Reducing Academic Procrastination Through a Group Treatment Program: A Pilot Study

The present study assessed a short-term group treatment program using cognitive interventions focused on students’ procrastination. A structured 90-min session program was used with 10 students (5 female, 5 male; M _age = 21.8, SD = 3.2) across 5 weeks. In the first and last session of the program participants completed a two reliable and valid procrastination scales, and then 8 weeks later in the follow up sessions filled out the same questionnaires. During the group sessions, participants identified their irrational thoughts as well as cognitive distortions associated with their procrastination tendencies. Results of a non-parametric Friedman Test revealed a significant decrease in participants’ academic procrastination score and general procrastination scores from the pre-test to follow-up test suggesting that the program was deemed to be successful.     

The efficacy of rational-emotive group therapy in psychiatric inpatients

The impact of rational-emotive theory and therapy upon the practice of clinical psychology has been profound, and many purportedly objective experimental tests of its efficacy as a mode of treatment have been reported. Yet the great majority of these reports have failed to utilize actual clinical populations. This study evaluated rational-emotive group therapy with psychiatric inpatients. Results supported the claim that irrational beliefs are related to emotional disturbance. It was also shown that patients undergoing rational-emotive group therapy changed their self-reported irrational beliefs more than did a control group. Finally, there was a trend for the experimental subjects to be more likely to have been discharged from the hospital during the 90-day follow-up period than were control subjects. However, this study failed to demonstrate that change in irrational beliefs was related to improvement in psychiatric symptoms or rates of discharge from the hospital. Some of the difficulties in conducting treatment evaluation research in a psychiatric hospital setting are discussed with respect to these results.     

Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims

Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low-threshold self-help interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self-help manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting-list control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one-month intervention, and at three-month follow-up. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post-traumatic stress symptoms. Post-intervention between-group effect sizes ranged from Cohen’s d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self-help manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self-help intervention for AjD problems. The findings provide evidence that a low-threshold self-help intervention without therapist contact is a feasible and effective treatment for symptoms of AjD.     

Brief cognitive behavioral intervention for children and adolescents with persistent post-concussive symptoms: A pilot study

This study aims to evaluate the efficacy of a brief cognitive behavioral intervention program for children and adolescents experiencing persistent post-concussion symptoms. A total of 31 patients aged 10 to 18 years participated in the intervention. The median time since injury at treatment onset was 95 days though the range was large (23–720 days). Treatment was on average four sessions in duration. Sessions included concussion education, activity scheduling, sleep hygiene relaxation training, and cognitive restructuring. Outcomes were measured using symptom reports on the Sports Concussion Assessment Tool – Third Edition (SCAT-3) and parent-reported quality of life on the Pediatric Quality of Life Inventory (PedsQL). Mixed-effects models revealed that symptom reports did not decrease prior to the initiation of this treatment, though significant symptom improvement occurred following treatment. Quality of life scores significantly improved across domains, with the largest gains made in the emotional and school domains. Participant characteristics including age, sex, maternal education, and previous mental health problems were not found to be significantly related to treatment outcomes. Contrary to predictions, length of time since injury was not related to symptom changes. The primary limitation of this study is that it lacks randomization and an experimental control group. The results suggest that brief cognitive behavioral intervention may be a promising treatment for children and adolescents experiencing persistent post-concussive symptoms and warrants further investigation.     

Rational-emotive therapy and the reduction of interpersonal anxiety in junior high school students

This study evaluated the effectiveness of rational-emotive therapy and rational-emotive imagery. Fifty-nine junior high school students who volunteered to participate in treatment for interpersonal anxiety were randomly assigned to rational-emotive therapy without imagery (RET), rational-emotive therapy with imagery (REI), relationship-oriented counseling (ROC), and waiting-list control (WLC) groups. Groups met for seven 50-minute treatment sessions during a three-week period. Assessments were conducted at pretreatment, posttreatment, and three-week follow-up. Both self-report and sociometric measures were used to evaluate treatment outcome. At postassessment, both the RET and REI groups were rated on sociometric measures as significantly less interpersonally anxious than the WLC group. Mean scores favored the RET and REI groups, but no significant differences between these groups and the ROC group were obtained. The self-report measure did not significantly differentiate between groups, but the REI group demonstrated significant pre- to follow-up changes. Both the RET and REI groups yielded greater reductions in irrational thinking than did the ROC and WLC groups. In addition, the pattern of the results supported the use of rational-emotive imagery as a component of rational-emotive therapy. The practical implications of these findings are discussed.     

Irrational Beliefs and the Experience and Expression of Anger

The present study assessed rational-emotive theories of anger by examining the interrelationships of irrational beliefs and the experience and expression of anger. An audiotaped anger-provoking scenario was used to determine whether irrational beliefs predicted state anger and hostile thoughts following provocation. After completing measures of irrational beliefs, trait anger, and anger expression and control, 161 college students were exposed to the provoking stimulus, which was followed by measures of state anger and hostile thoughts. Findings showed both low frustration tolerance and awfulizing were related to trait anger, anger suppression, and outward anger expression. Only low frustration tolerance was related to state anger following provocation. However, awfulizing was associated with all hostile thoughts, and both self-directed shoulds and self-worth were associated with derogatory thoughts about others. Only awfulizing had incremental validity over trait anger, and then, only in the prediction of derogatory thoughts.     

Emotional relief for parents: Is rational-emotive parent education effective?

The effects of a rational-emotive parent education program were studied on forty-eight parents from a nonclinical population using a pre-test, post-test control group design. The RET parenting program included four components: a) reducing emotional stress through disputing irrational beliefs, b) implementing rational discipline methods, c) rational problem solving skills and d) fostering rational thinking traits in their child. Four dependent variables were studied: parent irrationality, parent emotionality, parent perceptions of child problems and the perception of participants' parenting by their spouses. Results showed that for experimental group subjects there was a statistically significant reduction in parent irrationality, parent guilt and parent anger. An exploratory ten month follow-up suggested maintenance of effects, a reduction in perceived child behavior problems, and changes in parental irrational beliefs regarding self worth.     

Brief Christian and Non-Christian Rational-Emotive Therapy With Depressed Christian Clients: An Exploratory Study

The current outcome study operationalized a brief “Christian” form of rational-emotive therapy (CRET) and compared the therapeutic efficacy of this treatment with a standard version of brief rational-emotive therapy (RET) with depressed Christian clients. Results indicated that both treatments were effective in reducing depression and automatic negative thoughts, while only the CRET reduced clients' irrational beliefs. No between-group differences were obtained for clients' perceptions of the counselor. Findings are discussed in terms of applied integration issues and the long-standing antagonism of rational-emotive philosophy toward religious beliefs.     

Comparison of Cognitive-Behavioral Stress Management Techniques With Adolescent Boys

This study examined the effectiveness of two cognitive-behavioral interventions to help adolescent boys cope with stress and other forms of negative emotional arousal. One group of youths, those receiving cognitive restructuring, learned how to identify and monitor stress-promoting cognitions, restructure these cognitions into more adaptive thoughts, and practice and apply these acquired skills. Another group of youths received anxiety management training, and they were taught to recognize cues that signal the onset of anxiety and to react to these cues using various relaxation skills to reduce the anxiety. The youths who received training were compared with a waiting list control group on measures of anxiety, anger, self-esteem, depression, and reports of anxious self-statements. Both groups that received the intervention showed significant reductions in levels of state and trait anxiety, state anger, anger expression, and depression. These treatment gains were maintained at an 11-week follow-up.     

What Works Best for Reducing Symptoms and Improving Quality of Life? A 6-Months Follow-up Study on the Effectiveness of Group Cognitive Behaviour Therapy and Group Information and Support for Adults Suffering from Depression

A non-randomized effectiveness trial was conducted in an urban secondary care public mental health service in Ireland. The effectiveness of an 8 session group cognitive behavior therapy program (gCBT-8), where the focus was on behavioral activation and cognitive restructuring, was compared with that of an enhanced 12 session group cognitive behavior therapy program (gCBT-12), which contained additional sessions on schema work, and a 12 session information and support control group program (gIS-12) in which there was no CBT skills training. One hundred and eighty-one adults with unipolar mood disorders were allocated to gCBT-8 (N?=?67), gCBT-12 (N?=?62), or gIS-12 (N?=?52). Before and after treatment, and at 6 months follow-up participants completed the Beck Depression Inventory II (BDI-II), the Beck Anxiety Inventory, the Clinical Outcome and Routine Evaluation, the Dysfunctional Attitudes Scale, and the brief World Health Organization Quality of Life Scale. An intention-to-treat analysis of mean scores showed that the three programs had similar outcomes. There were significant improvements on all dependent variables with post-treatment gains maintained at follow-up. The three programs also led to similar remission and combined reliable improvement and remission rates on the BDI-II. It was concluded that all three programs had similar levels of effectiveness.     

A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes

This study examined the impact of a cognitive behavioral intervention for nonadherent adolescents with type 1 diabetes. Six youths having problems following the diabetes regimen received training in cognitive restructuring and problem solving during individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through 24-hr recall adherence interviews with adolescents and frequency of testing data was downloaded from glucose meters. Data was also collected for diabetes-specific stress. Five youths displayed improvement on at least one self-care behavior. Furthermore, the results suggest that the cognitive behavioral intervention was effective in diminishing diabetes-related stress in two participants. Cognitive behavioral interventions show promise for increasing self-care behaviors among nonadherent youths with type 1 diabetes. However, individual youths varied in their response to treatment. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.     

A rational-emotive group intervention for preventing and coping with stress among safety officers

A stress management and prevention workshop for nonclinical industrial workers using rational-emotive principles with 18 months followup is reported. Twenty-two senior safety officers participated in an intervention program of five weekly meetings aimed at improving cognitive skills and assertiveness mainly by decreasing irrational thought processes. We hypothesized an increase in assertiveness, and a decrease in irrational beliefs, and emotional and cognitive stress symptoms (manifested in somatic complaints and cognitive weariness). Assertiveness improved and somatic complaints and irrationality decreased in the short term. Eighteen months later, cognitive weariness was also reduced. The other improvements were still evident, but not to the same extent as short-term effects. Although the workshop improved rationality, further practice would be needed in the behavioral aspect of stress prevention to achieve long-term improvements in assertiveness.Talma Kushnir, Ph.D., is a social and medical psychologist at the Occupational Health and Rehabilitation Institute, Raanana, Israel, and teaches psychology and health promotion at the Tel-Aviv University Medical School.Ruth Malkinson, Ph.D., fellow and RET trainer and supervisor of the Institute for RET, and teaches at the School of Social Work and Medical School at Tel-Aviv University, Israel. Both authors contributed equally to this studyThis study was supported by the Committee for Preventive Action and Research in Occupational Health, The Ministry of Labor and Social Affairs, Jerusalem, Israel.The authors thank Estie Weisberg for her administrative assistance in organizing the workshops.     

CORRECTION DES VERBALISATIONS IRRATIONNELLES CHEZ DES JOUEURS DE POKER-VIDEO*

Earlier studies have shown that irrational thinking dominates rational thinking during gambling. The present study evaluated the effects of cognitive restructuring on gambling behaviors among video poker players. Within a single case experimental design across subjects, the results showed that irrational verbalizations decreased during treatment while rational verbalizations increased. Three out of four players reduced their frequency of gambling following treatment. The theoretical and clinical implications of these results are discussed.     

Perfectionism and Psychological Distress: A Modeling Approach to Understanding their Therapeutic Relationship

The present study assessed the effectiveness of a web-based psycho-educational intervention protocol for decreasing levels of perfectionism and psychological distress. Different levels of therapeutic intervention (no treatment, general stress management intervention, general stress management intervention plus cognitive behavioral intervention) were provided to perfectionistic participants over a 10-week period. It was found via a longitudinal structural equation model that higher levels of therapeutic intervention predicted greater improvements in perfectionism and psychological distress. Further, amount of improvement in trait perfectionism and perfectionistic automatic thoughts was highly related to amount of improvement in psychological distress. The findings attest to the potential usefulness of a web-based intervention that combines a general stress management intervention with a cognitive behavioral intervention.     

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 (M_age = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed Veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, whereas SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.     

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.     

The effects of a program to enhance self-compassion in Japanese individuals: A randomized controlled pilot study

To date, there is no evidence suggesting that a program aimed at increasing self-compassion is effective in interdependent cultures such as Japan. The aim of this study was to examine the effects of an Enhancing Self-Compassion Program (ESP) among Japanese individuals in a randomized controlled study. Individuals reporting low self-compassion (N = 40) were randomly assigned to an ESP or wait-list control group. Participants completed self-report questionnaires at pre-treatment, post-treatment, and a three-month follow-up. In the post-treatment and follow-up, ANOVAs revealed that the ESP group (N = 16) had significant improvements in each of the subscales of self-compassion (Cohen’s ds: .91–1.51) except for mindfulness, whereas the control group (N = 12) did not. Greater reductions in negative thoughts and emotions in the ESP group were also found. These gains remained at follow-up. These findings suggest that an ESP may be an effective and acceptable adjunct intervention for Japanese individuals with low self-compassion.     

School-Based Cognitive Mindfulness Intervention for Internalizing Problems: Pilot Study with Hong Kong Elementary Students

Childhood internalizing problems such as anxiety and depression can have serious personal, familial and societal repercussions, including drug and alcohol abuse, delinquency, unplanned pregnancy, and even suicide. There is little research on mindfulness interventions for children with clinical levels of internalizing problems, and school-based mindfulness research with children has focused on non-clinical groups. We employed a two-stage screening and intervention procedure to evaluate an in-school mindfulness-based cognitive intervention for Hong Kong children with subclinical internalizing difficulties. Ninety-three fourth to sixth graders were screened, and twenty students (age 9–13, median age 10) highest among their peers on internalizing problems, but lowest on externalizing problems, participated in a 9-week group mindfulness-based intervention. We employed a two-phase open trial design, with random assignment to an immediate intervention group or wait-list control group. In single-trial analysis, one-tailed dependent sample t-tests showed significant decreases in both worry and in symptoms of panic disorder, obsessive compulsive disorder, generalized anxiety and overall internalizing problems. In a randomized controlled trial analysis, the immediate intervention group evidenced larger but nonsignificant reductions on almost all measures. Eighty-five percent of the participants rated the program as helpful, and 65–80 % reported improvement in handling emotions and interpersonal relationships at post-treatment, with some treatment gains maintained at 3-month follow-up. These preliminary findings have encouraging implications for implementing time-limited school-based mindfulness interventions targeting elevated childhood internalizing difficulties.     

A Randomized Controlled Trial of the Impact of a Family-Based Adolescent Depression Intervention on both Youth and Parent Mental Health Outcomes

This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Eligible participants were families with a young person aged between 12 and 18 years who met diagnostic criteria for a depressive disorder (major, minor or dysthymic). Participating families (N = 64; 73.4% of youth were female) were recruited in Victoria, Australia and allocated to treatment condition using a block randomization procedure (parallel design) with two levels of blinding. This paper reports on the trial’s secondary outcomes on youth and parent mental health. General linear mixed models were used to examine the longitudinal effect of treatment group on outcome. Data were analyzed according to intention-to-treat; 31 families were analyzed in BEST MOOD, and 33 families in PAST. Parents in the BEST MOOD group experienced significantly greater reductions in stress and depressive symptoms than parents in the PAST group at 3-month follow-up. A greater reduction in parental anxiety was observed in the BEST MOOD group (d = 0.35) compared with PAST (d = 0.02), although the between-group difference was not significant. Both groups of youth showed similar levels of improvement in depressive symptoms at post-treatment (d = 0.83 and 0.80 respectively), which were largely sustained at a 3-month follow-up. The family-based BEST MOOD intervention appeared superior to treatment-as-usual (PAST) in demonstrating greater reductions in parental stress and depression. Both interventions produced large reductions in youth depressive symptoms.     

An Evaluation of Two Types of Cognitive Intervention in the Management of Chronic Tinnitus

Abstract

Fifty-four subjects with chronic distressing tinnitus were randomly allocated to one of four experimental treatment conditions: (1) attention control and imagery training (AC1); (2) cognitive restructuring (CR); (3) combined attention control and imagery training plus cognitive restructuring (ACI + CR); and (4) a waiting list control (WLC). Significant overall improvements were found on measures of distress associated with tinnitus, and on a number of other measures of cognition and coping strategies. These improvements were maintained at the six-month follow-up. Relative to the WLC, the three treatment conditions (combined) were associated with improvements in tinnitus-related distress, reductions in tinnitus-related dysfunctional cognitions and an increase in the frequency of use of coping strategies. There was a significant effect in favour of the ACI group compared to the CR group on the measure of irrational beliefs. The analyses also revealed that the combined treatment condition (ACI + CR) showed significantly greater improvement on a measure of psychological distress and achieved a higher clinical response rate compared to the two single treatments. There were significant improvements from pretreatment to follow-up on some measures, although the mean scores revealed that some of the gains had been lost at this stage on the main measure of tinnitus-related distress. There were no significant group X time effects for any of the dependent variables at the six-month follow-up. The results were interpreted as supporting the practice of combining the two cognitive approaches.