[New questionnaire to evaluate psychological treatment effects]. / Proposta di un nuovo strumento per la verifica dell'efficacia nella pratica dei trattomenti psicologici e psicoteropeutici.

A new questionnaire named CBA-VE (Cognitive Behavioral Assessment for outcome evaluation) was developed to evaluate psychological treatment intervention--especially for counseling and psychotherapy. The questionnaire has 80 items and a 5 point Likert-like scale ranging from 1 = nothing to 5 = a lot. The aim of this study was to evaluate the validity and the reliability of the five constructs of the questionnaire both in normal and clinical subjects. Participants. Two samples were analyzed: a "Normal" group composed of 250 normal adults plus 51 university students; and a "Clinical" group including 261 adults undergoing psychotherapy and psychological counseling provided by the public health service. The questionnaire includes five scales: three of them are related to important psychological aspects (anxiety, depression, and psychological distress); the remaining two are measurements of psychological wellbeing and self-perception of a positive change. The questionnaire has excellent psychometric characteristics, both for normal and clinical subjects. We observed a good reliability, good internal consistency, and an excellent structural validity for the five interrelated dimensions. The normalized factorial loadings are consistent, significant (from around 0.6 up), and similar in both the groups. The so-called Clinical group showed higher scores in anxiety, depression, and psychological distress and smaller scores in wellbeing and change perception. This is coherent with what the authors assumed a priori.

[Usefulness and effectiveness of group cognitive-behavioral psychotherapy and mutual support group therapy for depressed caregivers of psychiatric patients]. / Applicabilità ed efficacia della psicoterapia cognitivo-comportamentale e dei gruppi di Auto-Mutuo Aiuto nei caregivers depressi di pazienti psichiatrici.

The trend towards community-based mental health services and the de-institutionalization of psychiatric patients has led to a clear shift of the caring burden from health and welfare services to the families. Studies that have addressed the effect of this burden on caregivers have mostly focused on the extent of psychological distress and its link with the psychiatric patient; only a few have addressed the risk that caregivers run of is two to three times higher in caregivers of psychiatric patients than in the general population. In particular, there is evidence that the rate of depressive symptoms among caregivers of severe psychiatric patients ranges from 38% to 60%; these family members often go untreated. There is a great need for intervention and research in this field, in order to effectively prevent and treat depressive symptoms and reduce burden in caregivers. We developed a manualized treatment program, based on a cognitive-behavioural approach and administered in two different group conditions, namely psychotherapy and mutual support. In this paper, we examine the relative efficacy of group cognitive-behavioral therapy (CBT) and mutual support group therapy (MST) in reducing depressive symptoms and caring burden. Caregivers depressed or at risk of depression (N = 40) were randomly assigned to a CBT or a MST group, led respectively by 2 psychotherapists and 1 psychologist-facilitator. Before and after intervention, all participants were individually assessed with the Beck Depression Inventory and Family Problems questionnaire. Both the CBT and MST therapies produced reductions in depression score, though in the MST groups the trend was not significant. Nevertheless, analysis of the clinical significance of change in the BDI score for each subject showed an improvement in 58.3% of depressed caregivers treated with CBT and in 45.4% of those treated with MST. Differently from CBT, MST produced an improvement in two dimensions of family burden.

A computerized approach to cognitive behavioural assessment: an introduction to CBA-2.0 primary scales.

The Cognitive Behavioural Assessment-2.0 (CBA-2.0) Primary Scales is an automated assessment package investigating the cognitive-verbal response system. It consists of: (1) self-reports and questionnaires aimed at identifying and specifying patients' problems; (2) a group of programs and logical rules, implemented on personal computers, providing an editor with items, questionnaire scoring and an analysis of responses; (3) an intelligent program which analyzes the responses emerging from the questionnaires and forms hypotheses for the selection of Secondary Scales and for further assessment. The package is part of a research project aimed at reducing part of the decision-making process to an operational language and simulating behavioral therapists decisions in cases of clinical assessment.