Subjects -> SOCIAL SCIENCES (Total: 1815 journals)
    - BIRTH CONTROL (22 journals)
    - CHILDREN AND YOUTH (260 journals)
    - FOLKLORE (30 journals)
    - MATRIMONY (16 journals)
    - MEN'S INTERESTS (16 journals)
    - MEN'S STUDIES (96 journals)
    - SEXUALITY (57 journals)
    - SOCIAL SCIENCES (1091 journals)
    - WOMEN'S INTERESTS (44 journals)
    - WOMEN'S STUDIES (183 journals)

SOCIAL SCIENCES (1091 journals)                  1 2 3 4 5 6     

Showing 1 - 136 of 136 Journals sorted alphabetically
(En)clave Comahue. Revista Patagónica de Estudios Sociales     Open Access  
3C Empresa     Open Access   (Followers: 4)
A contrario     Full-text available via subscription   (Followers: 3)
AAS Open Research     Open Access   (Followers: 2)
Abant İzzet Baysal Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access   (Followers: 1)
Abant Kültürel Araştırmalar Dergisi     Open Access  
Abordajes : Revista de Ciencias Sociales y Humanas     Open Access   (Followers: 1)
Aboriginal and Islander Health Worker Journal     Full-text available via subscription   (Followers: 18)
About Performance     Full-text available via subscription   (Followers: 13)
Academic Journal of Interdisciplinary Studies     Open Access   (Followers: 1)
Academicus International Scientific Journal     Open Access   (Followers: 4)
Access     Full-text available via subscription   (Followers: 29)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 16)
ACCORD Occasional Paper     Open Access   (Followers: 4)
Accountability in Research: Policies and Quality Assurance     Hybrid Journal   (Followers: 18)
Acta Academica     Full-text available via subscription   (Followers: 6)
Acta Humana     Open Access   (Followers: 1)
Acta Scientiarum. Human and Social Sciences     Open Access   (Followers: 12)
Acta Universitatis Sapientiae, Philologica     Open Access   (Followers: 2)
Actes de la Journée des Sciences et Savoirs     Open Access   (Followers: 9)
Adelphi series     Hybrid Journal   (Followers: 14)
Adıyaman Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access  
Adıyaman Üniversitesi Sosyal Bilimler Enstitüsü Dergisi / Adiyaman University Journal of Social Sciences     Open Access  
Administrative Science Quarterly     Full-text available via subscription   (Followers: 242)
Administrative Theory & Praxis     Full-text available via subscription   (Followers: 8)
Adnan Menderes Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access  
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
África     Open Access   (Followers: 1)
Africa Spectrum     Open Access   (Followers: 17)
African Affairs     Hybrid Journal   (Followers: 74)
African Renaissance     Full-text available via subscription   (Followers: 4)
African Research Review     Open Access   (Followers: 9)
African Social Science Review     Open Access   (Followers: 11)
Afrika Focus     Open Access   (Followers: 1)
Afyon Kocatepe Üniversitesi Sosyal Bilimler Dergisi     Open Access  
Ágora : revista de divulgação científica     Open Access  
Ágora de Heterodoxias     Open Access   (Followers: 1)
Ağrı İbrahim Çeçen Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access   (Followers: 1)
Ahi Evran Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access  
Akademik Bakış Uluslararası Hakemli Sosyal Bilimler Dergisi     Open Access   (Followers: 1)
Akademik Hassasiyetler     Open Access  
Akademik İncelemeler Dergisi     Open Access   (Followers: 1)
Akademika : Journal of Southeast Asia Social Sciences and Humanities     Open Access   (Followers: 8)
AKADEMOS     Open Access   (Followers: 3)
Al Farabi Uluslararası Sosyal Bilimler Dergisi     Open Access  
Al-Mabsut : Jurnal Studi Islam dan Sosial     Open Access   (Followers: 1)
AL-Qadissiya Magzine for Human Sciences     Open Access   (Followers: 3)
Aleph : UCLA Undergraduate Research Journal for the Humanities and Social Sciences     Open Access   (Followers: 9)
Aletheia : Revista de Desarrollo Humano, Educativo y Social Contemporáneo     Open Access   (Followers: 1)
Algarrobo-MEL     Open Access   (Followers: 11)
Alinteri Journal of Social Sciences     Open Access   (Followers: 1)
Alliage     Free  
Alteridade     Open Access  
Ambigua : Revista de Investigaciones sobre Género y Estudios Culturales     Open Access   (Followers: 1)
American Communist History     Hybrid Journal   (Followers: 20)
Anais do Congresso de Pesquisa e Extensão e da Semana de Ciências Sociais da UEMG/Barbacena     Open Access  
Anais Eletrônicos do Congresso Epistemologias do Sul     Open Access   (Followers: 1)
ANALES de la Universidad Central del Ecuador     Open Access   (Followers: 4)
Anales de la Universidad de Chile     Open Access  
Análisis     Open Access  
Analysis     Full-text available via subscription   (Followers: 4)
Andamios. Revista de Investigacion Social     Open Access   (Followers: 1)
Anduli : Revista Andaluza de Ciencias Sociales     Open Access  
Anemon Muş Alparslan Üniversitesi Sosyal Bilimler Dergisi     Open Access  
Anka E-Dergi     Open Access  
Ankara Üniversitesi Sosyal Bilimler Dergisi     Open Access  
Ankara University SBF Journal     Open Access   (Followers: 1)
Annals of Humanities and Development Studies     Open Access   (Followers: 7)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 49)
Annuaire de l’EHESS     Open Access  
Anthropocene Review     Hybrid Journal   (Followers: 8)
Anthurium : A Caribbean Studies Journal     Open Access   (Followers: 8)
Approches inductives : Travail intellectuel et construction des connaissances     Open Access  
Apuntes : Revista de Ciencias Sociales     Open Access   (Followers: 2)
Apuntes de Investigación del CECYP     Open Access  
Arbejdspapirer : Professionshøjskolen Metropol     Open Access   (Followers: 6)
Arbetsliv i omvandling     Open Access  
Arbor     Open Access  
Argomenti. Rivista di economia, cultura e ricerca sociale     Open Access   (Followers: 4)
Argumentos : Revista do Departamento de Ciências Sociais da Unimontes     Open Access  
Argumentos. Revista de crítica social     Open Access  
Around the Globe     Full-text available via subscription   (Followers: 1)
Arquivos do CMD : Cultura, Memória e Desenvolvimento     Open Access  
Articulo - Journal of Urban Research     Open Access   (Followers: 8)
Artvin Coruh University International Journal of Social Sciences     Open Access  
Asia Pacific Journal of Sport and Social Science     Hybrid Journal   (Followers: 6)
Asian Journal of German and European Studies     Open Access  
Asian Journal of Quality of Life     Open Access   (Followers: 1)
Asian Journal of Social Science     Hybrid Journal   (Followers: 17)
Asian Journal of Social Sciences and Management Studies     Open Access   (Followers: 8)
Asian Research Journal of Arts & Social Sciences     Open Access   (Followers: 1)
Asian Social Science     Open Access   (Followers: 8)
Astrolabio, Nueva Época     Open Access  
Asya Araştırmaları Uluslararasi Sosyal Bilimler Dergisi / Journal of Asian Studies     Open Access  
Atatürk Dergisi     Open Access  
Atatürk Üniversitesi Edebiyat Fakültesi Dergisi     Open Access  
Ateneo Chinese Studies Program Lecture Series     Open Access  
Aurum Journal of Social Sciences     Open Access  
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 9)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription   (Followers: 2)
Australian Journal of Emergency Management     Full-text available via subscription   (Followers: 29)
Australian Journal on Volunteering     Full-text available via subscription   (Followers: 2)
Australian Population Studies     Open Access  
Austrian Journal of South-East Asian Studies     Open Access   (Followers: 1)
Bandung : Journal of the Global South     Open Access   (Followers: 1)
BARATARIA. Revista Castellano-Manchega de Ciencias sociales     Open Access  
Barn : Forskning om barn og barndom i Norden     Open Access   (Followers: 1)
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 45)
Basic Income Studies     Hybrid Journal   (Followers: 8)
Bayero Journal of Pure and Applied Sciences     Open Access   (Followers: 3)
Behavioural Sciences Undergraduate Journal     Open Access   (Followers: 5)
Berkeley Undergraduate Journal     Full-text available via subscription   (Followers: 1)
Beykent Üniversitesi Sosyal Bilimler Dergisi     Open Access  
Bhakti Persada : Jurnal Aplikasi IPTEKS     Open Access  
Big Data & Society     Open Access   (Followers: 51)
Bildhaan : An International Journal of Somali Studies     Open Access   (Followers: 5)
Bilecik Şeyh Edebali University Journal of Social Science Institute     Open Access  
Bingöl Üniversitesi Sosyal Bilimler Enstitüsü Dergisi     Open Access  
Black Sea Journal of Public and Social Science     Open Access  
Black Women, Gender & Families     Full-text available via subscription   (Followers: 18)
BMC Medical Ethics     Open Access   (Followers: 23)
Bodhi : An Interdisciplinary Journal     Open Access   (Followers: 3)
Body Image     Hybrid Journal   (Followers: 16)
BOGA : Basque Studies Consortium Journal     Open Access   (Followers: 3)
Boletín Cultural y Bibliográfico     Open Access   (Followers: 3)
Boletín Memoria     Open Access  
Border Crossing : Transnational Working Papers     Open Access   (Followers: 4)
Brain and Cognition     Hybrid Journal   (Followers: 38)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 4)
BU Academic Review     Open Access  
Bulletin de l’Institut Français d’Études Andines     Open Access   (Followers: 5)
Bulletin of Social Informatics Theory and Application     Open Access   (Followers: 1)
Búsqueda     Open Access  
Caderno CRH     Open Access   (Followers: 3)
Cadernos de Ciências Sociais Aplicadas     Open Access   (Followers: 1)
Cadernos de Estudos Sociais     Open Access   (Followers: 3)
Cadernos de Saúde     Open Access   (Followers: 1)
California Italian Studies Journal     Full-text available via subscription   (Followers: 6)
California Journal of Politics and Policy     Open Access   (Followers: 1)
Cambio : Rivista sulle Trasformazioni Sociali     Open Access  
Caminho Aberto : Revista de Extensão do IFSC     Open Access  
Campos en Ciencias Sociales     Open Access  
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 3)
Canadian Social Science     Open Access   (Followers: 14)
Caradde : Jurnal Pengabdian Kepada Masyarakat     Open Access  
Caribbean Studies     Full-text available via subscription   (Followers: 12)
Castalia : Revista de Psicología de la Academia     Open Access  
Catalan Social Sciences Review     Open Access   (Followers: 1)
Catalyst : A Social Justice Forum     Open Access   (Followers: 10)
Catholic Social Science Review     Open Access   (Followers: 5)
CBU International Conference Proceedings     Open Access   (Followers: 3)
Cemoti, Cahiers d'études sur la méditerranée orientale et le monde turco-iranien     Open Access   (Followers: 4)
Challenges     Open Access   (Followers: 3)
Chandrakasem Rajabhat University Journal of Graduate School     Open Access  
Changing Societies & Personalities     Open Access  
China Journal of Social Work     Hybrid Journal   (Followers: 2)
Chinese Journal of Social Science and Management     Open Access  
Chinese Studies     Open Access   (Followers: 9)
Cidadania em Ação : Revista de Extensão e Cultura: Notícias     Open Access  
Ciencia e Interculturalidad     Open Access   (Followers: 3)
Ciência ET Praxis     Open Access  
Ciencia Sociales y Económicas     Open Access  
Ciencia y Sociedad     Open Access   (Followers: 3)
Ciencia, Cultura y Sociedad     Open Access   (Followers: 1)
Ciencia, Técnica y Mainstreaming Social     Open Access  
Ciencias Holguin     Open Access   (Followers: 3)
Ciências Sociais Unisinos     Open Access   (Followers: 3)
Ciencias Sociales y Educación     Open Access   (Followers: 5)
Ciencias Sociales y Humanidades     Open Access   (Followers: 4)
Ciencias Sociales y Religión/Ciências Sociais e Religião     Open Access  
CienciaUAT     Open Access   (Followers: 1)
Científic@ : Multidisciplinary Journal     Open Access  
Citizen Science : Theory and Practice     Open Access   (Followers: 1)
Citizenship Teaching & Learning     Hybrid Journal   (Followers: 9)
Ciudad Paz-ando     Open Access   (Followers: 1)
Civilizar Ciencias Sociales y Humanas     Open Access   (Followers: 3)
Civitas - Revista de Ciências Sociais     Open Access   (Followers: 3)
Claroscuro     Open Access   (Followers: 1)
CLIO América     Open Access   (Followers: 2)
CMU Journal of Law and Social Sciences     Open Access   (Followers: 2)
Cogent Social Sciences     Open Access   (Followers: 4)
Cognitive and Behavioral Practice     Hybrid Journal   (Followers: 13)
Colección Académica de Ciencias Sociales     Open Access  
Colonial Academic Alliance Undergraduate Research Journal     Open Access   (Followers: 4)
Communication, Politics & Culture     Open Access   (Followers: 14)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 4)
Community Empowerment     Open Access  
Compendium     Open Access   (Followers: 2)
Comprehensive Results in Social Psychology     Hybrid Journal   (Followers: 1)
Comprehensive Therapy     Hybrid Journal   (Followers: 3)
Comuni@cción     Open Access   (Followers: 1)
Comunitania : Revista Internacional de Trabajo Social y Ciencias Sociales     Open Access   (Followers: 1)
ConCiencia     Open Access  
Confluenze Rivista di Studi Iberoamericani     Open Access  
Connections     Open Access  
Contemporary Journal of African Studies     Full-text available via subscription   (Followers: 4)
Contemporary Social Science     Hybrid Journal   (Followers: 14)
CONTRA : RELATOS desde el Sur     Open Access  

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Similar Journals
Journal Cover
Cognitive and Behavioral Practice
Journal Prestige (SJR): 1.245
Citation Impact (citeScore): 2
Number of Followers: 13  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1077-7229
Published by Elsevier Homepage  [3200 journals]
  • Adaptation of Transdiagnostic CBT for Turkish Adolescents: Examples From
           Culturally Adapted Multiplex CBT
    • Abstract: Publication date: Available online 21 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Z. Ceren Acarturk, Behiye Alyanak, Mustafa Cetinkaya, Birgul Gulen, Baland Jalal, Devon E. HintonAbstractThe present article illustrates how cognitive-behavioral therapy (CBT) was adapted for an adolescent Turkish population with mood and anxiety disorders. The resulting 10-session treatment—based on multiplex CBT—was efficacious in a treatment trial, showing large effect sizes (Acarturk et al., 2018). This paper discusses the cultural grounding of CBT, which increases effectiveness by such means as increasing acceptability and positive expectancy. We describe a culturally sensitive assessment measure of somatic complaints and cultural syndromes, the Turkish Symptom and Syndrome Addendum. We discuss how, in a culturally sensitive way, we normalized symptoms, conducted interoceptive exposure, and created positive reassociations to sensations. We describe how we used Turkish metaphors and religious ideas to teach CBT principles. We show how we adapted mindfulness and “loving kindness” for a Turkish population, and how we utilized transition “rituals” at the end of the treatment to give a sense of closure and a positive feeling of transformation. Two case examples are provided to further illustrate how we adapted multiplex CBT to a Turkish adolescent population.
       
  • Brief Intervention to Reduce Problem Drinking in College Students With
           ADHD
    • Abstract: Publication date: Available online 14 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): John M. Vasko, Michael C. Meinzer, James G. Murphy, Lauren E. Oddo, Katherine L. McCauley, Mary E. Rooney, Carl W. Lejuez, Andrea Chronis-TuscanoAbstractDespite gaining admission to college, many students with attention-deficit/hyperactivity disorder (ADHD) struggle to achieve academic, social, and occupational success. Additionally, college students with ADHD experience higher rates of problem drinking and comorbid psychology (e.g., depression). This paper describes the development of the Students Understanding College Choices: Encouraging and Executing Decisions for Success (SUCCEEDS) program for college students diagnosed with ADHD who are engaging in problem drinking. SUCCEEDS combines ADHD psychoeducation, behavioral activation, and brief motivational intervention treatment elements to help college students with ADHD achieve healthier and more fulfilling lifestyles. SUCCEEDS aims to decrease problem drinking by increasing substance-free, goal-directed behavior allowing for success in college. The iterative treatment development process, two SUCCEEDS illustrative case examples, and reliable change indices are presented. Preliminary results suggest that SUCCEEDS may be effective in reducing problem drinking and functional impairment in areas relevant to college students (e.g., academics).
       
  • Tailoring Cognitive Behavioral Therapy for Trauma-Exposed Persons Living
           With HIV
    • Abstract: Publication date: Available online 14 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Cristina M. López, Christine K. Hahn, Amanda K. Gilmore, Carla Kmett DanielsonAbstractThis treatment development report describes the need for evidence-based psychosocial trauma-focused treatment for people living with comorbid posttraumatic stress disorder (PTSD) and HIV. Individuals with HIV have higher rates of exposure to traumatic events and PTSD than the general public, and they also experience additional consequences of PTSD on the management of their chronic disease (e.g., established link between PTSD symptoms and lack of adherence to antiretroviral therapy [ART]). We used the empirically supported ADAPT-ITT approach to consider the initial steps in adapting evidence-based Cognitive Processing Therapy (CPT) for individuals with PTSD and HIV. This paper reviews a case example that involved various clinical issues that may arise when providing trauma-focused treatment for people living with HIV including HIV-stigma, disease management, and the need for making multicultural adaptations to psychotherapy. This case example illustrates how trauma-focused treatment may benefit from enhancement to address additional barriers that may arise over the course of PTSD treatment in this population. Feasibility of engaging and delivering a "full dose" of evidence-based PTSD treatment among individuals living with HIV is discussed. While evidence-based treatments can reduce PTSD symptom severity, issues related to chronic disease coping and HIV-related stigma management could be integrated to augment the efficacy of treatment for individuals with HIV. Adaptive intervention research targeting PTSD in persons living with HIV warrants further attention, especially given the association between PTSD and adherence to ART.
       
  • Multimedia Field Test: Can Users Strike Out OCD With the NOCD App'
    • Abstract: Publication date: Available online 14 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Natalie Hong, Amanda L. Sanchez, Jonathan S. ComerAbstractNOCD is a mobile application that was developed as an adjunct to evidence-based treatment for individuals diagnosed with OCD. NOCD is not a stand-alone treatment, but rather a resource for patients to access supported strategies outside of treatment sessions. NOCD allows users to assess OCD symptom severity, create exposure and response prevention treatment plans, participate in planned weekly out-of-session exposure exercises, receive guidance during unexpected OCD episodes, share assessment and treatment data, as well as communicate with other NOCD users in an online community. Despite some challenges with initial set-up and inflexibility with varying OCD presentations, we believe this application has strong potential to enhance treatment for patients with OCD. At present, NOCD has not been adequately evaluated in a controlled manner. Although quite promising, research is now needed to examine the extent to which NOCD indeed improves engagement and clinical outcomes relative to traditional evidence-based treatment options.
       
  • Supporting Grass Roots Implementation of an Evidence-Based Psychotherapy
           Through a Virtual Community of Practice: A Case Example in the Department
           of Veterans Affairs
    • Abstract: Publication date: Available online 14 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Sara J. Landes, Brandy N. Smith, Kenneth R. WeingardtAbstractIn contrast to a top-down dissemination approach, the present approach identified existing clinicians using an evidence-based psychotherapy (EBP), dialectical behavior therapy, throughout the Department of Veterans Affairs (VA) system, and created a virtual community of practice (VCoP) to facilitate sharing of materials, resources, information, and clinical expertise. This “bottom-up” or grassroots approach to building a VCoP has potential to support the adoption of EBPs in settings without the resources required to support a large-scale training and consultation initiative. The objective of the current paper is to describe creation, dissemination, and web analytics data of this VCoP to connect providers using an EBP in a national health care system. The VCoP was created using SharePoint and development included user acceptance testing. Dissemination was achieved through a variety of outlets, including use of e-mail listservs, promotion on internal Web sites, and presentations. Monthly Web analytics data were collected on number of unique users, location of users, and number of requests or visits. Monthly Web analytics data indicated that the site was visited every workday in the first year and consistently across 5 years. Number of unique users and number of requests was relatively stable with increases corresponding to efforts to increase site engagement. Location of users demonstrates a wide reach across the VA system. Web analytics data indicate sustained use of the site by providers and methods to facilitate and increase use and interaction appeared to have a positive impact. Future research should investigate the effectiveness of such a strategy on provider behavior.
       
  • Development and Implementation of a Multicultural Consultation Service
           Within an Academic Medical Center
    • Abstract: Publication date: Available online 14 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Gabriela A. Nagy, Kelly LeMaire, Melissa L. Miller, Marissa Howard, Kristin Wyatt, Noga ZerubavelAbstractA major challenge for our field is to ensure we meet the growing demand for culturally sensitive and responsive evidence-based practices to keep up with changing demographics in the U.S. as well as calls to action by our field. To address the mental health imperative to improve the multicultural competence of clinicians and to provide appropriate care, it is important to create opportunities for clinicians to receive training in this area. One route to meet these demands is to provide ongoing multicultural peer consultation to clinical providers. This model also facilitates direct application to clinical work. To that end, we present herein a model for developing and implementing a multicultural peer consultation team. In our implementation, our consultation team aimed to function as therapy for therapists in the context of provision of empirically supported, principle-driven cognitive and behavioral therapies, with a consultation focus on multicultural perspectives and multicultural competence. We demarcate consultation needs within an academic medical center, identify facilitators and barriers to implementation of the service, and provide recommendations for future directions. Moreover, herein we present a case study to demonstrate the process of multicultural peer consultation.
       
  • An Ethical Imperative: Effectively Reducing SGM Disparities Utilizing a
           Multilevel Intervention Approach
    • Abstract: Publication date: Available online 1 March 2019Source: Cognitive and Behavioral PracticeAuthor(s): Colleen A. Sloan, Jillian C. ShipherdAbstractHealth disparities for sexual and gender minority (SGM) populations are well documented and manifest systemically. Mental health professionals have begun working to address these disparities, demonstrating efforts to more effectively define and increase competency in SGM health and by adapting existing evidence-based interventions to more effectively target the unique needs of the SGM community. While such efforts are necessary, they inadequately address the systemic nature of the problem, placing an unnecessary burden on SGM individuals to tolerate systemic discrimination, injustice, and inequality. The current special series attempts to address this gap by featuring papers that describe multilevel (e.g., micro, mezzo, macro) intervention approaches to reduce SGM health disparities. We argue that advocacy is inherent to the work, and we hope that this special series will empower mental health professionals to engage in multilevel, systemic interventions as an ethical imperative.
       
  • An Online- and Mobile-Based Application to Facilitate Exposure for
           Childhood Anxiety Disorders
    • Abstract: Publication date: Available online 2 February 2019Source: Cognitive and Behavioral PracticeAuthor(s): Stephen P.H. Whiteside, Bridget K. Biggs, Michael S. Tiede, Julie E. Dammann, Julie C. Hathaway, Marc E. Blasi, Deanna Hofschulte, Kristin VickersAbstractIn the current paper, we describe an integrated online- and mobile-based application for the treatment of childhood anxiety disorders, Anxiety Coach. The technology is designed to increase the use of exposure therapy by therapists and patients. We begin by outlining the clinical content and design of the application, and then review the clinical administration and theoretical basis for the program. Next, using results from an implementation feasibility study, we illustrate how data collected during application use can inform therapists, supervisors, and researchers about process variables (i.e., use of exposure) and outcomes (i.e., symptom improvement). Implications of the potential for Anxiety Coach to increase access to evidence-based treatment and directions for further research are discussed.
       
  • Hope for the Worst: Occasional Reinforced Extinction and Expectancy
           Violation in the Treatment of OCD
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Jason W. Krompinger, Nathaniel P. Van Kirk, Lauryn E. Garner, Sriramya I. Potluri, Jason A. EliasAbstractAn inhibitory learning conceptualization of treatment mechanisms in exposure-based therapy appears to better account for durability of symptom reduction and index overall learning. Presented here is an overview of two core elements of inhibitory learning, expectancy violation and occasional reinforced extinction, as they are thought to function in exposure and response prevention (ERP) for OCD. The overview is then followed by case examples illustrating these processes at work in a naturalistic clinical setting. Implications for treatment are broadly discussed.
       
  • The Suitability of an Inhibitory Learning Approach in Exposure When
           Habituation Fails: A Clinical Application to Misophonia
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Brandon Frank, Dean McKayAbstractRecent findings have led to a reconceptualization of the mechanisms that account for the efficacy of exposure-based treatments. Termed the “inhibitory learning model,” this approach emphasizes new learning when confronted with previously avoided stimuli rather than merely the cessation of fear or aversive emotional responding. In this paper, we propose the applicability of the inhibitory learning model for conditions and contexts in which simple exposure does not produce habituation. We illustrate this application from an in-progress randomized controlled treatment trial for adults with misophonia. Misophonia is a condition marked by strong aversive reactions to specific sounds. It is a difficult to treat and understudied syndrome. All participants in the trial received exposure, either before or after a stress management module of treatment. Exposure treatment emphasized altered expectancies for the target sounds as well as deliberate practice in hearing sounds on the individually developed hierarchy. Inhibitory learning strategies were employed to increase treatment adherence and commitment, shape patient behavior during exposures, manufacture negative prediction errors, increase perceived control over reactions, and promote learning that generalized to functional improvements. The findings are discussed in the context of future applications of the inhibitory learning model for psychopathology associated with avoidance.
       
  • Reflections on the Field of School Attendance Problems: For the Times They
           Are a-Changing'
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Bruce J. Tonge, Wendy K. SilvermanAbstractThis article presents reflections on the seven articles included in this special series. The classification of school attendance problems (SAPs) based on structured checklists of SAP types (school refusal, truancy, school withdrawal, and school exclusion) together with functional analysis opens the way for establishing norms and social referents. We discuss how authorized nonattendance can also be problematic if it is persistent, and that it is important to take this type of SAP into account if the field is to effectively understand and respond to the complex range of bio-psycho-socio-cultural determinants of absenteeism. We highlight other gaps in the current literature, one of which is the lack of attention to evidence-based prevention and early intervention strategies. Avenues for future research are suggested, with emphasis on the need for pragmatic approaches to address the complexities of SAPs. Promising work is beginning to address the SAPs that are prevalent in special populations such as those with autism spectrum disorder. Overall, our reflections highlight the incremental changes that have characterized the field, exemplified by this series of articles, and the promise of transformational change in tackling the major challenge of SAPs as research in the field continues.
       
  • Antidepressant Medication: Is It a Viable and Valuable Adjunct to
           Cognitive-Behavioral Therapy for School Refusal'
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Glenn A. Melvin, Michael S. GordonAbstractCognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders, combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing antidepressant medication or referring for adjunctive antidepressant treatment for school refusal.
       
  • Reengagement With Education: A Multidisciplinary Home-School-Clinic
           Approach Developed in Australia for School-Refusing Youth
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Lisa McKay-Brown, Rebecca McGrath, Leah Dalton, Lorraine Graham, Alison Smith, Judy Ring, Kathy EyreAbstractSchool refusal (SR) can result in decreased academic achievement, impaired social connections, and family stress. Current interventions for SR include behavioral and cognitive-behavioral treatments that are not always effective. Incorporating multidisciplinary work that includes therapeutic and educational interventions may enhance outcomes for youth displaying SR. The In2School program fosters a working partnership between mental health clinicians and teachers. It was designed to meet the needs of young people missing more than 50% of school in the previous 6 weeks due to mental health disorders, including anxiety or depression. This paper reports on an action research study in which the In2School program was piloted. Over a 14-week period, therapeutic and educational interventions were integrated into the learning environment via a transitional classroom to support youths’ return to school. Outcomes of this program are reported for the first cohort of 7 youth. Of these youth, 6 returned to mainstream schooling with attendance levels being maintained for 6 months after completing the intervention. Progress was observed in mental health recovery, quality of life reports, increased social interactions with peers, and positive experiences at school. The preliminary results presented in this paper suggest that a multidisciplinary, home-school-clinic intervention holds promise for helping school-refusing youth to return to school.
       
  • The Link: An Alternative Educational Program in the Netherlands to
           Reengage School-Refusing Adolescents With Schooling
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Marije L. Brouwer-Borghuis, David Heyne, Floor M. Sauter, Ron H.J. ScholteAbstractFacets of school life affect the development and maintenance of school refusal (SR). These facets will warrant attention during intervention for SR. This paper considers a range of school-related factors associated with SR, grouped according to five domains of school climate. It also describes school-based interventions for SR in the form of alternative educational programs (AEPs). The paper then presents the Link, an AEP for Dutch adolescents with SR. The Link offers an educational setting that addresses school-related factors associated with SR. After participation in the Link, adolescents are helped to return to a more typical educational setting. Based on a review of 30 case files, we provide an account of adolescents who have participated in the Link. Often, these adolescents displayed chronic and severe SR, met criteria for anxiety or depressive disorders, and were diagnosed with an autism spectrum disorder. The Link process is illustrated via a case vignette. Thereafter, the role of AEPs in the treatment of SR is discussed.
       
  • Modular Treatment for Children and Adolescents With Problematic School
           Absenteeism: Development and Description of a Program in Germany
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Volker Reissner, Martin Knollmann, Svenja Spie, Diana Jost, Anja Neumann, Johannes HebebrandAbstractProblematic school absenteeism is defined as absence from school occurring with a clinical-level mental disorder. It represents a higher-order term for school refusal, school truancy, and the combination thereof and is associated with an increased risk for school dropout, prolonged mental disorders, and unemployment. This article describes the manualized modular treatment of problematic school absenteeism (MT) by a multiprofessional team. The manual was developed to target a broad spectrum of mental disorders characterized by internalizing but also externalizing behavior. The therapeutic focus is on the reintegration into school and on the cognitive behavioral treatment of the mental disorder. The MT is based on a multilevel model of problematic school absenteeism. The treatment is informed by an extensive case-conceptualization and addresses motivational aspects by offering a low-threshold therapeutic design and motivational interviewing. Core interventions are represented in four modules: cognitive behavioral therapy, family counseling, school counseling, and a psychoeducational physical exercise program. A case vignette provides an illustration of the treatment and the specific graduated approach for school reintegration. The current modular approach is discussed in relation to other cognitive-behavioral manuals targeting a broad spectrum of mental disorders or school refusal.
       
  • Emerging School Refusal: A School-Based Framework for Identifying Early
           Signs and Risk Factors
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Jo Magne Ingul, Trude Havik, David HeyneAbstractA student’s academic and social-emotional development is increasingly jeopardized with mounting absence from school. School refusal (SR) is one type of school attendance problem (SAP) that is often associated with absence from school. Once established, it can sometimes be difficult to treat. To prevent established SR and associated problems, indicators of emerging SR and risk for SR should be efficiently identified and acted upon. Risk factors are often discussed in relation to SAPs generally rather than considering risk for specific types of attendance problems. Based on literature review, this paper provides an account of the likely signs and risks for emerging SR. A school-based framework is provided to support school personnel and parents in working together to identify these signs and risks. Several challenges associated with the implementation of the framework are discussed.
       
  • Developing an Online Early Detection System for School Attendance
           Problems: Results From a Research-Community Partnership
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Brian C. Chu, Denise Guarino, Christina Mele, Jean O’Connell, Patricia CotoAbstractSchool refusal and other school attendance problems are vexing problems for school-aged youth, families, school personnel, and clinicians. However, few resources exist to detect problematic attendance. The current report describes three steps of a research-community partnership to develop an early identification program to detect youth at risk for problematic attendance. First, a survey was conducted to estimate the scope and cost of school refusal across grades K–12. School administrators estimated relatively few youth exhibiting significant school refusal (missing 5 or more days per year) but estimated the costs associated with services for these youth to be very high (mean cost of in-district programs: $94,052; mean cost of out-of-district placements: $496,657). Second, elementary school counselors were tasked with tracking absenteeism among at-risk youth using an online attendance tracking prototype. Counselors identified a high number of youth who showed elevated absences, lates, or early departures (17.2% of enrolled students), and counselor ratings were significantly related to whether the student (a) had received an individualized education plan or 504 plan, (b) had a sibling with similar attendance problems, (c) was older, or (d) had divorced or separated parents. In a final step, counselor feedback was sought and revisions were incorporated in the attendance tracker. Findings reinforce the prevalence and cost of school attendance problems, provide guidance for using technology to monitor attendance and related indices (tardies, early departures), and direct attention to youth factors that may be useful in identifying youth at risk for poor attendance.
       
  • Differentiation Between School Attendance Problems: Why and How'
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): David Heyne, Malin Gren-Landell, Glenn Melvin, Carolyn Gentle-GenittyAbstractSchool attendance problems (SAPs) are heterogeneous with respect to etiology and presentation. The long history of conceptualizing SAPs has led to a vast array of terms and definitions as well as different perspectives on the most helpful approach to classification. For educators, practitioners, researchers, and policymakers, this presents a challenge in understanding, assessing, and intervening with SAPs. This paper outlines evolution in the conceptualization of SAPs, focusing on two contemporary approaches to differentiating between them. One approach draws on the longstanding differentiation between SAP types labeled school refusal, truancy, and school withdrawal. A fourth type of SAP, labeled school exclusion, is also considered. The other approach focuses on the function of absenteeism, measured via the School Refusal Assessment Scale (SRAS). Anecdotal and scientific support for the SAP typology is presented, along with the benefits and shortcomings of the SRAS approach to differentiation. The paper offers suggestions for how to differentiate between SAPs and introduces the SNACK, a brief screening measure that permits differentiation by SAP type.
       
  • Acknowledgment to 2018 Reviewers
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s):
       
  • An Inhibitory Learning Approach to Cognitive-Behavioral Therapy for
           Children and Adolescents
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Joseph F. McGuire, Eric A. StorchAbstractAlthough exposure-based cognitive-behavioral therapy (CBT) is efficacious for childhood anxiety and obsessive–compulsive disorder (OCD), many youth do not adequately respond to treatment. Extinction learning is an important process in exposure-based CBT. However, youth with anxiety disorders and OCD exhibit impairments in extinction processes that are best characterized by deficits in inhibitory learning. Therefore, the utilization of strategies to optimize inhibitory learning during exposures may compensate for these deficits, thereby maximizing extinction processes and producing more robust treatment outcomes for exposure-based CBT. This paper reviews several strategies to optimize inhibitory learning in youth with anxiety disorders and OCD, and presents practical examples for each strategy. This paper also highlights the difference between inhibitory learning-based exposures and prior conceptual approaches to exposure therapy in clinical practice. It concludes with a discussion of future directions for clinical research on inhibitory learning and exposure-based CBT in youth.
       
  • Affect Labeling to Facilitate Inhibitory Learning: Clinical Considerations
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Elizabeth H. Marks, Rosemary S.W. Walker, Heidi Ojalehto, Michele A. Bedard-Gilligan, Lori A. ZoellnerAbstractExposure-based treatments known to be effective for a wide range of psychopathology are thought to work via inhibitory learning, where new learning acquired during exposure exercises inhibits previously learned fear and avoidance responses. One way in which this inhibitory learning may be enhanced is through affect labeling, during which clients verbalize their internal emotional experiences. Theoretically, affect labeling may be a subtle, implicit form of emotion regulation and may facilitate more explicit forms of extinction learning. Experimental research suggests that affect labeling may lead to attenuated fear responses to emotionally evocative stimuli in healthy samples and may be a helpful strategy in reducing physiological arousal experienced during exposure tasks, particularly for clients with inhibitory deficits. Research with clinical samples is limited and mixed, at best. Case examples illustrate how affective labeling may help get a client “unstuck” from unproductive processing loops, can contribute to shifts in perspective and meaning making, and may modulate distress and promote distress tolerance. We argue that routine use of affect labeling in clinical care is premature. When used, it should be employed strategically within a broader case conceptualization and may be of a limited benefit beyond what is already employed in quality exposure therapy.
       
  • Enhancing Inhibitory Learning: The Utility of Variability in Exposure
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Kelly A. Knowles, Bunmi O. OlatunjiAbstractExposure therapy has strong empirical support as a treatment for anxiety and related disorders, yet not all participants see clinically meaningful reduction in symptoms, and some experience return of fear. In this review, we examine the theoretical models of exposure therapy, from early precursors to the contemporary inhibitory learning model. The inhibitory learning model is applied to examine one potential method of improving outcomes in exposure therapy: increasing variability in the progression of the exposure hierarchy. We explore mechanisms that support the use of variability in exposure, including the violation of expectancies to enhance learning. In addition, the role of intolerance of uncertainty in anxiety is examined; variable exposure therapy could target this transdiagnostic mechanism in anxiety and related disorders. Suggestions for future research are then offered.
       
  • Inhibitory Learning for Anxiety-Related Disorders
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): David F. TolinAbstractThis article reviews the articles in this issue that describe the strategies derived from the inhibitory learning model as applied to exposure therapy for anxiety disorders. The major principles of inhibitory learning are to create and strengthen nonthreat associations in memory (largely by engaging prefrontal cortical regions), and to effectively retrieve those nonthreat associations in the long term. Several case vignettes are provided that demonstrate how the principles of inhibitory learning (which include maximizing expectancy violations, limiting distraction, fear antagonistic actions, deepened extinction, elimination of safety behaviors, occasional reinforced extinction, increasing variability of exposures and offsetting reinstatement and context renewal effects) can be applied in clinical practice.
       
  • When Is Seeking Safety Functional' Taking a Pragmatic Approach to
           Distinguishing Coping From Safety
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Lauren J. Hoffman, Brian C. ChuAbstractCurrently, most exposure-based treatments call for clinicians to assess for and remove all safety behaviors during exposure tasks. However, the notion that safety behaviors are detrimental across all scenarios has recently been challenged, and research regarding the effects of safety behaviors on exposure outcomes is limited and inconsistent. In clinical practice, classifying a strategy as a safety behavior can be a complex and challenging endeavor, particularly when distinguishing between harmful safety behaviors and helpful coping behaviors. We outline an approach that emphasizes the pragmatic truth criterion and uses functional outcomes to classify behaviors as serving either safety or coping functions. Our focus on doing what “works” simplifies decision-making for clinicians and maintains the focus of treatment on enhancing functioning. We propose a model for using functional outcomes to distinguish between safety and coping behaviors and illustrate our approach through case examples.
       
  • Dropping Safety Aids and Maximizing Retrieval Cues: Two Keys to Optimizing
           Inhibitory Learning During Exposure Therapy
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Shannon M. Blakey, Jonathan S. AbramowitzAbstractThe inhibitory learning model of exposure therapy posits that clinical anxiety is most effectively treated when clinicians employ strategies that maximize the (a) violation of negative expectancies and (b) generalization of nonthreat associations. Translation of basic learning research to exposure therapy via this explanatory model underscores two keys to optimizing inhibitory learning during exposure: dropping safety aids and maximizing retrieval cues. Although topographically similar, safety aids and retrieval cues are functionally distinct as well as therapeutically incompatible. In the present article, we delineate safety aids and retrieval cues in the context of exposure therapy from an inhibitory learning perspective, providing illustrative case examples of how clinicians may address the two when treating patients with clinical anxiety.
       
  • Using Multiple Contexts and Retrieval Cues in Exposure-Based Therapy to
           Prevent Relapse in Anxiety Disorders
    • Abstract: Publication date: February 2019Source: Cognitive and Behavioral Practice, Volume 26, Issue 1Author(s): Rachel de Jong, Miriam J.J. Lommen, Peter J. de Jong, Maaike H. NautaAbstractThe benefits of exposure-based interventions for anxiety disorders are substantial but not stable for everyone, given that these interventions are often followed by relapse of symptoms. A body of research provides a background on how to add certain strategies in exposure-based therapy to prevent relapse in anxiety disorders. This review summarizes some of these strategies and provides clear-cut clinical implications. Studies that provide support for two types of strategies to prevent relapse have been reviewed—the use of multiple contexts and the use of retrieval cues. The use of multiple contexts reduces context and stimulus specificity of extinction learning during exposure, while the use of retrieval cues enhances memory (re)consolidation and retrieval after exposure. The described strategies to enhance the accessibility and therefore the retrievability of exposure-based learning to prevent relapse in anxiety disorders can be summarized as advice to conduct exposure under variable conditions. This way, the generalizability of what is learned during exposure to the patients’ daily life after treatment improves. Therefore, adding these strategies in the course of exposure-based treatment of anxiety disorders seems beneficial. However, future replications and translational studies are needed to verify ecological validity.
       
  • Lessons Learned About Barriers to Implementing School-Based Interventions
           for Adolescents: Ideas for Enhancing Future Research and Clinical Projects
           
    • Abstract: Publication date: Available online 10 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Erin Girio-Herrera, Caroline J. Ehrlich, BreAnne A. Danzi, Annette M. La GrecaAbstractThe majority of youth with mental health problems do not receive treatment, highlighting the critical need to transport evidence-based interventions into community settings, such as schools. Despite being able to reach a large number of adolescents and minority youth, the process of implementing evidence-based interventions to schools is challenging. This paper discusses some expected and unexpected challenges experienced during the implementation of an open trial and a pilot randomized controlled trial examining the acceptability and effectiveness of a school-based preventive intervention for adolescents at risk for internalizing disorders. First, we highlight key programs and findings on preventive interventions for adolescents at risk for depression and anxiety. Next, we provide a brief overview of the preventive intervention we implemented in schools. This provides a context for the section that describes implementation issues and highlights specific challenges and potential solutions for intervention implementation. Finally, the paper offers recommendations for researchers and clinicians interested in implementing school-based mental health services for adolescents.
       
  • Clinical Guidelines for Improving Dialectical Thinking in DBT
    • Abstract: Publication date: Available online 9 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Lauren Bonavitacola, Alec L. Miller, Lata K. McGinn, Emma C. ZolothAbstractCognitive dysregulation, often characterized by extreme, nondialectical thinking, is a core problem area identified in dialectical behavior therapy (DBT) and is posited to contribute to pervasive emotional and behavioral dysregulation. However, cognitive flexibility is understudied and rarely considered a direct treatment target in DBT. This paper provides clinical guidelines for increasing dialectical thinking with patients in DBT. We review the historical context of dialectical thinking in DBT and present the results of a survey examining DBT therapists’ perspectives on nondialectical thinking as a treatment focus. We describe cognitive restructuring strategies from cognitive therapy models, and compare these with techniques targeting cognitive dysregulation in DBT. We highlight the rationale for incorporating dialectical thinking as a direct treatment focus in DBT, and offer strategies derived from cognitive restructuring to incorporate directly targeting dialectical thinking in conceptualization, treatment planning, and in session. These strategies are demonstrated with clinical vignettes and examples.
       
  • The Benefits and Limitations of a Behavioral Intervention for Caregivers
           of Dementia Patients: A Qualitative Study
    • Abstract: Publication date: Available online 4 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Nicole Nehrig, Maria Shifrin, Karen Abraham, Cory K. ChenAbstractThis study used qualitative methods to understand dementia caregivers’ experience of personal and therapeutic factors contributing to outcome following REACH VA, a behavioral intervention designed to alleviate caregiver burden and depressive symptoms. Caregivers and their interventionists were queried about their experiences of the treatment in semistructured interviews. Interviews were transcribed and analyzed using thematic analysis. The following themes emerged reflecting aspects of the intervention caregivers and interventionists found helpful: self-care, shared goals, psychoeducation, and stress-management skills. Some caregivers and interventionists found the provision of problem-solving skills to be helpful and others did not. Finally, some caregivers and interventionists reported that interpersonal support/bearing witness, insight, emotional transformation, and the discussion of interpersonal process were useful when part of the intervention or, when not included, would have been helpful. While behavioral interventions tend to be highly structured, interventionists’ ability to work flexibly within the protocol and tailor it to the caregiver’s needs was related to positive treatment response. The beneficial aspects of this treatment represent multiple theoretical orientations highlighting the importance of transtheoretical models of therapeutic action.
       
  • Nonbinary-Affirming Psychological Interventions
    • Abstract: Publication date: Available online 4 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Emmie MatsunoAbstractNonbinary individuals experience unique stressors and stigma compared to binary transgender individuals. Given the many social systems that operate on a binary gender system, nonbinary individuals frequently experience microaggressions, discrimination, and harassment and suffer from high rates of negative mental health outcomes as a result. The unique stressors that nonbinary individuals face warrant specific clinical considerations for working with this population. Yet, limited published clinical guidance exists on working with nonbinary clients. This article uses minority stress theory to understand the unique stressors and mental health risks that nonbinary individuals face, a cultural competency framework to describe affirming practices, and ecological theory to contextualize how mental health providers can intervene and support nonbinary individuals. Concrete micro-, mezzo-, and macro-level interventions are provided for clinicians to enact to support the well-being of nonbinary clients including affirming the client’s experience of gender, taking a stance of openness and flexibility, and advocating for inclusive policies and practices.
       
  • A Task-Shifting Problem-Solving Therapy Intervention for Depression and
           Barriers to Antiretroviral Therapy Adherence for People Living With HIV in
           Zimbabwe: Case Series
    • Abstract: Publication date: Available online 4 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Primrose Nyamayaro, Tarisai Bere, Jessica F. Magidson, Victoria Simms, Conall O’Cleirigh, Dixon Chibanda, Melanie AbasAbstractHIV is prevalent in Sub-Saharan Africa, and depression frequently co-occurs. Depression is one of the most important predictors of poor adherence to antiretroviral therapy (ART). Little has been done to develop integrated interventions that are feasible and appropriate for task-shifting to nonspecialists that seek to address both depression and barriers to ART adherence in Sub-Saharan Africa.This case series describes an integrated intervention for depression and ART adherence delivered by a lay adherence counselor and supervised by a local psychologist. The 6-session intervention was based on problem-solving therapy for depression and for barriers to adherence (PST-AD), with stepped care for those whose depression did not recover with PST-AD. Primary outcomes were acceptability and depression. Acceptability was measured by participant attendance to the 6 sessions.Three case studies illustrate the structured intervention, solutions identified to adherence barriers and to problems underlying low mood, and changes seen in the participant's psychological symptoms. Acceptability of the intervention was high and common mental disorder symptoms scores measured using the SRQ-8 decreased overall.An integrated intervention for depression and adherence to ART appeared feasible in this low-income setting. An RCT of the intervention versus an appropriate comparison condition is needed to evaluate clinical and cost-effectiveness.
       
  • Military Culture Considerations in Prolonged Exposure Therapy With
           Active-Duty Military Service Members
    • Abstract: Publication date: Available online 3 January 2019Source: Cognitive and Behavioral PracticeAuthor(s): Brittany N. Hall-Clark, Edward C. Wright, Brooke A. Fina, Tabatha H. Blount, Wyatt R. Evans, Patricia K. Carreño, Alan L. Peterson, Edna B. Foa, STRONG STAR ConsortiumAbstractOver 15 years of combat deployments to Afghanistan, Iraq, and surrounding locations have increased the risk of posttraumatic stress disorder (PTSD) in active-duty military service members, significantly amplifying the need for effective treatments within the military health care system. While effective evidence-based treatments for PTSD exist, results have not been as robust for service members and veterans as those found with civilians, suggesting that there are unique factors that may make PTSD in active military personnel more challenging to treat. Few clinical articles address military cultural aspects of the delivery of Prolonged Exposure therapy, especially with an active-duty military population. The aim of this paper is to highlight the role of military culture and lifestyle in PTSD symptom expression and recovery, and to provide clinical strategies to successfully conduct Prolonged Exposure with active-duty service members. Strategies to overcome logistical difficulties and clinical techniques to address common themes that emerge in working with military populations are delineated. Case examples are provided to illustrate concepts.
       
  • The (Extremely) Picky Eaters Clinic: A Pilot Trial of a Seven-Session
           Group Behavioral Intervention for Parents of Children With
           Avoidant/Restrictive Food Intake Disorder
    • Abstract: Publication date: Available online 19 December 2018Source: Cognitive and Behavioral PracticeAuthor(s): Katherine K. Dahlsgaard, Jessica BodieAbstractExcessive and impairing picky eating is a common problem among children for which there is little published research on efficacious psychosocial treatment. Extant research largely concerns single-case studies, or small samples of very young children, who are typically treated in hospital settings. This paper reports on outcomes of 21 children (ages 4–11) described by their parents as extremely picky eaters who met criteria for avoidant/restrictive food intake disorder not associated with a developmental disorder, other eating disorder, or other eating-related anxiety disorder (e.g., specific phobia of vomiting or choking). Seven cohorts of two to four families each took part in a seven-session manualized parent-only group treatment in an outpatient setting. This group treatment focused on training parents to serve as effective coaches for daily in-home exposures to nonpreferred foods, as well as in components of parent management training to reduce problematic mealtime behaviors. Parents completed standardized feeding measures to assess picky eating and associated problem mealtime behaviors at pretreatment, posttreatment, and at 3-month follow-up, as well as a satisfaction measure at posttreatment. Results showed excellent feasibility and adherence by parents and high parent satisfaction with treatment. Paired t tests to measure within-group change showed significant pre–post treatment reductions in picky eating scales with moderate to large effect sizes. Gains were maintained at 3-month follow-up. Findings indicate that a relatively brief group treatment that focuses specifically on training parents to facilitate and carry out food exposures and contingency management procedures in their homes is associated with reductions in functionally impairing picky eating and related negative mealtime behaviors in elementary school-age children.
       
  • The Social Context of Clinical Practice With Sexual Minority Clients:
           Commentary on the Special Issue
    • Abstract: Publication date: Available online 12 December 2018Source: Cognitive and Behavioral PracticeAuthor(s): Christopher R. Martell, Mark E. WilliamsAbstractClinical research with sexual minority clients has evolved and has contributed to recognition and affirmation of sexual minorities. This commentary traces a history of research that was at one time based on heteronormative biases, what we refer to as a “first wave” to a movement through a “second wave” of research comparing sexual minorities to heterosexual counterparts in order to adapt existing clinical practices and advocate for them in the context of political challenges and social opposition. We look at the articles in this special issue as exemplary of what may be considered the “third wave” of this research that begins with the assumption that sexual minority populations are unique and valued subcultures and proposes best practices with these populations.
       
  • iMAgery-Focused Psychological Therapy for Persecutory Delusions in
           PSychosis (iMAPS): A Novel Treatment Approach
    • Abstract: Publication date: Available online 17 November 2018Source: Cognitive and Behavioral PracticeAuthor(s): Christopher D.J. Taylor, Penny E. Bee, James Kelly, Gillian HaddockAbstractIntrusive mental imagery and negative beliefs about self and others are frequently reported problems for individuals who experience psychosis, but there are few treatment approaches that have specifically targeted these. Intrusive mental images and negative schema have been identified as potential maintaining factors for persecutory delusions. These can range from paranoia-related recurrent intrusive images (e.g., being attacked by others, being followed by unknown figures who mean you harm) from the past or “flash-forward” future paranoia related intrusive mental images. In this article we outline clinical issues and adaptations of an imagery-focused approach for persecutory delusions. Drawing on a number of sources including a systematic literature review, a qualitative study exploring core beliefs, an experience sampling study and techniques from existing manuals and approaches, we adapted these imagery approaches to work with images and schema. The close links between imagery and core beliefs highlighted an opportunity to also use imagery rescripting approaches to transform negative schema and reduce persecutory delusions. Individuals with psychosis often want help with intrusive mental images and negative beliefs; adapted evidence-based imagery focused interventions can be used and the interventions may also help to reduce persecutory delusions.
       
  • Be a Mom: Formative Evaluation of a Web-Based Psychological Intervention
           to Prevent Postpartum Depression
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Ana Fonseca, Marco Pereira, Anabela Araújo-Pedrosa, Ricardo Gorayeb, Mariana Moura Ramos, Maria Cristina CanavarroAbstractA formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention should be short-term, delivered postnatally, and grounded in cognitive-behavior therapy principles. Moreover, the intervention should include weekly sessions targeting basic contents: motherhood changes, reorganizations and emotional experience; cognitions, self-criticism, and self-compassion; parenting values, social support, and assertive communication skills; couple relationship, negotiation and conflict resolution skills; and postpartum depression signs and professional help-seeking. These results may improve the Be a Mom’s adequacy, implementation success, and effectiveness.
       
  • Special Considerations in the Adaptation of Cognitive Behavioral Therapy
           for Insomnia With Active-Duty U.S. Army Personnel
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Kristi E. Pruiksma, Brooke Fina, Jessica R. Dietch, Katherine A. Dondanville, Jacob Williams, Edward C. Wright, Alma Molino, Brittany Hall-Clark, Karin L. Nicholson, Alan L. Peterson, Daniel J. Taylor, STRONG STAR ConsortiumAbstractInsomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.
       
  • State of the Field of Mental Health Apps
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Martha Neary, Stephen M. SchuellerAbstractMental health apps offer unique opportunities for self-management of mental health and well-being in mobile, cost-effective ways. There is an abundance of apps available to consumers, but selecting a useful one presents a challenge. Most available apps are not supported by empirical evidence and thus consumers have access to a range of untested apps, the benefits of which are not known or supported. While user ratings exist, and are likely to be considered by consumers when selecting an app, they do not actually yield information on app suitability. A possible alternative way for consumers to choose an app would be to use an app review platform. A number of attempts have been made to construct such a platform, and this paper introduces PsyberGuide, which offers a step towards providing objective and actionable information for publicly available mental health apps.
       
  • Evaluating Triple P Online: A Digital Parent Training Program for Child
           Behavior Problems
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Amit Baumel, Keren FaberAbstractTriple P Online (i.e., TPOL; www2.tripleponline.net) is an online self-help parent training program aimed at reducing child behavior problems through “positive parenting practices”—available at time of review for $79.95. TPOL is comprised of 8 video-based modules that also incorporate in-session activities and homework. Randomized control trials have shown that TPOL effectively reduces child behavior problems. The program’s main strengths include very high-quality content with an abundance of relevant and easily locatable resources, an easy-to-use interface, and a professional look and feel. The program’s main weakness lies in its lack of monitoring and adaptation to the user’s state (e.g., child’s and parent’s behaviors), and real-time reminders for desired actions. Altogether, TPOL is an extremely valuable and important resource for families seeking evidence-based treatment for child behavior problems.
       
  • Assessment and Management of Suicide Risk in Children and Adolescents
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Jeremy W. Pettit, Victor Buitron, Kelly L. GreenAbstractThis article presents a pragmatic approach to assessing and managing suicide risk in children and adolescents. We first present general recommendations for conducting risk assessments with children and adolescents, followed by an algorithm for designating risk. Risk assessment and designation should be based on both distal (i.e., a prior history of self-harm behaviors) and proximal (i.e., suicide ideation, plans, intent, and preparations) predictors of suicide attempt. We then discuss safety planning as an easy-to-implement approach for intervening and managing suicide risk when working with children and adolescents. We end with a case example illustrating the implementation of risk assessment, risk designation, and safety planning with an adolescent client and her mother.
       
  • Using the Linehan Risk Assessment and Management Protocol With a
           Chronically Suicidal Patient: A Case Report
    • Abstract: Publication date: November 2018Source: Cognitive and Behavioral Practice, Volume 25, Issue 4Author(s): Adam Carmel, Elizabeth Templeton, Shannon M. Sorenson, Elena LogvinenkoAbstractThe Linehan Risk Assessment and Management Protocol (LRAMP) is an empirically supported, comprehensive framework used to assess suicide risk and protective factors, and provide a guide for the therapist to consider reasonable options for intervening on suicidal behavior. This protocol includes a structured checklist for assessing, managing, and documenting suicide risk. It also structures the documentation to clearly describe the presentation, assessment, in-session interventions, decision-making process, and follow-up to other members of the treatment team. This paper describes a case in which the LRAMP was used to guide the assessment, intervention, and documentation of the suicidal behavior of a patient, “Ann,” being treated with outpatient Dialectical Behavioral Therapy in a community mental health clinic. Each section of the LRAMP is discussed as it was used with this complex patient, who had history of high utilization of acute psychiatric services. Application of the LRAMP included the assessment of risk and protective factors, and the use of an individualized crisis plan that engaged the patient, her family, the therapist, and the clinical team, to decrease acute risk, continue outpatient treatment, and avoid inpatient hospitalization. The considerations for documenting clinical decision-making with chronically suicidal patients are discussed.
       
  • Erratum to “Transdiagnostic Theory and Application of Family-Based
           Treatment for Youth With Eating Disorders” [Cognitive and Behavioral
           Practice 19 (2012) 17–30]
    • Abstract: Publication date: Available online 30 October 2018Source: Cognitive and Behavioral PracticeAuthor(s): Katharine L. Loeb, James Lock, Rebecca Greif, Daniel Le Grange
       
  • Statewide Implementation of Cognitive Behavioral Therapy for Psychosis
           Through a Learning Collaborative Model
    • Abstract: Publication date: Available online 24 October 2018Source: Cognitive and Behavioral PracticeAuthor(s): Sarah L. Kopelovich, MacKenzie Hughes, Maria B. Monroe-DeVita, Roselyn Peterson, Corinne Cather, Jennifer GottliebAbstractCognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.
       
  • Contextual Adaptation of the Unified Protocol for the Transdiagnostic
           Treatment of Emotional Disorders in Victims of the Armed Conflict in
           Colombia: A Case Study
    • Abstract: Publication date: Available online 23 October 2018Source: Cognitive and Behavioral PracticeAuthor(s): Leonidas Castro-Camacho, Julián David Moreno, Iona NaismithAbstractThe delivery of a contextually adapted version of the Unified Protocol for transdiagnostic treatment of emotional disorders is illustrated through a case study of an internally displaced female victim of armed conflict in Colombia. A detailed account of how her history of continuous traumatic events and her forced displacement resulted in multiple emotional disorders and behaviors which hindered her ability to react to daily stressors illustrates the particular conditions of individuals exposed to extreme violence. Emphasis is placed on how her culture and context required adaptations of evidence-based interventions. The contextually adapted UP (CXA-UP) is described in “slow-motion,” through a session-by-session account of the procedure along with the specific changes in each module. Outcome measures showed four positive diagnoses at pretreatment, but none at posttreatment, 3-month, or 2-year follow-up. Implications for global applications with individuals in similar contexts and for widening access to such interventions are discussed.
       
  • A Contextual Adaptation of the Unified Protocol for the Transdiagnostic
           Treatment of Emotional Disorders in Victims of the Armed Conflict in
           Colombia
    • Abstract: Publication date: Available online 4 October 2018Source: Cognitive and Behavioral PracticeAuthor(s): Leonidas Castro-Camacho, Michel Rattner, Diana Melisa Quant, Laura González, Julián David Moreno, Amantia AmetajAbstractSeveral decades of armed conflict in Colombia have left a large number of victims who present with multiple emotional disorders and reactions that interfere with their capacity to face daily stressors and improve their life conditions. Evidence-based interventions might help to ameliorate their situation, as long as they are properly adapted to the context and culture of victims of armed conflict. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (Barlow, Farchione et al., 2013; Barlow et al., 2018) represents an empirically grounded alternative especially suited to address basic processes common to multiple emotional reactions and improve the level of functioning and quality of life in this population. This article presents a thorough account of the methodology used to adapt the Unified Protocol to the particular contextual and cultural characteristics of victims of armed conflict in Colombia, as well as a detailed description of the end result of the contextual adaptation (CXA-UP). Implications for adapting evidence-based interventions to contexts of extreme violence are discussed and possible directions for future studies are outlined.
       
  • Behavioral Experiments for Intolerance of Uncertainty: Challenging the
           Unknown in the Treatment of Generalized Anxiety Disorder
    • Abstract: Publication date: Available online 1 September 2018Source: Cognitive and Behavioral PracticeAuthor(s): Elizabeth A. Hebert, Michel J. DugasAbstractIntolerance of uncertainty (IU) is implicated in the development and maintenance of generalized anxiety disorder (GAD). Although an efficacious cognitive-behavioral treatment (CBT) targeting IU and associated factors has been established, approximately 20–30% of participants do not achieve full remission by posttreatment. IU remains elevated in these individuals. In addition, GAD treatments need greater parsimony and efficiency. To that end, we developed a novel, focused CBT protocol exclusively targeting IU via behavioral experiments. Treatment consists of three modules applied over 12 sessions: (a) psychoeducation and uncertainty awareness training, (b) behavioral experiments targeting IU, and (c) relapse prevention. The present article describes each treatment component, as well as additional considerations for therapists. We conducted a preliminary investigation of efficacy with seven (N = 7) participants with a primary diagnosis of GAD. Results indicated substantial decreases in GAD symptoms, general psychopathology, and IU by posttreatment that were generally maintained at 6-month follow-up. Six of seven participants demonstrated moderate to high end-state functioning at posttreatment and 6-month follow-up. Research and clinical implications are discussed.
       
  • What Is a Nonresponder' A Qualitative Analysis of Nonresponse to a
           Behavioral Intervention
    • Abstract: Publication date: Available online 17 August 2018Source: Cognitive and Behavioral PracticeAuthor(s): Nicole Nehrig, Sara Gillooly, Karen Abraham, Maria Shifrin, Cory K. ChenAbstractThis study used qualitative methods to understand reasons for treatment nonresponse following a behavioral intervention for family caregivers of people with dementia. Caregivers and interventionists completed semistructured interviews about their experience of the treatment after completing a course of Resources for Enhancing Alzheimer’s Caregiver Health in VA (REACH VA). Treatment response from the 22 caregivers who completed the 12-session treatment was assessed using pre- to posttreatment change scores on measures of depression and caregiver burden. Interviews from the 14 nonresponder caregiver/interventionist dyads (28 total) were analyzed qualitatively to identify caregiver factors that negatively impacted improvement in depression and caregiver burden, such as emotional processing difficulties, wanting more support than structure, and limited support/difficulty asking for help. Ways nonresponders benefited from REACH VA beyond improvement on self-report symptom measures were also identified and included learning to problem solve more effectively, feeling understood and supported by another, and taking a different perspective on caregiving. The benefits of using qualitative methods to assess the experience of treatment nonresponders and identify individuals who may benefit from additional treatment or a different approach are discussed.
       
  • Improving Young Male Couples’ Sexual and Relationship Health in the
           2GETHER Program: Intervention Techniques, Environments of Care, and
           Societal Considerations
    • Abstract: Publication date: Available online 4 August 2018Source: Cognitive and Behavioral PracticeAuthor(s): Kathryn Macapagal, Brian A. Feinstein, Jae A. Puckett, Michael E. NewcombAbstractYoung male couples are at high risk for acquiring human immunodeficiency virus (HIV). However, few HIV prevention programs meet the needs of young male couples that express an interest in how to maintain healthy relationships. As such, we developed 2GETHER, a couple-based program that integrates HIV risk reduction and sexual health information into a relationship education program specific to young male couples. 2GETHER was guided by cognitive-behavioral theories of HIV risk reduction and relationship functioning and was informed by a social–ecological perspective to address factors within and outside the couple that can impact sexual and relationship health. As a micro-level intervention, 2GETHER intervenes directly with couples via psychoeducation and cognitive-behavioral strategies to change couples’ communication patterns, sexual health behaviors, and relationship satisfaction. Successful implementation of 2GETHER requires mezzo-level interventions that create an affirming environment of care for sexual minority individuals and facilitators who are culturally competent in working with young male couples. Although macro-level interventions to change societal acceptance of and policies germane to sexual minority couples are beyond the scope of 2GETHER, we discuss how clinicians can advocate for systemic changes to improve sexual minority couples’ health, and how 2GETHER addresses the impact of such macro-level factors on the couple’s relationship. Our experience developing and testing 2GETHER indicates that HIV prevention programs for young male couples should reflect the unique contexts shaping sexual minority individuals’ relationships and lives, and that programs should intervene within and across multiple levels when possible to improve health for sexual minority men.
       
  • An Intensive Outpatient Program for Veterans With Posttraumatic Stress
           Disorder and Traumatic Brain Injury
    • Abstract: Publication date: Available online 3 August 2018Source: Cognitive and Behavioral PracticeAuthor(s): Margaret M. Harvey, Timothy J. Petersen, Julia C. Sager, Nita J. Makhija-Graham, Edward C. Wright, Erika L. Clark, Lauren M. Laifer, Lauren K. Richards, Louis K. Chow, Louisa G. Sylvia, René M. Lento, Laura K. Harward, Joan Clowes, Valerie Brathwaite, Laura K. Lakin, Noah D. Silverberg, Grant L. Iverson, Eric Bui, Naomi M. SimonAbstractPost-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.
       
  • Developing an Acceptance-Based Behavioral Weight Loss Treatment for
           Individuals With Binge Eating Pathology: A Preliminary Proof of Concept
           Study and Clinical Case Series
    • Abstract: Publication date: Available online 6 July 2018Source: Cognitive and Behavioral PracticeAuthor(s): Brittney C. Evans, Helen B. Murray, Alexandra F. Muratore, Elin L. Lantz, Adrienne S. JuarascioAbstractBinge eating (BE; i.e., the consumption of a large amount of food in a discrete time period, accompanied by a sense of loss of control) is highly comorbid with overweight or obesity and is the primary symptom of binge eating disorder (BED). Current gold-standard treatment for BED (i.e., CBT) does not produce meaningful weight loss, thus failing to address a critical treatment target. This article describes the development of a novel acceptance-based behavioral treatment (ABBT) for individuals with clinically significant BE desiring to reduce BE symptoms and achieve concurrent weight loss. We discuss the development and structure of the novel treatment approach, and describe the test of a proof of concept version of the treatment in a clinical case series of four individuals. In the context of each clinical case description, we present initial acceptability of the treatment and challenges faced in treatment development and delivery. Finally, we discuss future research directions for the treatment, which could improve BE symptoms and weight loss outcomes for individuals with BE pathology.
       
  • Application of Problem Solving Therapy for Late-Life Anxiety
    • Abstract: Publication date: Available online 28 June 2018Source: Cognitive and Behavioral PracticeAuthor(s): Sherry A. Beaudreau, Christine E. Gould, Nehjla M. Mashal, J.W. Terri Huh, J. Kaci FairchildAbstractCognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.
       
  • Managing Frustration for Children (MFC) Group Intervention for ADHD: An
           
    • Abstract: Publication date: Available online 8 June 2018Source: Cognitive and Behavioral PracticeAuthor(s): Paul J. Rosen, Kirsten D. Leaberry, Kelly Slaughter, Nicholas D. Fogleman, Danielle M. Walerius, Richard E.A. Loren, Jeffery N. EpsteinAbstractDeficient emotion regulation is a common and impairing area of difficulty among children with ADHD. Few interventions specifically address deficient emotion regulation. The Managing Frustration for Children With ADHD (MFC) group treatment was developed to specifically target deficient emotion regulation deficits common to children with ADHD. The MFC was developed as a 12-week multisystemic intervention for emotion regulation deficits among children with ADHD. An open trial assessed the effectiveness of the MFC as an adjunctive treatment for deficient emotion regulation among children with ADHD. Fifty-two children with ADHD ages 9–11 (42 boys, 10 girls) were enrolled in the MFC, with 44 completing treatment. The majority (71.2%) of participants had at least one comorbid internalizing, externalizing, or learning disorder. Intent-to-treat repeated-measures ANCOVA suggested significant decreases in emotion regulation deficits, mood difficulties, and externalizing difficulties following completion of treatment. More than half (53%) of children who completed treatment experienced reliable and clinically significant improvement in at least one area of functioning. The MFC demonstrated promising initial effectiveness in addressing the emotion regulation deficits of children with ADHD.
       
  • Providing Relationship Interventions to Same-Sex Couples: Clinical
           Considerations, Program Adaptations, and Continuing Education
    • Abstract: Publication date: Available online 27 April 2018Source: Cognitive and Behavioral PracticeAuthor(s): Shelby B. Scott, Sarah W. Whitton, Brian A. BuzzellaAbstractDespite remarkable similarities to different-sex couples in terms of core relationship processes and outcomes, same-sex couples differ from different-sex couples in important ways, including relational strengths (e.g., more egalitarian) and challenges associated with their sexual minority identity (e.g., discrimination). Given that most cognitive-behavioral relationship interventions have been designed for and tested on different-sex couples, clinicians wishing to serve same-sex couples will need to make appropriate adaptations to these interventions in order to remove heterosexist bias and sensitively meet the unique needs of same-sex couples. Further, clinicians should strive to be culturally competent in serving this population by developing knowledge of same-sex couple dynamics and issues, and by building a sense of comfort working with these families, which may involve addressing personal biases. The current paper seeks to provide an introduction to same-sex couple relational processes, and offers clinical recommendations and intervention adaptations to better serve this population. Some examples will refer to the development of the Strengthening Same-Sex Relationships programs, culturally sensitive relationship education programs specifically designed for and successfully piloted with male and female same-sex couples.
       
  • A Novel, Integrated Cognitive-Behavioral Therapy for Co-Occurring
           Posttraumatic Stress and Substance Use Disorders: A Case Study
    • Abstract: Publication date: Available online 27 April 2018Source: Cognitive and Behavioral PracticeAuthor(s): Anka A. Vujanovic, Lia J. Smith, Kathryn P. Tipton, Joy M. SchmitzAbstractPosttraumatic stress disorder (PTSD) and substance use disorders (SUD) are complex psychiatric conditions that commonly co-occur. No preferred, evidence-based treatments for PTSD/SUD comorbidity are presently available. Promising integrated treatments have combined prolonged exposure therapy with cognitive-behavioral relapse prevention therapy for SUD. We describe a case study that showcases a novel, integrated cognitive-behavioral treatment approach for PTSD/SUD, entitled Treatment of Integrated Posttraumatic Stress and Substance Use (TIPSS). The TIPSS program integrates cognitive processing therapy with cognitive-behavioral therapy for SUD for the treatment of co-occurring PTSD/SUD. The present case report, based upon a woman with PTSD comorbid with both cocaine and alcohol dependence, demonstrates that TIPSS has the potential to effectively reduce PTSD symptoms as well as substance use.
       
  • An Interdisciplinary Model for Meeting the Mental Health Needs of
           Transgender Adolescents and Young Adults: The Mount Sinai Adolescent
           Health Center Approach
    • Abstract: Publication date: Available online 14 April 2018Source: Cognitive and Behavioral PracticeAuthor(s): Matthew Oransky, Elizabeth Zacher Burke, John SteeverAbstractTransgender and gender nonconforming (TGNC) adolescents and young adults face significant mental health disparities, including increased rates of suicidality, depression, and self-harm. These disparities are multidetermined and stem, in part, from the emotional consequences of family rejection, peer and community victimization, social isolation, and discrimination and transphobia in both daily settings (e.g., school) and society as a whole. In order to meet the mental health needs of TGNC youth, we must intervene in multiple levels of youths’ lives and provide gender-affirming evidence-based therapies. In this paper, we describe an integrated model of meeting the mental health needs of TGNC youth, with the ultimate goal of reducing mental health disparities. We provide guidance for macro-level interventions, including efforts to implement social change; mezzo-level interventions, including structuring a health care setting to be gender-affirming; and micro-level interventions, including gender-affirming dialectical behavior therapy, cognitive behavioral therapy, family therapy and support group interventions. Throughout, we highlight our descriptions of interventions with case examples in order to provide additional practical guidance.
       
 
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