Cognitive Therapy Today

A study in BMC Psychiatry reported that the use of cognitive behavioral therapy (CBT) for Social Anxiety Disorder (SAD) was well established in Europe and North America but little was known about its effectiveness in non-Western cultures.

A pilot study of group CBT for SAD was conducted in Japan (groups of 3 or 4; average number of sessions per group was 15). The CBT methods included psychoeducation regarding anxiety, experiments to reduce safety behaviors, cognitive restructuring for dysfunctional assumptions, and others. Where needed, co-administration of antidepressants and benzodiazepines was allowed.

The researchers found a significant reduction in symptoms pre- to post-treatment, and concluded that group CBT “can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.”

Study authors: J. Chen, Y. Nakano, T. Ietzugu, S. Ogawa, et al.

A study in the International Journal of Impotence Research reported that men with erectile dysfunction (ED) benefited from Internet-based cognitive behavioral therapy (CBT). An important aspect of this approach was that it removed much of the anxiety and embarrassment associated with face-to-face discussions of sexual problems. The CBT protocol included the men and their partners, and focused on psychological and relationship factors related to ED.

Designed as a 10-week program, couples participated in communication exercises, sensate focus activities, and email contact with therapists when needed. Improvements in ED were significantly greater among men who completed the program compared to those who received no treatment, and these findings were consistent with face-to-face psychological treatments. Additionally, the positive treatment effects remained stable during the 3-month follow-up period.

Study authors: M. P. McCabe, E. Price, L. Piterman, D. Lording 

In a recent article in the Newark Star Ledger, J. K. Rowling, author of Harry Potter, discussed how cognitive behavioral therapy helped her to overcome a serious depression she experienced in her mid-twenties while she was a struggling writer and single mother.

Dr. Aaron Beck was honored on June 4, 2008, by the Philadelphia Behavior Therapy Association (PBTA) and the Drexel University Department of Psychology’s presentation of a Lifetime Achievement Award. (View PBTA announcement.)

Washington, D.C.: At the May 5-8, 2008, Annual Convention of the American Psychiatric Association, Dr. Aaron Beck was honored with an award for his distinguished service to the profession of psychiatry.

The Distinguished Service Award was presented “in recognition of your extraordinary contributions as a prominent leader in the areas of cognitive therapy and depression research, and for your dedicated commitment and work, which has improved the care of patients and ennobled the profession of psychiatry.” 

Aaron T. Beck, M.D., was featured in the May 11, 2008, issue of the Philadelphia Inquirer. Dr. Beck’s personal life and professional achievements in the founding and development of Cognitive Therapy were highlighted.

A recent review in Preventing Chronic Disease reported that about 5% to 15% of community-dwelling older adults (60+ y.o.) suffer from depression, which results in functional impairment and is possibly associated with increased mortality rates through suicide and complications of cardiac disease. As such, it is increasingly recognized as a significant public health problem in that population.

To address this problem, a panel was convened by the National Center for Chronic Disease Prevention and Health Promotion, one of eight centers within the Centers for Disease Control and Prevention. After systematically reviewing 97 studies, “the researcher-practitioner expert panel strongly recommended interventions based on the depression care management (DCM) model and recommended cognitive behavioral therapy (CBT) as treatment for depression in older adults.”

The report discussed strategies to implement its recommendations. It noted that many CBT practitioners work in specialty mental health settings and are not in contact with primary care or community-based programs for older adults. A further obstacle is that many older adults are reluctant to go to mental health specialists.

The panel concluded that partnerships among researchers, health care providers, and policy makers will be necessary to overcome the obstacles to the treatment of depression in older adults.

Study authors: M. Snowden, L. Steinman, J. Frederick

A new study in Pediatrics reported that adolescents with Chronic Fatigue Syndrome (CFS) who received 10 sessions (over 5 months) of cognitive behavioral therapy (CBT) continued to experience positive effects at 2-year follow-up. Researchers measured fatigue, functional impairment, school attendance, and work attendance (where applicable). At follow-up, participants continued to experience the same improvement in fatigue as they had at the end of treatment. Their physical functioning, school attendance, and work attendance actually improved during the follow-up period. The authors recommended that this treatment become available to more adolescent patients with CFS.

Study authors: H. Knoop, M. Stulemeijer, L. W. A. M. de Jong, T. J. W. Fiselier, G. Bleijenberg

A new study in JAMA reported that approximately 60% of depressed adolescents respond adequately to initial treatments with a selective serotonin reuptake inhibitor (SSRI), but there is a lack of information about subsequent treatment strategies. Four treatment strategies were employed in this study including medication-switching alone (to a different SSRI or to venlafaxine) and medication-switching plus cognitive behavioral therapy (CBT). CBT in this study emphasized cognitive restructuring, behavioral activation, emotion regulation, social skills, and problem solving. Additionally, parent-child sessions emphasized decreasing criticism and improving support, family communication, and problem solving. The authors found that CBT plus a switch to either medication regimen showed a higher response rate than a medication-switch alone (and that there was no difference in response rate between venlafaxine and a second SSRI).

Study authors: D. Brent, G. Emslie, G. Clarke, K. D. Wagner, J. R. Asarnow, M. Keller, et al. 

A recent review in the Journal of Psychiatric Practice found cognitive behavioral therapy (CBT) to be beneficial for medication-resistant symptoms of schizophrenia. This is an important study because persistent symptoms are often disabling, lead to significant distress, and are associated with increased depression, anxiety, and risk of suicide. CBT as part of a treatment protocol with anti-psychotic medications has been shown to reduce these and other symptoms, and to increase adherence to treatment and insight; additionally, the effects are durable and cost effective. Working collaboratively with patients to improve understanding and coping has overall reduced suffering and improved functioning.

Study authors: S. Rathod, D. Kingdon, P. Weiden, D. Turkington