The Importance of Culture in Cognitive and Behavioral Practice

The contributions of this special series highlight the importance of culture in cognitive-behavioral therapies. People who grow up in different cultures not only think about different things, but also seem to think differently. In other words, culture seems to shape and determine a person’s way of perceiving and reasoning. Therefore, cognitive-behavioral therapies need to be adapted to the client's cultural background and beliefs. This maximizes the likelihood that treatment strategies that have been found to be effective in one culture are also effective in another culture.     

Baby Boomers Mature and Gerontological Counseling Comes of Age

Gerontological counseling is the wave of the profession's future. With the majority of 76 million baby boomers beginning to turn 60 years old in 2006, there will be a great need for preretirement to end‐of‐life counselors. This article focuses on (a) the varied influences of this group on the U.S. and the nation's concerns and (b) theories, models, standards, and competencies for counseling this unique population.     

Cognitive and Behavioral Responses to Trauma

In order to identify cognitive and behavioral responses to trauma, we have studied responses to mass casualty body handling following the Gander, Newfoundland, plane crash of 1985 and the 1989 USS Iowa disaster, and responses to a simulated chemical and biological warfare environment. Individual and group trauma behaviors show prominent: (a) thinking by similarity (identification, and looking for the familiar/ seeing the past in the present); (b) attribution of meaning (rituals, symbols, language, and rumors); and (c) contagion of behavior. These processes highlight the importance of the study of responses to different traumatic stressors in order to identify cognitive mechanisms and behaviors activated by trauma. Such phenomena may be important to our understanding of the effects of traumatic stress and their acute and long-term health outcomes.     

An Introduction to Core Competencies for the Use of Mobile Apps in Cognitive and Behavioral Practice

Mobile technologies have become increasingly pervasive and integral in our daily lives. A growing number of mobile applications are focused on health applications with many specifically focused on helping the prevention, treatment, and management of mental health issues. These apps are slowly being introduced into clinical settings, either being brought in by clients who themselves are using these tools or by health systems or providers. Unfortunately, most practicing providers obtained their clinical training before the advent of mobile health tools and methods. Thus, a critical need exists to develop and disseminate resources to develop the essential skills needed to adopt mobile health techniques. We discuss the five core competencies in mobile health care: evidence, integration, security and privacy, ethics, and cultural considerations. Although this paper will not fully prepare a provider to use mobile apps in their practice, it provides an introduction that will helpfully guide a provider to additional resources and additional ways to develop these competencies. Finally, we discuss the future directions of the field, including a growing differentiation of the impact of mobile apps on clinical care and the need for training models and experiences to match this differentiation.     

Cognitive and Behavioral Changes Arising From Spirituality

Journal of Religion and Health - This article aims to explore the concept of spiritual transformation and address the question, ‘How does spirituality bring about changes in cognition and...     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.     

Boundary Management for Cognitive Behavioral Therapies

In recent years, the scholarship regarding professional boundaries has increased significantly in a variety of areas. Despite many advances in this line of research, less attention has been devoted to the question of boundary maintenance and its relationship to theoretical orientation. In this article we examine these issues for cognitive-behavioral therapies. After a brief historical review of the evolution of the concept of boundaries, we select three procedures integral to cognitive-behavioral practice and discuss how they may create boundary problems for practitioners. We conclude with recommendations for practice.     

抑郁症的计算机化认知行为治疗

计算机化认知行为治疗(computerized cognitive-behavioral therapy, CCBT), 即指通过电脑交互界面, 以清晰的操作步骤, 高度结构化的多种媒介互动方式(如网页、漫画、动画、视频、声音等)来表现认知行为治疗基本原则和方法的治疗方式。抑郁症的CCBT近年来在西方崭露头角, 目前Beating The Blues、MoodGYM、E-Couch和Good Days Ahead等抑郁症CCBT程序在西方使用较为广泛。从可行性分析上发现, 该疗法较受病人接纳、具有较高的成本效用和易用性; 现有实验研究证明了抑郁症采用CCBT是有效的, 但其有效性仍取决于诸多因素。以往研究存在着较少关注治疗有效性的内在机制、治疗效果差异较大、风险评估简化和被试选择偏向等问题, 建议未来研究应加强：(1)中介效应及机制研究; (2)以人为本的个性化服务研究; (3)风险评估与隐私保护研究; (4)在“弱势群体”中的研究与运用。最后, 对其在中国发展的必要性与可行性进行了展望。     

认知行为疗法在儿童焦虑症治疗中的应用

焦虑症是一种最常见的儿童疾病.病理焦虑通常被定义为与年龄不适当的焦虑,导致功能障碍和严重痛苦.目前大量调查儿童焦虑的CBT治疗效果的研究显示,针对各种患有不同焦虑障碍的儿童CBT是有效的.典型的认知行为治疗包括四个主要方面:心理教育,应对技能,暴露和应急管理.Coping Cat治疗方案是在随机对照试验中针对儿童焦虑最常被实施的CBT治疗方案.目前认知行为疗法在治疗儿童焦虑症中也存在着局限,今后需要进行更深入的研究.     

Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys

Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.     

攻击型受欺儿童的社会行为与心理调节

本文通过对488名上海市小学四五六年级学生,采用同伴提名、教师评定、自我评定以及假设情境测验等方法,确定了攻击型受欺者,并考察了性别差异、社会行为特点、心理调节等方面。研究发现,在中国的文化背景下可以通过同伴提名的方法来确定攻击型受欺者,在性别上同样存在明显差异;攻击型受欺儿童明显具有同伴拒绝、缺乏自信心、有孤独感等社会行为特征;攻击型受欺者在社会认知上存在心理失调,表现在社会归因和应对风格上;同伴友谊是影响同伴受欺状况的重要因素。     

Integrating Psychotherapeutic Processes with Cognitive Behavioral Procedures

There has been a recent focus on the processes that underlie intervention delivery for children and adolescents throughout the Cognitive-Behavioral Therapy (CBT) literature. Certain process variables have been associated with treatment outcome among youth receiving CBT. Data for these process variables including: the therapeutic alliance or therapeutic relationship, child and parent involvement, other child and therapist variables, and issues of diversity, are reviewed. Based on this data, specific clinical recommendations are made. The treatment relationship as a very important process (VIP), and the facilitation of CBT so that it is real and relevant to youth are emphatically discussed. Process issues in modular CBT are identified. Ultimately, genuine collaborative empiricism and guided discovery preserve the therapeutic relationship as a VIP, and foster the customization of therapeutic tools and the treatment trajectory.     

Metaphors and Stories in Cognitive Behavioral Therapy with Children

Despite the recent proliferation of material on cognitive behavioral approaches with children and adolescents and the call for these approaches to be more child-friendly, there is scant attention paid to the use of metaphors with youngsters. This paper emphasizes the value metaphors add to cognitive behavioral therapy with children and adolescents. The advantages which recommend metaphor use for cognitive behavioral therapy with children are delineated. Further, seven guidelines for clinical practice are outlined. Examples of both clinician-generated and patient-generated metaphors are also presented.