Classroom-based cognitive-behavioral intervention to prevent aggression: Efficacy and social validity

Classroom teachers need effective, efficient strategies to prevent and/or ameliorate destructive student behaviors and increase socially appropriate ones. During the past two decades, researchers have found that cognitive strategies can decrease student disruption/aggression and strengthen pro-social behavior. Following preliminary pilot work, we conducted a study to determine whether a classwide, social problem-solving curriculum affected measures of knowledge and behavior for 165 4th and 5th grade students at risk for behavior problems. We found significant positive treatment effects on knowledge of problem-solving concepts and teacher ratings of aggression. Outcomes differed across teachers/classrooms, and there was no evidence that booster lessons affected treatment efficacy. Teacher ratings of social validity were generally positive. We discuss issues about classroom-based prevention research and future research directions.     

Effects of a school-based cognitive-behavioral intervention for ADHD children

Two variations of school-based cognitive-behavioral training (CBT) program were compared to each other and to a waiting-list control condition in the treatment of children with attention-deficit hyperactivity disorder (ADHD). The experimental interventions included a multicomponent condition that provided coordinated training programs for parents, teachers, and children and a teacher-only condition that offered training for classroom teachers only. Evaluation of outcome occurred at pre-intervention, post-intervention and at 6-week followup periods. Depedent measures included classroom behavior observations, teacher ratings of child behavior, child self-report, and teacher ratings of adjustment. The multicomponent CBT condition was significantly better than the other conditions at improving observed off-task/disruptive behavior at post-test. This improvement was maintained at followup, although treatment condition differences were no longer significant. There were no treatment condition differences on any other measures at postintervention or followup. It was concluded that the intervention had minimal short-term effects on the ADHD children. The results are discussed within the context of several methodological limitations of the study which serve as proposals for continued research in this area.The authors gratefully acknowledge the support and assistance of the faculty and staff at Echo Park, Cedar Park and Westview Elementary Schools (Rosemount, MN, Independent School District), and the parents and children who participated in this study. The authors would also like to extent special thanks to the principals of these schools, Mr. Robert Keaton, Mr. William Mack and Mr. Marvin Skinner, and the school psychologists servicing these schools, Ms. Sheila Peterson, Ms. Ann O'Brien, and Mr. Mark Kaloski, for their commitment and service to children with attention-deficit hyperactivity disorder.     

A cognitive-behavioral intervention program for students with special reading disabilities

Interaction among cognitive, meta-cognitive, and emotional factors seems to play a determining part in achievement behavior and especially in scholastic performance. In this study some preliminary results are presented of the implementation of a multidimensional cognitive-behavioral psychoeducational program especially designed for students with reading disabilities in which parents and teachers also take part. The aim of the program was to provide students with appropriate emotional and cognitive skills with which to address their learning problems. First results on the efficacy of the implemented program to 20 primary school boys and girls with special reading disabilities encourage research on management of learning problems with focus on cognitive and emotional aspects in which parents and teachers contribute. Research including a control group is necessary.     

A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials

Cognitive-behavioral therapy incorporating exposure and response prevention (ERP) is widely considered a first-line psychosocial treatment for patients with obsessive-compulsive disorder (OCD). However, a number of obstacles prevent many patients from receiving this treatment, and self-administered ERP may be a useful alternative or adjunct. Forty-one adult outpatients with a primary diagnosis of OCD, who reported at least 1 current or previous adequate medication trial, were randomly assigned to self-administered or therapist-administered ERP. Patients in both treatment conditions showed statistically and clinically significant symptom reduction. However, patients receiving therapist-administered ERP showed a superior response in terms of OCD symptoms and self-reported functional impairment. We discuss several potential reasons for the superiority of therapist-administered treatment, and propose a stepped-care integration of self-administered and therapist-administered interventions for OCD.     

Promoting career preparedness and intrinsic work-goal motivation: RCT intervention

We examined the role of an in-company training program aimed at enhancing employees' intrinsic work-goal motivation by increasing their career preparedness in a randomized field experimental study. The program activities were implemented using an organization-level two-trainer model with trainers from the human resources management and occupational health services. Within-organizations randomly assigned field experimental study (RCT) investigated the impact of the intervention on immediate career preparedness and both immediate and follow-up intrinsic work-goal motivation. A total of 718 eligible individuals filled in and returned the questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either intervention (N = 369) or control groups (N = 349). Those in the intervention group were invited to group intervention workshops, whereas the control group received printed material covering the information content of the intervention. The participants filled in the work-goal questionnaires before intervention, after the week-long intervention and seven months later. In addition they filled in a career preparedness scale before and after the intervention. The results showed that intervention increased career preparedness which in turn was related to intrinsic work-goal motivation and increased intrinsic work-goal motivation at the follow-up.     

Two-year follow-up of an interdisciplinary cognitive-behavioral intervention program for obese adults

Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.     

Brief cognitive-behavioral phone-based intervention targeting anxiety about the threat of attack: a pilot study

A brief, cognitive-behavioral, phone-based intervention was employed with an Israeli sample experiencing anticipatory anxiety about potential war-related attacks. In this quasi-experimental controlled pilot study, the cognitive-behavioral therapy intervention (diaphragmatic breathing and a modified cognitive-restructuring technique) was compared with the standard hotline care administered when worried citizens called a mental health emergency hotline in Israel. Individuals (n=32) were administered anxiety and worry measures pre-intervention, post-intervention, and three days post-intervention. The results indicated that anxiety levels decreased for the experimental and control group immediately post-intervention; however, three days later, the levels of anxiety in the CBT group continued to decline, while anxiety levels in the control group reached pre-intervention levels on two of the three outcome measures. These results suggest that CBT can be effectively delivered by paraprofessionals over the phone, which is cost-effective and efficient. Limitations are considered, and implications for treating individuals coping with the threat of terrorism are discussed.     

Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.     

Panic disorder: cognitive-behavioral treatment

The effectiveness of an integrated treatment program utilizing cognitive-behavioral therapies for Panic Disorder was examined. Treatment was comprised of Cognitive Model of Panic-derived procedures, Cognitive Therapy and Applied Relaxation Training. Subjects meeting DSM-III-R criteria for Panic Disorder received thirteen 2.5-hr sessions of outpatient therapy in small groups, over a 12-week period. Subjects were given an extensive rationale of the etiology, development and maintenance of Panic Disorder, within the framework of the Cognitive Model of Panic, and controlled behavioral experiments in panic evocation to internal panicogenic cues, cognitive reappraisal of somatic and ideational cues, breathing retraining, Applied Relaxation Training and Cognitive Therapy to identify and remediate maladaptive beliefs and dysfunctional cognitive schemas. A comprehensive assessment battery was given at pre-mid-post-treatment which included measures of tripartite functioning, global severity, panic, fear, anxiety, depression and psychiatric symptomatology. Analyses indicated statistically significant improvements across all outcome domains. All subjects were free of spontaneous (uncued) panic attacks at post-treatment, and all met operationalized criteria for high endstate functioning. These findings are discussed, with recommendations for future research.     

Tele-pain management: use of videoconferencing technology in the delivery of an integrated cognitive-behavioral and physical therapy group intervention

Chronic pain has been recognized as a highly prevalent problem, and interdisciplinary treatments have been shown to be effective in the treatment of chronic pain. An integrated cognitive-behavioral and physical therapy group protocol has been developed and then implemented at remote sites using videoconferencing technology to provide pain management for veterans. The treatment model is summarized and recommendations are made for addressing challenges in implementing this type of treatment via videoconferencing.     

自然关联性:概念、测量、功能及干预

自然关联性是指人们主观上感到与自然融为一体的程度,包括对自然的认知、情感和行为三个维度。自然关联性的测量主要采用自陈式量表和内隐联系测验从外显和内隐两个层面进行。已有理论与实证研究发现,与自然接触能够帮助恢复心理疲劳、改善认知表现、缓解身心症状、提升幸福感、促进亲社会行为。研究者采用了多种干预方式提升自然关联性。未来的研究需要进一步探究自然关联性的概念、研究方法、积极效应的条件、以及文化的影响等。     

Differential efficacy of a cognitive-behavioral intervention versus pharmacological treatment in the management of fibromyalgic syndrome

Given that studies about the differential efficacy of existing treatments in fibromyalgia syndrome are scarce, the aim of this study was to compare the differential efficacy of a cognitive-behavioral and a pharmacological therapy on fibromyalgia. Using a randomized controlled clinical trial, 28 fibromyalgic patients were assigned to one of following experimental conditions: (a) pharmacological treatment (i.e., cyclobenzaprine), (b) cognitive-behavioral intervention (i.e., stress inoculation training), (c) combined pharmacological and cognitive-behavioral treatment and (d) no treatment. The results show the superiority of cognitive-behavioral intervention to reduce the severity of fibromyalgia both at the end of the treatment and at follow-up. We conclude that cognitive-behavioral interventions must be considered a primary treatment of fibromyalgia syndrome.     

Preventing depression: A review of cognitive-behavioral and family interventions

Depression is one of the most common psychological disorders. It is associated with tremendous costs in terms of suffering, decrease in productivity, and loss of life. For many individuals, depression is a disorder that will recur throughout life. Recent findings suggest that the prevalence of depression is on the rise, particularly in young people. Clearly, depression prevention is an important goal. Can depression be prevented? In this article we review research on interventions designed to prevent episodes and symptoms of unipolar depression in adults and children. Our review focuses specifically on cognitive-behavioral and family interventions. We discuss what researchers have learned about the prevention of depression and conclude with recommendations for future investigations.     

Stress management for teachers: A cognitive-behavioral program

Urban secondary school teachers participated in a cognitive-behavioral stress management program. Assessment data were also collected from a waiting list control group. Dependent measures included self-reported anxiety and stress, and observations of teacher classroom behavior. Results showed that the training program significantly decreased self-reported stress and anxiety. Follow-up data indicated further decrease six weeks after termination of the training program. Results also indicated decreases in motoric manifestations of anxiety in the classroom as a result of the training.     

Emotional consequences of collective action participation: differentiating self-directed and outgroup-directed emotions

The present research examines the emotional and behavioral consequences of collective action participation. It demonstrates that "positive" and "negative" emotions can be experienced simultaneously as a result of collective action participation, yet it is important to distinguish outgroup-directed from self-directed emotions. Results of two experiments (N = 71 and N = 101) that manipulated participation in collective action illustrate that whereas collective action participants experience more outgroup-directed anger and contempt, they feel more self-directed positive affect. Furthermore, collective action participation predicted willingness to engage in moderate and radical collective actions in the future. These relations were mediated by outgroup-directed, but not by self-directed, emotions, suggesting that outgroup-directed rather than self-directed emotions play a crucial role in the maintenance of protest behavior. Theoretical and practical implications of these findings are discussed.