private practice setting, many of the strategies described here can also prove useful in the conduct of research in hospital or community settings.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 195-207"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48616720","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":"iCOPE With COVID-19: A Brief Telemental Health Intervention for Children and Adolescents During the COVID-19 Pandemic","authors":"Michelle S. Zepeda,&nbsp;Stephanie Deighton,&nbsp;Veronika Markova,&nbsp;Joshua W. Madsen,&nbsp;Nicole Racine","doi":"10.1016/j.cbpra.2021.10.001","DOIUrl":"10.1016/j.cbpra.2021.10.001","url":null,"abstract":"<div><p>The COVID-19 pandemic has prompted extensive disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase in anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care was initially reduced, causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 208-217"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675912","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":"Application of a Quality Improvement Process to Evaluate Self-Directed Therapy for Patients on a Waitlist in an Outpatient Anxiety Disorders Specialty Clinic","authors":"David F. Bradley,&nbsp;Terence H.W. Ching,&nbsp;Lauren Languido,&nbsp;Robert E. Brady","doi":"10.1016/j.cbpra.2021.11.006","DOIUrl":"10.1016/j.cbpra.2021.11.006","url":null,"abstract":"<div><p>The demand for psychological services in the United States is higher than the available supply of qualified mental health professionals. As a result, there is a substantial need for low-cost interventions that are more accessible and amenable to scale-up independent of the availability of clinicians. Previous studies have found that self-directed bibliotherapy can be an effective intervention with minimal therapist contact. Using the Plan-Do-Study-Act (PDSA) improvement process framework, we implemented self-directed therapy in our outpatient anxiety disorders specialty clinic. We identified four self-directed therapy resources (two books and two smartphone apps) based on cognitive behavioral or acceptance and mindfulness principles. We conducted initial 30-minute billable bibliotherapy consultations with six patients on our waitlist, where we provided the rationale for self-guided treatment, introduced the four resources, helped the patient identify one resource to use, and answered any questions. Eight weeks later, we met with five of these patients for a second billable 30-minute consultation (one had already started individual therapy) and gathered information regarding feasibility and acceptability of these resources as well as helped the patient make continued or better use of the resource until beginning therapy. This case series suggests that self-directed interventions can be effectively implemented in this manner, though with mixed outcomes and effects on patients and their course of care. We describe improvements we intend to implement in future iterations of self-directed therapy.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 229-237"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47805611","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":"Post-Admission Cognitive Therapy for a Transgender Service Member With a Recent Suicidal Crisis: A Case Study of Gender-Affirming Care","authors":"Rebecca L. Kauten,&nbsp;Sarah P. Carter,&nbsp;Max Stivers,&nbsp;Laura A. Novak,&nbsp;Margaret M. Baer,&nbsp;Jessica M. LaCroix,&nbsp;Nicholas E. Grant,&nbsp;Britt Sickmann,&nbsp;David B. Goldston,&nbsp;Alyssa Soumoff,&nbsp;Marjan Ghahramanlou-Holloway","doi":"10.1016/j.cbpra.2021.10.007","DOIUrl":"10.1016/j.cbpra.2021.10.007","url":null,"abstract":"<div><p>While elevated suicide risk in the American military and veteran population has led to the development of targeted interventions, the increased risk of suicidal ideation and behavior among transgender and gender diverse (TGD) Service members requires that interventions address suicide risk within the context of minority stressors and gender-affirming care. This case study presents Jordan (an alias), a transgender Service member who received inpatient psychiatric treatment following a suicide attempt precipitated by distress relating to gender dysphoria, minority status, and associated stressors. Jordan completed Post-Admission Cognitive Therapy (PACT; Ghahramanlou-Holloway, Cox, &amp; Greene, 2012), a cognitive-behavioral intervention targeting suicide risk among military personnel and dependents psychiatrically hospitalized following a suicidal crisis. Within the context of PACT, Jordan’s treatment included identifying and addressing distress related to minority stressors (externalized stigma, internalized transphobia, anticipated rejection, gender concealment) using gender-affirming best practices. Marked changes in Jordan's self-report measures from baseline to follow-up, as well as qualitative changes reported by Jordan, demonstrate that she felt comfortable, safe, and ready to be discharged from the inpatient unit after completing PACT treatment and gaining exposure to the skills necessary to help prevent and/or manage future suicidal crises. Treatment implications and recommendations for addressing suicide risk within the context of gender-affirming care and prevalent minority stressors are discussed.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 273-286"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49251991","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":"Race in the Space: Clinical Considerations for Addressing Race in Treatment","authors":"Faithlynn Morris,&nbsp;Zachary W. Rawlings","doi":"10.1016/j.cbpra.2021.12.001","DOIUrl":"https://doi.org/10.1016/j.cbpra.2021.12.001","url":null,"abstract":"<div><p>During a period of intense racial unrest in the nation, we were working as clinicians delivering a manualized protocol to LGBTQ adults of varying racial and ethnic backgrounds. Intrigued by the differences in our modes of engagement with clients, we, a Black, cis female therapist and White, cis male therapist, set out to further explore how our positionalities informed our communications with, and expectations of, White and non-White clients during this time. In this paper, we reflect on these differences when delivering therapy in cross-racial and same-race dyads. We highlight where our experiences overlap as clinicians trained in the same program and where they diverge due to our respective worldviews. We conclude with considerations for practitioners to engage with race in psychotherapeutic treatment.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 248-255"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49708722","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":"Cover 2: Editorial Board","authors":"","doi":"10.1016/S1077-7229(23)00022-6","DOIUrl":"https://doi.org/10.1016/S1077-7229(23)00022-6","url":null,"abstract":"","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Page IFC"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49718058","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":"Is It Easy to Use and Useful? Mental Health Professionals’ Perspectives Inform Development of a Novel Treatment Engagement System for Youth Mental Health Services☆☆☆","authors":"Wendy Chu,&nbsp;Kimberly D. Becker,&nbsp;Maya M. Boustani,&nbsp;Alayna L. Park,&nbsp;Bruce F. Chorpita","doi":"10.1016/j.cbpra.2021.11.003","DOIUrl":"10.1016/j.cbpra.2021.11.003","url":null,"abstract":"<div><p>User experiences are essential to the adoption of an intervention and can be integral to intervention design. We applied two concepts from the technology acceptance model (i.e., perceived ease of use, perceived utility) to understand how mental health professionals experienced a novel system of resources (i.e., engagement system) designed to improve problem identification, coordination, and treatment planning decisions related to addressing problems of low treatment engagement in school mental health services. We conducted a 1-hour focus group with 10 mental health professionals (provider <em>n</em> = 8, supervisor <em>n</em> = 2) using prompts to elicit their perspectives about the effort involved in using the engagement system and about the usefulness of the system in their work. The focus group was transcribed and segmented into 70 excerpts by trained coders. We analyzed the transcript using a consensual qualitative research approach. Ease of use was coded in 15 (39%) excerpts and utility was coded in 24 (61%) excerpts. The valences of excerpts were neutral (<em>n</em> = 18; 46%), positive (<em>n</em> = 10; 26%), and negative (<em>n</em> = 11; 28%). Thirty-nine (56%) excerpts discussed the engagement system. Excerpts pertained to problem identification (<em>n</em> = 18; 46%), coordination (<em>n</em> = 18; 46%), and treatment planning (<em>n</em> = 3; 8%). Findings revealed that resources and procedures were rated differently on their perceived ease of use and utility. Participants reported that the coordination resource had high utility and positively impacted their clinical practice and supervision, while the problem identification resources had low ease of use and were burdensome or difficult to use. Some lessons learned include the value of designing resources that provide structure to clinical decision processes yet allow for some flexibility, the need for simpler and automated procedures to reduce provider burden, and the importance of clear guidelines on how resources should and should not be used. We used this feedback to inform changes to the engagement system prior to testing in a randomized trial. This brief report highlights how applying the technology acceptance model to evaluate interventions can aid in the successful implementation of novel clinical interventions.</p></div>","PeriodicalId":51511,"journal":{"name":"Cognitive and Behavioral Practice","volume":"30 2","pages":"Pages 256-262"},"PeriodicalIF":2.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42549842","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}