Posts

CBT for Depression

Dr. Aaron Beck explains the history of biological and psychological research on depression. He also discusses studies that looked at the likelihood of depression in people who experienced trauma during childhood. This video was taken at Beck Institute’s CBT for Children and Adolescents workshop, for more information, or to register for our next workshop visit: www.beckinstitute.org/cbt-workshops/

Evaluation of a DVD-Based Self-Help Program in Highly Socially Anxious Individuals – Pilot Study

A recent study published in Behavior Therapy found a CBT-oriented DVD-based self-help program (SHP), to be a potential treatment option for those with nonclinical degrees of social anxiety. Social anxiety disorder is described as a constant fear of particular social or performance situations coupled with acting in an embarrassing manner in those situations. The current study sought to evaluate the effectiveness of CBT-oriented DVD-based SHP supplemented by therapeutic assistance. The participants in the current study suffered from subthreshold social anxiety, which if not treated could evolve into social anxiety disorder as diagnosed in the DSM-IV. Participants had access to therapists via phone, email, or in-person sessions, in addition to the SHP.

Following several self-report questionnaires and an interview, twenty-four participants were selected to participate in the study. Twelve participants were assigned to the control group and were placed on a wait-list while the remaining twelve were given the SHP. Both groups completed self-report measures before and after the intervention. The experimental group underwent an eight-week trial program during which time they viewed guided lessons and were subsequently given homework assignments (e.g., approaching a stranger and asking for the time.) Participants then emailed their therapist a summary of their homework assignment. This helped researchers ensure that participants were truly completing the program and understanding the material presented to them.

Results demonstrated that participants in the experimental group showed improvement in their scores on the self-report assessments. Out of the twelve participants in the experimental group, only one withdrew during the eight-week session for unknown reasons. This low attrition rate may suggest that the program was well-received. The researchers concluded that CBT-oriented DVD-based SHPs supplemented by therapeutic assistance could benefit those with social anxiety symptoms.

Mall, A.K., et al. (2011). Evaluation of a DVD-based self-help program in highly socially anxious individuals—Pilot study. Behavior Therapy, 42, 439-448.

CBT for Bipolar I Patients (Students Ask Dr. Beck – Part TEN)

Dr.  Aaron Beck describes how cognitive behavior therapy  has been applied to Bipolar I Patients. He begins by explaining the development of scales for measuring symptoms, and then discusses techniques which therapist’s can implement when approaching mania, insomnia, and maladaptive behaviors.

Cognitive Therapy in the Future (Students Ask Dr. Beck – Part NINE)

Dr. Beck discusses the growing nature of cognitive therapy. Based on the building blocks of an empirically validated theory, cognitive therapy, is continually evolving through numerous trials, moving towards inclusion of biological aspects.

Therapist adherence to manualized cognitive-behavioral therapy for anger management delivered to veterans with PTSD via videoconferencing

It is important that veterans with Posttraumatic Stress Disorder (PTSD) have access to evidence-based treatment (EBT). A significant number (40%) of military service members leaving active duty return to rural or remote areas where access to EBT and specialized PTSD treatment is often limited or unavailable. To overcome this obstacle, the use of video conferencing is becoming a more widespread and acceptable method of providing therapy to those living in areas with limited access to EBT.

While research indicates that cognitive behavior therapy (CBT) is an effective treatment for PTSD, there are few studies that examine outcomes of group CBT with veterans.  In the current study, Morland et al. compared therapist adherence to manualized cognitive-behavioral anger management group treatment (AMT) between therapy delivered via video conference (VC) and the traditional in-person modality. The researchers also compared the equivalency of cognitive-behavioral anger management group therapy delivered via VC and the same therapy delivered in-person.

The results of this study indicate that utilizing video conferencing did not affect therapists’ adherence to CBT anger management group therapy. This study provides support for the utility of video conferencing as a method for delivering effective therapy to veterans. It also identifies video-conferencing as a potential gateway to evidence-based CBT for veterans and service members returning to remote areas following deployment. These findings encourage future research on the effectiveness of video conferencing among different populations and EBTs.

Morland, L.A., Greene, C.J., Grubbs, K., Kloezeman, K., Mackintosh, M., Rosen, C., et al. (2011). Therapist Adherence to Manualized Cognitive-Behavioral Therapy for Anger Management Delivered to Veterans with PTSD via Videoconferencing. Journal of Clinical Psychology, 67, 629-638.

Beck Spotlight on Antonette Zeiss

At a 90th birthday party for Dr. Aaron Beck, given by Pearson Assessment at the American Psychological Association annual conference in Washington, D.C., we had the opportunity to catch up with our colleague, Dr. Antonette Zeiss, Ph.D., whom we have known for many years. We are so pleased that she, a very prominent cognitive behavior therapist, has been appointed to be Chief Consultant for the Office of Mental Health Services, in the Veterans Health Administration at the Department of Veterans Affairs (VA). Dr. Zeiss was already the highest ranking psychologist in the VA, and is now the first psychologist, and first woman, to hold the role of Chief Consultant.

In 2007, Dr. Zeiss received an American Psychological Association (APA) Presidential Citation recognizing her leadership contributions both in APA and the VA. And last year, Dr. Zeiss won a Distinguished Career Award from the Association of VA Psychologist Leaders for her continued efforts to improve mental health services.

We applaud Dr. Zeiss’s accomplishments in the field of psychology and cognitive behavior therapy, and we appreciate the efforts of the tens of thousands of health and mental health professionals who treat active duty and veteran military service members and their families. To learn more about a scholarship initiative to help train these professionals in cognitive behavior therapy please visit www.soldiersuicideprevention.org.

The Use of Cognitive Behavioral Therapy as a Method to Improve Self Care in Medical Students

Commentary: Medical Student Distress: A Call to Action

Research has indicated that medical students tend to be more depressed than others their own age, which may have professional consequences. For example, a decline in mental health could have adverse effects on students’ levels of empathy and professionalism, and it could lead to burnout or fatigue.

A study at the Northwestern University Feinberg School of Medicine required medical students to use a cognitive behavioral approach to (1) identify a behavior they wished to improve or change, (2) monitor that baseline behavior, (3) learn about recommendations for the targeted behavior, (4) set goals for themselves, (5) implement a self-improvement plan, and (6) perform a self-assessment of effectiveness and identify factors that either promoted or hindered their goals. The types of behaviors that the students identified were related to nutrition, exercise, sleep, work/study habits, and mental/emotional health. Data was later evaluated to determine (1) whether students reached their goals, (2) what factors helped or hindered success, and (3) if the students planned to apply behavioral change techniques in the future.

Results of this study indicate that just 2.6% of the students chose to focus on direct improvement of their mental/emotional health. This may be attributed to confidentiality concerns or the inexact nature of measuring improvement in this area. Following participation, however, 80% of the students felt they were healthier as a result of completing this cognitive behavioral exercise. Students also showed insight into what factors helped and hindered achievement of their goals, and more than 80% indicated that they would be inclined to use a cognitive behavioral approach to address problems in the future.

CBT has shown to be useful in helping medical students develop skills necessary to assess personal well-being and maintain solid health habits throughout their lives. By maintaining their own health via self-care methods, medical students will hopefully be able to provide better care to their patients.

Dyrbye, Liselotte N. and Shanafelt, Tait D. (2011). Commentary: Medical Student Distress: A Call to Action. Academic Medicine, 86, 801-803.

Beck Institute Scholar Meets with Dr. Aaron Beck

Marcus Huibers, Ph.D., a former Beck Institute Scholar, visited us last week. He has conducted important research in the field of Cognitive Therapy and Depression in the Netherlands and followed up his visit with this message:

When I was first invited to become a Beck Institute Scholar in June 2006, I initially thought someone was pulling a prank on me. It was late at night when I received the email from Drs. Aaron T. Beck and Judith Beck, inviting me for the extramural training program in Philadelphia for the upcoming academic year, and it felt like I had just won the lottery. At that time, I was an assistant professor at Maastricht University, fortunate to have been awarded three large research grants in the previous years, but also struggling with the responsibilities that came along with it and the theoretical directions my work was about to take. The year before, I had met Dr. Steven Hollon for what turned out to be the start of a long and fruitful collaboration on depression research in the Netherlands, and he had nominated me for the Scholarship, which in itself was a great honor. The academic year that followed (2006-2007), I visited Philadelphia three times on overseas trips that were a tremendous learning experience, and great fun at the same time. I felt I already was a pretty good cognitive therapist, but coming to Philadelphia made me realize there was so much more I could learn on the art and wonders of state-of-the-art cognitive therapy. Not surprising, of course, since it was the founder of cognitive therapy that stood in front of the classroom to pass on his infinite knowledge.

I learned so much, talking (and even role playing) with Dr. Beck, but also from Judy Beck and Leslie Sokol, my all-time favorite CT supervisor. It also opened up the (international) world of CT research for me, with many new friends and colleagues I made during my many stays in Philly, the undisputed CT capital of the world. Since then, the depression research program we are doing in the Netherlands has expanded, with treatment studies on Internet CT, CT and interpersonal therapy (IPT), CT and behavioral activation, schema-focused therapy for chronic depression, mechanisms of change studies and experimental lab studies on cognitive theory in depression., This month, I am on a ‘mini-sabbatical’ visiting with Dr. Robert DeRubeis at the University of Pennsylvania, another one of my ‘heroes’ in the field of cognitive therapy. It has been so great to interact with Rob, his students and colleagues at the Department of Psychology, and meet Dr. Beck, Judy and many others at the Beck Institute again. Coming back here, I realize what a strong impact the Beck Institute Scholarship has had on my professional career as a researcher and therapist, and I am very grateful for that. My time at the Beck Institute has been most rewarding, and I can recommend the training program to anyone who is interested in CT. Here is where you learn from the best.

Marcus J.H. Huibers, PhD,
Professor of Empirically Directed Psychotherapy
Chair of the Department of Clinical Psychological Science
Maastricht University
The Netherlands