Dissertations / Theses: 'Cognitive-behavioral therapy'

1

Edwards, Emily A. "GROUP COGNITIVE BEHAVIORAL THERAPY OVER INDIVIDUAL COGNITIVE BEHAVIORAL THERAPY? A META-ANALYSIS OF EFFECTIVE TREATMENT OF ANXIETY DISORDERS IN MIDDLE CHILDHOOD." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/236.

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Anxiety is a commonly diagnosed disorder in middle childhood that affects many aspects of the child’s life. Effective treatment is needed so that children are able to experience fewer or no symptoms of anxiety and to manage anxiety. Cognitive behavioral treatment (CBT) is widely used as a treatment for children with anxiety. CBT can either be facilitated in an individual or group format but there are inconsistencies in the literature regarding which modality is most effective. A meta-analysis was conducted to compare the effectiveness of individual CBT (ICBT) and group CBT (GCBT) in treating school-aged children with anxiety disorders. Eligible studies focused on the Coping Cat program for ICBT or GCBT programs such as FRIENDS. Participants from the selected studies were between the ages of 5-12 years and were treated by either ICBT or GCBT. Effect sizes were calculated from post-intervention measures and combined to examine group differences. It was found that ICBT was associated with a very large effect size (1.05) and GCBT (0.54) had a large effect size. This suggests that ICBT is the superior treatment modality as children who received individualized treatment reported a greater reduction or elimination of anxiety symptoms. Individual treatment allows opportunity for the therapist to work with the child and their families whereas in GCBT, there is less time to create treatment plans that are uniquely tailored. A proposed ICBT program is outlined that addresses a richer family component and social skills training.

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Cavallini, Adriane Ito de Queiroz. "Sudden Gains in Cognitive-Behavioral Therapy for Eating Disorders." BYU ScholarsArchive, 2010. https://scholarsarchive.byu.edu/etd/2466.

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The present study examined whether or not the temporal pattern of symptom change defined as sudden gains is applicable to and has significant ramifications for understanding recovery from eating disorders. Sudden gains were defined as stable and clinically significant changes that take place between two sessions of treatment. Data for the current study were drawn from an efficacy study of CBT for eating disorders which included session-by-session measures of eating disorder symptomatology. Predictors of sudden gains were measured by an observer coded scale that included ratings of therapist use interventions, client change in behaviors and beliefs, client engagement, and homework completion. Three research questions were addressed: First, is the phenomenon of sudden gains present in CBT for eating disorders? Second, do sudden gains in CBT for eating disorders follow the three-stage model proposed for sudden gain recovery in other disorders (i.e., cognitive changes during critical sessions => sudden gains => upward spiral that includes further cognitive changes and greater long-term symptom improvement (Tang & DeRubeis, 1999b)? Third, what are the predictors of sudden gains in CBT for eating disorders that distinguish the critical session that takes place right before the sudden gain? Findings suggest that many eating disordered clients (62%) experienced at least one sudden gain during the course of CBT treatment. Three distinct types of sudden gains were identified: total symptom sudden gains, eating-related sudden gains, and body-related sudden gains. The average magnitude of these sudden gains was large representing on average 35% of total symptom improvement. Clients who experienced total symptom and body-related sudden gains demonstrated fewer eating disordered symptoms than the other clients at posttreatment. During the session preceding the sudden gain, therapists had increased levels of cognitive interventions and empathy, and clients experienced more cognitive changes and increased motivation.

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Gortner, Eric Tomas. "Cognitive-behavioral treatment for depression : relapse prevention /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/9041.

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Whelen, Megan L. "Positive and Negative Affect in Cognitive Behavioral Therapy for Depression." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586452794797565.

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Au, Yeung Wai-yin, and 歐陽慧賢. "The application of cognitive-behavioral procedures in probation setting." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1987. http://hub.hku.hk/bib/B31247763.

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Cecchettini, Paul David. "Cognitive-behavioral therapy with depressed, involuntarily confined mentally retarded individuals." Scholarly Commons, 1993. https://scholarlycommons.pacific.edu/uop_etds/2764.

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The purpose of this study was to examine whether cognitive-behavioral therapy could be effective in alleviating depression in mildly mentally retarded or borderline intelligence individuals. It was hoped this would prove to be a viable alternative or adjunct to medical interventions in treating depression with this population. Subjects participated in one of two cognitive-behavioral groups for 12 weeks. Two other treatments (two exercise and two structured, talk-oriented groups) served as control groups; these group members had the same daily routine as individuals in the treatment group. Control group subjects were also administered the same pre- and post-test. Seventy-three subjects were referred to participate, all on a volunteer basis. Subjects resided at the Stockton Developmental Center. All subjects were at the Center involuntarily, with 39 percent committed to the Center due to penal code violations. The Beck Depression Inventory (BDI) was used as a pre-screening device, and subjects scoring in the clinical ranges of depression on the BDI were included in the study. Fifty-eight subjects met pre-screening criteria and were included. Based on BDI scores, subjects were assigned to one of three ranges of depression specified for the BDI. Subjects in each range were then matched on BDI scores and randomly assigned to the treatment groups. The pre- and post-test measure was the Emotional Problems Scales, which include both a personality inventory with questions answered by each individual and a behavior rating scale answered by the individual's primary counselor. Scores on depression and related scales were examined through the multivariate analysis of variance procedure. Forty-nine subjects were included in the final statistical analysis. There was no significant finding across groups for a decrease in depression or for other variables. No treatment proved more effective than any other. An examination of subject characteristics for those demonstrating the highest levels of improvement following treatment found that subjects with scores initially in the extremely severe range on depression were most likely to evidence change in a positive direction. Those who demonstrated improvement in the cognitive-behavioral groups tended to have IQ's over 62.

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Au, Yeung Wai-yin. "The application of cognitive-behavioral procedures in probation setting /." [Hong Kong : University of Hong Kong], 1987. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12341733.

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Levin, Laura. "Adolescent Interpersonal Predictors of Early Therapeutic Alliance in Cognitive-Behavioral Therapy." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/701.

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This study examined interpersonal predictors of early therapeutic alliance in a cognitive-behavioral treatment study for adolescents with anxiety and/or depressive disorders. Client, therapist, and observer rated measures of alliance were obtained from the third session of treatment in a sample of twenty-seven adolescents. Results indicate that alliance ratings across the three perspectives are significantly associated with one another, but that pretreatment interpersonal variables were differentially associated with varying informant perspectives. Adolescents’ perceptions of their relationships to their caregivers positively related to their perceptions of the therapeutic alliance, such that adolescents with more positive representations of relationships with their attachment figures were more likely to endorse stronger working alliances early in treatment. Adolescent-reported symptom severity at pretreatment predicted observer ratings of alliance, such that adolescents who indicated greater symptoms at pretreatment were rated as having stronger early alliances with their therapists by independent observers. Adolescent perceptions of social support also predicted observer ratings of alliance. Therapists perceived having weaker alliances with adolescents showing clinically significant depression, as compared to adolescents diagnosed with anxiety disorders alone. Future research is needed to examine whether identification of relevant interpersonal factors can help improve therapeutic engagement and outcomes for the psychosocial treatment of adolescents with anxiety and depressive disorders.

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Brauhardt, Anne, Zwaan Martina de, Stephan Herpertz, Stephan Zipfel, Jennifer Svaldi, Hans-Christoph Friederich, and Anja Hilbert. "Therapist adherence in individual cognitive-behavioral therapy for binge-eating disorder." Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-215587.

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While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials.

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Duverge, Marielle V. "Adherence in family cognitive behavioral therapy among youths with anxiety disorders." FIU Digital Commons, 2006. http://digitalcommons.fiu.edu/etd/3110.

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The purpose of this thesis was to assess the agreement between youths and therapists on homework adherence. Kappas were computed for sessions 4 through 12. Agreement ranged from poor (κ = .22) in session 4 to excellent (κ = .83) in session 6, with percent agreement ranging from 69.9% to 95.6%. All other sessions fluctuated from excellent to fair to good. Additionally, homework completion was examined as a function of youth characteristics according to both reporters. An independent sample t-test determined there were no significant differences in percent completion according to both reporters, except for parent income according to therapists. Possible explanations for discrepancies in agreement are discussed. It is suggested that in order to avoid discrepancies between youth and therapist reports, it may be necessary for therapists to clearly set rules and enlist the help of parents in order to ensure homework completion throughout therapy.

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Manchaiah, Vinaya, Eldre Beukes, Elizabeth Parks Aronson, Maria Munoz, Gerhard Andersson, and Marc A. Fagelson. "Internet-based Cognitive Behavioral Therapy (ICBT) for Tinnitus in the U.S." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/7814.

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Objectives: Although tinnitus is one of the most commonly-reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related accessibility of care, and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence- based interventions are necessary. This presentation focuses on the adaptation of an Internet-based Cognitive Behavioral Therapy (ICBT) intervention, originally used in Sweden and in the UK, for individuals with tinnitus in the United States. Elements of the ICBT program requiring consideration included (a) adaptations to the platform’s features and functionalities, (b) translation into Spanish to extend the reach of the program (c) user acceptability and satisfaction of the program, (d) outcomes from a pilot trial from which it was hypothesized that patients would demonstrate a reduction in tinnitus distress and associated difficulties as measures using standardized self-reported outcome measures, and (e) discussion of the relative merits and appropriateness of the intervention. Design: The iTerapi platform developed in Sweden was adopted for use in the US. The platform required functional and security features modifications to confirm its compliance with both institutional and governmental regulations, and to ensure it was suitable for the US population. Acceptability and suitability of the materials were evaluated by both hearing healthcare professionals (n=11) andindividuals with tinnitus (n=8). A pilot study followed as adults with bothersome tinnitus completed the 8-week program (n=30). Results: Cultural adaptations included word substitutions, adapting counseling examples for a US population, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured the suitability of the chapters. Literacy level analysis confirmed all chapters were within the guidelines to be below the 6th grade level for readability. Healthcare professionals and individuals with tinnitus reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability and exercises provided in the ICBT platform. Preliminary analyses of pilot data indicated a reduction in tinnitus distress and associated difficulties (i.e., anxiety, depression, insomnia) and an improvement in quality of life. Conclusions: Ensuring that the ePlatform offers the appropriate features and functionalities for the intended population is an essential part of developing Internet-based intervention. The user evaluations and pilot trial outcomes indicated that clinical trials can be performed to assess the effectiveness of ICBT for tinnitus in the US.

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Diserio, Theresa R. "Effects of developmental level on outcome with Kendall's cognitive behavioral therapy /." The Ohio State University, 1989. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487673114113847.

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Schmidt, Iony Danielle. "Predictors of Treatment Dropout in Computerized Cognitive Behavioral Therapy for Depression." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1491509588836769.

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Hilbert, Anja, Stephan Herpertz, Ross D. Cosby, Stephan Zipfel, Hans-Christoph Friedrich, Andreas Mayr, Brunna Tuschen-Caffier, and Martinade Zwaan. "Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder." Elsevier, 2019. https://ul.qucosa.de/id/qucosa%3A75708.

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Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change—including moderate and low decreasing—as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.

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Johnson, Patrick R. "The cognitive behavioral treatment of chronic headache : group versus individual treatment format /." The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487260531956491.

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Troughton, Leonard Charles Wiedow. "Implementation of a cognitive-behavioral-based intervention for students with emotional/behavioral disorders." Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6513.

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The purpose of this study was to determine if there was a functional relation between the Cognitive-Behavioral Therapy-Based intervention curriculum, Tools for Getting Along (Smith & Daunic, 2012), and Externalizing Behaviors exhibited by students with EBD served in special education. Four students, nominated by their teacher and principal and receiving services in special education for behavioral goals addressing Externalizing Behaviors, participated in this single-subject, multiple-baseline study. Data collected to answer the research question were Systematic Direct Observations, Direct Behavior Ratings, The Strengths and Difficulties Questionnaire (Goodman, 1997), and the Social Problem-Solving Inventory-Revised (D’Zurilla et al. 2002). Participants began receiving Tools for Getting Along instruction in staggered intervals based on their baseline SDO, DBR, and consulting with their special education teacher. The SDQ and SPSI-R:S were administered pre- and post-intervention. Data indicated that although two students showed some improvements on DBR, there was not a functional relation between TFGA and Externalizing Behaviors. However, SDQ and SPSI-R:S sub-scale data did indicate some individual improvements. In addition to individual participant improvements, a number of implications for future research were noted from social validity data completed by the special education teacher, treatment fidelity observations, and in order to address the limitations of the study.

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Williams, Tracee Felice. "The Effect of Cognitive Behavioral Therapy and Chiropractic Care on Stress Reduction." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4581.

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Decreasing the impact of stressors on the body remains an important area of study for the affected population. While there is evidence showing that cognitive behavior therapy (CBT), a psychotherapy approach, results in decreased stress, little was found about the effects of chiropractic treatment (CC) on stress. The purpose of this quantitative archival study was to determine whether the combination therapy of CC and CBT was more effective in decreasing stress than CBT independently. Cognitive neuropsychology served as the theoretical lens. Client data from a mental health and chiropractic care center on the West coast (N = 112) were divided into 2 treatment groups, CBT and CC and CBT alone. Pre and posttreatment data were collected on stress, anxiety, and nerve conduction. ANOVA test results indicated that there were no statistically significant differences in the mean change scores between the 2 groups in terms of individual participants' stress, anxiety, and nerve interference. Although there was no significant interaction effect, results showed that both the combination therapy and CBT alone led to a decrease in stress and anxiety and an increase in the nerve conduction of participant's posttreatment. While this archival study did not yield evidence of the benefits of CC for stress-related disorders, its results suggest that future researchers should pursue more direct efforts to evaluate the effects of combination therapies. Considering the high number of people who experience stress-related challenges, the incorporation of CC along with a psychological treatment might engender positive social change for individuals and healthcare practitioners through the potential reduction of stress.

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Brenjo, Tea. "Patient Characteristics as Predictors of Group Climate in Cognitive-Behavioral Group Therapy." Thesis, Norges teknisk-naturvitenskapelige universitet, Psykologisk institutt, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-18210.

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Calamaras, Martha R. "Evaluating Changes in Attentional Biases following Cognitive Behavioral Therapy for Social Phobia." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/psych_theses/79.

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The purpose of the current study was to evaluate changes in attentional biases following CBT for Social Phobia. It was found that 1.) consistent with previous investigations, the overall sample displayed vigilance toward threatening facial stimuli prior to receiving treatment, and 2.) participants’ pattern of responding to threatening facial stimuli changed following treat-ment, but only when the sample was divided into those who were vigilant and those who were avoidant prior to treatment. Findings provide support for the presence of two distinct sub-groups with differing attentional styles, one with a tendency for vigilance toward social threats, and a second with a tendency to avoid threat cues. These findings have important implications for how individuals may differentially respond to treatment and may help explain some of the mixed findings in the extant literature on Social Phobia and attention bias.

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Cox, Julia R. "Therapist Adherence to Cognitive Behavioral Therapy for Anxious Youth Across a Case." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/3691.

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The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address primary symptoms of anxiety. Adherence to CBT was measured by the CBT Adherence Scale for Youth Anxiety (Southam-Gerow & McLeod, 2011). Four methods to assess order were developed. Analyses include descriptive and correlative statistics that characterize the delivery of CBT and the relation between adherence to order and pretreatment characteristics.

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Podell, Jennifer Lynn. "Cognitive behavioral therapy for anxious youth: therapist variables and child treatment outcome." Diss., Temple University Libraries, 2011. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/95657.

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Psychology
Ph.D.
We assessed the relationship between several therapist variables and treatment outcome by examining the predictive power of therapist training/demographic characteristics, therapist competence and treatment integrity, and therapist style, to child outcome in a sample of 279 youth who participated in the Child and Adolescent Anxiety Multimodal Study (CAMS). All youth participated in 14 sessions of CBT (randomly assigned either with medication or without) delivered by trained therapists. Youth across both treatment conditions experienced significant treatment gains with youth in the CBT+MED and CBT only conditions showing greater gains than those in the placebo group. Therapist (a) prior clinical experience and (b) prior anxiety-specific clinical experience were significant predictors of treatment outcome across both parent- and diagnostician- rated measures. Higher levels of prior clinical experience predicted better outcome; higher levels of anxiety-specific experience were less favorable. Therapist treatment integrity, competence, and a collaborative style were also predictive of outcome. Therapists who were more collaborative and empathic, followed the treatment manual, and implemented it in a developmentally appropriate way, had youth with better treatment outcomes. Clinical implications and recommendations for future research are discussed.
Temple University--Theses

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Edwards, D. J. A. "Cognitive-behavioral and existential-phenomenological approaches to therapy : complementary or conflicting paradigms?" Journal of Cognitive Psychotherapy, 1990. http://hdl.handle.net/10962/d1007854.

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The relationship between the cognitive-behavioral and existential-phenomenological traditions in therapy is examined. While Beck cites phenomenological writers such as Heidegger, Husserl, and Binswanger, he does not initiate any dialogue with this tradition in depth. Parallels are drawn between the goals of psychotherapy as outlined by Rogers and goals identified in the contemporary cognitive-behavioral literature, between cognitive therapy's approach to clients' underlying assumptions and the phenomenological reduction as described by Husserl, and between a shared acceptance of the therapeutic use of the client-therapist interaction. While, in both approaches, therapists take on an educative role, in each approach a different aspect of the learning process is focused on. Phenomenological therapy's attitude to reality testing, the dangers of a directive stance by the therapist, the conflict between empathy and rational dialogue, and cognitive therapy's view of emotion are also discussed. The complementarity between the two approaches is emphasized and a continuing dialogue recommended.

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Peterman, Jeremy Scott. "The Effects of Cognitive-Behavioral Therapy for Youth Anxiety on Sleep Problems." Diss., Temple University Libraries, 2016. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/401478.

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Psychology
Ph.D.
Research supports shared neurological, cognitive, and environmental features among youth with sleep-related problems (SRPs) and anxiety. Despite overlap in interventions for SRPs and anxiety, little is known about the secondary benefit on SRPs following anxiety-focused treatment. The present study examined whether SRPs improved following cognitive-behavioral therapy (CBT) for youth with anxiety disorders. It also examined whether variables that may link anxiety and sleep problems (e.g. pre-sleep arousal, family accommodation, sleep hygiene) changed across treatment, and whether said changes predicted SRPs at posttreatment. Youth were diagnosed with anxiety at pretreatment and received weekly CBT that targeted their principal anxiety diagnosis at one of two specialty clinics (N = 69 completers, Mage = 10.86, 45% males). Youth completed a sleep diary between pretreatment and session one and again one week prior to posttreatment. All other measures were administered in the first session and at the posttreatment assessment. Results indicated that parent-reported SRPs improved from pre- to post-treatment and that treatment responders yielded greater improvement than nonresponders. Specific areas of bedtime resistance and sleep anxiety showed significant improvement. Youth reported lower rates of SRPs and no pre- to post-treatment changes. Pre-sleep arousal and parental accommodation decreased over treatment but did not predict lower SRPs at posttreatment. However, higher accommodation positively correlated with greater SRPs. Sleep hygiene evidenced no change and did not mediate accommodation and posttreatment SRPs. Clinical implications for the treatment of anxious youth are discussed and suggestions for future research are offered.
Temple University--Theses

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Dahan, Jessica. "Individual Child Cognitive Behavioral Treatment versus Child-Parent Cognitive Behavioral Treatments for Anxiety Disorders in Children and Adolescents: Comparative Outcomes." FIU Digital Commons, 2013. http://digitalcommons.fiu.edu/etd/963.

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Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers’ use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed.

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Snell, Carolyn. "A Daily Phone Diary Procedure to Assess Behavioral Engagement in the Treatment of Adolescent Anxiety and Depressive Disorders." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/700.

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Anxiety and depressive disorders are common conditions for adolescents and are associated with significant impairments in functioning. Cognitive behavior therapy (CBT) is an effective treatment modality for these youth, and the behavioral components of CBT protocols, in particular, are thought to be one of the active mechanisms through which positive symptom changes are produced. However, few procedures are available to measure the behavioral changes taking place in adolescents’ daily lives as they make therapeutic progress. This study examined adolescents’ “behavioral engagement” throughout treatment, a construct defined as time spent in social, athletic and academic activities. Behavioral engagement was measured using the Daily Phone Diary (DPD), a validated measure of daily activities utilized in the child health literature, which employs the principles of Ecological Momentary Assessment (EMA). Twenty-four adolescents reported each activity they engaged in throughout the day, in chronological order, over the past 24 hours. Participants were diverse in their ages, ethnicities, socioeconomic statuses and internalizing disorder diagnoses. Activities were reported during phone calls scheduled before, during, and after treatment using a transdiagnostic formulation of CBT and, for a randomized subset of the sample (N=8), both before and following a Waitlist comparison condition. Results indicated that “behavioral engagement” is a construct that is measurable and that daily phone diaries are an acceptable method of data collection for this population. Based on theoretical and empirical literature, three key categories of activities on the DPD comprised behavioral engagement: 1) Time spent socially engaged with others; 2) Time spent on any physical or athletic activity; and 3) Time doing homework. Results supported good inter-rater reliability and potentially reasonable test-retest reliability; data collection via the DPD was feasible and acceptable in this context. Tests of convergent validity with other measures of anxiety and depressive symptoms suggested that prior to treatment, more time spent in some activity categories was associated with more internalizing symptoms for those with anxiety disorders only, but fewer internalizing symptoms for those with depression as well as anxiety. Tests of convergent validity with other measures of weekly mood were promising. Future studies will explore alternate definitions of behavioral engagement, examine this construct in a larger sample that has completed a full course of CBT, and explore this construct’s potential role as a mediator of clinical improvement.

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Hollars, Shannon N. "Examination of the Skills of Cognitive Therapy for Depression: Evaluating Specificity and Prediction of Differential Response in Cognitive and Behavioral Treatments." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1431011986.

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Corbridge, Claire. "The role of emotional inhibition in bulimic disorders : evaluation of a schema-focused model of emotionally-driven eating in bulimia." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299411.

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Anglin, Lewis Leon. "A cognitive behavioral therapeutic approach to a Christian African American family system." Theological Research Exchange Network (TREN), 2006. http://www.tren.com/search.cfm?p068-0584.

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Dimidjian, Sona. "Behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of major depression /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/9064.

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Pearson, Beth Lauren. "Effects of a Cognitive Behavioral Play Intervention on Children's Hope and School Adjustment." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1210040952.

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ELIAS, DENNIS CHARLES. "AN APPLICATION OF COGNITIVE-BEHAVIORAL SELF-CONTROL PROCEDURES WITH HOSPITALIZED ADOLESCENTS." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184209.

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This study assessed the efficacy of the application of cognitive-behavioral self control therapy with a sample of psychiatrically impaired adolescents. Ten adolescent inpatients (5 male/5 female), residing within the Adolescent Unit of the State Hospital of a Southwestern state, were selected as subjects. Subjects ranged in age from 12 to 17 years and were paid volunteers. Subjects were assessed pretreatment for non self controlled behavior via the teacher rated Self Control Rating Scale (Kendall & Wilcox, 1979). This measure also served as the blocking variable utilized for random assignment to treatment or control group. Five adolescents were assigned to each group. Pretreatment measures of social perspective taking (Chandler Bystander Cartoons; Chandler, 1973) and social problem solving (Means-Ends Problem Solving test: Platt & Spivack, 1975) were taken additionally. All three measures were repeated at posttreatment and at 4 week follow-up. Treatment consisted of twelve 60-minute sessions held 3 times a week over the period of 4 weeks. The treatment consisted of a group application of Kendall's (1980) Cognitive-Behavioral Self Control therapy. The main treatment strategies included: (1) a problem solving approach, (2) self instructional training, (3) behavioral contingencies, (4) modeling, (5) affective education, and (6) role play exercises. The separate strategies were essentially interwoven. Except for the cognitive-behavioral self control training proper, subjects in both treatment and control groups were given similar tasks, task instructions, and performance feedback. Results found a range of behavioral self control skills distributed among the subjects but failed to support the hypothesis of associated poor social perspective taking and social problem solving skills. Treatment failed to improve teacher ratings of behavioral self control at posttreatment and at follow-up. Likewise, no significant improvement was found in social problem solving skills at posttreatment or follow-up, although a trend toward improvement was suggested. A significant improvement in social perspective taking skills was found in the treatment group at posttreatment. The improvement was maintained at 4 week follow-up. The results are interpreted as suggesting that cognitive-behavioral self control training can be useful in facilitating the further development and enhancement of previously inadequate cognitive capacities in psychiatrically impaired, non self controlled adolescents. Certain suggestions for enhancing the effectiveness and generalization of the treatment approach are discussed.

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Johnson, Leigh G. "Atypical and typical winter depressive symptoms and responsiveness to light therapy, cognitive-behavioral therapy, or combination treatment /." Download the thesis in PDF, 2005. http://www.lrc.usuhs.mil/dissertations/pdf/Johnson2005.pdf.

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Steelman, Burle G. "Evaluating the use of cognitive-behavioral treatment programs in the federal probation system /." Read thesis online, 2009. http://library.uco.edu/UCOthesis/SteelmanBG2009.pdf.

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Arb, Julie Diann Leeds Glaros Alan G. "Effectiveness of cognitive-behavioral therapy for pain management in a homeless veterans program." Diss., UMK access, 2004.

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Thesis (Ph. D.)--School of Education. University of Missouri--Kansas City, 2004.
"A dissertation in counseling psychology." Advisor: Alan G. Glaros. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed May 30, 2006. Includes bibliographical references (leaves 172-177 ). Online version of the print edition.

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Nauta, Helga Mariëtte. "Nothing to lose? cognitive and behavioral therapy for obesity and binge eating disorder /." Maastricht : Maastricht : Universiteit Maastricht ; University Library, Maastricht University [Host], 2001. http://arno.unimaas.nl/show.cgi?fid=7007.

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Maciel, Mayra P. "Cognitive behavioral therapy for panic disorder| An empirically supported treatment option for Latinos?" Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1587911.

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This content analysis of existing literature explored the published research supporting cognitive behavioral therapy for panic disorder and assessed if the research documented a sufficient number of Latinos in the samples of participants to be generalized for success in this population. The instruments used to measure panic disorder were assessed for cultural and linguistic validity for Latinos. The findings indicated that the research supporting CBT for panic disorder included insufficient Latino participants in the samples. Therefore, the success of CBT for Latinos with panic disorder is uncertain. Furthermore, there is paucity of culturally validated instruments that measure panic disorder. Panic disorder has been associated with many cultural expressions and syndromes that need to be adequately assessed when measuring panic disorder symptomatology.

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Harb, Lauren. "The use of Cognitive Behavioral Therapy to address shame in Binge Eating Disorder." Thesis, Pepperdine University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3630236.

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To date, research on Binge Eating Disorder is limited compared to studies on other eating disorders, including Anorexia Nervosa and Bulimia Nervosa. Given that Binge Eating Disorder recently became an independent diagnosis in the DSM-5, has significant medical implications, and commonly involves psychiatric comorbidity, it is worthwhile to explore contributing factors and evidence-based treatment for the disorder. Cognitive Behavioral Therapy is an evidence-based treatment for Binge Eating Disorder, and most experts agree that while it yields positive treatment results, there is room for improvement in treatment. Shame is an important contributing factor in the development and maintenance of Binge Eating Disorder. The purpose of this review of the literature was to examine shame literature in order to explore potential methods for improving evidence-based Cognitive Behavioral Therapy for Binge Eating Disorder. The importance of researching Binge Eating Disorder is reviewed, and then shame is explored from a cognitive behavioral standpoint. Cognitive Behavioral Therapy for Binge Eating Disorder is outlined, and limited techniques that address shame in treatment are identified. Recommendations for addressing shame more directly in Cognitive Behavioral Therapy for Binge Eating Disorder are then made prior to suggestions for future research.

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Halldorsdottir, Thorhildur. "Comorbid ADHD: Implications for Cognitive-Behavioral Therapy of Youth with a Specific Phobia." Diss., Virginia Tech, 2014. http://hdl.handle.net/10919/56618.

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Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed.
Ph. D.

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Arnold, Cassidy C. "Adherence to and Competence in Cognitive Behavioral Therapy for Youth Anxiety: Psychometric Evaluation." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/3922.

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Treatment integrity—the extent to which a treatment is delivered as it was intended—has long been recognized as critically important in treatment evaluation research, but has garnered increased attention in recent years within the context of dissemination and implementation science. However, the field’s development has been hindered by inadequate measurement tools. This project is focused on developing and evaluating the psychometric strength of two measures of treatment integrity. To evaluate the psychometric strength of the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Adherence Scale (CBAY-A)and the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Competence Scale (CBAY-C), 954 psychotherapy sessions from two treatment evaluation studies were coded. Analysis of the evidence for reliability and validity of the item scores for each measure provide substantial support for each measure, while also highlighting areas in need of further evaluation. The discussion focuses on interpreting the psychometric strength of the CBAY-A and CBAY-C compared to other measures of treatment integrity, next steps for evaluating the psychometric strength of the two measures, and potential applications of the CBAY-A and CBAY-C.

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Shimkus, Erica Kathleen, and Erica Kathleen Shimkus. "Family Nurse Practitioners' Use of Cognitive Behavioral Therapy Treatment for Depression in Adolescents." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622941.

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Background: Cognitive behavioral therapy (CBT) is an effective treatment modality for adolescents suffering from depression. Yet, it is often under-utilized among family nurse practitioners (FNPs) in the primary care setting. Known barriers exist within the realm of providers' lack of use of CBT in the primary setting, however, there is little research specifically on FNPs usage of the modality. Purpose: This paper seeks to understand FNPs' use of CBT in the primary care setting to treat adolescents with depression. Method and Sampling: A qualitative design was used to understand FNPs' use of CBT for adolescents suffering from depression. A faculty member and I recruited FNP participants through email. Ten FNPs currently working in the primary care setting with experience ranging from one to ten years participated in the study. Two focus group interviews were conducted in order to have a deeper understanding of the use of CBT in practice to treat adolescent depression. The interviews were audio taped and analyzed to reveal emerging themes. Results: After analyzing the audio recordings two common themes emerged: Unpreparedness and role conflict. Subthemes emerged within the area of unpreparedness that included knowledge regarding screening for depression in the adolescent population, utilization of clinical practice guidelines, available community resources and referrals, and the application of CBT in the treatment of adolescent depression. The theme of role conflict was associated with time constraints within the allotted time frame per patient and the conflict of providing mental health services when feeling as though their primary training is that of a family practice provider. Conclusion: The findings showed that the lack of use of CBT is multifactorial with knowledge being the greatest inhibiting factor. CBT is a recommended, first-line treatment option within the clinical practice guidelines for the treatment of adolescent depression. However, FNPs are not currently utilizing CBT in their practice to treat adolescent depression. There is much to be learned about adolescent depression in its entirety prior to incorporating CBT into practice.

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Beidas, Rinad. "A randomized controlled trial of training in cognitive-behavioral therapy for youth anxiety." Diss., Temple University Libraries, 2011. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/112224.

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Psychology
Ph.D.
Establishing evidence-based training for therapists is of paramount importance for effective dissemination of evidence-based interventions. Using cognitive-behavioral therapy (CBT) for child anxiety, this study compared three therapist training conditions: (1) routine training: a workshop that covered a specific manual, (2) computer training: computer-based training via an interactive DVD, and (3) augmented training: a workshop that included a focus on core CBT competencies and active learning with behavioral rehearsal. Training success was operationalized as: (1) adherence to CBT for child anxiety, (2) therapeutic skillfulness, (3) a knowledge test, (4) and training satisfaction. The study also investigated the degree to which consultation following training impacted therapist outcomes. Participants (115 therapists) were randomly assigned to training condition and, following training, were invited to participate in weekly consultation. The results indicate that all three training conditions were effective in improving therapist adherence, skill, and knowledge. Participants were most satisfied with the in-person conditions. With regard to consultation, the number of consultation hours attended significantly predicted therapist training outcomes. This finding underscores the importance of consultation when training therapists.
Temple University--Theses

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Wason, Sonali. "Psychological Reactions Post-athletic Injury| A Trauma-Informed Cognitive Behavioral Group Therapy Approach." Thesis, Azusa Pacific University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10931361.

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This study presents a group therapy program for injured athletes recovering from a traumatic physical injury to address and provide coping skills for the trauma-related symptoms athletes may experience post-athletic injury. Eleven expert reviewers in the field of sport psychology, injury rehabilitation, and athletic development reviewed the program and provided feedback regarding the utility, accuracy, organization, applicability, and additional factors. Although reviewers noted traumatic reactions are experienced by a sub-group of athletes, they also generally agreed the group therapy program could aid in clinical work and reduce trauma-related distress experienced by athletes after an injury and provide social support within a safe environment, allowing discussion and sharing of experiences with one another.

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Alexander, Helen. "Coping with Sickle Cell Disease Using Cognitive Behavior Therapy." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5157.

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This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the underpinnings of the study process. The Johns Hopkins Nursing evidence-based practice model (JHNEBP) was the framework for this project. A systematic review was conducted utilizing research-based articles from the major healthcare databases. The original search resulted in over 12,000 articles. This pool was further refined based upon a link between the pediatric population with chronic or life-threatening conditions and family coping skills. This was further narrowed down based on the use of social-cognitive therapy and coping skills. This process resulted in 6 research articles on the use of CBT with the target population. An evaluation of these studies found evidence that CBT can improve parental coping skills. Nursing support for parental coping with SCD has the positive social impact of decreased parental stress and improved quality of life for both the child and the family unit.

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Phillips, Kristin Michelle. "Applying Latent Growth-Curve Modeling to Investigate Intervention-Related Changes in Evening Serum Cortisol among Women as They Move Through Treatment for Non-Metastatic Breast Cancer." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_dissertations/305.

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Prior work has provided support that women with breast cancer are hyper-responsive to stressful challenges and that Cognitive-Behavioral Stress Management (CBSM) interventions can lead to reductions in cortisol, a measure of physiological stress. It may follow that breast cancer patients would show decreases in cortisol levels if they are taught stress management techniques. The purpose of this study was to investigate post-intervention psychosocial processes (i.e., participants' perceptions of achieved specific skills targeted by CBSM and non-specific changes associated with the group experience) that may explain intervention-related changes in cortisol among a sample of women as they moved through medical treatment for non-metastatic breast cancer. It was hypothesized that (a) women receiving a 10-week, group-based stress management intervention during ongoing medical treatment for breast cancer would show reductions in late afternoon serum cortisol levels and (b) perceived ability to implement stress management skills or other experiences gained in the supportive group environment may explain changes in cortisol. Participants (N = 128) were women recruited 4-8 weeks post-surgery for non-metastatic breast cancer. Women were randomly assigned to receive either the 10-week CBSM intervention (N = 63) or a one-day psychoeducational seminar (n = 65). The intervention aimed to teach relaxation, cognitive restructuring, and interpersonal skills. Participants were assessed at study entry, 6 month follow-up (i.e., 3 months post-intervention) and 12 month follow-up (i.e., 6 months post-intervention). Latent Growth Curve Modeling (LGM) was used to test for differential effects of study condition on change over time in cortisol and the effects of specific and non-specific group processes on change in cortisol. Results indicated there was a significant effect of study condition on change over time in cortisol, relaxation skills, and assertiveness skills. There were not significant relationships between changes in cortisol and any of the components analyzed and mediation was not established using LGM. There was, however, a significant association between changes in an item that assessed cognitive restructuring and cortisol. Exploratory analyses of lagged (Time 2 controlling for Time 1) psychosocial processes mediating (Time 3 controlling for Time 2) cortisol changes were then conducted. Results indicated that condition's effect on cortisol approached significance and condition had a significant effect on the muscle relaxation component and cognitive restructuring item. Furthermore, there was evidence that intervention-related changes in confidence about using muscle relaxation and cognitive restructuring may help explain decreases in cortisol levels among this sample of women. Overall, this study demonstrated that a 10-week, CBSM intervention was associated with decreased cortisol levels and increased relaxation and assertiveness skills. Furthermore, there was a strong relationship between changes in cognitive restructuring and cortisol. Future research should investigate how changes in cortisol may be related to health behaviors and health outcomes among breast cancer patients.

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Bhatnagar, Kelly Anne Constant. "Effectiveness and Feasibility of a Cognitive-Behavioral Group Intervention for Body Image Disturbance in Women with Eating Disorders." Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1264038517.

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Lam, Yuk-king. "The effects of one session cognitive behavioral therapy for elderly patients with cardiopulmonary diseases /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B30469727.

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Kircher, Tilo, Volker Arolt, Andreas Jansen, Martin Pyka, Isabelle Reinhardt, Thilo Kellermann, Carsten Konrad, et al. "Effect of Cognitive-Behavioral Therapy on Neural Correlates of Fear Conditioning in Panic Disorder." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120091.

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Background: Learning by conditioning is a key ability of animals and humans for acquiring novel behavior necessary for survival in a changing environment. Aberrant conditioning has been considered a crucial factor in the etiology and maintenance of panic disorder with agoraphobia (PD/A). Cognitive-behavioral therapy (CBT) is an effective treatment for PD/A. However, the neural mechanisms underlying the effects of CBT on conditioning processes in PD/A are unknown. Methods: In a randomized, controlled, multicenter clinical trial in medication-free patients with PD/A who were treated with 12 sessions of manualized CBT, functional magnetic resonance imaging (fMRI) was used during fear conditioning before and after CBT. Quality-controlled fMRI data from 42 patients and 42 healthy subjects were obtained. Results: After CBT, patients compared to control subjects revealed reduced activation for the conditioned response (CS+ > CS–) in the left inferior frontal gyrus (IFG). This activation reduction was correlated with reduction in agoraphobic symptoms from t1 to t2. Patients compared to control subjects also demonstrated increased connectivity between the IFG and regions of the “fear network” (amygdalae, insulae, anterior cingulate cortex) across time. Conclusions: This study demonstrates the link between cerebral correlates of cognitive (IFG) and emotional (“fear network”) processing during symptom improvement across time in PD/A. Further research along this line has promising potential to support the development and further optimization of targeted treatments.

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Lam, Yuk-king, and 林淯琼. "The effects of one session cognitive behavioral therapy for elderly patients with cardiopulmonary diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010183.

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Selles, Robert Rein. "Treatment Maintenance of Cognitive-Behavioral Therapy for Anxiety in Youth with Autism Spectrum Disorders." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4843.

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Anxiety disorders commonly co-occur in children and adolescents with an autism spectrum disorder (ASD). Recently, treatment of anxiety using cognitive behavioral therapy (CBT) has been modified and studied in youth with ASD, with results consistently demonstrating positive treatment outcomes. In typically developing populations, CBT gains are well maintained as long as 14-years post-treatment; however, maintenance of CBT has not yet been studied in anxious youth with ASD. Using a sample of 32 youth who previously completed one of three CBT for anxiety in ASD treatment studies, the present study re-assessed parent report of anxiety symptoms in youth, 12-26 months (M = 17.16 Months; SD = 4.32) following treatment completion. Retrospective data from the original studies' screening/baseline and post-treatment time points were used in combination with newly obtained follow-up data to determine treatment maintenance. Compared to baseline, follow-up scores on all measures of anxiety were associated with large effects for treatment. Compared to post-treatment, no significant differences in scores were observed; however, scores on the Pediatric Anxiety Rating Scale suggested a small effect for return in symptoms. While the percentage of individuals with remission of their primary anxiety diagnosis was identical at post-treatment and follow-up, significantly fewer individuals were rated as responders at follow-up as compared to post-treatment. Similar to CBT for anxiety in neurotypical youth, CBT for anxiety in youth with ASD appears to be relatively durable over a one to two year interval. Despite this, a significant portion of participants demonstrate some level of symptom regression. Future study should investigate factors associated with poor treatment maintenance, as well as modifications or additions to treatment protocols (e.g., booster sessions) that may help maintain treatment gains.

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Barmish, Andrea J. "Self-disclosure as a predictor of outcomes in cognitive-behavioral therapy for anxious youth." Diss., Temple University Libraries, 2008. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/12076.

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Psychology
Ph.D.
Cognitive-Behavioral Therapy (CBT) is an empirically supported treatment for anxious youth; however, approximately 30% of youths continue to meet diagnostic criteria for their primary anxiety disorder at posttreatment. Efforts to identify predictors and moderators of outcome in CBT are encouraged in order to enhance treatment efficacy. One potential predictor is youth pretreatment self-disclosure (e.g. Panichelli-Mindel, Flannery-Schroeder, Kendall, & Angelosante, 2005). Using a sample of 101 Anxiety Disordered (AD) youths meeting criteria for a primary diagnosis of Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder (SAD), or Social Phobia (SOP) who were treated with 16-weeks of CBT (individual or family), this study examined (a) youth self-disclosure as a predictor of CBT outcomes, (b) pre- to post-treatment change in disclosure and distress during disclosure task, for responders relative to nonresponders, (c) disclosure and distress while disclosing in anxious youth relative to community volunteers (N=74); and (d) disclosure and distress while disclosing in treatment responders and nonresponders (posttreatment), and community volunteers. Videotaped recordings of a four-minute Youth Speech Sample (YSS) in which the youth was instructed to talk about him/herself were coded by reliable coders who were blind to diagnostic status, using the Youth Self-Disclosure Rating Scale (YSDRS) for each of the variables of interest (Feared Situations, Personal Content, Global Rating of Disclosure, and Distress while Disclosing). Text analysis software was used to measure Disclosure Language. Treatment outcome was measured using posttreatment diagnostic status and severity, youth self-report, and mother- and father-reports. Findings of the present study indicate that pretreatment disclosure does not predict CBT outcomes for anxious youth. Additionally, there were no differences in the pre- to post-treatment change in disclosure and distress for responders and nonresponders; however, a main effect of treatment on disclosure of personal content was observed, such that youths disclosed more at posttreatment relative to pretreatment. Anxious youths appear more distressed in the disclosure task relative to community volunteers, but groups do not differ in their level of disclosure. Similarly, treatment responders and nonresponder at posttreatment were rated as more distressed while disclosing relative to community volunteers, but do not differ in their level of disclosure. Clinical implications and future directions are discussed.
Temple University--Theses

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