A cohort study of engagement in telehealth psychotherapy versus in-person services.

Objective: Although telehealth psychotherapies have been studied for over 20 years, mental health services remained largely delivered in person until the COVID-19 pandemic forced clinics to reconsider the utility of telehealth psychotherapy. This study aims to compare patient engagement in in-person versus telehealth services in outpatient psychotherapy for mood and anxiety disorders.

Method: A cohort investigation was conducted, using a propensity score matched sample, extracted from an electronic health record (EHR) to compare engagement in psychotherapy for 762 patients who used in-person services before the pandemic to a cohort of 762 patients who used telehealth psychotherapy after the onset of COVID-19.

Change over time in brain serotonin transporter binding in major depression: effects of therapy measured with [(123) I]-ADAM SPECT.

Several studies have reported low brain serotonin transporter (SERT) binding in individuals with major depression. We hypothesized that the SERT standardized uptake ratio (SUR) values using [(123) I]-ADAM single photon emission computed tomography would increase in depressed subjects who responded to cognitive behavior therapy (CBT) compared to CBT nonresponders. [(123) I]-ADAM scans were acquired before and after 12 weeks of CBT from 20 depressed subjects and on two occasions 12 weeks apart from 10 nondepressed, healthy volunteers.

Research setting versus clinic setting: Which produces better outcomes in cognitive therapy for depression?

Objective: To compare the outcomes of cognitive therapy for depression under controlled and clinically representative conditions, while holding several therapist and clinical assessment factors constant.

Method: Treatment outcomes for a sample of 23 adults with a primary diagnosis of Major Depressive Disorder who received cognitive therapy in an outpatient clinic were compared with outcomes of 18 clients who were treated in the cognitive therapy condition of a large, multi-site randomized clinical trial of treatments for depression. All participants had been treated by one of two therapists who served as clinicians in both settings.

Training Cognitive Behavioral Therapy Supervisors: Didactics, Simulated Practice, and "Meta-Supervision".

The delivery of competent clinical supervision is vital to the successful training of new cognitive behavioral therapists, and-in the case of peer supervision and consultation-a boon to the maintenance of therapists' high professional standards throughout their careers. However, it is only recently that the field of psychotherapy in general and cognitive behavioral therapy (CBT) in particular has implemented formal methods of training clinicians to be competent supervisors. Drawing on recent findings from evidence-based programs of CBT supervision, this article highlights the contents and processes of a graduate training course in CBT supervision involving didactics, readings, and experiential exercises.

The Dynamics of Self-Esteem in Cognitive Therapy for Avoidant and Obsessive-Compulsive Personality Disorders: An Adaptive Role of Self-Esteem Variability?

Self-esteem variability is often associated with poor functioning. However, in disorders with entrenched negative views of self and in a context designed to challenge those views, variable self-esteem might represent a marker of change. We examined self-esteem variability in a sample of 27 patients with Avoidant and Obsessive-Compulsive Personality Disorders who received Cognitive Therapy (CT).

Competency in conducting cognitive-behavioral therapy: foundational, functional, and supervisory aspects.

The delivery of cognitive-behavioral therapy (CBT) is described in terms of foundational and functional competencies, with additional attention paid to how these skills are applied in clinical supervision. Foundational competencies include such qualities as ethical behavior, good interpersonal relational skills, a healthy capacity for self-awareness and self-correction, cross-cultural sensitivity, and an appreciation for the empirical basis of clinical procedures. Functional competencies include the ability to think like an empiricist and to teach clients to do the same, to conceptualize cases in terms of maladaptive beliefs and behavioral patterns, to structure sessions in an organized and time-effective manner, and to assign and review homework assignments.

Medial prefrontal cortex hyperactivation during social exclusion in borderline personality disorder.

Frontal systems dysfunction and abandonment fears represent central features of borderline personality disorder (BPD). BPD subjects (n=10) and matched non-psychiatric comparison subjects (n=10) completed a social-cognitive task with two confederates instructed to either include or exclude subjects from a circumscribed interaction. Evoked cerebral blood oxygenation in frontal cortex was measured using 16-channel functional near infrared spectroscopy.

Photochemical generation and reactivity of the 5,6-dihydrouridin-6-yl radical.

Nucleobase radicals are the major family of reactive intermediates formed when nucleic acids are exposed to hydroxyl radical, which is produced by gamma-radiolysis and Fe.EDTA. Significant advances have been made in understanding the role of nucleobase radicals in oxidative DNA damage by independently generating these species from photochemical precursors.

Regulation of orthogonal functions in a dual catalyst system. Subservient role of a nonchiral Lewis acid in an asymmetric catalytic heteroatom Diels-Alder reaction.

A catalytic asymmetric heteroatom Diels-Alder reaction of unactivated imines with Danishefsky’s diene is described which gives high asymmetric induction for N-benzhydryl imines derived from a variety of aldehydes. The catalyst is derived from B(OPh) and the VAPOL ligand and gives good induction but the reaction stalls and does not give high conversion (~50%). It was found that in the presence of the both the chiral catalyst and excess amounts of B(OPh) the reaction proceeds to completion and gives high yields of the dihydropiperidinone product.

Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive-compulsive personality disorders.

Participants were 30 adult outpatients diagnosed with avoidant personality disorder or obsessive-compulsive personality disorder who enrolled in an open trial of cognitive therapy for personality disorders. Treatment consisted of up to 52 weekly sessions. Symptom evaluations were conducted at intake, at Sessions 17 and 34, and at the last session.

Hypothesized mechanisms of change in cognitive therapy for borderline personality disorder.

Preliminary evidence suggests that cognitive therapy (CT) is effective in treating borderline personality disorder (BPD). According to cognitive theory, BPD patients are characterized by dysfunctional beliefs that are relatively enduring and inflexible and that lead to cognitive distortions such as dichotomous thinking. When these beliefs are activated, they lead to extreme emotional and behavioral reactions, which provide additional confirmation for the beliefs.

Cognitive therapy for chronic depression.

Recent literature indicates that there are important clinical differences between chronic and non-chronic depression. This article considers the implications of these differences when conducting cognitive therapy (CT) with chronically depressed patients. CT with chronic patients requires a greater emphasis on combating hopelessness, helplessness, and perfectionism, addressing early life-adverse experiences, and modifying maladaptive schemas.

A cognitive perspective on resistance in psychotherapy.

The phenomena that comprise resistance in therapy are described and discussed from a cognitive viewpoint. The cases of Brian, Julie, and Victoria are reviewed to illustrate similar and contrasting manifestations of resistance, and suggestions for further individualized conceptualization and intervention are presented. Emphasis is placed on gaining an accurate, empathic understanding of the client's difficulties in changing.

A case illustration of resistance from a cognitive perspective.

Brian, a 36-year-old, single, white male, entered cognitive therapy in response to a depressive episode precipitated by the loss of a job. In addition to his Major Depression, the client met diagnostic criteria for Dysthymia and Personality Disorder Not Otherwise Specified. The first three sessions focused on Brian's unemployment crisis and related dysphoria, as well as his passive-avoidant approach to life.