University of York | May 2018 | How our research could help children overcome severe phobias
Researchers at the University of York are testing a new form of therapy based of cognitive behavioural therapy (CBT) techniques. The new approach, called One Session Treatment, can be delivered during one three- hour session. This means that the therapy sessions will be less time-consuming and disruptive for children and potentially a more efficient way of treating children.
Prior to the sessions there will be a pre-assessment of one hour’s duration, after this the child will experience exposure therapy, where the patient is gradually exposed to whatever they are afraid of. The child’s confidence continues to be developed at home- with them continuing to confront the thing they are scared of. The children will be followed up six months later to assess the effectiveness of the therapy.
The trial is recruiting over 280 children aged 7 to 16-years-old across a number of NHS trusts and other services in the North of England, Norfolk and Suffolk. It is run in conjunction with Leeds and York Partnership NHS Foundation Trust and the University of Sheffield.
The study will address a gap in the literature which Professor Barry Wright lead author of the study says OST is not currently widely used which he attributes to there being no randomised controlled trials in the UK in children. (University of York)
The full story is available from the University of York New study at York to help children overcome severe phobias uses new techniques
Science Daily|Cognitive behavioral therapy can improve emotion regulation in children with autism
A Canadian study that examined the impact of cognitive behavioural therapy (CBT) on young children with autism spectrum disorder (ASD) found that children assigned to the intervention (CBT) group demonstrated improved emotional regulation, compared to those in the control. The 68 children who participated in the study each received 10 sessions of CBT intervention, this was intended to improve their emotional regulation and This study is the first of its kind to demonstrate the benefits of CBT extend beyond treating anxiety (via Science Daily).
Mental health problems are common among individuals with autism spectrum disorder (ASD), and difficulties with emotion regulation processes may underlie these issues. Cognitive behavior therapy (CBT) is considered an efficacious treatment for anxiety in children with ASD. Additional research is needed to examine the efficacy of a transdiagnostic treatment approach, whereby the same treatment can be applied to multiple emotional problems, beyond solely anxiety. The purpose of the present study was to examine the efficacy of a manualized and individually delivered 10‐session, transdiagnostic CBT intervention, aimed at improving emotion regulation and mental health difficulties in children with ASD.
Sixty‐eight children (M age = 9.75, SD = 1.27) and their parents participated in the study, randomly allocated to either a treatment immediate (n =35) or waitlist control condition (n =33) (ISRCTN #67079741). Parent‐, child‐, and clinician‐reported measures of emotion regulation and mental health were administered at baseline, postintervention/postwaitlist, and at 10‐week follow‐up.
Children in the treatment immediate condition demonstrated significant improvements on measures of emotion regulation (i.e., emotionality, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors) compared to those in the waitlist control condition. Treatment gains were maintained at follow‐up.
This study is the first transdiagnostic CBT efficacy trial for children with ASD. Additional investigations are needed to further establish its relative efficacy compared to more traditional models of CBT for children with ASD and other neurodevelopmental conditions.
Full reference: Weiss, J.A., Thomson, K., Burnham Riosa, P., Albaum, C., Chan, V., Maughan, A., Tablon, P., Black, K. | A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism |Journal of Child Psychology and Psychiatry | 2018; DOI: 10.1111/jcpp.12915
This review aims to evaluate brief, intensive and concentrated (BIC) cognitive behavioural therapy, adapted from “standard” CBT treatments for anxiety disorders in young people | Simon Brett for the Mental Elf
Anxiety disorders affect 10% of children and 20% of adolescents at any one time. These disorders frequently persist into adulthood and are often associated with significant difficulties across the life span (e.g., major depression, substance abuse) (Woodward & Fergusson, 2001).
However, despite the existence of evidence-based interventions, the majority of young people do not access treatment. Young people face substantial barriers to seeking and receiving treatment; stigma, infrequent contact with health services, waiting times, lack of knowledge about mental health and few sufficiently trained mental health professionals.
Given the sound underlying therapeutic principles and evidence-base of CBT, it appears to be an ideal therapy to adapt and develop brief, intensive and concentrated (BIC) approaches designed to reach more young people, be more efficient and more cost-effective.
Blake, M. et al. Sleep | Published online: 18 April 2017
Objective: The aim of this study was to test whether a cognitive-behavioral and mindfulness-based sleep intervention could improve sleep and anxiety on school nights in a group of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and pre-sleep hyperarousal.
Conclusion: This study provides evidence that pre-sleep arousal but not sleep hygiene awareness is important for adolescents’ perceived sleep quality, and could be a target for new treatments of adolescent sleep problems.
Furukawa, T. A. et al. The British Journal of Psychiatry. Published online: 19 January 2017
Background: The influence of baseline severity has been examined for antidepressant medications but has not been studied properly for cognitive–behavioural therapy (CBT) in comparison with pill placebo.
Conclusions: Patients suffering from major depression can expect as much benefit from CBT across the wide range of baseline severity. This finding can help inform individualised treatment decisions by patients and their clinicians.
Primary Care Corner with Geoffrey Modest MD. BMJ Evidence-Based Medicine Blog
The Agency for Healthcare Research and Quality (AHRQ) just released their clinical review comparing nonpharmacological vs pharmacological treatments for patients with major depressive disorders
They reviewed 44 trials from 1990-2015 of patients with mild to severe major depressive disorder (MDD)
Cognitive behavioral therapy (CBT) is as effective as second-generation antidepressants (SGAs, which for this review includes SSRIs, SNRIs, bupropion, mirtazapine, nefazodone, and trazodone) for mild to severe MDD, with moderate level of evidence. The evidence does not support SGAs plus CBT as being better than SGAs alone, though this was based on low quality of evidence
Therapy (SGA vs CBT) was discontinued at equal rates, for either SGAs or CBT, for adverse effects or patient dissatisfaction
Goldschmidt, K. Journal of Pediatric Nursing. Published online: October 7, 2016
Mental health disorders occur in 4% of children and 10 to 20% of adolescents and are linked with “depression, anxiety, risky behaviors, poor physical health, obesity, substance abuse and suicide” (Garber, Frankel, & Herrington, 2016, p. 181). Adolescents diagnosed with a depressive disorder have high rates of recurrence: 25% within one year, 40% within two years, and 70% within five years (Mash & Wolfe, 2012). It is imperative for mental health specialist to reach children with mental health disorders early in their development in an effort to decrease morbidity and mortality; however, access to mental health care, especially for children, is limited (Lauckner & Whitten, 2015).