Comparing CBT and SFBT for Anxiety Disorder - Research Paper Example

? Comparing CBT and SBT for Anxiety Disorder Griffith (2007) conducted a quantitative study seeking to evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) and Solution Focused Brief Therapy (SFBT) in the treatment of Obsessive Compulsive Disorder among young adult. The study was conducted in a Teaching Hospital located in United Kingdom where 160 outpatients who met the DSM-IV criteria for the diagnosis with Obsessive Compulsive Disorder were recruited for the survey. Patients who were currently unstable, using psychotropic drugs and did not understand English were excluded from the study. In addition, patients with suicidal ideation and intellectual impairment were also excluded from the study. After obtaining consent from the participants, they were randomly assigned to receive Cognitive Behavioral Therapy or Solution Focused Brief Therapy. Patients were to undergo the randomly assigned modality of treatment for 10 weeks after which they were to be reviewed. The authors reviewed the patients after 2, 4, 6, 8 and 10 weeks. The efficacy of treatment was assessed using Yale-Brown Obsessive Compulsive Rating Scale (Y-BOCS) following 0, 2, 4, 6, 8 and 10 weeks of treatment. The authors conducted both a self-rated Y-BOCS and a clinician administered Y-BOCS. The results from these versions were correlated to produce the rating of the severity and improvement of the patient’s rating. The interview focused on elaborating on the amount of time spent on the obsessions, distress or impairment experienced by the patient, and how much control or resistance the patient had over these urges (Griffith, 2007). The Y-BOCS scores obtained at the commencement of the study were compared with those of subsequent weeks. The Y-BOCS score in the two groups was significantly reduced at 2, 4, 6, 8 and 10 weeks following treatment. According to the authors, the YBOCS score of patients receiving CBT was significantly lower than that of patients receiving Solution Focused Brief Therapy. In conclusion, the authors concluded that although SFBT resulted in the improvement of patient symptoms, CBT was superior in the management of patient with OCD (Griffith, 2007). However, the authors noted that there was room for research to determine whether CBT was effective in maintaining long-term improvement of the patient. Salzer, Winkelbach, Leweke, Leibing and Leichsenring (2011) conducted a qualitative study seeking to elaborate on the long-term effects of cognitive-behavioral therapy and Solution Focused Therapy for patients with generalized anxiety disorders. The authors aim was to demonstrate the long term stability effects of these treatment modalities in patients diagnosed with generalized anxiety disorder. The study recruited 60 outpatients who were diagnosed with Generalized Anxiety Disorder according to DSM-IV criteria. In addition, the sample population included patients who had received treatment for not less than 2 years in the outpatient clinic. Furthermore, the patients recruited were not receiving any form of medication for their current condition (Salzer, Winkelbach, Leweke, Leibing and Leichsenring, 2011). According to the authors, this was to ensure that there was no biasness introduced by the use of pharmacological agents for the treatment of generalized anxiety disorder. After obtaining consent, the patients were randomly assigned to receive Cognitive Behavioral Therapy or Solution Focused Brief Therapy. The treatment was carried out according to the manual and included an estimated 30 sessions conducted within 12 months. Before the commencement of the study, the patients were rated using the Hamilton Anxiety Rating Scale to determine the patient functioning and improvement after receiving treatment. After 12 months of follow-up, both patients receiving CBT and SFBT reported significant improvement in the clinical symptoms and reduction in, Hamilton Anxiety Rating Scale. There was no significant reported difference between treatments concerning the primary outcome measure. In addition, the results of the study were corroborated with a self-report that measured the level of anxiety following treatment. The study concluded that in the measure for worries and anxiety, CBT was superior. However, SFBT was found to be effective in the long-term. This is because patients reported improvement in the long-term while patients receiving CBT reported short-term improvement (Salzer, Winkelbach, Leweke, Leibing and Leichsenring, 2011). The authors, however, recognized that there was still room for research to confirm the long term effects of SFBT in these patients as the sample size and follow-up period was not adequate. Sprinks (2008) conducted a qualitative study seeking to establish the effectiveness of Cognitive Behavioral Therapy and Solution Focused Brief Therapy in the treatment of Patients diagnosed with Social phobia. The study recruited 70 patients below 25 years who were receiving treatment in an outpatient psychiatric uni,t in a national teaching hospital. The survey included patients who were diagnosed with social phobia and were not receiving any form of psychotherapy or pharmacological treatment modalities. After obtaining consent, the patients were randomly assigned to receive either cognitive Behavioral Therapy or Solution Focused Therapy for 12 weeks. The authors reviewed the patients after 2, 4, 6, 8, 10 and 12 weeks of receiving treatment. The authors administered a self and clinician oriented Social Anxiety Scales to determine the functioning of the patients before and after the commencement of treatment. The data collected from the self and clinician interviews were corroborated to obtain the overall score of the patient. Following 12 weeks of treatment, the patients reported marked improvement in the symptoms and performance of the patients on both modalities of treatment. Cognitive Behavioral Therapy was found to be superior because patients reported significant improvement and lower ratings on the Social Anxiety Scale (Sprinks, 2008). However, the clinicians noted that Solution Focused Brief Therapy was more cost effective, and can be applied in busy clinical settings where resources are scarce. It can also be used to supplement for CBT where resources to provide CBT are not available. White (2011) conducted a qualitative study seeking to establish the efficacy and cost-benefit of guided Cognitive Behavioral Therapy and Solution Focused Brief Therapy for the treatment of adolescent patients with anxiety disorder. The study was conducted in Oxfordshire, United Kingdom, among adolescent patients were referred to the Primary Child and Adolescent Mental Health Services (PCAMHS) for the treatment of anxiety disorders. The study aimed at assessing whether guided self-help results in improved outcomes when compared with standard care (solution-focused brief therapy). The study also aimed to demonstrate whether the differences in patient outcome where maintained in the long-term (White, 2011). The author also aimed to find out whether the application of CBT was cost-effective when compared with SFBT. The sample population included adolescent patients who were referred to the primary Child and Adolescent Mental Health Services for the treatment of anxiety. The treatment using CBT involves 4 face to face sessions with a therapist and four review sessions that were conducted over the telephone. Using SBFT, patients were to receive 4 sessions with the therapist and 4 sessions within the home setting of the patient. The sample population included 60 patients who were diagnosed with anxiety disorder two years prior the commencement of the study. In addition, patients on psychotropic medication, clinically unstable and has accompanying intellectual impairment, for example, mental retardation, were excluded from the study (White, 2011). After obtaining consent, the patients were randomly assigned to receive CBT or SFBT. Following eight weeks of treatment, the anxiety severity was assessed using ADIS where the participant was expected to fill a self-report questionnaire. In addition, the patient was examined by a clinician whose results were corroborated with those obtained from the self-reported score. After eight weeks of treatment, all patients reported significant improvement and reduction of anxiety symptoms. Patients receiving CBT reported a significant reduction of symptoms when compared to SFBT. However, the cognitive behavioral therapy was expensive when compared with SFBT. There no difference in the results in the long-term. The authors noted that there was room for research to establish where improvement of symptoms was maintained better when CBT or SFBT was applied. Faraci, Triscari and Urso (2011), conducted a quantitative study seeking to establish the efficacy of Cognitive Behavioral Therapy and Support Focus Therapy for the management of flight phobia. This study recruited 59 participants who reported symptoms identified by DSM-IV to describe the flight phobia. All the patients participating in the study undertook an initial assessment prior to receiving treatment. They were assessed by qualified psychologist using Millon Clinical Multiaxial Inventory to determine whether they meet the criteria described by DSM-IV. The study excluded patients with intellectual impairment, suicidal tendencies and those who depended wholly on psychotropic medications. In addition, patients were informed about the study to obtain consent. In the survey, patients were randomly assigned to receive support focused brief therapy and cognitive behavioral therapy. To reduce potential bias in the study, the researchers conducted a double-blinded randomized trial where both the patient and psychologist were not aware of the assigned mode of treatment. To achieve this, both the patient and psychologist were randomly assigned to participate in one treatment modality. The patients were assessed after 4 and 8 weeks of treatment using the Millon Clinical Multiaxial inventory (Faraci, Triscari and Urso, 2011). Following 4 and 8, patients reported a significant improvement in the symptoms. The authors highlighted that there was no significant difference in the improvement of patient. The authors concluded that patients seeking psychological treatment for flight phobia did not require the comprehensive complement of standard cognitive behavioral therapy interventions. The authors noted that the patients sufficiently benefited from core interventions that allowed them to focus on their treatment. In addition, the authors noted, that unlike CBT, SFBT was cost effective and efficient in treating flight phobia. The authors recommended the synthesis of CBT and SFBT for the treatment of flight phobia in busy clinical setting where resources were scarce. This is because both treatment modalities provided similar results in the improvement of patients with flight phobia. Kim (2008) conducted a quantitative study examining the efficacy of Solution Focused Brief Therapy and other traditional modalities in the management of anxiety disorder. The study was conducted through a systemic meta-analytic procedure where 22 studies were utilized. A systemic meta-analysis was chosen since the 22 studies selected utilized different quasi-experimental and experimental designs. The primary studies selected were from 1999- 2006 that employed the components of SFBT and CBT for the management of anxiety disorder. In the study, the author included unpublished studies and dissertations so as to increase the statistical power, sample size and reduce the publication bias. In addition, studies that incorporated the use of psychotropic agents were not included in the study. The meta-analytical review concluded that both SFBT and CBT demonstrated positive improvement results of the patient. However, the studies revealed that SFBT resulted in minimal improvement when compared with CBT. In addition, patients on follow-up after both CBT and SFBT reported recurrence of symptoms. It was noted that CBT was superior in providing short-term relief of symptom. However, it was not cost effective, and a majority of patients developed relapse symptoms after 12months follow-up (Kim, 2008). The authors highlighted that there was a need for research to identify methods in which the principles of SFBT and CBT could be used for the treatment of patients with anxiety to provide long-term effects. This treatment modality should be cost effective in terms of finances and qualified staff required to conduct the treatment. References Faraci,N., Triscari, L., & Urso, D. (2011). Psychotherapy for Flight Phobia. Journal of Affective Disorders, 107, 95-106. Griffith, L. (2007). Effectiveness of Cognitive Behavioral Therapy and Solution Based Therapy in Treatment of OCD in young adults. Chinese Mental Health, 19,288-290. Kim, B. (2008). Examining the effectiveness of Cognitive Behavioral Therapy and solution-focused brief therapy: A meta-analysis, Research on Social Work Practice, 18,107-116. Salzer, D., Winkelbach, A., Leweke, B., Leibing, L., & Leichsenring, R. (2011). Long-term effects of C BT and SFBT for patient with Generalized Anxiety Disorder. Dissertation Abstracts International, 68, 484-497 Sprink, H. (2008). CBT or SFBT for the treatment of Social Phobia? Research on Social Work Practice, 12, 238-252. White, E. (2011). Going beyond the efficiency of CBT and SBFT in the management of anxiety disorder in adolescent patient. Journal of Affective Disorders, 107, 95-106. Read More