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The Use of Distraction in the Treatment of Anxiety

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck describes the use of distraction in the treatment of anxiety disorders. He discusses the ways in which distraction can be productive for different forms of anxiety. Although distraction is not a long term solution, Dr. Beck shows how using distraction can provide an initial sense of relief and control for the patient and help reduce the intensity of anxiety symptoms.

For more information on Beck Institute’s workshops, visit our webiste.

Individualized Internet-CBT Reduces Symptoms in Adults with Panic Attacks

According to a recent study published in the Journal of Medical Internet Research, individually tailored, internet-based cognitive behavior therapy (iCBT) may help alleviate panic symptoms and comorbid anxiety and depression. The current study examined the efficacy of iCBT for adults with reoccurring panic attacks. Participants (n=57) were randomly assigned to either receive treatment immediately (n=29), or to a waitlist control group (n=28).  Treatment included eight weeks of therapist-guided and individually-tailored, modular CBT designed to target participants’ comorbid symptoms. At post-treatment, 67% of participants in the experimental group showed significant improvements in symptoms, as compared to 11% in the control group. At a 12-month follow up, 70% of participants interviewed had maintained improvements. These results suggest that tailored iCBT may be a valuable, short- and long-term treatment option for individuals with panic and comorbid anxiety and depressive symptoms.

Silfvernagel, K., Carlbring, P., Kabo, J., Edström, S., Eriksson, J., Månson, L., & Andersson, G. (2012). Individually tailored internet-based treatment for young adults and adults with panic attacks: Randomized controlled trial. Journal of Medical Internet Research, 14(3) e65.

The Effectiveness of Evidence-Based Treatment in Combating Multiple Anxiety Disorders

researchlogo72x65bl-new.jpgA recent study published in The Journal of the American Medical Association compared the effectiveness of Evidence-Based Treatment against usual care for multiple types of anxiety disorders.  The participants consisted of 1004 patients with varying anxiety disorders including panic, generalized anxiety, social anxiety, and post-traumatic stress disorder in 17 primary care clinics in 4 US cities.The researchers used a Brief Symptom Inventory (BSI) to measure both anxiety and somatic symptoms.  These initial scores were compared with follow-up measurements taken after 6, 12 and 18 months of either Coordinated Anxiety Learning and Management (CALM) or usual care.

The CALM model allowed participants in the intervention group to choose between Cognitive Behavior Therapy (CBT), medication alone, or CBT combined with medication. Real-time web-based outcomes monitoring was also incorporated to optimize treatment decisions, as well as a computer-assisted program to optimize the delivery of CBT.

Results showed that CALM techniques were significantly more effective than usual care in reducing global anxiety symptoms.  Patients undergoing CALM treatment had significantly reduced scores on the Brief Symptom Inventory.  These patients also had higher response and remission rates.   Response was defined as at least a 50% reduction on the BSI or meeting the definition of remission.  Remission was defined as an anxiety score between none and mild.

The results of this trial illustrate the effectiveness of Evidence-Based Treatment, specifically Coordinated Anxiety Learning and Management in real-world practice settings. CALM proved to be more effective than usual care for multiple types of anxiety disorders.  This trial indicated that Evidence-Based Treatment may be of greater help to patients with anxiety disorders than those measures currently being used.

Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., Bystritsky, A., Welch, S. S., Chavira, D. A., Golinelli, D., Campbell-Sills, L., Sherbourne, C. D., & Stein, M. B.  (2010).  Delivery of evidence-based treatment for multiple anxiety disorders in primary care.  The Journal of the American Medical Association, 303, 1921-1928.

Generalizing Cognitive Behavior Therapy for Anxiety Disorders to Clinical Practice

NewStudy-Graphic-72x72_edited-3 Studies conducted at the University of Pennsylvania add to a growing body of research that supports the use of cognitive behavior therapy (CBT) in clinical practice. In their meta-analysis review of 56 studies, Stewart and Chambless (2009) examined CBT treatments for social anxiety disorder, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD), panic disorder, and posttraumatic stress disorder (PTSD), and found significant support for each treatment within the clinical setting. When CBT treatments were compared to control conditions, 78% of participants improved with CBT treatment as compared to 22% of participants in control groups. Additional analyses also indicated lower effect sizes for treatment outcomes when therapists were not trained, when treatment manuals were not used, and when treatment fidelity was not monitored. This data points to the importance of training, the use of treatment protocols, and the monitoring of treatment fidelity.

Reference

Stewart R.E. & Chambless, D.L. (2009). Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77, 595-606.

Cognitive Therapy of Anxiety Disorders: Science and Practice

Anxiety-Clark-Beck-2009-1 We asked David A. Clark to send us a description of the excellent, state-of-the-art new book on anxiety he co-authored with Aaron Beck, along with some behind-the-scenes history. Here’s what he wrote:

Cognitive Therapy of Anxiety Disorders: Science and Practice (Clark & Beck, 2010, from Guilford Press, pp. 628) represents the outgrowth of my 26 year journey of inquiry, discovery and acquired knowledge on the cognitive basis of the emotional disorders.  It has been an honor and privilege to collaborate with Aaron T. Beck on many different projects over the years.  He has been the mentor who contributed enormously to what I know about psychological problems like anxiety and depression, and who taught me most about the importance of adopting an integrative, scientific perspective in which theory, research and practice are mutually informed by each other.  Read more