Browsing by Subject "Cognitive-behavioral therapy"
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Item Drama-based strategies in the elementary classroom : increasing social perspective-taking and problem-solving(2014-08) Combs, Austin Beasley-Rodgers; Cawthon, Stephanie W.Educational PsychologyItem Examining sudden gains during cognitive-behavioral therapy for depressed 9 to 13 year old girls(2010-08) Fisher, Melissa Elizabeth, 1980-; Stark, Kevin Douglas; Tharinger, Deborah J.; Keith, Timothy Z.; Loukas, Alexandra; Weersing, RobinCognitive-behavioral therapy (CBT) is used to treat children and adolescents with depression. Researchers determined that many individuals undergoing CBT and other therapies experienced sudden gains, meaning that they experienced a rapid and large improvement in their symptoms between sessions. The studies demonstrated that by the end of treatment, individuals who experienced sudden gains were significantly less depressed and had better long-term outcomes than individuals who did not experience sudden gains. Previous studies investigated sudden gains in individual therapy while the present study examined sudden gains in group treatment. In addition to replicating results of previous studies, the present study sought to examine the effect of sudden gains on depressive symptoms, family environment, cognitive triad, and negative life events at pre-treatment and at a one year follow-up using multivariate analysis of variance. Participants included 136 girls, aged 9 to 13, in two treatment conditions (CBT, CBT+ parent training (CBT+PT), and a Minimal Contact Control (MCC)). At pre-treatment, post-treatment, and at a one year follow-up, participants completed self-report measures of the family environment, cognitive triad, and negative life events. They also completed a semi-structured diagnostic interview designed to symptoms of depression. After beginning the study, participants’ depressive symptoms were monitored with a brief symptom interview and/or a self-report measure of depressive symptoms. Findings from the study provided further evidence that sudden gains occur during group CBT, and that the majority of sudden gains occur early in CBT. The number of sudden gains did not vary significantly by treatment condition, and similar to previous research, the presence of a parent intervention component did not appear to significantly change the relation between sudden gains and treatment outcome. One important finding was participants in the Minimal Contact Control group experienced sudden gains despite not being in treatment. Another important finding was that the participants who experienced sudden gains differed significantly from the participants who did not experience sudden gains on pre-treatment measures of family environment and the cognitive triad but no differences were found at post-treatment or at a one year follow-up. Implications of these results, limitations, and recommendations for future research are provided.Item The relation between problem-solving interventions in cognitive-behavioral therapy and depression in early adolescent girls(2012-08) Nguyen, Kimhoang Thi; Stark, Kevin Douglas; Gray, Jane; Repp, Ann; Tharinger, Deborah; Whittaker, TiffanyDepression in youth is a serious mental health concern affecting many different domains of functioning. Currently, cognitive behavioral therapy (CBT) is the most extensively studied psychosocial treatment for depression; however, there is limited research on how the specific components of CBT function to produce effective treatment outcomes. In addition to identifying the components responsible for effective treatment outcome, it is also important to investigate the changes in youth with depression that account for the reduction of symptomatology. Problem-solving is one of the effective CBT strategies used to improve depressive symptoms. The purpose of the current study was to investigate the association between problem-solving interventions and depression. The current study also sought to investigate if depressive symptoms are mediated through changes in the view of the future. Participants were 40 girls, aged 9 to 14, who completed a manualized CBT protocol for depression in a group format. Participants completed a diagnostic interview for depression and self-report measures assessing the view of the future dimension of the cognitive triad. Group therapy sessions were coded for problem-solving interventions using an investigator developed coding system. The results indicated that the level of problem-solving intervention implemented by the therapist failed to predict a decrease in depressive symptoms, after controlling for the girls’ initial levels of depression severity. Level of problem-solving intervention was significantly related to positive future views on the cognitive triad, after controlling for initial levels of the future subscale on the cognitive triad. Results also indicated that participants with a more positive view of their future were less depressed at post-treatment. Treatment specificity could not be conducted because the relation between problem-solving interventions and treatment outcome was not significant. An exploratory analysis was conducted with additional control variables. After controlling for mastery of problem-solving skills, level of expectancies for change, and initial level of depression, problem-solving intervention was a significant predictor of treatment outcome. Exploratory analysis also concluded that levels of consequential thinking and levels of brainstorming were related to treatment outcome. Implications, limitations, and recommendations for future research are presented.Item Relational factors and cognitive interventions in group cognitive-behavioral therapy : effects on the cognitive triad and depression in preadolescent females(2010-08) Gerber, Bradley Louden; Stark, Kevin Douglas; Tharinger, Deborah; Keith, Timothy; Stapleton, Laura; Hargrave, JenniferPrevious research indicates that cognitive-behavioral therapy (CBT) is helpful in reducing depression in youth. However, little research exists into what specific components within CBT treatment protocols are associated with decreases in depression. Furthermore, little is known about how components within CBT treatment protocols reduce depression. Cognitive theories suggest that interventions targeted at negative cognitions reduce depression. Research has provided initial support for this position, although these studies did not utilize clinically depressed youth. Research has also shown that the therapeutic ingredients of therapist relational behaviors and group cohesion are important general factors in treatment; however, research exploring these variables in youth depression is lacking. Cognitive theories of depression suggest depressogenic thinking mediates the relationship between interventions and depression. However, no research exists exploring depressogenic thinking as a mediator between specific components of CBT treatment protocols and youth depression. The purpose of the current study was to investigate the association between specific components of a CBT treatment protocol and depression. The current study also sought to investigate depressogenic thinking as a mediator between the components of interest and depression. Participants were 42 girls, aged 9 to 14, who completed a manualized CBT group treatment protocol for depression. Participants completed a diagnostic interview for depression and completed self-report measures of depressogenic thinking. Group therapy sessions were coded for cognitive interventions, therapist relational behaviors, and group cohesion. The results of the main hypotheses indicated no significant associations between cognitive interventions, therapist relational behaviors, group cohesion and depression. Furthermore, tests of depressogenic thinking as a mediator could not be conducted based on the aforementioned results. However, post-hoc power analysis revealed extremely low power for the analyses. To further investigate the data, an exploratory analysis was conducted, with steps taken to increase power. Results from the exploratory analysis indicated the therapist relational behaviors measure consisted of two factors, both of which were significantly associated with post-treatment depression. Furthermore, the exploratory analysis revealed a significant association between cognitive interventions and post-treatment depression. Finally, no significant association was found between group cohesion and post-treatment depression. Implications, limitations, and recommendations for further areas of research are presented.Item The relations between parent training, family messages, cognitive triad, and girls’ depressive symptoms(2012-08) Funk, Catherine Lee; Carlson, Cindy I., 1949-; Stark, Kevin Douglas; Keith, Timothy Z.; Gray, Jane; Loukas, AlexandraIt is important to understand the development of depression, and how a family component to treatment affects early adolescent girls’ depression given the association between depression and negative future outcomes. A potential vulnerability to depression is the cognitive triad, which encompasses beliefs about the self, world, and future and is shaped by early learning experiences. Research indicates that the vulnerability originates from parent-child relationships and family messages, which are important in the development of youth cognitive styles. Previous research also indicates that family variables are important factors to consider in the treatment of depression. The purpose of the current study was to expand previous research by examining the roles of perceived family messages and the cognitive triad in the development of depression for early adolescent girls. The study also explored whether parent gender differentiated how family messages affect girls’ cognitions and depressive symptoms. The study evaluated how the addition of a parent training component to a school-based, group-administered CBT intervention affected change in the model’s variables in comparison to group-administered CBT intervention alone and a monitoring control condition. Participants included early adolescent girls diagnosed with depression and caregivers in the parental treatment component. Girls were randomly assigned to a CBT, CBT+PT, or minimal contact control condition. Ratings of girls’ perceptions of family messages, cognitions, and depressive symptoms were obtained at pre-treatment and post-treatment. Results from structural equation modeling indicated significant effects from perceived family messages to girls’ cognitions. Further, girls’ cognitions mediated the relation between perceived family messages and girls’ depressive symptoms at post-treatment for participants within the CBT and monitoring conditions. No significant differences were evident between parent gender and perceived messages. Results indicated that the addition of a parent component to the CBT intervention did not significantly differ from the CBT intervention alone in its effects on the variable relations within the model at post-treatment. Supplemental analyses highlighted parent attendance as a significant factor, with larger effects from the family messages on girls’ cognitions appearing when parents attended majority (six or more) of the eight parent training sessions. Implications, limitations, and areas for further research are discussed.