An investigation of cognitive-behavior therapy combined with oral valium for children undergoing painful medical procedures

In previous research, a cognitive-behavioral therapy (CBT) package was found to be effective in reducing children's distress associated with the painful medical procedures of bone marrow aspirations (BMAs) and lumbar punctures (LPs). Orally administered Valium demonstrated less effectiveness but was helpful in reducing behavioral distress before the medical procedure. In the present study, we investigated whether the combination of oral Valium and CBT would result in increased efficacy of the CBT. Eighty-three subjects were randomly assigned to receive either CBT or CBT plus Valium while undergoing either a BMA or an LP. Dependent variables included observed behavioral distress, self-reported fear and pain, and pulse rate. Results failed to support the value of such a combination but did provide additional evidence in regard to the effectiveness of the CBT. The need for more potent medical interventions for some children is discussed.     

Combining mindfulness meditation with cognitive-behavior therapy for insomnia: a treatment-development study

This treatment-development study is a Stage I evaluation of an intervention that combines mindfulness meditation with cognitive-behavior therapy for insomnia (CBT-I). Thirty adults who met research diagnostic criteria for Psychophysiological Insomnia (Edinger et al., 2004) participated in a 6-week, multi-component group intervention using mindfulness meditation, sleep restriction, stimulus control, sleep education, and sleep hygiene. Sleep diaries and self-reported pre-sleep arousal were assessed weekly while secondary measures of insomnia severity, arousal, mindfulness skills, and daytime functioning were assessed at pre-treatment and post-treatment. Data collected on recruitment, retention, compliance, and satisfaction indicate that the treatment protocol is feasible to deliver and is acceptable for individuals seeking treatment for insomnia. The overall patterns of change with treatment demonstrated statistically and clinically significant improvements in several nighttime symptoms of insomnia as well as statistically significant reductions in pre-sleep arousal, sleep effort, and dysfunctional sleep-related cognitions. In addition, a significant correlation was found between the number of meditation sessions and changes on a trait measure of arousal. Together, the findings indicate that mindfulness meditation can be combined with CBT-I and this integrated intervention is associated with reductions in both sleep and sleep-related arousal. Further testing of this intervention using randomized controlled trials is warranted to evaluate the efficacy of the intervention for this population and the specific effects of each component on sleep and both psychological and physiological arousal.     

A comparison of cognitive-behavior therapy with interpersonal and cognitive behavior therapy in the treatment of generalized anxiety disorder

Objective: The aim of this study was to compare the effectiveness of cognitive behavior therapy with the combination of cognitive behavior therapy and interpersonal therapy on decreasing the excessiveness of pathological worry and increasing happiness of the individuals with generalized anxiety disorder.

Method: The sample consisted of 36 female undergraduate students who referred themselves to the Isfahan University Counseling Center and met the criteria for GAD. They were randomly assigned into three groups; namely, two experimental groups and one control group. Before receiving the interventions all of the groups completed Penn State Worry Questionnaire and Oxford Happiness Inventory. One of the experimental groups underwent cognitive behavior therapy and the other one received the integration of cognitive behavior therapy and interpersonal therapy. The control group received no intervention.

Result: The statistical analyses indicated that the differences between the CBT and CBT+ IPT groups on excessive worry and happiness in the post tests were not significant. But significant mean differences were observed in the follow-ups regarding pathological worry and happiness between two groups.

Conclusion: It can be concluded that the integration of cognitive behavior therapy and interpersonal therapy can be applied as an effective intervention for decreasing the rate of GADs’ relapses after cognitive behavior therapy.     

A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness

Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness.     

Naturalistic outcome of case formulation-driven cognitive-behavior therapy for anxious depressed outpatients

This article describes a case formulation-driven approach to the treatment of anxious depressed outpatients and presents naturalistic outcome data evaluating its effectiveness. Fifty-eight patients who received case formulation-driven cognitive-behavior therapy (CBT) in a private practice setting were studied. All received individual CBT guided by a case formulation and weekly outcome monitoring; in addition, 40 patients received adjunct therapies, including pharmacotherapy, which were added as indicated by the case formulation and the results of weekly outcome monitoring. Patients treated with case formulation-driven CBT showed statistically and clinically significant changes in anxiety and depression that were generally comparable to those reported in published randomized controlled trials of empirically supported therapies (ESTs) for single mood and anxiety disorders. Findings support the proposal that anxious depressed patients who have multiple comorbidities and require multiple therapies can benefit from empirically supported treatments guided by a case formulation and weekly outcome monitoring.     

A time-limited group therapy model for men sexually abused as children

This article explores the clinical dimensions of male child sexual abuse, and its effects upon these children in their adult lives. The number of men receiving therapeutic help for their sexually abusive past is unknown. Prevalence figures are equally elusive, but reporting of this abuse has steadily increased over the last decade. The majority of these children never tell anyone about their sexual victimization, and enter their adulthoods with long-term psychological difficulties. A short-term psycho/educational model is presented in order that more clinicians will treat this vastly underserved population.This article is dedicated to Marion Dragoon, with special thanks to Len Solomon, James Garland, and the staff of St. Luke's.     

Picture book reading with young children: A conceptual framework

The purpose of this paper is to synthesize research on picture book reading with young children (i.e., children under the age of 3). In this paper, we review cross-sectional, longitudinal, and intervention reading research and describe changes in both parental and children’s behaviors during picture book reading from birth to age 3. Research related to additional factors that impact picture book reading between parents and their children such as parental characteristics (e.g., socioeconomic status), children’s characteristics (e.g., interest in books), and attachment status is also reviewed. Such factors are proposed to influence the frequency and/or quality of reading interactions and the beneficial outcomes of reading on children’s language development. Throughout the paper, we highlight gaps in the existing literature. From our synthesis, we propose a theoretical framework to guide future research involving reading with young children.     

Coexisting and conflicting self-referential conceptual systems: A model for describing malfunctioning in the contemporary family-implications for therapy

In the proposed model, intra- and interpersonal conflicts are formalized as information-processing problems created by inconsistent self-referential conceptual systems. Three self-referential conceptual systems corresponding to the three forms of family lifetraditional-rural, industrial-nuclear, information-transactional-coexist and intermingle, creating difficulties in the coordination of interactions.Each of these ecotheories is viewed as a constellation of hierarchically-ordered, dynamic, cognitive-emotional structures which express the particular family system's perceptions of itself in relation to its environment and life in general. The model correlates in an integrative manner phenomena at the level of societal change with evolving patterns of intrapersonal and familial dynamics and provides a framework for guiding preventive and therapeutic interventions. The evolving ecotheory model presented in this work follows the metatheoretical paradigms of cognitive science, self-reference and self-organization. The attempted synthesis has been achieved in the context of the unifying concepts and principles of General Systems Theory.     

A model for group therapy with latency-age boys

This paper describes a model of group therapy with latency-age boys 9 through 12 years old. Usually parents and families are involved in family therapy while a boy is in group therapy. The model described here is appropriate for outpatient or inpatient treatment and has been used extensively by the author in a variety of settings.     

Outcome of group cognitive-behavior therapy for bulimia nervosa: the role of core beliefs

It is hypothesized that individuals who benefit less from CBT will be those who have more pathological core beliefs (unconditional beliefs, unrelated to food, shape and weight). Twenty bulimic women were treated using 12 sessions of conventional group CBT. Eating behavior and attitudes were assessed pre- and posttreatment. Core beliefs were assessed at the beginning of the programme, and were used as predictors of change across treatment (once any effect of pretreatment psychopathology was taken into account). Group CBT was effective, with reductions of over 50% in bulimic symptoms. Outcome on most indices was associated with pretreatment levels of pathological core beliefs. Possible reasons for these findings are discussed.     

A uniform model of computational conceptual blending

We present a mathematical model for the cognitive operation of conceptual blending that aims at being uniform across different representation formalisms, while capturing the relevant structure of this operation. The model takes its inspiration from amalgams as applied in case-based reasoning, but lifts them into category theory so as to follow Joseph Goguen’s intuition for a mathematically precise characterisation of conceptual blending at a representation-independent level of abstraction. We prove that our amalgam-based category-theoretical model of conceptual blending is essentially equivalent to the pushout model in the ordered category of partial maps as put forward by Goguen. But unlike Goguen’s approach, our model is more suitable to capture computational realisations of conceptual blending, and we exemplify this by concretising our model to computational conceptual blends for various representation formalisms and application domains.     

An investigation of computer-assisted cognitive-behavior therapy in the treatment of depression

Increasing demands are being placed on a limited pool of mental health professionals to deliver a steadily growing array of effective treatments in an efficient and acceptable manner. The integration of behavioral technology and computing technology may provide a possible solution to the problem of resource limitations. An interactive computer-assisted program for the treatment of mild to moderate unipolar and dysthymic depressive disorders is described. The effectiveness of this treatment will be empirically examined.     

A conceptual model and case study for the psychological assessment of hysterical pseudo-seizures with the Rorschach

Conceptual models are being increasingly utilized to guide psychological assessment of complex clinical problems. In this article, I present a conceptual model to direct the assessment of personality processes involved in producing hysterical pseudo-seizures. Pathological personality processes present in hysterical reactions are outlined. Rorschach parameters that have been validated and that are therefore considered good indicators of the relevant personality processes are presented. A case study of a patient with both documented genuine and hysterical pseudo-seizures demonstrates use of the model. I offer a treatment plan that is related to the psychological structure of the patient. Use of this model may improve psychological consultation in medical settings.     

PSN: A prolog declarative model of conceptual knowledge

This paper introduces a declarative model of semantic memory, called PSN, written in Prolog. It is shown to be a descendant of Quillian’s (1969) Teachable Language Comprehender (TLC) in its structuring of knowledge as a conceptual reticulum and in its use of spreading activation as a retrieval mechanism. PSN goes beyond TLC, however, in its ability to instantiate the essential benchmark properties of human semantic retrieval. As such, it can provide cognitive science with a normative model on which to assess further research and it demonstrates the value of the Prolog language for modeling psychological processes.