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Cognitive Therapy

Cognitive Therapy Research

Summarized by the Ottawa Centre for Cognitive Therapy

The Empirical status of Cognitive-Behavioral therapy: A review of meta-analyses.

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). Clinical Psychology Review, 26 (1), 17-31.

  • Cognitive Therapy (CBT) is one of the most researched forms of therapy.
  • CBT is superior to antidepressants in the treatment of adult and adolescent unipolar depression.
  • When treated with CBT, relapse rates for depression are cut in half compared to anti-depressants.
  • CBT more effective than benzodiazepines in treating anxiety.
  • CBT treatment of anxiety lasted up to 8-10 years following treatment.
  • CBT leads to approximately 70% lower drop out rates than pharmacotherapy.

Cognitive Therapy effective for:

  • Adult and adolescent depression
  • Generalized anxiety disorder
  • Panic disorder
  • Social phobia
  • PTSD
  • Childhood anxiety and depression
  • Bulimia Nervosa
  • Anorexia Nervosa
  • Marital distress
  • Anger
  • Somatic disorders
  • Chronic pain
  • Self esteem
  • Personality disorders

The effects of Cognitive Therapy are maintained for substantial periods beyond the cessation of treatment. The London School of Economics estimates that CBT is more cost effective than anti-depressants. The London School of Economics has issued a Depression Report recommending CBT for depression and anxiety.

Cognitive Behavioral Therapy (CBT) Outcome Studies  The following has been selected from www.academyofct.org

Cognitive Behavioral Therapy (CBT) has been demonstrated in hundreds of studies to be an effective treatment for a variety of disorders and problems for adults, older adults, children and adolescents. The list below is just a sample of the published studies.

ADULTS

CBT has been clinically demonstrated through randomized controlled trials to be an effective treatment for the following disorders and problems:

Depression

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I. (1998). A meta-analysis of the effects of cognitive therapy in depressed patients. Journal of Affective Disorders, 49, 59-72.

Geriatric Depression

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Relapse Prevention for Depression

Fava G.A., Rafanelli C., Grandi S., et al. (1998). Prevention of recurrent depression with cognitive behavioral therapy. Preliminary findings. Arch Gen Psychiatry. 55:816–20.

Paykel, E.S., Scott, J., Teasdale, J., Johnson, A.L. et al. (1999). Prevention of Relapse in Residual Depression by Cognitive Therapy. Arch Gen Psychiatry. 56:829-835.

Generalized Anxiety Disorder

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Gould, R. A., Otto, M. W., Pollack, M. H., & Yap, L. (1997). Cognitive behavioral and pharmacological treatment of generalized anxiety disorder: A preliminary meta-analysis. Behavior Therapy, 28, 285-305.

Panic Disorder

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Gould, R. A., Otto, M. W., & Pollack, M. H. (1995). A meta-analysis of treatment outcome for panic disorder. Clinical Psychology Review, 15(8), 819-844.

Agoraphobia and Panic Disorder with Agoraphobia

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Oei, T. P. S., Llamas, M., & Devilly, G. J. (1999). The efficacy and cognitive

processes of cognitive behaviour therapy in the treatment of panic disorder with

agoraphobia. Behavioural and Cognitive Psychotherapy, 27, 63-88.

Social Anxiety / Social Phobia

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Gould, R. A., Buckminster, S., Pollack, M. H., Otto, M.W., & Yap, L. (1997).

Cognitive-behavioral and pharmacological treatment for social phobia: A meta-

analysis. Clinical Psychology: Science & Practice, 4, 291-306.

Obsessive-Compulsive Disorder

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Post-Traumatic Stress Disorder (Trauma)

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

National Institute for Health and Clinical Excellence (2005). CG26 Post-traumatic stress disorder (PTSD): Information for the public. Retrieved from: http://www.nice.org.uk/download.aspx?o=CG026publicinfo&template=download.aspx.

Withdrawal from Anti-Anxiety Medications

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Dental Phobia

Berggren, U. (2001) Long-Term Management of the Fearful Adult Patient Using Behavior Modification and Other Modalities. Journal of Dental Education. 65:12.

Bipolar Disorder (in combination with medication)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Lam D.H., Watkins E.R., Hayward P., Bright J., et al. (2003) A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. Arch Gen Psychiatry. 60(2):145-52.

Binge-eating disorder

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Bulimia Nervosa

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Anorexia Nervosa

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Roth A.D., Fonagy P. (1996). What Works for Whom? A Critical Review of Psychotherapy Research. New York: Guilford.

Body Dysmorphic Disorder (extreme dissatisfaction with body image)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Somatization Disorder

Allen, L.A., Woolfolk, R.L., Escobar, J.I., Gara, M.A., et al. (2006) Cognitive-Behavioral Therapy For Somatization Disorder. Arch Intern Med. 166:1512-1518.

Cocaine abuse (CBT relapse prevention is effective)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Opiate Dependence

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Smoking Cessation (Group CBT is effective, as well as CBT that has multiple treatment components, in combination with relapse prevention)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Marital discord

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Dunn, R. L., & Schwebel, A. I. (1995). Meta-analytic review of marital therapy

outcome research. Journal of Family Psychology, 9, 58-68.

Anger

Beck, R., & Fernandez, E. (1998). Cognitive-behavioral therapy in the treatment

of anger: A meta-analysis. Cognitive Therapy and Research, 22, 63-74.

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Borderline Personality Disorder

Brown, G.K., Newman, C.F., Charlesworth, S.E., Crits-Christoph, P. & Beck, A.T. (2004). An open clinical trial of cognitive therapy for borderline personality disorder. Journal of personality disorders, 18(3): 257-271.

Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., et al. (2006). Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy. Arch Gen Psychiatry. 63:601.

Atypical sexual practices/sex offenders

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Nagayama Hall, G. C. (1995). Sexual offender recidivism revisited: A meta-

analysis of recent treatment studies. Journal of Consulting and Clinical

Psychology, 63(5), 802-809.

INITIAL STUDIES

CBT has been clinically demonstrated to be an effective treatment in case series, same-investigator studies, or studies without a control group for the following problems and disorders (among adults unless otherwise noted):

Geriatric Anxiety

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Schizophrenia (in combination with medication)

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Rector, N. A., & Beck, A. T. (2001). Cognitive-behavioral therapy for

schizophrenia: An empirical review. Journal of Nervous and Mental Disease, 189,

278-287.

Dissociative Disorders

Nathan, P. E., & Gorman, J. M. (2002). A Guide To Treatments That Work, Second Edition. New York: Oxford University Press.

Suicide attempts

Brown, G.K., Have, T. T., Henriques, G.R., Xic, S.X., Hollander, J.E., & Beck, A.T. (2005). Cognitive Therapy for the Prevention of Suicide Attempts: A Randomized Controlled Trial. JAMA, 294, (5).

Substance/alcohol abuse

Anton, R.F., Moak, D.H., Latham, P., Waid, L.R. et al. (2005). Naltrexone combined with either cognitive behavioral or motivational enhancement therapy for alcohol dependence. J Clin Psychopharmacol. 25(4): 349-57.

Baker, A., Bucci, S., Lewin, T.J., Kay-Lambkin, F. et al. (2006). Cognitive-behavioural therapy for substance use disorders in people with psychotic disorders: Randomised controlled trial. Br J. Psychiatry. 188:439-48.

Baker, A., Lee, N.K., Claire, M., Lewin, T.J. et al. (2005). Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. Addiction. 100(3):367-78.

Feeney, G.F., Connor, J.P., Young, R.M., Tucker, J. et al. (2004). Alcohol dependence: the impact of cognitive behaviour therapy with or without naltrexone on subjective health status. Aust N Z J Psychiatry. 38(10):842-8.

Attention deficit disorder

Hinswaw S.P., Henker B., Whalen C.K. (1984). Self-control in Hyperactive Boys in Anger-Inducing Situations: Effects of Cognitive-Behavioral Training and Methylphenidate. J Abnorm Child Psychol. (12): 55-77

CHILDREN AND ADOLESCENTS

CBT has been clinically demonstrated in randomized controlled trials to be an effective treatment for the following disorders and problems:

Depression (among adolescents and depressive symptoms among children)

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Grossman, P. B., & Hughes, J. N. (1992). Self-control interventions with internalizing disorders: A review and analysis. School Psychology Review, 21(2), 229-245.

Reinecke, M. A., Ryan, N. E., DuBois, D. L. (1998). Cognitive-behavioral therapy

of depression and depressive symptoms during adolescence: A review

and meta-analysis. Journal of the American Academy of Child & Adolescent

Psychiatry, 37(1), 26-34.

Anxiety disorders

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Grossman, P. B., & Hughes, J. N. (1992). Self-control interventions with internalizing disorders: A review and analysis. School Psychology Review, 21(2), 229-245.

Separation anxiety

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Avoidant disorder

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Overanxious disorder

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Obsessive-compulsive disorder

March, J.S. (1995). Cognitive-Behavioral Psychotherapy for Children and Adolescents with OCD: A Review and Recommendations for Treatment. Journal of the American Academy of Child & Adolescent Psychiatry. 34(1):7-18.

O’Kearney RT, Anstey KJ, von Sanden C. (2006). Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents (Review). The Cochrane Database of Systematic Reviews, 4.

Phobias

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Post-traumatic stress disorder

Cohen J.A., Deblinger E., Mannarino A.P., Steer R. (2004), A multi-site randomized controlled trial for multiply traumatized children with sexual abuse-related PTSD. J Am Acad Child Adolesc Psychiatry 43(4):393-402.

Deblinger E., Stauffer L.B., Steer R.A. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their non-offending mothers. Child Maltreatment, 6: 332-343.

Conduct disorder (oppositional defiant disorder)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Distress due to medical procedures (mainly for cancer)

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Recurrent abdominal pain

Chambless, Diane L., Ollendick, & Thomas H. (2001). “Empirically Supported Psychological Interventions: Controversies and Evidence.” Annu. Rev. Psychol. 52:685-716.

Physical complaints not explained by a medical condition (Somatoform disorders)

Butler, A.C., Chapman, J.E., Forman, E.M., & Beck, A.T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

Grossman, P. B., & Hughes, J. N. (1992). Self-control interventions with internalizing disorders: A review and analysis. School Psychology Review, 21(2), 229-245.

COGNITIVE BEHAVIORAL THERAPY IS ALSO USED FOR:

  • Stress
  • Low self-esteem
  • Relationship difficulties
  • Group therapy
  • Family therapy
  • Psychiatric Inpatients
  • Work problems & procrastination
  • Pre-menstrual syndrome
  • Separation and Divorce
  • Grief and loss
  • Aging
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