Cognitive Behavioral Therapy Issues - Term Paper Example

Cognitive Behavioral Therapy Name Institution Name Introduction Cognitive Behavioral Therapy is one of the most effective therapies for mental disorders including depression, schizophrenia, and anxiety. Various experts have conducted intensive studies and reviews to establish the truth in the aforementioned statement. Depression comes in different manners and hence there a myriad of treatments associated with this disorder. Schizophrenia is regarded as one of the most serious mental disorders and thus requires superb medication and therapies to alleviate the problem and ensure long-term positive effects to the patients. Anxiety like depression and schizophrenia is a disorder that brings about restlessness among the patients. This paper tremendously gives an excellent discussion as to how Cognitive Behavioral Therapy is an effective therapy in treating this disorder. The paper analyses different articles together with their findings on these disorders. CBT and Depression Cognitive Behavioral Therapy as established in various studies provides a wide range of depression management together with other mental disorders. According to the study; “A comparison of residual insomnia symptoms following the pharmacotherapy or cognitive-behavioral therapy for major depressive disorder” by Carney et al., (2007) established that the depression is effectively addressed by these treatments. However, some patients exhibited residual insomnia. In their study, Carney and others found out that different pharmacologic studies had established insomnia to be one of the common residual symptoms after a patient is remitted from depression. Residual symptoms are a sign that a patient is likely to suffer subsequent depression. In regard to this, the objective of their study was to determine the rates of residual insomnia after CBT for depression and comparing CBT results with pharmacotherapy for depression on residual insomnia rates. A naturalistic study methodology was used to examine the rates of post-treatment insomnia symptoms in 98 patients with major depressive disorder (MDD), in accordance with DSM-IV criteria and who had completed a minimum of 20 weeks of either pharmacotherapy or CBT. The participants were randomly assigned to the treatment conditions; however, data from patients who completed the treatment and remitted were analyzed. Carney et al. (2007) found out that; 22% of post-treatment insomnia was exhibited for sleep-onset insomnia, 26% for sleep-maintenance insomnia and 17% for early morning wakening. The rates were not found to statistically differ across the two treatment groups. About these results, it was concluded that regardless of the two treatments being effective in addressing depression in patients as well as addressing insomnia symptoms, some patients were found to exhibit residual insomnia. Accordingly, despite the fact there is no difference between pharmacotherapy and CBT in relation to rates of residual insomnia, the rates of such insomnia remaining after the two treatments show that adjunctive sleep treatment to address insomnia is essential for some MDD patients (Carney et al., 2007) Regarding Behavioral and Cognitive Psychotherapy, Mitchell & Gordon (2007) established that there is evidence that computerized cognitive behavioral therapy (CCBT) is effective in depression treatment; however, the rates of its uptake and/or completion are very low. In their study, Mitchell and Gordon investigated attitudes towards CCBT for depression in 122 University students. In their findings, they deduced that CCBT credibility, improvement expectancy, and perceived use likelihood were poor; contrary to this, a minority of 9.8% of participants preferred CCBT over other treatment methods. With regard to this, Mitchell and Gordon took 20 of the original sample to demonstrate the effectiveness of CCBT program for depression. This sample showed increased credibility, improvement expectancy, and perceived likelihood of using CCBT. Students also preferred CCBT program for depression to be accompanied by counseling (Mitchell & Gordon, 2007) In another study; Preliminary Evaluation of Culturally Sensitive CBT for Depression in Pakistan: Findings From Developing Culturally-Sensitive CBT Project by Naeem and others (2011) found out that a culturally sensitive CBT is effective in reducing symptoms of depression and anxiety in Pakistan. Naeem et al. (2011) confirm that there is massive evidence in favor of cognitive therapy in western countries while limited research about CBT effectiveness has been carried out in other countries. This study aimed to evaluate the efficacy of culturally adapted CBT using a therapist manual. In a randomized controlled methodology, combined CBT and antidepressants were compared with antidepressants alone in primary care. Naeem et al. (2011) established that patients who received CBT exhibited statistically significant improvement on depression. Stuhlmiller and Tolchard (2009) in there study; Computer-assisted CBT for depression and anxiety: increasing accessibility to evidence-based mental health treatment, concluded that CBT is the most effective non-pharmacological treatment of approximately all mental disorders including depression and anxiety. For instance, they allude that the treatment is time limited, encourages self-help skills, inductive, problem focused and required individuals to develop and practice skills in their environment through homework (Stuhlmiller and Tolchard, 2009). In summary, from the above cited articles it largely evident that CBT is the best cure for depression. Carney and others (2007) study “A comparison of residual insomnia symptoms following the pharmacotherapy or cognitive-behavioral therapy for major depressive disorder.” This study established that pharmacotherapy and CBT are essential in addressing residual insomnia for MDD patients. Mitchell & Gordon, (2007) study: Attitudes towards Computerized CBT for Depression Amongst a Student Population. Behavioral and Cognitive Psychotherapy established that there is evidence that computerized cognitive behavioral therapy (CCBT) is effective in depression treatment. Consequently, Naeem et al. (2011) study: Preliminary Evaluation of Culturally Sensitive CBT for Depression in Pakistan: Findings from Developing Culturally-Sensitive CBT Project by Naeem and others (2011) found out that a culturally sensitive CBT is effective in reducing symptoms of depression and anxiety CBT and Schizophrenia/Psychosis Cognitive Behavioral Therapy as established in the introduction is a psychological treatment which is strongly based on a wide range of psychological disorders; it is applicable to serious psychological disorders including schizophrenia and psychoses. Tarrier, (2010) in the article “Cognitive Behavior Therapy for Schizophrenia and Psychosis: Current Status and Future Directions. Clinical Schizophrenia & Related Psychoses; outlines the background with regard to the development and theoretical base to CBTp. More importantly, Tarrier (2010) established that there is massive evidence emanating from various clinical trials which confirm that CBTp provides consistent clinical benefit particularly when it is used to supplement standard care. Neil and Aron (2012) in their empirical review observed that early case studies and non-controlled studies that only focus on treatment of delusions and hallucinations provide a firm foundation for the recent strides in comprehensive CBT interventions for schizophrenia. In the article “Cognitive Behavioral Therapy for Schizophrenia: an Empirical review, Neil and Aaron established that there are seven randomized, controlled trial studies that are essential in testing the efficacy of CBT for schizophrenia as identified in MEDLINE and PsychInfo as well as by personal competence. By reviewing these studies, Neil and Aaron computed the effect size (ES) which, on the other hand, were essential in determining the statistical magnitude of clinical change in CBT and control treatment conditions. It was found out that CBT produced large clinical effects on measures of both positive and negative symptoms of schizophrenia. Those patients who received routine care and adjunctive CBT experienced improved benefits as compared to those who received routine care and adjunctive supportive therapy. Given this scenario, it is evident that CBT is essential in schizophrenia treatment. The Journal; Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: A randomized clinical practice trial (Tania et al., 2012) observed that huge numbers of patients in clinical practice tremendously benefit from CBTp. This study was aimed at investigating CBT effectiveness in routine clinical psychotic symptoms. Tania and others confirmed that various randomized controlled trials have attested the efficacy of CBT in reducing psychotic symptoms. In this study, they used eight schizophrenic patients seeking outpatient treatment who were then randomized to a specialized cognitive behavioral intervention for psychosis. In this regard, CBTp patients were assessed at baseline, post treatment together with a one-year follow-up. The initial results showed both positive and negative syndrome Scale (PANSS). The CBTp patients exhibited significant improvements as compared to other groups of patients. Accordingly, CBTp patients also showed superior secondary outcomes, depression, psychopathology and functioning. Tania et al, (2012) also concluded that positive effects of the CBTp treatment can be maintained at 1-year follow-up. According to Thomas et al. (2011) CBT is an effective treatment for residual psychotic symptoms; however, a large percentage of people do not reap the benefits of this treatment. In their study; Cognitive Behavioral Therapy for Auditory Hallucination: Effectiveness and Prediction of Outcomes in a Specialist Clinic. Behavioral and Cognitive Therapy, Thomas, et al. (2011) confirmed the above statement. Psychotic Symptom Rating Scales (PSYRAYS) and PANSS were administered at pre- and post-therapy to 33 individuals suffering from schizophrenia receiving CBT for auditory hallucination. The results obtained were compared with pre-therapy measures in terms of insight, beliefs with regard to the source of hallucinations, cognitive disorganization, and negative symptoms. This study found out that significant improvements were recorded at post-treatment on both PSYRAT and PANSS (Thomas et al., 2011). The above discussion strongly confirms that CBT plays a major role in treating schizophrenia and psychosis. Tarrier (2011) observed that CBT is an empirically based psychological treatment that has strong evidence in a wide range of psychological disorders and is also applied to schizophrenia and psychosis. Neil and Aaron (2012) found out that CBT produces large clinical effects on measures of positive and negative symptoms of schizophrenia. Accordingly, they established that patients receiving adjunctive CBT and routine care exhibit additional benefits as compared to those who receive routine care and adjunctive supportive therapy. Additionally, Tania et al. (2012) in their study found out that a large proportion of patients in clinical practice environments benefits from CBTp. Thomas et al. (2011) in their study established that CBT is an effective treatment for residual psychotic symptoms; however, only a few people benefit from this treatment. CBT and Anxiety CBT has also been found to improve anxiety together with associated somatic disorders. Warner and others (2009) in their open pilot study; CBT for Anxiety and Associated Somatic Complains in Pediatric Medical settings established that cognitive behavioral approach provides massive benefits to patients suffering from anxiety and somatic disorders. Their study was tasked with examining the initial feasibility and potential of CBT intervention for youths with anxiety disorders and non-medical somatic symptoms (Warner, et al., 2009). Seven boys and girls aged between 8 and 15 suffering from unexplained gastrointestinal complains and anxiety disorders were subjected to a 12-session cognitive behavioral intervention that targeted anxiety and physical symptoms. Among the participants, three never met the diagnostic criteria for principle anxiety disorder. The participant’s physical discomfort was significantly decreased. Otte (2011) in the Cognitive behavioral therapy in anxiety disorder: current states of the evidence, established that various studies have been undertaken to examine the efficacy and effectiveness of CBT for adult anxiety disorders. Accordingly, Otte alludes that in recent years meta analyses have been conducted to review quantitatively the evidence of CBT anxiety disorder. Otte’s review summarizes and discusses current state of CBT treatment for generalized anxiety, panic disorders, social anxiety disorder, post-traumatic stress, and obsessive compulsive disorder. In this review, Otte found out that, CBT demonstrates both efficacy with regard to both randomized controlled trials and effectiveness in naturalistic settings with regard to treating adult anxiety disorders. Cognitive Behavioral Therapy for adult anxiety disorders: a meta analyses of randomized placebo controlled trials (Hofmann and Smith, 2008) established that CBT is effective in treating adult anxiety disorders. In their research, Hofmann and Smith observed that CBT is frequently used for different adult anxiety disorders; contrastingly, there has never been a systematic review of randomized placebo-controlled trials. This study aimed to meta-analytically review the efficacy of CBT versus placebo for adult anxiety disorder. Hofmann and Smith conducted a computerized search of treatment outcomes with regard to anxiety disorder. Similarly, they examined reference lists from identified articles as well as asked experts to identify eligible studies internationally. After identifying and selecting eligible studies, each study was assigned a continuous measure of anxiety severity. After extraction of results and their overall synthesis, Hofmann and Smith (2008) concluded that randomized placebo-controlled trials showed that CBT is efficacious for adult anxiety disorder. The Cochrane Database Review: Cognitive Behavioral Therapy for Anxiety disorders in children and adolescents by James and others (2013) found out that CBT is an effective treatment for adolescent and childhood anxiety disorders. They understood that the previous Cochrane review established that CBT provided an effective treatment for childhood anxiety but there were unanswered questions with regard to the relative efficacy of CBT vs. Non-CBT treatments, CBT vs. Medication and the combination of CBT and medication vs. Placebo, and medication and the combination of medication and CBT vs. Placebo. The long-term effects of CBT were not known. In this study, James et al. (2013) aimed at examining whether CBT is an effective cure for childhood and adolescent anxiety disorders in combination with wait-list controls, active non-CBT treatments, and medication and the combination of medication and CBT versus placebo and the long term effects of CBT. This review used Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Group Register that consisted of randomized controlled trials from the bibliographic databases (James et al, 2013). A review of all randomized controlled trials of CBT versus waiting list, active control conditions, and medication was conducted. The data collected extensively analyzed and eventually the researchers concluded that CBT is an effective treatment for adolescent and childhood anxiety disorders. Hunot, Churchill, Silva de Lima, and Teixeira (2007) established that psychological therapies based on CBT principles are effective in alleviating anxiety symptoms for short-term treatment of GAD. There review: Psychological therapies for generalized anxiety disorder (GAD); they found that GAD is a prevalent condition and is characterized by excessive worry about everyday events and problems. Accordingly, Hunot et al. (2007) showed that the effectiveness of psychological therapies as a group is yet to be evaluated in GAD treatment. In this regard, their review aimed at examining the efficacy and acceptability of psychological therapies in terms of cognitive behavioral therapy (CBT), supportive therapy, and psychodynamic therapy compared to waiting list treatment. In this particular review, (Hunot et al., 2007) found out that CBT treatment is effective in reducing anxiety symptoms. Anxiety disorder as seen from the above discussion can be effectively be addressed by CBT. In the open pilot study: CBT for Anxiety and Associated Somatic Complains in Pediatric Medical settings established that cognitive behavioral approach provides massive benefits to patients suffering from anxiety and somatic disorders (Warner et al 2009). Otte (2011) found out that generally, CBT demonstrates both efficacy with regard to both randomized controlled trials and effectiveness in naturalistic settings with regard to treating adult anxiety disorders. Accordingly, James et al (2013) confirmed that CBT is an effective treatment for adolescent and childhood anxiety disorders. Conclusion The discussion above provides evidence that Cognitive Behavioral Therapy is and effective treatment for various mental disorders particularly; depression, schizophrenia, and anxiety. The cited articles provide different perspectives with regard to how CBT is an essential treatment in the aforementioned disorders. Carney et al (2007) in their study concluded that pharmacotherapy and CBT are essential in addressing residual insomnia for MDD patients. Neil and Aaron (2012) on the other hand found out that CBT produces large clinical effects on measures of positive and negative symptoms of schizophrenia. More importantly, anxiety can be significantly addressed by CBT. For instance, Otte (2011) established that generally, CBT demonstrates both efficacy with regard to both randomized controlled trials and effectiveness in naturalistic settings with regard to treating adult anxiety disorders. References Carney, CE., Segal, ZV., Edinger, JD., & Krystal, AD. (2007). A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder. The Journal of Clinical Psychiatry , 68(2), 254-260] Hofmann, S., & Smits, J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69(4), 621-632 Hunot, V., Churchill, R., Silva de Lima, M., & Teixeira, V. (2007). Psychological therapies for generalised anxiety disorder. Cochrane Database Systematic Review, 24(1), CD001848 James, AC., James, G., Cowdrey, FA., Soler, A., & Choke, A. (2013). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Systematic Review, 3(6), CD004690 Mitchell, N., & Gordon, P. (2007).Attitudes towards computerized cbt for depression amongst a student population. Behavioural and Cognitive Psychotherapy, 35(04) 421-430 Naeem, F., Waheed, W., Gobbi, M., Ayub, M., & Kingdon, D. (2011). Preliminary evaluation of culturally sensitive CBT for Depression in Pakistan: Findings from developing culturally-sensitive CBT Project (DCCP). Behavioural and Cognitive Psychotherapy, 39(02) 165-173 Neil, R., & Aaron, B. (2012). Cognitive Behavioral Therapy for Schizophrenia: An Empirical Review Neil A. Rector, PhD and Aaron T. Beck, MD (2001). Reprinted from the J Nerv Ment Dis 189:278–287. Journal of Nervous & Mental Disease, 200(10), 832-839 Stuhlmiller, C., & Tolchard, B. (2009). Computer-assisted CBT for depression & anxiety: increasing accessibility to evidence-based mental health treatment. Journal of Psychosocial Nursing and Mental Health Services, 47(7), 32-39 Tania, L., Ziegler, M., Stephanie, M., Marie-Luise, K., Eva, L., Stefan, W., & Winfried, R. (2012). Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: A randomized clinical practice trial. Journal of Consulting and Clinical Psychology, 80(4), 674-686 Tarrier, N. (2010). Cognitive Behavior Therapy for Schizophrenia and Psychosis: Current Status and Future Directions. Clinical Schizophrenia & Related Psychoses, 4(3), 176-184 Thomas, N., Rossell, S., Farhall, J., Shawyer, F., & Castle, D. (2011). Cognitive behavioural therapy for auditory hallucinations: Effectiveness and predictors of outcome in a specialist clinic. Behavioural and Cognitive Psychotherapy, 39(02) 129-138 Warner, C., Reigada, L., Fisher, P., Saborsky, A., & Benkov, K. (2009). CBT for anxiety and associated somatic complaints in pediatric medical settings: An open pilot study. Journal of Clinical Psychology in Medical Settings, 16(2), 169-177 Read More