Search Our Scientific Publications & Authors

Cogn Behav Pract 2018 Aug 29;25(3):391-401. Epub 2017 Oct 29.

Drexel University.

Cognitive behavioral therapy (CBT) is regarded as the gold-standard treatment for bulimia nervosa (BN), yet despite impressive empirical support for its effectiveness, over 50% of patients fail to achieve abstinence from binge eating and purging by the end of treatment. One factor that may contribute to reduced efficacy rates in CBT is weight suppression (WS; the difference between a person's highest weight ever at their adult height and current weight). A growing body of research indicates that WS in patients with BN may have a clinically significant effect on symptomatology and prognosis. Read More

Cogn Behav Pract 2018 Aug 21;25(3):402-415. Epub 2017 Nov 21.

University of North Carolina School of Medicine.

Depression is prevalent among mothers who participate in home visitation programs. This case study describes In-Home Cognitive Behavior Therapy (IH-CBT), an empirically based treatment for depressed mothers that is strongly integrated with ongoing home visitation. The use of a Parenting Enhancement for Maternal Depression (PEMD) module was added to address parenting difficulties in a depressed mother. Read More

Cogn Behav Pract 2018 Aug 13;25(3):377-390. Epub 2017 Oct 13.

Department of Psychiatry, Rush University Medical Center.

Moral injury refers to acts of commission or omission that violate individuals' moral or ethical standards. Morally injurious events are often synonymous with psychological trauma, especially in combat situations; thus, morally injurious events are often implicated in the development of PTSD for military service members and veterans. Although Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have been well-established as effective treatments for veterans who are struggling with posttraumatic stress disorder (PTSD), it has been suggested that these two evidence-based therapies may not be sufficient for treating veterans whose PTSD resulted from morally injurious events. Read More

Cogn Behav Pract 2018 Aug 5;25(3):361-376. Epub 2017 Dec 5.

University of Miami.

In the U.S. Black women with HIV face numerous psychosocial challenges, particularly trauma, racism, HIV-related discrimination, and gender role expectations, that are associated with negative HIV health outcomes and low medical treatment adherence. Read More

Cogn Behav Pract 2018 Feb 2;25(1):105-118. Epub 2017 Mar 2.

University of Houston and University of Texas MD Anderson Cancer Center.

Persons living with HIV/AIDS (PLHIV) are able to live full lifespans after infection, however, rates of anxiety disorders among this population are elevated compared to national samples. Importantly, these anxiety symptoms and disorders have a negative effect on medication adherence, quality of life and other psychological disorders, such as depression. In order to reduce the impact of anxiety among PLHIV, a six-session transdiagnostic CBT-based treatment manual for anxiety among PLHIV named the HIV/Anxiety Management-Reduction Treatment (HAMRT) was developed and implemented. Read More

Cogn Behav Pract 2018 Feb 6;25(1):44-56. Epub 2017 Jun 6.

The University of Kansas.

Depressive symptoms are the most frequently treated psychiatric condition in the United States. Brief behavioral activation treatment for depression (BATD) is a popular, evidence-based psychotherapy with strong research support for the treatment of depression. In this paper, we describe the development and initial pilot feasibility testing of a BATD mobile application (Behavioral Apptivation) to be used by patients and therapists in conjunction with BATD therapy. Read More

Cogn Behav Pract 2018 Feb;25(1):135-144

San Diego State and University of California, San Diego.

Depression in low-income Latino populations can be treated using group cognitive behavioral therapy (GCBT). However, effective delivery of GCBT for depression in primary care settings is often impeded by high dropout rates and poor homework adherence. In this study, we describe the structure, processes, and outcomes (including attendance, homework completion, and symptom measures) of GCBT for Spanish-speaking Latino patients with depression in an urban public sector primary care setting. Read More

Cogn Behav Pract 2018 Feb 21;25(1):119-134. Epub 2017 Mar 21.

Wayne State, University.

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Read More

Cogn Behav Pract 2017 Aug 5;24(3):363-373. Epub 2016 Oct 5.

University of Minnesota.

Data suggests that individuals who binge eat are more responsive to food cues in the environment and less sensitive to satiety cues. The aim of this open trial was to evaluate the feasibility, acceptability, and initial of a novel treatment grounded in Schachter's externality theory targeting food cue reactivity and satiety responsiveness with obese adults who binge eat. Treatment was provided in groups, and utilized appetite monitoring, cue-exposure treatment, exercises, self-monitoring, and coping skills. Read More

Cogn Behav Pract 2017 Nov 12;24(4):496-507. Epub 2017 Jan 12.

The Miriam Hospital and Brown University.

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. Read More

Cogn Behav Pract 2017 Nov;24(4):393-404

Anxiety disorders are among the most common psychiatric problems in youth, fail to spontaneously remit, and place some youth at risk for additional behavioral and emotional difficulties. Efforts to target anxiety have resulted in evidence-based interventions but the resulting prevention effects are relatively small, often weakening over time. Mobile health (mHealth) tools could be of use to strengthen the effects of anxiety prevention efforts. Read More

Cogn Behav Pract 2017 May;24(2):245-255

University of Oxford.

Distorted negative self-images and impressions appear to play a key role in maintaining Social Anxiety Disorder (SAD). In previous research, McManus et al. (2009) found that video feedback can help people undergoing cognitive therapy for SAD (CT-SAD) to develop a more realistic impression of how they appear to others, and this was associated with significant improvement in their social anxiety. Read More

Cogn Behav Pract 2017 Aug 8;24(3):374-381. Epub 2017 Feb 8.

Alpert Medical School of Brown University, Bradley Hospital.

TicHelper.com ("TicHelper") is an interactive online treatment program for youth with chronic tic disorders (CTDs) or Tourette Syndrome (TS) and their parents. It is based on Comprehensive Behavioral Intervention for Tics (CBIT), an individual, outpatient therapy protocol shown to effectively reduce tics in randomized controlled trials. Read More

Cogn Behav Pract 2017 Aug;24(3):269-287

UCLA.

Although the evidence base for treatment of depressive disorders in adolescents has strengthened in recent years, less is known about the treatment of depression in middle to late childhood. A family-based treatment may be optimal in addressing the interpersonal problems and symptoms frequently evident among depressed children during this developmental phase, particularly given data indicating that attributes of the family environment predict recovery versus continuing depression among depressed children. Family-Focused Treatment for Childhood Depression (FFT-CD) is designed as a 15-session family treatment with both the youth and parents targeting two putative mechanisms involved in recovery: (a) enhancing family support, specifically decreasing criticism and increasing supportive interactions; and (b) strengthening specific cognitive-behavioral skills within a family context that have been central to CBT for depression, specifically behavioral activation, communication, and problem solving. Read More

Cogn Behav Pract 2017 Aug;24(3):296-311

West Virginia University.

Cognitive behavior therapy (CBT) is efficaciously and effectively used in the treatment of anxiety disorders; however, as CBT for anxiety routinely utilizes exposure components, clients often experience ambivalence about treatment and their clinicians often must deal with resistance. Motivational Interviewing (MI) is a therapeutic strategy that addresses ambivalence about change in clinical interventions. MI has been applied as an adjunct for treatments such as CBT in order to increase motivation for and commitment to the intervention, especially when components of the treatment may be challenging (e. Read More

Cogn Behav Pract 2017 Feb;24(1):121-127

Temple University.

Anxiety Coach is a smartphone application ("app") for iOS devices that is billed as a self-help program for anxiety in youth and adults. The app is currently available in the iTunes store for a one-time fee of $4.99. Read More

Cogn Behav Pract 2016 Aug;23(3):356-367

University of Massachusetts Medical School.

Most serious mental illnesses (SMI) have onset by emerging adulthood and SMI can impair adolescents' transitions into healthy, productive adults. Emerging adults (EAs) with SMI are at high risk for justice involvement, and rates of recidivism are greater for offenders with SMI than without. These EAs are frequently multi-system involved (e. Read More

Cogn Behav Pract 2017 Feb;24(1):38-49

Fenway Health, Harvard Medical School and Massachusetts General Hospital, and University of Miami.

One dramatic advance in human immunodeficiency virus (HIV) prevention efforts has been the prescription of medications typically used for HIV treatment as prophylaxis against acquiring HIV. As a preventative agent, this practice is referred to as "preexposure prophylaxis" (PrEP). The U. Read More

Cogn Behav Pract 2017 Feb 24;24(1):1-13. Epub 2016 Feb 24.

Drexel University.

Binge eating disorder (BED), characterized by recurrent eating episodes in which individuals eat an objectively large amount of food within a short time period accompanied by a sense of loss of control, is the most common eating disorder. While existing treatments, such as cognitive behavioral therapy (CBT), produce remission in a large percentage of individuals with BED, room for improvement in outcomes remains. Two reasons some patients may continue to experience binge eating after a course of treatment are: (a) Difficulty complying with the prescribed behavioral components of CBT due to the discomfort of implementing such strategies; and (b) a lack of focus in current treatments on strategies for coping with high levels of negative affect that often drive binge eating. Read More

Cogn Behav Pract 2016 Nov;23(4):459-463

Department of Psychology, University of Washington, Box 351525, Seattle WA 98195-1525.

Functional Analytic Psychotherapy (FAP) focuses on what happens in session between clients and therapists in order to create more intense and curative therapeutic relationships. FAP may be used as a standalone treatment or as an adjunct to other therapies in order to maximize therapeutic gains through strengthened alliance and differential reinforcement. When it fits within a client's case conceptualization, FAP clinicians often choose to use structured, evocative activities to progress the therapy at a faster pace. Read More

Cogn Behav Pract 2016 May;23(2):194-204

University of North Carolina at Chapel Hill.

Children from low-income families are more likely to develop early-onset disruptive behavior disorders (DBDs) compared to their higher income counterparts. Low-income families of children with early-onset DBDs, however, are less likely to engage in the standard-of-care treatment, behavioral parent training (BPT), than families from other sociodemographic groups. Preliminary between-group findings suggested technology-enhanced BPT was associated with increased engagement and boosted treatment outcomes for low-income families relative to standard BPT. Read More

Cogn Behav Pract 2016 May 11;23(2):184-193. Epub 2015 May 11.

La Salle University.

Despite the abundance of research that supports the efficacy of exposure therapy for childhood anxiety disorders and OCD, negative views and myths about the harmfulness of this treatment are prevalent. These beliefs contribute to the underutilization of this treatment and less robust effectiveness in community settings compared to randomized clinical trials. Although research confirms that exposure therapy is efficacious, safe, tolerable, and bears minimal risk when implemented correctly, there are unique ethical considerations in exposure therapy, especially with children. Read More

Cogn Behav Pract 2016 Aug 26;23(3):368-384. Epub 2015 Oct 26.

University of Massachusetts Medical School.

Improving outcomes of youth with mental health (MH) needs as they transition into adulthood is of critical public health significance. Effective psychotherapy MH treatment is available, but can be effective only if the emerging adult (EA) attends long enough to benefit. Unfortunately, completion of psychotherapy among EAs is lower than for more mature adults (Edlund et al. Read More

Cogn Behav Pract 2016 Aug;23(3):316-328

Department of Psychiatry, University of Minnesota, Minneapolis, MN.

Currently, research support is strongest for family-based treatment (FBT) for the treatment of anorexia nervosa (AN) in adolescents. However, a strong evidence base for treatments for older adolescents and young adults with AN is lacking. Emphasizing social support in the treatment of AN may be beneficial for older adolescents and young adults with AN. Read More

Cogn Behav Pract 2016 May;23(2):205-220

Anxiety Disorders Clinic, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.

Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out of session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this manuscript describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI's focus on building and maintaining motivation to change into BATD. The manuscript provides an overview of MI and BATD, theoretical issue raised in integrating the two approaches, and examples of how this integration results in a nondirective and motivation-focused approach to conducting BATD. Read More

Cogn Behav Pract 2016 Feb 16;23(1):40-50. Epub 2014 Oct 16.

Texas A&M University.

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment for children with Chronic Tic Disorders (CTDs). Nevertheless, many families of children with CTDs are unable to access CBIT due to a lack of adequately trained treatment providers, time commitment, and travel distance. This study established the interrater reliability between in-person and VoIP administrations of the Yale Global Tic Severity Scale (YGTSS), and examined the preliminary efficacy, feasibility, and acceptability of Voice over Internet Protocol (VoIP)-delivered CBIT for reducing tics in children with CTDs in an open case series. Read More

Cogn Behav Pract 2015 Nov;22(4):430-438

Massachusetts General Hospital and Harvard Medical School.

There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Read More

Cogn Behav Pract 2015 Aug;22(3):393-406

Ferkauf Graduate School of Psychology, Yeshiva University, and Albert Einstein College of Medicine, Yeshiva University.

Depression and illness-specific distress are more common among adults with Type 1 diabetes (T1DM) than the general population and have been associated with poorer control of blood glucose and increased risk for serious diabetes-related complications. Treatment nonadherence has also been associated with depressive symptoms and diabetes-related distress, and has repeatedly been suggested as an important modifiable behavioral pathway linking depression and diabetes outcomes. The present study reports on the feasibility and acceptability of a pilot intervention using group-based cognitive-behavioral therapy to improve treatment adherence among adults with T1DM and elevated levels of diabetes-related distress or depressive symptoms. Read More

Cogn Behav Pract 2015 Feb;22(1):74-86

University of Washington.

Research in children's mental health has suggested that emotional and behavioral problems in are inextricably tied to academic difficulties. However, evidence-based programs implemented in school-based mental health tend to focus primarily on treatment practices, with less explicit emphasis on components of evidence-based assessment (EBA), such as progress monitoring and feedback. The current paper describes two studies that incorporated standardized assessment and progress monitoring/feedback into school-based mental health programs. Read More

Cogn Behav Pract 2015 Aug;22(3):281-290

University of Vermont.

Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. Read More

Cogn Behav Pract 2015 Aug;22(3):345-358

National Development Research Institute.

Combat veterans from the wars in Iraq and Afghanistan commonly experience posttraumatic stress disorder (PTSD) and substance use problems. In addition, these veterans often report significant barriers to receiving evidence-based mental health and substance use care, such as individual beliefs that treatment will be unhelpful, inconvenient, or that they should be able to handle their problems on their own. To increase access to treatment for this underserved population, a Web-based patient self-management program that teaches cognitive-behavioral therapy (CBT) skills to manage PTSD symptoms and substance misuse was developed. Read More

Cogn Behav Pract 2015 Aug;22(3):302-316

University of Florida.

Given the enormous individual, familial, and societal costs associated with early disruptive behavior disorders, transformative efforts are needed to develop innovative options for overcoming traditional barriers to effective care and for broadening the availability of supported interventions. This paper presents the rationale and key considerations for a promising innovation in the treatment of early-onset disruptive behavior disorders-that is, the development of an Internet-based format for the delivery of Parent-Child Interaction Therapy (PCIT) directly to families in their own homes. Specifically, we consider traditional barriers to effective care, and discuss how technological innovations can overcome problems of treatment availability, accessibility, and acceptability. Read More

Cogn Behav Pract 2015 May 4;22(2):116-126. Epub 2015 Feb 4.

Massachusetts General Hospital and Harvard Medical School.

Although ADHD in adolescents is an impairing and prevalent condition, with community prevalence estimates between 2% and 6%, psychosocial treatments for adolescents compared to younger children are relatively understudied. Our group has successfully developed an evidence base for cognitive-behavioral therapy (CBT) for ADHD in medication-treated adults with ADHD with clinically significant symptoms. In the current paper, we describe an adaptation of this treatment to adolescents, and provide case reports on 3 adolescents who participated in an open pilot trial. Read More

Cogn Behav Pract 2015 May;22(2):192-202

Duke ADHD Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.

Clinicians who conduct cognitive-behavioral therapy (CBT) targeting attention-deficit/hyperactivity disorder (ADHD) in adulthood have noted that their patients sometimes verbalize overly positive automatic thoughts and set overly optimistic goals. These cognitions are frequently related to failure to engage in compensatory behavioral strategies emphasized in CBT. In this paper, we offer a functional analysis of this problematic pattern, , and suggest methods for addressing it within CBT for adult ADHD. Read More

Cogn Behav Pract 2015 May;22(2):172-191

Duke University Medical Center, Department of Psychiatry and Behavioral Sciences.

Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Read More

Cogn Behav Pract 2015 Feb;22(1):5-19

Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA 19104, USA.

Evidence-based assessment has received little attention despite its critical importance to the evidence-based practice movement. Given the limited resources in the public sector, it is necessary for evidence-based assessment to utilize tools with established reliability and validity metrics that are free, easily accessible, and brief. We review tools that meet these criteria for youth and adult mental health for the most prevalent mental health disorders to provide a clinical guide and reference for the selection of assessment tools for public sector settings. Read More

Cogn Behav Pract 2015 Feb;22(1):49-59

Indiana University and University of Washington.

Measurement-based care (MBC) can be defined as the practice of basing clinical care on client data collected throughout treatment. MBC is considered a core component of numerous evidence-based practices (e.g. Read More

Cogn Behav Pract 2014 May;21(2):127-133

Virginia Commonwealth University.

Murray et al. (this issue) present a fascinating account of their international dissemination and implementation (D&I) research focused on training therapists in Thailand and Iraq to provide a modular treatment approach called Common Elements Treatment Approach to youth. In this commentary, we use Murray et al. Read More

Cogn Behav Pract 2014 May;21(2):111-123

Johns Hopkins Bloomberg School of Public Health.

This paper describes the Common Elements Treatment Approach (CETA) for adults presenting with mood or anxiety problems developed specifically for use with lay counselors in low- and middle-income countries (LMIC). Details of the intervention development, training, supervision, and decision-making process are presented. Case vignettes are used as examples throughout. Read More

Cogn Behav Pract 2014 May;21(2):191-205

The Fenway Institute, Fenway Health, Massachusetts General Hospital/Harvard Medical School, Harvard School of Public Health.

Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Read More

Cogn Behav Pract 2014 Nov;21(4):386-403

University of Maryland, College Park, and University of North Carolina, Chapel Hill.

Antiretroviral therapy to treat HIV/AIDS has substantially improved clinical outcomes among patients living with HIV/AIDS, but only in the presence of very consistent adherence. One of the most prevalent and impactful individual-level predictors of poor adherence is depressive symptoms, even at subthreshold levels. Evidence-based cognitive behavioral interventions exist to address improvements in depressive symptoms and adherence in this population, yet these techniques have largely been designed and tested as individual treatments for delivery in mental health settings. Read More

Cogn Behav Pract 2014 May;21(2):161-175

Johns Hopkins University.

This paper describes a family-based intervention for addressing both substance use and unprotected sexual behavior in adolescents presenting for outpatient substance use treatment. The intervention combines contingency management (CM) for adolescent substance use, which is a behavioral intervention modeled on the Community Reinforcement Approach, with a sexual risk reduction protocol that mirrors aspects of the CM model. As a family-based intervention, caregivers attend every session and actively collaborate with the therapist to address their youth's behavior problems. Read More

Cogn Behav Pract 2014 Feb;21(1):97-108

University of South Florida, Tampa.

Young children who are exposed to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). While effective psychosocial treatments for childhood PTSD exist, novel interventions that are more accessible, efficient, and cost-effective are needed to improve access to evidence-based treatment. Stepped care models currently being developed for mental health conditions are based on a service delivery model designed to address barriers to treatment. Read More

Cogn Behav Pract 2014 Feb;21(1):78-88

VA San Diego Healthcare System, University of California - San Diego.

Guilt related to combat trauma is highly prevalent among veterans returning from Iraq and Afghanistan. Trauma-related guilt has been associated with increased risk for posttraumatic psychopathology and poorer response to treatment. Trauma Informed Guilt Reduction (TrIGR) therapy is a 4-module cognitive-behavioral psychotherapy designed to reduce guilt related to combat trauma. Read More

Cogn Behav Pract 2014 Feb;21(1):1-11

University of Washington, Seattle.

Behavioral rehearsal, when a trainee engages in a simulated interaction with another individual, is an underutilized but potentially cost-effective and feasible solution for two difficult questions in implementation science: how to improve training, a commonly used implementation strategy, and how to feasibly measure fidelity using analogue methods in community settings. This paper provides practical information on how to develop and use behavioral rehearsal for both of these purposes to implementation researchers. Therefore, we focus on development and use of behavioral rehearsal as a training and analogue fidelity tool in the context of three illustrative studies. Read More

Cogn Behav Pract 2014 Nov;21(4):432-445

Weill Cornell Medical College.

Fall accidents among older adults can be devastating events that, in addition to their physical consequences, lead to disabling anxiety warranting the attention of mental health practitioners. This article presents "Back on My Feet," an exposure-based cognitive-behavioral therapy (CBT) protocol that is designed for older adults with posttraumatic stress disorder (PTSD), subthreshold PTSD, or fear of falling resulting from a traumatic fall. The protocol can be integrated into care once patients have been discharged from hospital or rehabilitation settings back to the community. Read More