Comparison between PST and CBT - Essay Example

Comparison between PST and CBT Name Course Lecturer Date Most adults are prone to post-traumatic stress disorder both acute and chronic levels. This is due to chronic grief following a stressful situation or event of a catastrophic and threatening nature. Stress result from social adversity and trauma. Herrman, Maj, & Sartorius, (2009) argues that when emotional responses are triggered with reasoning biases unusual experiences result. Patients, sometimes can exhibit hallucinations and delusions. Most adult’s traumatic experiences become a problem for clinical interventions and therefore a consideration for therapeutic approach becomes significant. One adults risk to a major depression is panic attack and stress disorders. The key role of stress in the onset of depression must be understood for preventive strategies. Stress has a complex manifestation of phobias that result and together, progress toward agoraphobia, obsessive- compulsive and panic attack (Goodwin, 2002). The most adult common co-occurrence is depression from stress and thus psychotherapeutically, systems are developed for diagnosis, effective assessment, and management of depressions. In considering the form, course, frequency and outcome this assists the patients in remission of symptoms, reduction of relapse and therefore returns to the previous and normal functioning level. For this to be realized physicians must choose the best care through evidence based strategy and integrate system of the best practice as information for this implementation. Best practice and effective management capacity has to include patient routine screening as a preventive service. Other factors put into considerations are interim screening plan for the patient at high risk due to diabetes, chronic pain, cancer, post stroke as well as patients with a previous depression history (Edition, 2010). Efficacy determines the strength or intervention potency of psychotherapy in highly controlled conditions. It guides the physician on the best therapy to adopt and shows its generalized effects. Researches compare the efficacy through the use of randomized controlled trial of different therapies as the optimum source of information recommended by evidence based practice (Grimes & Schulz, 2002). For a particular therapy to be adopted in management of depression, it must have the evidence of efficacy through RCTs. Therapy must cause changes in symptoms in the treatment process measured by reduction in severity from the start toward the end. Efficacious therapy is conducted with all other factors that might not be the core cause of change controlled. Before generalization external validity involving different context, of patients, therapists and time must be ascertained. Thus they give one treatment in isolation while controlling the use of alternative treatment or psychological therapy. A treatment is nonbiased if credited according to the potency while all other probable factors were controlled. Efficacious is therefore the internal validity of the provided treatments within the health system to improve the patient outcome (Bower, 2003). Effectiveness determines the service quality. It is measured by the degree to which the severity of depression and anxiety symptoms lessen and by noting changes before and after treatment. The therapy is considered effective if it is specific and sensitive in improving quality, outcomes and is fit for primary care purposes. Effective psychotherapy is determined by research outcomes from routine clinical setting. It is the sufficiency of service quality as compared to the others. Effectiveness differs from efficacy since it does not tend to explain the effects of a particular psychological treatment, rationalize on why the patient developed certain problem or alliances between the therapist and client. However, it is hard to generalize effectiveness of a psychotherapy considering the length, type of treatment, control group, or severity of initial symptoms. The core of effectiveness is to determine how a particular treatment works in a context. There are different effects of psychotherapies depending on conceptualizations differences of depression (Barlow, & Durand, 2012). After diagnosis the physician’s choice of the therapy will determine the effectiveness of therapy by reduction levels of depressive symptoms. Therapies mostly include group treatment in weekly sessions, education, and care and antidepressant support management by the physician. An evidence based treatment must therefore include all the dependent measures recorded at baseline, after or post treatment and a period of follow up in self- report and observer assessments of symptoms. Most significant are periodic assessments, treatments, functional impairment, and satisfaction of care and life quality (Unützer et al, 2002) .A study carried by Eskin, Ertekin, & Demir, (2008) showed significant symptoms reductions at post-treatment by use of Problem solving therapy. Participants showed positive change in improvement, remission and follow up evaluations. A research by Cuipers, et al (2008) did a comparison between Cognitive behavior therapy (CBT) and problem-solving therapy (PST) in stress management patients. Participants completed a trauma and depression scale, grilled on stress Ideation at pre-treatment. Client Satisfaction Questionnaire and Social Problem-Solving Inventory were completed at post-treatment. PST had significant improvements within the majority over time for the measured variables as compared to CBT. Both groups indicated considerable differences on satisfaction. Comparing PST with CBT results showed major differences on stress reduction. Thus overall efficacy was indicated on brief therapies for patients with post- trauma stress disorder. One of psychological intervention is problem solving therapy (PST). It is relevant a short-term based. It begins with problem definition, in this case anxiety causing depression disorder. In one of the therapy treating depression, participants were administered to certain measures including potential for committing suicide, problem solving, assertiveness and self-esteem. Then multiple solutions are generated for remission of stress, therapist then selected and considered a short-term, structured problem solving therapy as the best amongst the solutions. There was work out a systematic plan for the solution, where 22 out of 27 participants under PST condition were reached for follow up for 12 months. Finally evaluation of how effective the solution was to resolve that the problem was done. The participants were to complete depression and problem solving follow-up measures. The results showed a significant decrease of reasoning biases and post-treatment depression for the participants under PST condition. Likewise post-treatment scores for assertiveness and self-esteem increased significantly. At the end of post-treatment, 77.8% of participants under PST achieved partial or full recovery according to the scores (Eskin, Ertekin & Demir, 2008). Therapist followed the prescriptive model in the description as a conceptual framework stress treatment approach. Its efficacy resulted from its structured method of teaching people on how to overcome problems. Patients were able to evaluate their contribution to depressive state and analyze the difficulties in overcoming it. Most adults showed a lack of skills of problem solving. Inabilities and deficits resulted from cognitive and executive functions changes that are age-related. PST therefore effectively intervened for acute depression. Since it is a relatively straightforward in the mode of intervention, most patients were in a position to learn and use it. Important aspects of problem solving therapy enhanced treatment outcome, but were significantly affected by treatment moderators such as social support, poverty and memory impairment (DʼZurilla, & Nezu, 2009). Cognitive- behavior therapy (CBT) was used as a control. Therapists were concerned with the impact of patient’s dysfunctional thoughts on current and future behavior and functioning. Brief training of individuals and group enhanced its successful use among the participants. Participants exhibited stress disorder due to various traumatic experiences and cognitive behavior therapy was used as intervention measure for its management. Participants were evaluated, challenged through engagement topics to modify their dysfunctional beliefs. The tasks and assignment were given to the participants to experience on how they can cope with the real situation and be able to manage their stress. The outcomes showed a significant high outcome in developing social and coping skills, behavioral activation and enhanced relaxation in a stressful situation (Stewart, 2009). Hypnosis was utilized as a way of treatment delivery and enhancing efficacy. This enhanced changes in cognitive distortions. The mechanism of CBT action for acute and chronic traumatic stress was effective and safe. The study also reported physiological, electroencephalographic and functional changes as correlating with CBT response. CBT was highly valued for its potential for preventive as well as its neuropsychological action mechanisms (Chan, 2008). However there was a significant high nonresponsive case of up to 50% of participants to CBT due to the population nature and co morbidity. From the research group the cognitive model supported the formation and maintenance of symptoms. Adults’ expectations and trauma realities held their attention, limiting immediate solution. The developed treatment showed efficacy in milder cases of trauma and stress treatments. Perspective of depression, therapeutic ingredients, therapy stages were hard to account as patients followed a cycle of stress scenarios. Generalization of CBT failed for the participants as there were noted some clinical problems as well as special considerations with the aged (DʼZurilla & Nezu, 2009). Follow up improvements were measured for 12 month. In comparison the results showed a significant decrease in post-treatment stress and depression risk scores for PST participants as compared to pre-treatment scores. Post-waiting and pre-waiting stress condition and depression risk scores of CBT participants were unchanged. Similarly, participants’ scores for assertiveness and self-esteem in post-treatment increased significantly in PST condition. CBT condition post and pre-waiting for assertiveness and self-esteem were unchanged. Results indicated that stress management and recovery from trauma was 77.8% for PST participants but only 65.8% for CBT condition. Full or partial recovery compared at 96.3% and 71.1% for PST and CBT respectively. The improvements were maintained at 12-months follow-up. The conclusion favored problem-solving therapy as more viable option in treating and managing depression and stress potential in adults. CBT however, was considered viable for its preventive and adaptability mechanism (Nezu et al 2004). The idea behind this study was to evaluate the efficacy and effectiveness of two therapeutic treatments. In each potential and specificity mediators are evaluated for depressive symptoms. Through a randomized controlled trial problem-solving therapy (PST) and cognitive behavioral therapy (CBT) as a control group were carried out. PST treatments were more effective compared to the CBT, the control group (Kar, 2011). Differences were seen in stress reduction, orientation to negative problem, worry, and enhancing control feelings. No significant differences were found among the treatments potential mediators. Moreover, results recommended that stress, dysfunctional attitudes, perceived control and negative problem orientation had a mediating role in both. Problem solving therapy was significant as a model of training for problem solving. It decreased psychological distress and enhanced participant’s social competency. There are three most important aspects that were analyzed as a result. First, a relationship between distress and problem solving was identified to exists; second, effective problem solving helped to attenuate deleterious effects resulting from stressful events in life that increase psychological distress likelihood and thirdly training individuals with varieties of psychological distress and problems is an effective way of enhancing patients quality of life decreasing their pathology (DʼZurilla, & Nezu 2009). The nature of problem solving therapy is flexible for a target population, problem, goals of clinical treatment and implementation modes. Thus the findings suggested that despite therapy’s theoretical background, psychological processes for reduction of symptom are comparable. References Barlow, D.H., & Durand, V.M. (2012). Abnormal psychology: An integrative approach. (6th Ed.). Belmont, CA: Wadsworth Cengage Learning. Bower, P. (2003). Efficacy in evidence-based practice. Clinical Psychology and Chan, R. (2008). A case study of chronic post-traumatic stress and grief: Hypnosis as an integral part of cognitive-behavior therapy. Australian Journal of Clinical Experimental Hypnosis, 36(1), 13-22. Australian Society of Hypnosis. Cuipers, P., van Straten, A., Andersson, G., and van Oppen, P. (2008). Psychotherapy for Depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909-922. DʼZurilla, T. J., & Nezu, A. M. (2009). Problem-solving therapy. (K. S. Dobson, Ed.)Handbook of Cognitive Behavioral Therapies (Vol. 39, pp. 197-226). SLACK. Edition, T. (2010). Major Depression in Adults in Primary Care. Women’s Health. Eskin, M., Ertekin, K., & Demir, H. (2008). Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults. Cognitive Therapy and Research, 32(2), 227-245. Springer. Goodwin, C. (2002). Multi-Modal Gesture. First Conference of the International Society Grimes, D. A., & Schulz, K. F. (2002). An overview of clinical research: the lay of the land. Lancet; 359: 57-61. Herrman, H., Maj, M. & Sartorius, N. (2009). Depressive disorders. Chichester, UK Hoboken, NJ: Wiley-Blackwell. Kar, N. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric Disease and Treatment, 7, 167-181. Dove Medical Press. Nezu, A. M., DʼZurilla, T. J., Zwick, M. L., & Nezu, C. M. (2004). Problem-Solving Therapy for Adults. In E. C. Chang, T. J. DʼZurilla, & L. J. Sanna (Eds.), Social problem solving Theory research and training (pp. 171-191). American Psychological Association. Psychotherapy, 10, 328–336. Stewart, C. D., Quinn, A., Plever, S., & Emmerson, B. (2009). Comparing cognitive behavior therapy, problem solving therapy, in a high risk population. Trauma and Stress behavior, 39(5), 538-547.  Unitzer J, ChoiY, Cook IA, Oishi S. (2002). A web-based data management system to improve care for depression in a multicenter clinical trial. Psychiatric services: Washington, D.C, 53 (6) 671-3,678. Read More

Before generalization external validity involving different context, of patients, therapists and time must be ascertained. Thus they give one treatment in isolation while controlling the use of alternative treatment or psychological therapy. A treatment is nonbiased if credited according to the potency while all other probable factors were controlled. Efficacious is therefore the internal validity of the provided treatments within the health system to improve the patient outcome (Bower, 2003).

Effectiveness determines the service quality. It is measured by the degree to which the severity of depression and anxiety symptoms lessen and by noting changes before and after treatment. The therapy is considered effective if it is specific and sensitive in improving quality, outcomes and is fit for primary care purposes. Effective psychotherapy is determined by research outcomes from routine clinical setting. It is the sufficiency of service quality as compared to the others. Effectiveness differs from efficacy since it does not tend to explain the effects of a particular psychological treatment, rationalize on why the patient developed certain problem or alliances between the therapist and client.

However, it is hard to generalize effectiveness of a psychotherapy considering the length, type of treatment, control group, or severity of initial symptoms. The core of effectiveness is to determine how a particular treatment works in a context. There are different effects of psychotherapies depending on conceptualizations differences of depression (Barlow, & Durand, 2012). After diagnosis the physician’s choice of the therapy will determine the effectiveness of therapy by reduction levels of depressive symptoms.

Therapies mostly include group treatment in weekly sessions, education, and care and antidepressant support management by the physician. An evidence based treatment must therefore include all the dependent measures recorded at baseline, after or post treatment and a period of follow up in self- report and observer assessments of symptoms. Most significant are periodic assessments, treatments, functional impairment, and satisfaction of care and life quality (Unützer et al, 2002) .A study carried by Eskin, Ertekin, & Demir, (2008) showed significant symptoms reductions at post-treatment by use of Problem solving therapy.

Participants showed positive change in improvement, remission and follow up evaluations. A research by Cuipers, et al (2008) did a comparison between Cognitive behavior therapy (CBT) and problem-solving therapy (PST) in stress management patients. Participants completed a trauma and depression scale, grilled on stress Ideation at pre-treatment. Client Satisfaction Questionnaire and Social Problem-Solving Inventory were completed at post-treatment. PST had significant improvements within the majority over time for the measured variables as compared to CBT.

Both groups indicated considerable differences on satisfaction. Comparing PST with CBT results showed major differences on stress reduction. Thus overall efficacy was indicated on brief therapies for patients with post- trauma stress disorder. One of psychological intervention is problem solving therapy (PST). It is relevant a short-term based. It begins with problem definition, in this case anxiety causing depression disorder. In one of the therapy treating depression, participants were administered to certain measures including potential for committing suicide, problem solving, assertiveness and self-esteem.

Then multiple solutions are generated for remission of stress, therapist then selected and considered a short-term, structured problem solving therapy as the best amongst the solutions. There was work out a systematic plan for the solution, where 22 out of 27 participants under PST condition were reached for follow up for 12 months. Finally evaluation of how effective the solution was to resolve that the problem was done. The participants were to complete depression and problem solving follow-up measures.

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