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Happy 2017, Beck Institute Community


I know, it’s February and perhaps a little late to wish everyone a happy New Year. But we are already running at a fast pace to make this another memorable year, and wanted to let you know what is ahead in 2017.

 

First, let’s talk about the amazing growth we experienced in 2016. As you know, the mission of the Beck Institute is to promote excellence in CBT around the world.  We accomplish this with workshops for individuals in Philadelphia and around the US, training for organizations around the world, and courses online.  2016 saw tremendous growth in each of these areas. 

Here are some highlights:

  • We launched our online programs, delivering over 2,000 courses to individuals in over 70 countries. 
  • We increased our work with organizations by 30%! 
  • We delivered our workshops On the Road in cities across the US, and on weekends, which meant less time missing work for attendees.

 

With 2017 underway, we expect another banner year.  Here are a few of the exciting things we have planned:

 


We established the Beck Institute over 20 years ago. In that time, we estimate that we’ve trained over 10,000 health and mental health professionals to improve their CBT skills. If those individuals had even 10 people on their caseload (and we know you have more), that is over 100,000 clients that have had the benefit of better therapeutic interventions. That’s what we’re about… better trained therapists mean more healthy people.

 

Could you take a few moments to complete our short, 3-question survey? It will help us design an array of training opportunities to suit your needs and the needs of professionals worldwide.

 

 

Sincerely,

Judith Beck

 

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The Evolution of CBT in Community Mental Health

 

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Aaron T. Beck, MD

Part 2 of 3 (Read part 1, A Biography of Cognitive Behavior Therapy)

 

At some point, Cognitive Therapy morphed into what was then called Cognitive Behavioral Therapy, and continued to be quite popular.  It turned out to be widespread, and people came to us from all over the world for training.  However, I had a nagging feeling that we were mostly training therapists who would be seeing individuals in private practice. That meant that people with a higher social economic status tended to receive Cognitive Therapy, but there was a huge population of other individuals, being treated within the community, who did not receive Cognitive Therapy or any of the other evidence based treatments.  So the question become, how do we get to treat patients in a community setting?  I had no contacts within the community in Philadelphia.  And then by a stroke of fortune, I heard that there was a new director of the Philadelphia Department of Behavioral Health and Intellectual Disabilities Services (DBHIDS). Arthur Evans, Ph.D. was coming from Yale University.  I could see right off there would be a meeting of the minds.  I was looking for a community in which to disseminate Cognitive Therapy and he was looking for an evidence based treatment to disseminate in DBHIDS.  Thus, we started a partnership in 2007.

And so we continued on and it was quite successful.  Dr. Torrey Creed joined my team and headed up the work, developing implementation strategies to bring CBT to diverse real-world settings.  Again, there was a great deal of adaptation, but this time it was to find ways to fit CBT to the challenges of community mental health.  We published a paper in the Journal of Consulting and Clinical Psychology describing the first 7 years of our work, showing that we are able to bring high-quality CBT to the previously missed community populations, even in non-traditional treatment settings with complex patients.  In fact, the clinicians were able to deliver CBT with as much competency as therapists in the earlier clinical trials!

Then around 2011, Arthur Evans told me that there was a panel at the American Psychological Association on the Recovery movement, and he asked if I would give a lecture on Recovery.  Well, that puzzled me. I asked, “What is Recovery?  Well, Recovery has to do with setting up certain objectives for the individuals rather than simply focusing on relief of symptoms.  It was ascertaining from the individuals what their major goals in life were—e.g., to be independent, to have connections with other people, to be involved productively, to have a restoration of dignity and to have purpose.  I thought, wow – that all sounds ideal.  So I asked Arthur, “How do you go about doing this?  They are wonderful objectives, but how do you go from A to Z?  For example, a patient who is huddled in a corner and talking to himself all day, how do you get him out, to living independently, getting a job, making connections with other people?”  And he said, “Well, that’s going to be the topic of your speech!”

So I did a lot of head work.  I talked with Dr. Paul Grant, and we came up with a new way in which we are able to use the same principles of Cognitive Therapy that we use with depression and anxiety.  The same principles could be utilized within a Recovery framework, working with severely mentally ill individuals – but it differed in many respects from the standard Cognitive Therapy techniques. For example, there is less emphasis on dialogue and much more on forming a solid relationship with the individual – some call it engagement – and then setting goals with the individuals, and following this up with a number of experiential and behavioral experiences or assignments, which would advance the individual from being huddled in a corner, to becoming more engaged with the therapist and with the therapeutic community (which was very important), and then moving on to less restrictive levels of care, and then finally, finding their place in the community.

And so we started off at the Episcopal Hospital and then moved on to Girard Hospital, and from there, we went to various other settings. Eventually, we were able to go to facilities that were serving the severely mentally ill individuals.

The Hallmark of Cognitive Therapy

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The hallmark of cognitive therapy is understanding clients’

reactions—emotional and behavioral—in terms of

how they interpret situations.

– Judith S. Beck

 

Positive Reinforcement

“Clients should always be positively reinforced for expressing their doubts and concerns about therapy or the therapist. ”

Judith S. BeckBeck JSB Portait

Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia

Abstract

As part of a larger randomized controlled trial, 188 participants were randomized to behavior therapy (BT), cognitive therapy (CT), or cognitive-behavioral therapy (CBT) for insomnia. The aims of this study were threefold: (a) to determine whether change in dysfunctional beliefs about sleep was related to cresearch blog (10)hange in sleep, insomnia symptoms, and impairment following treatment; (b) to determine whether BT, CT, and CBT differ in their effects on dysfunctional beliefs; and (c) to determine whether the treatments differ in their effects on particular kinds of dysfunctional beliefs. Beliefs, sleep, insomnia symptoms, and sleep-related psychosocial impairment were assessed at pretreatment, posttreatment, and 6- and 12-month follow-up. Greater change in dysfunctional beliefs occurring over the course of BT, CT, or CBT was associated with greater improvement in insomnia symptoms and impairment at posttreatment and both follow-ups. All groups experienced a significant decrease in dysfunctional beliefs during treatment, which were sustained through 6- and 12-month follow-up. Compared with the BT group, a greater proportion of participants in the CT and/or CBT groups endorsed dysfunctional beliefs below a level considered clinically significant at posttreatment and 12-month follow-up. The results demonstrate the importance of targeting dysfunctional beliefs in insomnia treatment, suggest that beliefs may be significantly modified with BT alone, and indicate that cognitive interventions may be particularly powerful in enhancing belief change.

 

Eidelman P., Talbot, L., Ivers H., Belanger, L., Morin, C. M., & Harvery A. G. (January 2016) Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia. Behavior Therapy, 47(1), 102-115.

A Randomized Clinical Trial Comparing Group Cognitive-Behavioral Therapy and a Topical Steroid for Women With Dyspareunia

Abstract

OBJECTIVE:This 13-week randomized clinical trial aimed to compare group cognitive-behavioral therapy (GCBT) and a topical steroid in the treatment of provoked vestibulodynia, the most common form of dyspareunia.

METHOD:Participants were 97 women randomly assigned to 1 of 2 treatment conditions and assessed at pretreatment, posttreatment and 6-month follow-up via structured interviews and standard questionnaires pertaining to pain (McGill Pain Questionnaire, 11-point numerical rating scale of pain during intercourse), sexual function (Female Sexual Function Index, intercourse frequency), psychological adjustment (Pain research blog (9)Catastrophizing Scale, Painful Intercourse Self-Efficacy Scale), treatment satisfaction, and participant global ratings of improvements in pain and sexuality.

RESULTS:Intent-to-treat multilevel and covariance analyses showed that both groups reported statistically significant reductions in pain from baseline to posttreatment and 6-month follow-up, although the GCBT group showed significantly more pain reduction at 6-month follow-up on the McGill Pain Questionnaire. The 2 groups significantly improved on measures of psychological adjustment, and the GCBT group had significantly greater reductions in pain catastrophizing at posttreatment. Both groups’ sexual function significantly improved from baseline to posttreatment and 6-month follow-up, and the GCBT group was doing significantly better at the 6-month follow-up. Treatment satisfaction was significantly higher in the GCBT group, as were self-reported improvements in pain and sexuality.

CONCLUSIONS:Findings suggest that GCBT may yield a positive impact on more dimensions of dyspareunia than a topical steroid, and support its recommendation as a first-line treatment for provoked vestibulodynia.

Bergeron, S., Khalife S., Dupuis, M. J., & McDuff P. (January 2016)  A Randomized Clinical Trial Comparing Group Cognitive-Behavioral Therapy and a Topical Steroid for Women With Dyspareunia. Journal of Clinical and Counseling Psychology. 

Characteristics of U.S. Veterans Who Begin and Complete Prolonged Exposure and Cognitive Processing Therapy for PTSD

New Study (1)Abstract

This retrospective chart-review study examined patient-level correlates of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) among treatment-seeking U.S. veterans. We identified all patients (N = 796) in a large Veterans Affairs PTSD and anxiety clinic who attended at least 1 individual psychotherapy appointment with 1 of 8 providers trained in EBP. Within this group, 91 patients (11.4%) began EBP (either Cognitive Processing Therapy or Prolonged Exposure) and 59 patients (7.9%) completed EBP. The medical records of all EBP patients (n = 91) and a provider-matched sample of patients who received another form of individual psychotherapy (n = 66) were reviewed by 4 independent raters. Logistic regression analyses revealed that Iraq and Afghanistan veterans were less likely to begin EBP than veterans from other service eras, OR = 0.48, 95% CI = [0.24, 0.94], and veterans who were service connected for PTSD were more likely than veterans without service connection to begin EBP, OR = 2.33, 95% CI = [1.09, 5.03]. Among those who began EBP, Iraq and Afghanistan veteran status, OR = 0.09, 95% CI = [0.03, 0.30], and a history of psychiatric inpatient hospitalization, OR = 0.13, 95% CI = [0.03, 0.54], were associated with decreased likelihood of EBP completion.

 

Mott, J.M., Mondragon, S., Hundt, N.E., Beason-Smith, M., Grady, R.H., & Teng, E.J. (2014).Characteristics of U.S. veterans who begin and complete prolonged exposure and cognitive processing therapy for PTSD. Journal of Traumatic Stress, 27(3), 265-273.doi: 10.1002/jts.21927.

A Monthly Summary of Beck Institute Updates [August 2013]

In its efforts to encourage the growth and dissemination of CBT throughout the world, Beck Institute has expanded its online presence across social media and other platforms. To keep you (our readers) informed of our most recent updates, we’ve decided to implement a monthly summary including: blogs, CBT articles, CBT trainings, and other updates for our readers. We’re very excited about some of the new developments at Beck Institute, including our new Core Curriculum. Please use the following links to go back and read what you may have missed from August 2013:

Click here for a complete schedule of Beck Institute workshops

See what you missed in July 2013

Group Cognitive Behavior Therapy

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck explains how CBT techniques used during individual therapy can be effectively applied in the group setting. Dr. Beck discusses the “the 3 C’s”, a CBT technique in which patients are taught how to “catch”, “check”, and “correct” their automatic thoughts. In group-based cognitive behavior therapy, patients can use the “the 3 C’s” to help each other recognize and modify automatic thoughts they experience.

To learn more about cognitive behavior therapy training and workshops, visit www.beckinstitute.org.

Cognitive Behavior Therapy for Chronic Disease

In this video from Beck Institute’s recent CBT Workshop for Students and Faculty, Dr. Aaron Beck discusses cognitive behavior therapy for patients coping with medical problems.  Dr. Beck explains that depression associated with disease derives from the meaning one attaches to the physical ailment. It is neither realistic nor is it a derivative of disease, itself. Instead, patients who experience physical symptoms of disease may have exaggerated feelings of helplessness which leads to feelings of worthlessness. The depression they experience derives from the negative value judgments they make of themselves.

For more information on CBT workshops and training, visit our website.