Archive for the ‘Children & Adolescents’ Category

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Family Based Cognitive-Behavioral Therapy is Effective for Youth With OCD

Tuesday, July 6th, 2010

newstudy-graphic-66x60.jpgA recent open trial conducted by researchers at the University of South Florida tested the effect of family-based cognitive-behavioral therapy (CBT) on children and adolescents with Obsessive-Compulsive Disorder (OCD). The participants were 30 youth (7-19 years old), half boys and half girls, who were partial or nonresponders to two or more medication trials. Each patient received 14 sessions of intensive family-based CBT.

At post-treatment and 3-month follow-up, 80% of participants had improved. Symptom severity was reduced by 54%. Over 50% were classified as being in remission at the end of treatment, and at the 3-month follow-up. While there was no notable difference in self-reported anxiety, researchers observed significant reductions in OCD-related impairment, depressive symptoms, behavioral problems, and family accommodation.

To read the entire article, click here: http://www.ncbi.nlm.nih.gov/pubmed/20390817

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Posted in Children & Adolescents, Cognitive Behavior Therapy, OCD | 1 Comment »

Learning Resilience at a Young Age

Tuesday, February 16th, 2010

No matter the age, a person’s emotions can be pulled down by small disappointments being made to feel like disasters. With CBT, people are able to identify errors in thought, and learn to avoid ‘disastrous’ outcomes. People can learn to avoid irrational thoughts, and by aligning thoughts with reality, they are better able to think in a clear, healthy way about every day situations. It has shown that it could be particularly useful to start teaching these thought techniques at a young age.

With ‘resilience training,’ fifth, sixth and seventh graders, at New York City’s KIPP Infinity Charter School in West Harlem, learn about self-talk, the things you tell yourself, and how they effect your emotions regarding what is happening in negative situations. What they are learning is not the act of blindly creating positive thoughts, but reality based positive thinking, helping kids to step back and assess a situation before reacting.

Empirical evidence shows that two years later, students who had gone through this resilience training had fewer incidents of depressive and negative thinking than students who had not gone through the training.

To learn more about this emotional training for children, go to:

http://www.npr.org/templates/story/story.php?storyId=122526518&ps=cprs

Posted in Children & Adolescents, Cognitive Behavior Therapy | No Comments »

CBT and CBT Plus Medication for the Treatment of OCD in Children

Monday, November 9th, 2009

NewStudy-Graphic-72x72_edited-3 A recent study published in Child and Adolescent Mental Health found both Cognitive Behavior Therapy (CBT) and CBT in combination with medication to be effective in the treatment of Obsessive Compulsive Disorder (OCD) in children. During a ten-year period, 75 children were evaluated and treated for OCD in an outpatient setting. Investigators later contacted a subset of that sample to investigate the long-term maintenance of their therapeutic gains. Treatment groups in this follow up investigation included, (1) those treated with medication before beginning CBT, (2) those treated with CBT only, and (3) those treated with CBT and medication, simultaneously. Participants in each group had all met diagnostic criteria for OCD as determined by their Children’s Yale Brown Obsessive-Compulsive Scale (CYBOCS) scores. Long term maintenance was assessed by comparing post-treatment and pre-treatment CYBOCS scores. Results showed significant improvement for each group, yielding further support for the use of CBT and CBT plus medication (SSRIs) in the treatment of OCD.

Reference
Nakatani, E. (2009). Outcomes of cognitive behaviour therapy for obsessive compulsive disorder in a clinical setting: A 10-year experience from a specialist OCD service for children and adolescents. Child and Adolescent Mental Health, 14, 133-139.

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Posted in Anxiety, Children & Adolescents, Cognitive Behavior Therapy, Cognitive Therapy, OCD | No Comments »

Child and adolescent Anxiety: Most effective treatments combine CBT and pharmacotherapy

Tuesday, February 10th, 2009

Authors of a new study in the New England Journal of Medicine reported that anxiety disorders in children and adolescents negatively affect school performance, family relations, and social functioning. Despite a high prevalence (10-20%), they are largely “underrecognized and undertreated.” The anxiety disorders evaluated in this study included separation and generalized anxiety and social phobia. Cognitive behavioral therapy (CBT) and selective serotonin-reuptake inhibitors (SSRIs) have already been demonstrated to be effective in this group but a randomized controlled study of the two in combination has been lacking.

To address this, children ranging in age from 7 to 17 received CBT, an SSRI (sertraline/Zoloft) or placebo, or a combination of the CBT and sertraline. The CBT involved fourteen 60-minute sessions and included anxiety-management skills and behavioral exposure to anxiety-provoking situations.

The authors found that improvement was greatest for the combination therapy (80.7%), followed by cognitive behavioral therapy alone (59.7%), then sertraline alone (54.9%), and all therapies were superior to placebo (23.7%). An interesting additional finding was that “there was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline.”

The authors concluded that “all three of the treatment options may be recommended, taking into consideration the family’s treatment preferences, treatment availability, cost, and time burden.”

Study authors: J. T. Walkup, A.M. Albano, J. Piacentini, B. Birmaher, et al.

Posted in Anxiety, Children & Adolescents, Cognitive Behavior Therapy | No Comments »

For children and adolescents, psychological harm of traumatic events reduced by CBT

Tuesday, August 26th, 2008

In a review in the American Journal of Preventive Medicine, it was noted that children and adolescents who experience psychological harm caused by traumatic events are often treated by practitioners who are not aware of, and do not employ, treatments that are “based on the best available evidence.”

Meta-analyses were conducted on interventions that included cognitive behavioral therapy (CBT) in individual and group settings, play therapy, psychodynamic therapy, and others.

The traumas themselves covered a wide range and included sexual abuse, domestic violence, serious illness, and natural disasters. The CBT methods included exposure techniques, modification of inaccurate cognitions, reframing counterproductive cognitions regarding the trauma, and others.

Based on their analyses, the review authors concluded there was “strong evidence … that individual and group CBT can decrease psychological harm among symptomatic children and adolescents exposed to trauma.”

Review authors: H. R. Wethington, R. A. Hahn, D. S. Fuqua-Whitley, et al.

Posted in Anxiety, CT in the News, Children & Adolescents, Cognitive Behavior Therapy, Cognitive Therapy, Depression, Post-Traumatic Stress | No Comments »

VLOG: Dr. Robert Findling discusses CBT for adolescent Depression

Friday, August 22nd, 2008

Watch and listen as Dr. Robert Findling discusses cognitive behavioral therapy (CBT) for adolescent depression and the findings of the TORDIA study published in JAMA earlier this year.

Robert L. Findling, M.D., is the Director of the Division of Child and Adolescent Psychiatry at University Hospitals Case Medical Center, and Professor of Psychiatry and Case Western Reserve University School of Medicine.

Posted in Children & Adolescents, Cognitive Behavior Therapy, Cognitive Therapy, Depression | No Comments »

UK national guidelines emphasize CBT for children and adolescents

Friday, August 22nd, 2008

A recent article in Current Opinion in Psychiatry summarized the UK National Institute for Health and Clinical Excellence (NICE) clinical guidelines and reviews of cognitive behavioral therapy (CBT) for children and adolescents with mental health problems.

NICE is the UK’s independent organization responsible for providing national guidance on the “promotion of good health and the prevention and treatment of ill health.”

For the treatment of depression in children and young people, NICE guidelines recommended “that pharmacological approaches should not be the first-line approach to the treatment of depression in this age group.” It recommended instead “the initial use of psychosocial interventions, including CBT, for all severities of depression.”

Meta-analyses of randomized controlled trials suggested the importance of CBT for children and adolescents with generalized anxiety disorder, depression, obsessive compulsive disorder, and posttraumatic stress disorder. More limited evidence suggested CBT’s benefit in attention deficit hyperactivity disorder and others conditions.

The authors noted that CBT for these populations “should be extended by further primary and secondary research.”

Review authors: A. Munoz-Solomando, T. Kendall, C. J. Whittington

Posted in Anxiety, BI Blog Info, Children & Adolescents, Cognitive Therapy, Depression, OCD, United Kingdom (UK) | No Comments »

Adolescents with Chronic Fatigue Syndrome experience enduring benefits of CBT

Monday, March 10th, 2008

A new study in Pediatrics reported that adolescents with Chronic Fatigue Syndrome (CFS) who received 10 sessions (over 5 months) of cognitive behavioral therapy (CBT) continued to experience positive effects at 2-year follow-up. Researchers measured fatigue, functional impairment, school attendance, and work attendance (where applicable). At follow-up, participants continued to experience the same improvement in fatigue as they had at the end of treatment. Their physical functioning, school attendance, and work attendance actually improved during the follow-up period. The authors recommended that this treatment become available to more adolescent patients with CFS.

Study authors: H. Knoop, M. Stulemeijer, L. W. A. M. de Jong, T. J. W. Fiselier, G. Bleijenberg

Posted in Children & Adolescents, Chronic Fatigue Syndrome, Cognitive Therapy | No Comments »

Adolescents with SSRI-resistant Depression show improved response to treatment that includes CBT

Monday, March 3rd, 2008

A new study in JAMA reported that approximately 60% of depressed adolescents respond adequately to initial treatments with a selective serotonin reuptake inhibitor (SSRI), but there is a lack of information about subsequent treatment strategies. Four treatment strategies were employed in this study including medication-switching alone (to a different SSRI or to venlafaxine) and medication-switching plus cognitive behavioral therapy (CBT). CBT in this study emphasized cognitive restructuring, behavioral activation, emotion regulation, social skills, and problem solving. Additionally, parent-child sessions emphasized decreasing criticism and improving support, family communication, and problem solving. The authors found that CBT plus a switch to either medication regimen showed a higher response rate than a medication-switch alone (and that there was no difference in response rate between venlafaxine and a second SSRI).

Study authors: D. Brent, G. Emslie, G. Clarke, K. D. Wagner, J. R. Asarnow, M. Keller, et al.

Posted in Children & Adolescents, Cognitive Behavior Therapy, Cognitive Therapy, Depression | No Comments »

Antidepressants used in combination with CBT reduces risk of teen suicide

Friday, October 19th, 2007

The use of the antidepressant fluoxetine (Prozac) alone has been associated with increased suicidality among teens and children, leading to black-box warnings on antidepressants in those populations. This in turn has caused serious concern in parents and has discouraged prescription, according to some researchers. A recent report on this issue focused on combining Cognitive Behavioral Therapy (CBT) with the fluoxetine and found that “adding CBT to medication enhances the safety of medication. Taking benefits and harms into account, combined treatment appears superior to either monotherapy as a treatment for major depression in adolescents.”

In a related report, the researchers added that cognitive behavior therapy “should be made readily available as part of comprehensive treatment for depressed adolescents” and added that such a shift in the current practice would be of “considerable public health relevance.”

Posted in BI Blog Info, Children & Adolescents, Cognitive Therapy, Depression | 1 Comment »

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