Materials used to support cognitive behavioural therapy for depression: a survey of therapists’ clinical practice and views

ABSTRACT

Use of supporting materials in cognitive behavioural therapy (CBT) is widely advocated, and homework increases effectiveness. The study aimed to identify materials most frequently used by CBT therapists to support CBT for depression, and those perceived clinically most effective. Questionnaires were sent to 3665 accredited CBT therapists asking about their use of resources commonly described in CBT manuals, and their views on effectiveness. Of 3665 approached by post/email, 994 (27%) responded. Another 33 completed the questionnaire via the study website. 818/1027 (80%) of respondents were accredited practitioners who deliver one-to-one therapy. Symptom measures, lists of problems/goals, activity schedules, behavioural activation diaries/plans, and case formulation worksheets were used “frequently” or “very frequently” by over 85% of respondents. Sleep diaries and computerised CBT were used least. Most resources were used within and between sessions. Activity schedules, behavioural activation diaries/plans, case formulation worksheets, thought records, and resources to support the identification of conditional beliefs were regarded as most effective. Symptom measures, sleep diaries, and computerised/online materials were considered only moderately effective. Therapists use a wide range of materials to support individual CBT. For delivering CBT, technology-enabled approaches should incorporate a range of materials to enable therapists to tailor treatment effectively.     

Cognitive Behaviour Therapy to Improve Mood in People with Epilepsy: A Randomised Controlled Trial

This study compared a 9-week individualised Cognitive Behaviour Therapy (CBT) programme for people with epilepsy (PWE), with a wait-list control. Fifty-nine PWE were randomised and 45 (75%) completed post-treatment outcomes. People with lower quality of life (QoL), particularly for cognitive functioning, were more likely to drop out. Analyses based on treatment completers demonstrated significant improvements on the Neurological Depressive Disorders Inventory for Epilepsy (p = .045) and Hospital Anxiety Depression Scale-Depression subscale (p = .048). Importantly, CBT significantly reduced the likelihood of clinical depressive symptoms (p = .014) and suicidal ideation (p = .005). Improvements were not observed for anxiety, QoL or maintained overtime for depression. Results suggest that CBT was effective, however, and could be improved to increase patient retention and long-term outcomes.     

Ethnic Differences in Parents' Attitudes toward Girls' Use of Aggression

Few studies have attempted to explain ethnic differences in female aggression. The degree to which ethnic differences exist in the influence of parents' approval of aggression on their preadolescent daughters' use of physical, verbal, and relational aggression was explored in a sample of 97 parent-child dyads. Results indicate that European American parents were more disapproving of their daughters' aggressive behavior than were African American parents. Parents' attitude toward aggression was predictive of European American girls' use of physical and verbal aggression and African American girls' use of relational aggression. Implications for aggression prevention and intervention for girls are discussed.     

Do You See What I See? The Influence of Gender Stereotypes on Student and Royal Canadian Mounted Police (RCMP) Perceptions of Violent Same-Sex and Opposite-Sex Relationships

ABSTRACT

Forty-one men and 67 women undergraduate students, as well as 35 men and 27 women Royal Canadian Mounted Police (RCMP) officers, rated the abusiveness of intimate partner violence (IPV) vignettes portraying each possible gender combination of victim and perpetrator (Harris &; Cook, 1994 Harris, R. J. and Cook, C. A. 1994. Attributions about spouse abuse: It matters who the batterers and victims are. Sex Roles, 30: 553–565. [Crossref], [Web of Science ®] , [Google Scholar]). Rating differences according to victim and perpetrator gender, occupation (student or RCMP officer), and participant gender were anticipated. Analyses found that student and RCMP ratings of abuse severity were both highest for the male-female scenario. However, the RCMP considered the female-male, male-male, and female-female scenarios to be more abusive than did the students. Our findings suggest that, while the RCMP appeared to be more sensitive to male and same-sex victims than students, both groups remain somewhat biased.     

Therapeutic Implications of Religious-Related Emotional Abuse

Religion can play a positive role in preventing all types of abuse. Consequently, it is often difficult to believe that religion or a particular manner of religious awareness can also be conducive to the degradation and humiliation of individuals, and that it can be maneuvered to justify abusive behavior. In this article we discuss the emotional repercussions of religious-related abuse in the family, an aspect that is rarely documented in the field of psychotherapy, but has many negative consequences. Religious-oriented emotional abuse is traceable to several levels of human functioning: the individual's internal level of experiencing themselves, the interpersonal and systemic levels, where the individual enters relationships, as well as within the framework of the individual's relationship with God.     

The Role of Rape Myth Acceptance and Psychopathy in Sexual Assault Perpetration

Perpetrators of sexual aggression consistently report higher scores on measures of psychopathy and acceptance of rape myths relative to nonperpetrators. However, less is known about psychopathy among nonincarcerated individuals and the relation between the two constructs has not been empirically examined among college perpetrators. To address this gap, both constructs were measured in a sample (N?=?308) of college men. Rape myth acceptance was positively correlated with psychopathy, and perpetrators scored higher on both constructs. Myths transferring responsibility to victims were related to Factor 1 psychopathy (i.e., callous and manipulative traits). The myth that “rape is trivial” was associated with Factor 1 and Factor 2 (i.e., impulsive and antisocial behavior), possibly suggesting that this myth is related to a larger tendency to excuse aggressive behavior. Although both constructs distinguished perpetrators when considered individually, rape myth acceptance did not explain unique variance in the presence of psychopathy.     

Current Treatment Strategies for Dissociative Identity Disorders in Adult Sexual Abuse Survivors

SUMMARY

During the past decade, increasing numbers of clinicians and researchers have suggested that the dissociative disorders, including dissociative identity disorder (DID), may be more prevalent than previously hypothesized. The “rediscovery” of DID is due, in part, to the recognition that early childhood trauma in conjunction with the propensity to dissociate, are etiologic factors for the development of DID. The purpose of this article is to raise clinical consciousness regarding DID, discuss the definition and etiology of the dissociative disorders, their assessment, and an approach to treatment of the sexual abuse survivor who has DID. This treatment program, while integrating some of the techniques recommended by others, is unique in its step-by-step flexible organization as well as its multifaceted format. The author's experience to date suggests that the sooner that a dissociative disorder can be identified in the adult sexual abuse survivor client, the more rapid the therapeutic progress.     

Mechanisms for the Relationship between Traditional Masculine Ideologies and Rape Myth Acceptance Among College Men

We explored mechanisms for the relationship between traditional masculine ideologies and rape myth acceptance. We hypothesized that locus of control would serve as a mediator for victim precipitation rape myths, and negative attitudes toward women would serve as a mediator for victim masochism and victim fabrication rape myths. Using a sample of 100 male college students, the results indicated that negative attitudes toward women mediated the relationship between traditional masculine ideologies and all 3 types of rape myths, but locus of control did not serve as a mediator for any. Implications and directions for future research are discussed.     

Maternal Dysphoria,Maternal Attitudes Toward Parenting,and Childhood Externalizing Behavior as Predictors of Physical Aggression

The purpose of this study was to test for reciprocity and chaining in 4,897 children (2,568 boys, 2,329 girls) from the Fragile Families and Child Wellbeing Study (FFCWS). Cross-lagged correlations between maternal dysphoria and attitude at Waves 2 and 3 of the FFCWS revealed that maternal dysphoria and negative maternal attitudes toward parenting were reciprocally related. Regarding chaining, the direct effects of Wave 2 maternal dysphoria and attitudes on Wave 5 offspring physical aggression were nonsignificant, although both variables predicted Wave 5 physical aggression via their cross-lagged correlations with each other at Wave 3 and offspring externalizing behavior at Wave 4. These results indicate that dysphoria and negative maternal attitudes toward parenting are equally important in predicting offspring physical aggression.     

Cognitive styles and person–environment fit: Investigating the consequences of cognitive (mis)fit

There is currently considerable interest in the key elements of person–environment fit to understand vocational behaviour and to develop strategic human resource management practices. In the light of this interest, we wanted to investigate (1) whether people within similar functions have similar cognitive styles, and (2) what the consequences of cognitive (mis)fit are on three work attitudes, using two large-scale databases (N = 24,267 and N = 2,182). We identified a knowing-oriented cognitive climate in finance, information technology (IT), and research and development (R&D) functions; a planning-oriented cognitive climate in administrative and technical and production functions; and a creating-oriented cognitive climate in sales and marketing functions and general management. Furthermore, we found that the relationship between people's cognitive styles and work attitudes (i.e., job satisfaction, job search behaviour, and intention to leave) does not depend on the cognitive climate in which they work. However, we did find that people with a higher creating style on average score higher on intention to leave and job search behaviour in comparison with people who score lower on the creating style, irrespective of the cognitive climate they are working in. The cognitive climate also partially affects job satisfaction and intention to leave after controlling for cognitive styles. In summary, cognitive styles and cognitive climate seem to have separate influences on people's work attitudes. Our findings are relevant for selection and recruitment policies of organizations and in the context of training, job design, and workforce planning.