Cognitive-behavioral therapy and decision science

In recent decades cognitive-behavioral therapy (CBT) and decision science (DS) have emerged within the field of psychological science. Though these are two vastly different areas of study, they are similar in that they address human information processing, cognition, behavior, and the link between them. In this article, we provide brief summaries of CBT and decision science, discuss their similarities and differences, and discuss how future research can identify ways in which these fields can inform each other. Several CBT techniques that might be of use to the efforts of the decision science field to prevent cognitive biases are suggested. Research that integrates these two fields may lead to the improvement of both.     

The Acceptability of Computer-Aided Cognitive Behavioural Therapy: A Pragmatic Study

The clinical and cost-effectiveness of a computer-aided cognitive behavioural therapy (CCBT) programme, Beating the Blues, is indicated by a number of studies, but relatively little is known about its acceptability for patients with depression, anxiety, or both. This study investigated the acceptability of Beating the Blues offered on eight scheduled clinic visits with brief face-to-face support. Pre and posttreatment measures explored the relationship among programme acceptability, treatment continuation, and outcomes for people accessing the programme in routine care. Two hundred and nineteen patients with depression, anxiety, or both were offered Beating the Blues in 11 primary and secondary care practices. One hundred and ninety-one (87%) completed the pretreatment measures and 84 (38%) completed a treatment feedback questionnaire. Analysis of treatment acceptability for CCBT indicated a positive patient experience with the programme. Pretreatment expectancies predicted CCBT treatment completion but not outcomes. No differences were found between men and women on pretreatment measures. Posttreatment, women reported more favourable responses to the therapy, finding the programme more helpful and more satisfactory, than did men. No relationship between treatment acceptability and age was found. Study limitations, including research methods and attrition rates, and implications for future research are discussed. It is concluded that the Beating the Blues CCBT programme is an acceptable treatment for common mental health problems in routine care.     

Advanced Brief Strategic Therapy: An overview of interventions with eating disorders to exemplify how theory and practice work

This paper aims at introducing some of the central aspects of the evolution that brief strategic therapy has undergone at the Centro di Terapia Strategica of Arezzo, Italy, towards advanced therapeutic strategies which differ from the original Palo Alto model. (Fisch, Weakland, &; Segal, 1982; Watzlawick, 1978 Watzlawick, P. 1978. The language of change: Elements of therapeutic communication, New York: Basic Books.  [Google Scholar]; Watzlawick, Beavin, &; Jackson, 1967; Watzlawick, Weakland, &; Fisch, 1974). We will focus on how the concept of self-deception is central to the formation and the persistence of psychological disorders; and how the usage of non-ordinary logics and the understanding of the individual's perceptive-reactive system are of key importance in unravelling such disorders, allowing the therapist to guide the patient towards an efficacious and efficient solution. Rather than attempting to describe and enlist the theoretical corpus that underlies brief strategic therapy, we have chosen to exemplify some focal concepts that connect theory to practice, and vice versa, by presenting the outline of some therapeutic protocols devised for solving eating disorders which can be specifically tailored for each individual patient.     

A Natural Approach in Mental Health Practice: Occupational Adaptation Revealed

A single case study of the stories told by one occupational therapist about her clients in mental health settings is presented in this article. Qualitative analysis revealed key concepts of the role of the occupational therapist as defined by occupational adaptation theory, along with unique perspectives of occupational therapy in mental health settings. The outcome of this study is a demonstration of the unique insight occupational therapy brings to addressing client recovery in mental health settings, specifically from an occupational adaptation perspective. This insight should enlighten others as to the necessity of skilled occupational therapy in mental health settings.     

Introducing Assertiveness Training in Hungary

Abstract

The preliminary results of an evaluation of a systematic assertiveness training programme (based on a cognitive-behavioural approach) in psychiatric care in Hungary are presented. The method adopted was specific to the Hungarian/Middle-European circumstances since people had difficulty in exercising their personal rights in the past. In groups of “neurotic” patients and comparison subjects three questionnaires (the Rathus-scale (R), the Assertiveness Inventory (AI) and the Uncertainty Questionnaire (UQ)) were administered at the beginning and at the end of the treatment. The training programme consisted of eight sessions with an emphasis on education about assertiveness and on the practice of skills such as saying “no” or standing up for oneself. A statistical analysis indicated significant improvement in the social skills of the participants, while an item analysis showed high internal consistency in all three questionnaires, and a concurrent validity analysis revealed a strong correlation between the Rathus-scale and the Assertiveness Inventory. The results indicate that assertiveness training can be used effectively in mental health care in Hungary.     

A Contemporary View of Applied Relaxation for Generalized Anxiety Disorder

Applied relaxation (AR), originally developed by Lars-Göran Öst, is a long-standing, efficacious treatment for generalized anxiety disorder (GAD). While newer treatments are continuing to be developed, AR remains one of the most efficacious treatments for GAD. However, AR has received less in-depth attention more recently, particularly in terms of potential mechanisms of action. This article is written to honor the development and history of AR and to highlight the ways that it has continued to be adapted. In this article, AR treatment strategies are presented, which include: noticing early signs of anxiety, learning relaxation skills, and applying relaxation at the first sign of anxiety. Then, additional adaptations to AR are presented along with recommendations of how AR may be enhanced by understanding potential mechanisms of change. Finally, recommendations are made for the continued evolution of AR as a powerful and efficacious treatment for GAD.     

The Mediatory Role of Maladaptive Schema Modes Between Parental Care and Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) is being increasingly recognised as a behaviour of significant clinical importance. Yet, there remains uncertainty regarding the underlying mechanisms of NSSI. This study aimed to explore the relationship between maladaptive schema modes, parental bonding, and NSSI. Seventy psychiatric outpatients with a history of NSSI completed the Deliberate Self-Harm Inventory, Schema Mode Inventory, and Parental Bonding Inventory. Results revealed that maladaptive schema modes were significantly associated with low parental care and with an earlier age of onset, longer duration, and higher number of methods of NSSI. Maladaptive schema modes also significantly mediated the relationship between parental care and age of onset of NSSI and between parental care and duration of NSSI. Two maladaptive schema modes (namely, Punitive Parent and Angry Child) were also found to be significant mediators in this relationship. The clinical implications of this research are discussed.     

From Projective Identification to Empathic Connection

SUMMARY

This article examines the challenging journey of successful coupling by understanding the marital relationship within a developmental framework. The process of Projective Identification is viewed as a useful concept found at the confluence of family systems and psycho-dynamic streams of thought, bridging the interpersonal and intrapsychic experience of couples whose individuative strivings are stalled. A map is offered for the transformation of a marriage from the stages of Idealization and Disillusionment toward the stage of Acceptance and empathic connection.     

Clinical Issues with Gay Male Couples

SUMMARY

Although gay male couples share with all couples three essential tasks of couplehood-creating boundaries in order to form a couple identity, negotiating closeness and distance, and accommodating to their individual differences-gay male couples face special complications in each task. These complications, examined herein, are largely the result of the marginalization gay men experience from living in a homophobic culture, and male gender acculturation that makes male-to-male intimacy difficult. A model of brief couple therapy for gay men is presented that is designed to honor, as well as challenge, the relationship the men have co-constructed and specifically addresses the difficulties men have in maintaining intimate bonds. A case study illustrates the treatment of clinical issues presented by male couples.     

A Learning Abilities Program for Learning Disabled Students

This report describes a treatment program for learning disabled soldiers who have completed their basic training and are experiencing academic difficulties as they begin their Advanced Individual Training. Rationale for the evaluation/treatment techniques used as well as suggested class room modifications are described.