Cognitive Behavior Therapy – Dr Martin Fracker

Cognitive Behavior Therapy Works with Depressed Young People By Reducing Negative Thinking

The authors of this study tried to determine the mechanisms by which two types of psychotherapy help relieve clinical depression in young people: Cognitive Behavior Therapy (CBT) and Interpersonal Psychotherapy (IPT). To do this, they examined the results of 34 randomized controlled experiments, 27 of which focused on CBT while only 6 examined IPT studies and one included both CBT and IPT. Among their results, they found clear evidence that CBT helps to alleviate depression by reducing negative thinking.

But how does CBT reduce negative thinking? In theory, CBT should reduce negative thinking by improving the person’s problem solving skills and helping them to reframe or change how they think about problems in their lives. But the authors did not find evidence that CBT improved problem solving or reframing. Does this mean that CBT doesn’t work the way we think it does? Or does it mean that we are just not very good at measuring problem solving skill or reframing? Answers to those questions remain for the future. For now, it may be sufficient to know that CBT does reduce negative thinking in young people and thereby helps them to overcome depression.

Two-Step Family Cognitive Behavior Therapy May Benefit Some Autism Spectrum Disorder (ASD) Children with Anxiety

Cognitive behavior therapies are generally effective for treating anxiety, but modifications may be needed when anxiety is accompanied by Autism Spectrum Disorder (ASD). Storch and associates evaluated the effectiveness of a two-step approach to family-based cognitive behavior therapy for anxiety with ASD children up to 14 years of age. The first step was parent-led with therapist assistance. The second step was therapist-led for children who had not shown improvement in step 1 (non-responders). These non-responders generally had higher levels of pre-treatment anxiety than those who had improved.

All children were evaluated again 12 weeks following step 1. At this point, the authors reported no difference between those that had improved in step 1 and those that had continued into step 2. A major weakness of this study however was a high attrition rate: of the 76 children who started in step 1, only 45 completed their entire treatment program. The authors noted that this attrition rate is higher than that observed with more standard forms of Cognitive Behavior Therapy, and noted that some of the attrition may have been due to the COVID-19 pandemic.

Patients with Autism Spectrum Disorder (ASD) and Anxiety Can Benefit From Cognitive Behavior Therapy

Standard Cognitive Behavior Therapy (CBT) focuses on teaching patients to recognize self-defeating ways of thinking and replace them with more constructive thoughts. Hollocks and colleagues knew that CBT treatments for Autism Spectrum Disorder (ASD) patients with anxiety were most effective when tailored to the specific needs of ASD patients. They hypothesized that patient decision-making ability and sensitivity to reward contingencies might underlie the superiority of specially tailored CBT treatments. Accordingly, they assessed the decision-making ability and reward sensitivity of 148 children with ASD who were randomly assigned to standard CBT or tailored CBT treatments. Their results suggested that ASD patient decision-making ability and reward sensitivity accounted for the superiority of tailored CBT.

Cognitive Behavior Therapy is the Best Intervention for Social Anxiety Disorder

Mayo-Wilson and colleagues performed a meta-analysis across 41 interventions for patients with social anxiety disorder including cognitive-behavioral therapy, psychodynamic therapy, psychopharmacological therapy, and others. Based on the results from 101 clinical trials including over 13,000 participants, including various control groups, they concluded that cognitive-behavior therapy was best for most patients. For patients for whom cognitive-behavior therapy was not appropriate, they recommended psychopharmacological therapy as the next best treatment.

Recommendations for Improving Communication of Empirical Support for Clinical Interventions

Helping clinical psychologists select the best form of psychotherapy for a particular client with a particular problem requires a way to communicate to them the results of comparisons of clinical interventions. In this article, David Tolin and his associates take a detailed look at where communication needs to be improved, and they recommend actions to take now while the field undertakes a long-range process to develop better standards.

Noisy Data Makes Comparisons of Psychotherapies More Challenging

In this article, David Tolin looks at why some studies do not find cognitive-behavior therapies to be better than other forms of therapy. He identifies several sources of error variance (in other words, noisy data) that may hide any differences between the effectiveness of candidate psychotherapies. He then suggests ways to improve comparisons of such psychotherapeutic evaluations.

Cognitive Behavior Therapy Works Better than Other Psychotherapies

David Tolin has spent years comparing the effectiveness of cognitive behavior therapies to other forms of psychotherapy. In this article, he publishes the results of a meta-analytic review across 26 other studies. (You can learn more about meta-analysis from the Association for Psychological Science website.) His basic finding was that cognitive behavior therapy was more effective than other forms of therapy in treating patients with anxiety and depression disorders.