Exploring the role of CBT in the self-management of type 2 diabetes: A rapid review

Background: Type 2 diabetes has been recognised as a global health concern: one that requires intervention to lessen the incumbrance caused by the chronic illness. This rapid review was conducted to determine the scientific evidence available on how Cognitive Behaviour Therapy (CBT) interventions improved the self-management of individuals with type 2 diabetes. Aim: The aim of the review was to synthesise current scientific evidence regarding CBT-based interventions and self-management practices. Method: The rapid review served as a framework to appraise current national and international literature. The researchers used Google Scholar, Journal Storage (JSTOR), PsycINFO, APA PsycArticles, SAGE journals and EBSCO Discovery Services to search for relevant studies. This was performed by employing keywords. Nine relevant studies were identified. The studies were heterogenous in methodology. Seven of the nine studies were conducted in developing countries. Results: The study found that the context of developmental countries plays a significant role in the development of type 2 diabetes and requires tailored intervention because of socio-economic variabilities. The main themes identified in relation to improving self-management included: the characteristics of the CBT-based interventions, namely the format, duration, and outcomes, and identifying the techniques and components used in the CBT-based interventions. Conclusion: The review emphasised the need to further investigate the role of CBT in improving self-management of type 2 diabetes, especially in a South African context.

Effectiveness Of Cognitive Behaviour Therapy in managing Rumination And Insomnia among adolescent girls

Background: The present study attempts to study the effectiveness of cognitive behaviour therapy in managing rumination and insomnia among adolescent girls from the Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore. Methodology: 200 students from undergraduates were screened for their level of Rumination and Insomnia using Ruminative Response Scale and Insomnia Inventory. Out of 200, 120 students with high and average level of Rumination and Insomnia were selected using random sampling technique. Cognitive Behaviour Therapy was given to manage Rumination and reduce Insomnia for the adolescent girls. Results: The age range is 17 to 18 years. Pearson correlation, mean and standard deviation and ‘t’ test was computed to analyse the data. The results indicate that there was a positive correlation between rumination and insomnia and significant difference in managing rumination and insomnia among the adolescent girls proving the effectiveness of Cognitive Behaviour Therapy. Conclusion: Cognitive Behaviour Therapy is an effective therapy for the management of insomnia and rumination in adolescent girls and further studies in this area are needed.

Effectiveness of Cognitive behavior therapy of panic disorder in adults: A naturalistic study from a Medical College Hospital

Background: Panic disorder is the most prevalent among anxiety disorders in psychiatry clinics. Randomized controlled trials and open studies in research settings and studies from naturalistic settings have proved the efficacy and effectiveness of cognitive behavior therapy (CBT) for panic disorder (PD). Panic disorder responds in only a few CBT sessions. In India studies in this regard are practically non-existent. Materials and methods: This study was a part of study titled “The utilization pattern and effectiveness of Cognitive Behavior Therapy for anxiety disorders in adults: A naturalistic study from a medical college hospital”. Out of 80 anxiety disorder patients taken for study, 26 PD patients attended at least one CBT session. In these 26 patients‟ pre and post CBT scores on Panic Disorder Severity Scale (PDSS) were assessed and analyzed for clinically significant change (CSC) and response rate. Effect size, refusal and dropout rates were assessed. Results: Pre and post PDSS score reduction was statistically significant at P<0.5. Large effect size of 1.78 was noted. Though 30% of patients were on medication, they were stably on same medication throughout the evaluation. CSC, as defined by twin criteria proposed by Jacobson and Truax, was noted in 57% of patients. In the intent to treat analysis number needed to treat to achieve CSC/recovery was about four. Response (defined as 40% reduction in PDSS rating) rate was 88%. There was about 50% CBT refusal rate. Conclusions: This open prospective naturalistic study shows that CBT of panic disorder can be effective, when it is conducted by a psychiatrist who has not received rigorous training from certified Sylvester Satish Romero, Sudhir Hebbar. Effectiveness of Cognitive behavior therapy of panic disorder in adults: A naturalistic study from a Medical College Hospital. IAIM, 2018; 5(10): 44-49. Page 45 training centers. Effect size is comparable to that observed in other settings. CBT can be integrated along with medications for PD in general hospital psychiatry setting. Response and recovery can be obtained in as few as 5 sessions. More than half of treatment seeking panic disorder patients refused to take cognitive behavior therapy reducing its effectiveness.

Aaron Temkin Beck

Background: Aaron Beck is one of the pioneers in the field of psychiatry and a contemporary psychiatrist who played a seminal role in the development of ‘cognitive behaviour therapy’ for depression. He is regarded as ‘father of cognitive therapy’ and contributed his research on psychotherapy, psychopathology, study of suicide and various rating scales.

Effectiveness of Group Cognitive Behaviour Therapy Augmentation In Reducing Negative Cognitions In The Treatment Of Depression In Malaysia

Objective: Cognitive Behaviour Therapy (CBT) for depression is popular in Western countries. In the context of Malaysia, CBT has been applied as an individual session in a clinical setting. However, there is limited research in the area of group CBT for depression among Malays. The aim of this study is to investigate the effectiveness of Group Cognitive Behavioural Therapy (GCBT) in reducing the negative cognitions that are related to depression in a group of Malay patients. Methods: One hundred and thirteen patients, diagnosed with depression, were randomly allocated to either a Treatment As Usual (TAU) group (n = 55), or a TAU plus GCBT group (n = 58). All participants completed two questionnaires that measured maladaptive cognitions at pre-treatment, midway through treatment, post-treatment (week 4), and at follow-ups after three (week 16) and six months (week 28). Results: The TAU+GCBT patients improved significantly more, and at a faster rate, than the TAU group; which showed minimal improvement. The effect size (Cohen’s d) of the treatment group was 0.93 and 96.55% of the treatment group achieved a clinically significant change. Conclusions: The findings suggest that GCBT, when used in addition to the TAU, is effective in reducing negative thoughts and maladaptive attitudes of Malaysian patients suffering from depression.

Yoga and Cognitive Behaviour Techniques for Academic Stress and Mental Wellbeing among School Students.

There are many stressors acting upon school children. Today in the era of increasing competitiveness,a child is overloaded with daily living stresses, and he lives a tight rope existence trying to cope up with the tremendous pressures from all institutions, whether it is school, family or society. These are resulting in various stress related ailments and psychological problems, which poses threat and challenges for the physical as well as mental wellbeing of the school going children. The present work was an attempt to measure one of the major source of stress,i.e. academic stress and mental wellbeing of a sample of school children and then to provide an intervention plan for a selected group of students who are having high academic stress and poor mental wellbeing. Certain specific Asanas, Mudras and Pranayams of Yoga were combined with some specific techniques of Cognitive Behaviour therapy (C.B.T.) to reduce the academic stress and to enhance the mental wellbeing of the selected group of school children. The results have shown a significant relief from academic stress and significant improvement in the mental wellbeing of these children. Detailed methodology and results are discussed in this paper. This paper highlights the efficacy of Yoga in combination with certain techniques of C.B.T. in enhancing overall wellbeing of school children.

Effectiveness of Different SSRI Antidepressants in Combination with CBT for Short-term Management of Panic Disorder

Objective: This paper reports the result of an analysis of data of brief therapy for out-patients with panic disorder reffered by physicians in a busy specialist hospital in Kuala Lumpur. Methods: The patients were randomly assigned into different groups of SSRI (Specific Serotonin Reuptake Inhibitor) antidepressants i.e. escitalopram, setraline, or fluoxetine. All patients received cognitive behaviour therapy (CBT). The therapy was aimed for a maximum of twelve sessions. There were 33 patients in the escitalopram group, 31 patients in the setraline group, and 31 patients in the fluoxetine group. Results: the result shows that all the groups were similar in the severity and scores for pre-treatment but for post-treatment, there were significant differences among them. Conclusion: All groups showed significant improvements in all modalities of measurements. However, the escitalopram and setraline groups showed faster overall improvement compared to the fluoxetine group.