Smartphone-assisted online brief cognitive behavioral therapy to treat maternal depression: findings of a randomized controlled trial

Objective: To test the efficacy of smartphone-assisted online brief cognitive behavioral therapy (b-CBT) to treat maternal depression compared to online brief CBT plus an active control app. Methods: A randomized controlled trial was conducted. Assessments were performed at baseline (T0), midpoint (T1, week 4-5), post-treatment (T2, week 8), and follow-up (T3, 2-month postnatal follow-up) by blinded interviewers. The primary outcome was depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at T2. We also assessed anxiety, stress, sleep quality, well-being, physical activity, treatment response, and offspring child behavior problems. Results: Eighty-one participants were randomized to the intervention (n=37) or active control (n=44) groups. Seventy-one participants completed the post-treatment assessment or reported primary outcome data. No differences were found between the intervention and active control groups regarding maternal depression or other mental health outcomes. Overall, we found large within-group effect sizes, with 80% of the total sample responding to treatment. Conclusions: Our data showed no difference between the groups, suggesting that adding apps to psychotherapy treatment may not enhance treatment effects on prenatal depression. A within-groups analysis showed that most participants with depression responded to treatment; however, future studies are needed to confirm whether this effect is related to factors other than the intervention.

The effectiveness of dialectical behavior therapy for mental disorders / 中华行为医学与脑科学杂志

Dialectical behavior therapy (DBT), as an important representative of the " third wave" of cognitive behavior therapy (CBT), has been paid more attention. Since the publication of the treatment manual in 1993, DBT has been widely spread in several treatment settings, including outpatient, community, and inpatient settings, and has been applied to the diagnosis and treatment of various mental disorders. In recent years, more and more studies have proved that DBT has a clear effect on a variety of mental disorders and psychological and behavioral problems, especially the clinical problems related to emotion regulation. This article summarizes and evaluates the effectiveness of DBT in the treatment of mental disorders and discusses the limitations of the current research and the future development direction.

Acceptance and commitment therapy for chronic pain: a quasiexperimental study / Terapia de aceitação e compromisso em grupo para dor crônica: estudo quase-experimental

Objective Chronic pain is an important health problem and affects both quality of life and mental health. This study assessed psychological inflexibility, pain intensity, quality of life, anxiety and depression symptoms, self-efficacy, and social support among patients with chronic pain. Method A quasiexperimental design was used to assess six adult participants pre- and post-group intervention (eight sessions) based on acceptance and commitment therapy. Results After the intervention, the patients experienced a reduction in psychological inflexibility, pain, and depression and anxiety symptoms and improvements in quality of life and self-efficacy. The quality of life and depression symptoms and the domains of quality of life and psychological inflexibility were negatively correlated. Conclusion Acceptance and commitment therapy is a promising treatment for the interdisciplinary treatment of the Pain Clinic.

Objetivo Dor crônica é um problema de saúde prevalente que acarreta prejuízos para qualidade de vida e saúde mental. Este estudo avaliou inflexibilidade psicológica, intensidade da dor, qualidade de vida, sintomas de ansiedade e de depressão, autoeficácia e suporte social em pacientes com dor crônica. Método Utilizou delineamento quase-experimental e os seis participantes adultos foram avaliados por meio de instrumentos no pré e pós-intervenção em grupo (oito sessões) com Terapia de Aceitação e Compromisso. Resultados Após a intervenção houve redução da inflexibilidade psicológica e da dor, melhora da qualidade de vida, redução dos sintomas de ansiedade e de depressão e aumento da autoeficácia. Houve correlação inversa entre qualidade de vida e sintomas de depressão e entre domínios da qualidade de vida e inflexibilidade psicológica. Conclusão Conclui-se que a Terapia de Aceitação e Compromisso é um tratamento promissor a ser integrado no atendimento interdisciplinar da Clínica de dor.

Implicações neurológicas da meditação do tipo terapia cognitiva baseada em mindfulness em pacientes com transtorno de ansiedade ou transtorno depressivo: uma revisão integrativa / Neurological implications of mindfulness-based cognitive therapy in patients with anxiety or depressive disorders: an integrative review / Implicaciones neurológicas de la meditación de la terapia cognitiva basada en mindfulness en pacientes con trastorno de ansiedad o trastorno depresivo: una revisión integradora

A Terapia Cognitiva Baseada em Mindfulness (MBCT, do inglês Mindfulness-Based Cognitive Therapy) é uma técnica baseada na combinação da Terapia Cognitiva-Comportamental e da meditação mindfulness, na busca pela melhoria de sintomas psiquiátricos. O presente trabalho tem como objetivo a busca por publicações que discutam as implicações neurológicas de pacientes diagnosticados com transtorno depressivo e transtorno de ansiedade e que buscaram nessa técnica a melhoria de sua condição clínica ou qualidade de vida. Nossos resultados preliminares mostraram que os benefícios dessa prática foram colhidos na totalidade dos estudos encontrados, elucidando as áreas cerebrais modificadas e o motivo pelo qual elas foram ativadas. Procuramos abordar ainda a diferença entre essa técnica e o uso de medicamentos e tratamento usual. PALAVRAS-CHAVE: Terapia Cognitiva-Comportamental; Cérebro; Transtornos Psiquiátricos; Antidepressivos.

Mindfulness-Based Cognitive Therapy (MBCT) is a technique based on the combination of Cognitive-Behavioral Therapy and mindfulness meditation, in the search of improving psychiatric symptoms. This present work aims to search for studies and articles that discuss the neurological implications of patients diagnosed with anxiety and major depressive disorders who sought improvement in their clinical condition or life quality through this technique. The preliminary results showed that the benefits of this practice were observed in all of the studies found, elucidating the modified brain areas and the reason why they were activated. The differences between this technique and the use of medication and treatment-as-usual was also addressed.

La Terapia Cognitiva Basada en Mindfulness (MBCT) es una técnica basada en la combinación de la Terapia Cognitivo-Conductual y la meditación mindfulness, en la búsqueda de la mejora de los síntomas psiquiátricos. El presente trabajo tiene como objetivo buscar publicaciones que discutan las implicaciones neurológicas de pacientes diagnosticados con trastorno depresivo y trastorno de ansiedad y que busquen en esta técnica mejorar su condición clínica o calidad de vida. Nuestros resultados preliminares mostraron que los beneficios de esta práctica se cosecharon en todos los estudios encontrados, dilucidando las áreas cerebrales modificadas y la razón por la cual se activaron. También tratamos de abordar la diferencia entre esta técnica y el uso de medicación y tratamiento habitual.

Preliminary outcomes from a single-session, asynchronous, online stress and anxiety management workshop for college students

Abstract Objectives Self-guided, asynchronous, online interventions may provide college students access to evidence-based care, while mitigating barriers like limited hours of service. Thus, we examined the preliminary effectiveness of a 45-minute, self-guided, asynchronous, online, dialectical behavior therapy (DBT)-informed stress and anxiety management workshop. College undergraduates (n = 131) were randomized to either workshop (n = 65) or waitlist control (n = 66) conditions. Methods Participants in the workshop condition completed baseline measures of depression, stress, and anxiety, before completing the workshop. Participants in the waitlist control condition only completed the baseline measures. All participants were reassessed at 1-week follow-up. Results Controlling for baseline measures, students in the workshop condition experienced significantly less stress and greater self-efficacy to regulate stress and anxiety at follow-up, compared to waitlist controls. Conclusion A 45-minute, self-guided, asynchronous, online DBT skills-informed stress and anxiety management workshop may reduce stress and improve self-efficacy to regulate stress and anxiety.

Effect of cognitive behavioral therapy for insomnia on sleep quality and cognitive function in patients with chronic insomnia disorder / 四川精神卫生

BackgroundInsomnia disorder has become a common disease in the current society. Cognitive Behavior Therapy for Insomnia （CBTI） is one of the non-drug treatment methods for insomnia disorder， but relevant studies of its effect on sleep quality and cognitive function of patients with insomnia disorder are limited. ObjectiveTo explore the effects of CBTI on sleep quality and cognitive function in patients with insomnia disorder， so as to provide references for non-drug treatment of insomnia disorder. MethodsA total of 47 patients with insomnia disorder were recruited as the study subjects. They all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and have visited Sichuan Mental Health Center from January 2021 to October 2022. The patients underwent CBTI for 6 weeks. Before the treatment， depression and anxiety symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） and Hamilton Anxiety Scale （HAMA）. Sleep status and cognitive function were assessed using Pittsburgh Sleep Quality Index （PSQI） and Montreal Cognitive Assessment （MoCA） before and 6 weeks after the treatment. Spearman correlation analysis was used to examine the correlation between the reduction of PSQI score and the increase of MoCA score after treatment. ResultsAfter the 6-week treatment， the factor scores and total score of PSQI across 6 subscales （the sleep quality， sleep onset time， sleep time， sleep efficiency， sleep disorder and daytime dysfunction） were lower than those before the treatment， and the score differences were of statistical significance （t=5.569~15.290， P<0.01）. Both factor and total scores of MoCA across 6 items （visuospatial and executive， naming， attention， language， abstraction and memory） were significantly higher than those before the treatment with score differences reaching statistical significance （t=-11.273~-4.277， P<0.01）. Spearman correlation analysis demonstrated that there was a positive correlation between the decrease in PSQI total score and the increase in MoCA total score after the 6-week CBTI treatment （r=0.323， P=0.027）. ConclusionCBTI may help improve sleep quality and cognitive function in patients with insomnia disorders. The improvement of sleep quality after CBTI intervention may be related to the improvement of cognitive function. ［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ216）］

Effectiveness of self-designed dental storybook as behavior modification technique in 5 – 7 year-old children A randomized controlled study

Background: Dental anxiety is one of the key factors that prevent children from obtaining dental treatment and raises anxiety levels in children. The first dental visit is usually fearful for the child and contributes to managing the child patient in a dental operatory. A pediatric dentist's role is to perform effective treatment using various nonpharmacological behavior management techniques. Aims: The aim of the study was to evaluate and compare the effect of self-designed dental storybook on behavior and pulse rate before and after dental procedures in 57-year-old children. Settings and Design: The study was a prospective, randomized, controlled trial. Materials and Methods: The study was conducted on 380 aged 57 years. Children were randomly allocated into two groups, namely, Group A ? Behavior modification using a self-designed dental storybook and Group B – Behavior modification without storybook. Research was carried out in two dental visits (screening, examination, and preventive and restorative treatment) wherein, before and after intervention, pulse rate, Facial Image Scale (FIS), and Venham Scale (VS) were recorded. Descriptive statistical analyses followed by the paired t-test and Wilcoxon signed-rank test were applied and tabulated using the SPSS software version 23.0. Results: There was a significant difference observed in the interventional group as compared to the control group for pulse rate, FIS, and VS. Conclusion: Self-designed dental storybook as an adjuvant was found to be promising behavior modification technique for 57-year-old children.

Current situation and enlightenment of researches on culturally adapted cognitive behavior therapy / 中华行为医学与脑科学杂志

Cognitive behavior therapy(CBT) is one of the most widely used psychotherapy methods in the world.However, its origin in Western culture makes many researchers doubt whether it can be effectively applied to other cultural groups.The discussion on this issue is conducive to further adjusting CBT from an international perspective to better serve different cultural groups.This review focuses on the research progress of acculturation in CBT at home and abroad.Firstly, it discusses the necessity of acculturation and introduces the relevant major researchers in this field abroad, so as to explain how to carry out the work of acculturation.Then the effectiveness of current acculturation work is demonstrated, and the research progress of acculturation related to Chinese culture is introduced emphatically.In previous studies, most scholars supported the development of acculturation, and preliminary evidence has shown that CBT after acculturation has equal or even better effectiveness.Based on this, different researchers have put forward their own acculturation framework or adaptation suggestions.However, there are still many shortcomings in current research, which are mainly reflected in six aspects: few comparative studies, lack of unified framework, blank fields in some areas, shallow level of acculturation, unknown mechanism and lack of bottom-up research.Thus, this review is aimed to point out the urgency and necessity of CBT cultural adaptation in China, and put forward some suggestions and preliminary ideas for the further development of more culturally adaptable CBT in China, in order to better promote the application of CBT in China.

Application of cognitive behavior therapy for insomnia in treating psychiatric disorders / 中华行为医学与脑科学杂志

Insomnia symptom is one of the most common types of sleep disturbances.Apart from being a risk factor for psychiatric disorders, insomnia symptom has been found to affect the course of psychiatric disorders and increase the relapse rate of psychiatric disorders.Therefore, insomnia treatment is beneficial to mitigate the psychiatric symptoms among chronic insomnia patients, which may help prevent mental health disorders.On the other hand, insomnia treatment for psychiatric patients is conductive to reduce the harm consequence in social function, which can help improving the prognosis of psychiatric disorders.Cognitive behavior therapy for insomnia (CBT-I) is a first-line treatment for chronic insomnia.This paper reviews the research progress on the efficiency of CBT-I on the psychiatric symptoms of chronic insomnia patients, as well as its application in comorbid psychiatric conditions.Findings from previous research suggested that CBT-I is effective to improve the psychiatric symptoms of insomnia patients through insomnia improvement, and it can also promote the remission of depression and anxiety symptoms, reduce the risk of substance disorder and suicide behaviors, and reduce the impairment of life quality and costs of treatment through insomnia improvement among psychiatric patients comorbid with insomnia, which indicated that CBT-I is a safe and effective treatment for insomnia symptoms in psychiatric patients.Moreover, this paper listed the contraindications and the decision-to-treat algorithm of CBT-I among psychiatric patients, as well as the CBT-I availability and adherence that limited the clinical application.More understanding of CBT-I is beneficial to provide support for a broad clinical application in mental health services.

Interpretation to the European clinical guidelines of psychological interventions for Tourette syndrome and other tic disorders in 2021 / 中华实用儿科临床杂志

Tic disorders are one of the common neurodevelopmental disorders in children, which are mainly managed by pharmacological and non-pharmacological treatment.Psychological interventions belong to the non-pharmacological treatment, which, however, have not yet been fully recognized and understood in China.The analyses on clinical effectiveness and availability to pediatric patients are limited.This study aims to interpret the clinical guidelines of psychological interventions for Tourette syndrome and other tic disorders by European Society for the Study of Tourette syndrome in the journal of European Child and Adolescent Psychiatry in 2021, aiming to provide reference for the psychological interventions of tic disorders in China.

Behavioral therapy in the treatment of urinary incontinence: quality of life and severity / Terapia comportamental no tratamento da incontinência urinária: qualidade de vida e gravidade

Abstract Introduction: Behavioral therapy (BT) is an association of techniques that aim to minimize or abolish urinary symptoms, including urinary incontinence (UI), through education about the health condition, changes in lifestyle and nutritional habits, and bladder training. Objective: To analyze whether there is a change in the quality of life and severity of UI after group behavioral therapy in women with UI. Methods: Prospective observational study conducted in a pelvic physical therapy public service. Women with UI of any etiology, over 18 years of age, who completed a protocol of four weekly group BT meetings as the first treatment option for UI were included. Outcomes (impact of UI on QoL and classification of UI severity) were assessed before, immediately after, and one month after BT using the King's Health Questionnaire (KHQ) and the Incontinence Severity Index (ISI). Results: Sample of 146 participants. A reduction in the impact of UI on QoL was observed in the KHQ domains: impact of UI, physical limitations, personal relationships, emotions, general health perception (p < 0.05) immediately after BT. After one month, there was a reduction in the UI impact domains, daily activity limitations, physical limitations, general health perception, emotions, and sleep (p < 0.05). In addition, there was a reduction in the classification of UI severity assessed by the ISI (p < 0.001). Conclusion: There was an improvement in QoL and a decrease in UI severity in women with UI who completed a BT group as the first treatment option.

Resumo Introdução: A terapia comportamental (TC) é uma associação de técnicas que visam minimizar ou abolir sintomas urinários, incluindo a incontinência urinária (IU), por meio da educação sobre a condição de saúde, mudanças em hábitos de vida e alimentares e treinamento vesical. Objetivo: Analisar se existe alteração da qualidade de vida e da gravidade da IU após terapia comportamental em grupo de mulheres com IU. Métodos: Estudo observacional prospectivo realizado em um serviço público de fisioterapia pélvica. Mulheres com IU de qualquer etiologia e maiores de 18 anos foram submetidas a um protocolo de quatro encontros de TC em grupo, semanalmente, como primeira opção de tratamento para IU. Os desfechos, impacto da IU na qualidade de vida (QV) e classificação da gravidade da IU foram avaliados antes, imediatamente após e um mês depois da TC pelos questionários King's Health Questionnaire (KHQ) e Incontinence Severity Index (ISI). Resultados: Amostra de 146 participantes. Observou-se redução do impacto da IU na QV nos domínios do KHQ: impacto da IU, limitações físicas, relações pessoais, emoções, percepção geral de saúde (p < 0,05) imediatamente após a TC. Após um mês, observou-se redução nos domínios de impacto da IU nas limitações de atividades diárias, limitações físicas, percepção geral de saúde, emoções e sono (p < 0,05), além da redução na classificação de gravidade da IU avaliada pelo ISI (p < 0,001). Conclusão: Houve melhora da QV e diminuição da gravidade da IU em mulheres com IU submetidas à TC em grupo como primeira opção de tratamento.

Effects of Promove - Saúde da Mulher on anxiety, depression, social skills, and satisfaction: A single-subject design

Terapia Analítico-Comportamental (TAC) (in English, behavioral-analytic therapy, behavior therapy, or clinical behavior analysis) is a possible intervention for cases of anxiety and depression, but it still has much to advance in terms of efficacy and clinical utility evidence. This article aims to describe the effects of a semi-structured intervention in the model of TAC regarding anxiety and depression, behavior, complaints, and satisfaction indicators. Participants included three women with children, marital relationships, and work, aged between 34 and 41 with complaints compatible with anxiety and depression disorders. The intervention used Promove - Saúde da Mulher (PSM) (in English, Promote Women's Health), which included 17 topics, most of them related to social skills. Instruments included the GAD-7 for anxiety, PHQ-9 for depression, IHS-2 Del Prette for social skills, a Complaints Checklist for monitoring clinical demands, and an Evaluation of the Therapeutic Process to describe clients' satisfaction rates. The results from the standardized instruments were statistically analyzed via the JT method. All three participants showed reliable improvements in anxiety and/or depression, improvement in most complaints, and satisfaction with the intervention and its outcomes. Acquisition of social skills occurred in two cases. One participant dropped out and another one relapsed at follow-up. The efficacy criteria were used to evaluate the internal validity of the present study. The study collected the first evidences of outcome and satisfaction for PSM, thus enabling future investigations on the efficacy and clinical utility of this intervention program. (AU)

Study of the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder

Abstract Introduction The effects of dialectical behavior therapy on generalized anxiety disorder have not been examined to date, whereas cognitive behavioral therapy is a well-known psychotherapy for generalized anxiety disorder. Objectives This study investigated the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder. Method In the present study, 72 generalized anxiety disorder patients were randomly assigned to one of two groups: dialectical behavior therapy or cognitive behavioral therapy. Evaluations were performed at baseline, post-test, and three months after interventions as a follow-up. Measures included the Structured Clinical Interview for DSM-IV Axis I disorders, the Generalized Anxiety Disorder scale, the Beck Anxiety Inventory, the Beck Depression Inventory, the Tower of London Task, and the Wisconsin Card Sorting Task.Results: The results of the present study showed that both groups had reduced scores for depression and anxiety and increased scores for executive function after the psychotherapies. These changes were maintained at follow-up. Conclusion Although depression and anxiety symptoms were significantly reduced by cognitive behavioral therapy, dialectical behavior therapy was more effective for improving executive function.

Efectividad de la terapia cognitivo conductual para trastorno obsesivo compulsivo en pacientes con trastorno del espectro autista: Artículo de revisión / Effectiveness of cognitive behavioral therapy for obsessive compulsive disorder in patients with autism spectrum disorde: Review article

La terapia cognitivo conductual (TCC), es el tratamiento de elección para el trastorno obsesivo compulsivo (TOC), principalmente la exposición con prevención de respuesta (EPR). En pacientes que presentan TOC co-ocurrente con trastorno del espectro autista (TEA) se cree que la TCC tendría un menor efecto debido al empobrecimiento de la comprensión de las propias emociones y de la rigidez cognitiva de estos pacientes. A través de la siguiente revisión se busca evaluar la efectividad de la TCC en pacientes que tengan TOC en asociación a TEA en niños, adolescentes y adultos. Métodos: Se realizó una búsqueda de artículos, de los últimos 10 años, que abordasen la efectividad de la TCC en niños, adolescentes o adultos con TOC y TEA en conjunto. Resultados: A pesar de que no todos los estudios concuerdan en sus resultados, la mayoría de éstos, indican que hay efectividad en la TCC en disminuir la sintomatología del TOC en pacientes con TEA co-ocurrente tanto en niños como en adolescentes y adultos. Existen terapias de TCC con ciertas adaptaciones que mejorarían los resultados de estos pacientes al personalizar su tratamiento, por lo que se incentiva al mayor desarrollo de este tipo de terapias. Conclusión: Los estudios revisados respaldan que a pesar de la rigidez que presentan los pacientes con TEA co-ocurrente, la TCC es efectiva para tratar TOC en niños, adolescentes y adultos, especialmente al realizar adaptaciones de esta.

The treatment of choice for obsessive compulsive disorder (OCD) is cognitive behavioral therapy (CBT), mainly exposure with response prevention (ERP). In patients with OCD co-occurring with autism spectrum disorder (ASD), it is believed that CBT should have a lesser effect due to the impoverishment of the understanding of their own emotions and the cognitive rigidity of these patients. The following review seeks to evaluate the effectiveness of CBT in patients who have OCD in association with ASD in children, adolescents and adults. Methods: A search was carried out for articles, from the last 10 years, that addressed the effectiveness of CBT in children, adolescents or adults with OCD and ASD together. Results: Although not all studies agree on their results, most of these indicate that CBT is effective in reducing OCD symptoms in patients with co-occurring ASD in children, adolescents and adults. There are CBT therapies with certain adaptations that would improve the results of these patients by personalizing their treatment, which is why the further development of this type of therapy is encouraged. Conclusion: The reviewed studies support that despite the rigidity that patients with co-occurring ASD present, CBT is effective to treat OCD in children, adolescents and adults, especially when making adaptations to it.

Application of dialectical behavior therapy in adolescents with non-suicidal self-injury behaviors / 四川精神卫生

The purpose of this article is to analyze the effectiveness of dialectical behavior therapy （DBT） in adolescent non-suicidal self-injury （NSSI） behavioral therapy， in order to provide a reference for the intervention of NSSI behavior in adolescents in China. NSSI behavior is a common mental health threat for adolescents. In recent years， it has become a mental health problem that cannot be ignored worldwide. At present， psychotherapy is mainly used for NSSI behavior. Increasing evidence shows that DBT is effective in reducing NSSI behavior. This article summarizes the effectiveness of DBT in the treatment of NSSI behavior by describing the risk factors of NSSI behavior， an overview of DBT and the efficacy of DBT in the application of NSSI.

Advances in the efficacy of dialectical behavior therapy in the treatment of non-suicidal self-injury： evidence from brain function imaging / 四川精神卫生

This paper intends to systematically review the efficacy and imaging related studies of dialectical behavior therapy （DBT） in the treatment of non-suicidal self-injury （NSSI）， so as to provide references for DBT treatment of NSSI. NSSI has a very high incidence in the population and is a major threat to the physical and mental health of adolescents. DBT shows certain advantages in the treatment of NSSI. Previous studies have preliminarily revealed the neurological effects of DBT treatment on patients， which provides an important objective basis for the efficacy of DBT treatment. In this paper， the efficacy of DBT in the treatment of NSSI and the brain imaging evidence are described and discussed， so as to provide references for the effectiveness of DBT in the treatment of NSSI.

Assertive skills: a comparison of two group interventions with Brazilian university students

The improvement or acquisition of socioemotional skills contributes to the academic and personal adaptation of university students. The way students think about themselves and others influence their social skills and well-being. Considering the importance of social competence for professional practice in the face of new social realities, the university must invest in programs that promote the socio-emotional development of students. This study compared the effects of interventions based on Rational Emotive Behavior Therapy and Psychoeducation on assertive skills and subjective well-being. This study involved 25 undergraduate students of a public university. The students were randomly allocated to three groups, including the Control group, and they were evaluated by means of questionnaires, inventories, scales, and written evaluation of the group process. The program consisted of 10 meetings and a 6-week follow-up. Irrational beliefs were reduced and their assertive skills' scores increased in the post-intervention and follow-up evaluations, regardless of the group. Only verbal reports from participants indicated an increase in well-being. The students' written reports after the end of the meetings indicate that the two forms of intervention were evaluated as promoting change by the students. One of the limitations of the study is the size of the groups. Despite the very small sample size, the study highlights that developing a set of flexible beliefs is fundamental to the exercise of assertiveness. (AU)

Biblioterapia para medos noturnos em crianças: um estudo de caso / Bibliotherapy for nighttime fears in children: a case study / Biblioterapia para miedos nocturnos en niños: un estudio de caso

Medos noturnos na infância estão associados a ansiedade, problemas de sono e problemas de comportamento diurnos. O objetivo deste artigo é apresentar um estudo de caso de uma intervenção comportamental breve para o medo noturno severo e comportamento de dormir com os pais em uma menina de oito anos de idade. O tratamento consistiu em uma sessão em que os pais foram orientados a ler o livro Dormindo com Rafi: Boa Noite Filhote para sua criança por um período de quatro semanas e a encorajá-la a conduzir uma série de rotinas pré-sono e dormir sozinha. Medo noturno, padrões de sono e problemas de comportamento foram avaliados com medidas de relato parental. A menina também foi questionada para reportar seus medos noturnos por meio de uma escala visual analógica. Verificou-se aumento no número de noites em que a criança dormiu em sua própria cama e redução dos medos noturnos. Os efeitos positivos no pós-tratamento foram mantidos no seguimento de três meses. O presente estudo fornece suporte inicial para o uso desta breve intervenção, que empregou princípios comportamentais básicos, como modelação, modelagem e dessensibilização sistemática no tratamento de medos noturnos em crianças.(AU)

Nighttime fears in childhood are associated with anxiety, sleeping problems, and daytime behavioral problems. This article presents a case study of a brief intervention for severe nighttime fears and co-sleeping problems in an eight-year-old girl. The treatment consisted of instructing the parents to read the book Dormindo com Rafi: Boa Noite Filhote (Sleeping with Rafi: Good Night, Darling) to their daughter for a four-week period, besides encouraging her to adopt a bedtime routine and to sleep on her own. Nighttime fear, sleep patterns, and behavioral problems were assessed with parent-report measures, and the girl was asked to track her nighttime fears using a visual analogue scale. The results showed an increase in the number of nights the child slept in her own bed and a reduction of nighttime fears, which were maintained at the 3-month follow-up. This study provides initial support for the use of this brief intervention that enlisted basic behavioral principles such as shaping, modeling, systematic desensitization, and reinforcement in the treatment of nighttime fears in children.(AU)

Los miedos nocturnos en la infancia están asociados a la ansiedad, a los problemas de sueño y a los problemas de comportamiento diurno. El objetivo de este artículo es presentar un estudio de caso de una intervención conductual breve para el miedo nocturno severo y comportamiento de dormir con los padres de una niña de 8 años de edad. El tratamiento consistió en una sesión en la que se orientó a los padres a leer el libro Dormindo com Rafi, Boa Noite, Filhote! ("Durmiendo con Rafi: buenas noches, mi hijo") para su hija, por un período de cuatro semanas, y la alentasen a conducir una serie de rutinas de presueño y a dormir sola. El miedo nocturno, los patrones de sueño y los problemas de comportamiento fueron evaluados con medidas de relato parental. Los miedos nocturnos de la niña también se evaluaron por una escala visual analógica. Se verificó un incremento de la cantidad de veces en que la niña durmió por las noches en su propia cama y una reducción de sus miedos nocturnos. Los efectos positivos en el postratamiento se mantuvieron tras tres meses. Este estudio proporciona soporte inicial para el uso de esta breve intervención que empleó principios comportamentales básicos, como modelado, desensibilización sistemática y refuerzo en el tratamiento de miedos nocturnos en niños.(AU)

Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method

Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a "full-package" treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety - a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.

A single-case quasi-experimental design of functional analytic psychotherapy for substance abuse / Um delineamento quase-experimental de caso único da psicoterapia analítica funcional para abuso de substâncias / Un diseño de caso único cuasi experimental de psicoterapia analítica funcional para abuso de sustancias

This study evaluated the effectiveness of Functional Analytic Psychotherapy (FAP) on clinically relevant behaviors (CRBs) in the context of substance abuse/chemical de pendence and identifying the therapeutic components of change. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to categorize therapist and client behaviors, and Timeline Followback was used to record drug abuse. Two participants were treated in a single case A/A + B quasi-experimental design, in which A = analytical-behavioral therapy and A + B = FAP. The results showed that with the introduction of FAP, specifically the therapist's contingent responding to the participant's progress, there was a decrease in the use of substances after three months for both participants. The participant who spent more time in psychotherapy experienced greater benefits at follow-up and a larger reduction in drug use. We concluded that FAP altered CRBs by positively reinforcing progress in-session and was significantly correlated with improvement out-of-session.

O objetivo da pesquisa foi avaliar o efeito da Psicoterapia Analítica Funcional (FAP) sobre os comportamentos clinicamente relevantes (CRBs) e abuso de substâncias de dependentes químicos e identificar os componentes terapêuticos de mudança. Foram utilizados os instrumentos Functional Analytic Psychotherapy Rating Scale para categorização de comportamentos do terapeuta e cliente e Timeline Followback para registrar o abuso de drogas. Dois participantes foram atendidos em um delineamento quase-experimental de caso único A/A+B, onde A = Terapia Analítico-Comportamental e A+B = FAP. Os resultados indicaram que a introdução da FAP, em especial o responder contingente do terapeuta, acompanhou os progressos e houve melhora no consumo de substâncias após 3 meses para ambos. O participante que se manteve mais tempo em psicoterapia obteve maior benefício no follow-up e no consumo de drogas. Concluiu-se que a FAP alterou CRBs reforçando positivamente progressos em sessão e que isto provavelmente se correlacionou com melhoras extrassessão.

El objetivo fue evaluar el efecto de la Psicoterapia Analítica Funcional (FAP) en los comportamientos clínicamente relevantes (clinically relevant behaviors - CRBs) e el abuso de sustancias de dependientes químicos, e identificar los componentes terapéuticos de cambio. Se utilizaron Functional Analytic Psychotherapy Rating Scale, para clasificar los comportamientos del terapeuta y del cliente, y timeline followback, para registrar el abuso. Dos participantes fueron evaluados a través de un diseño cuasiexperimental de caso único A/A + B, donde A = terapia analítico-comportamental y A + B = FAP. Los resultados indicaron que la implementación de la respuesta contingente del terapeuta llevó a cambios en las CRBs y mejorías en el consumo de sustancias en los dos participantes después de tres meses de intervención. El participante que se mantuvo más tiempo en psicoterapia obtuvo mayor beneficio durante el seguimiento. Se concluye que FAP modificó las CRBs a través del reforzamiento positivo en sesión, lo que se relacionó con las mejoras fuera de sesión.