On therapy


The American Academy of Sleep Medicine issued the following news release:

Bright light therapy improves sleep disturbances in soldiers with combat PTSD

Study suggests that bright light therapy may be an effective treatment
for combat-related post-traumatic stress disorder

Bright light therapy has significant effects on sleep disturbances
associated with combat-related post-traumatic stress disorder, according
to a research abstract that will be presented Monday, June 7, 2010, in
San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the
Associated Professional Sleep Societies LLC.

Results indicate that bright light therapy produced a significantly
greater improvement than placebo in sleep disturbances specific to PTSD.

Bright light therapy also produced a moderate improvement in PTSD
symptoms and depression.

“Results of this ongoing study show significant effects of bright light
on disruptive nocturnal behaviors associated with combat PTSD, as well
as positive effects of bright light therapy on PTSD symptom severity,”
said study coordinator Shannon Cornelius, PhD, graduate research
assistant for Dr. Shawn D. Youngstedt in the department of exercise
science at the University of South Carolina in Columbia, S.C.

“Because bright light therapy is a relatively simple, self-administered,
inexpensive treatment with few side effects, these results are an
important step to further establish the efficacy of bright light therapy
as an alternative or adjunct treatment for combat-related PTSD.”

The study involved 16 soldiers who returned to the U.S. with combat-
related PTSD after serving in Operation Enduring Freedom or Operation
Iraqi Freedom. Following a one-week baseline, participants were
randomized to one of two four-week treatments.

Eight soldiers received 10,000 lux of bright light therapy for 30
minutes each day. The other eight participants were assigned to the
placebo group and received sham treatment with an inactivated negative
ion generator.

The Clinician-Administered PTSD Scale (CAPS-2) was completed at
baseline and immediately following completion of the study.

At weekly intervals, depression was assessed with the Beck Depression
Inventory (BDI-II), and sleep quality was assessed with the Pittsburgh
Sleep Quality Index (PSQI) with addendum for PTSD (PSQI-PTSD).

Cornelius noted that sleep disturbance is a commonly reported problem
that can play both a precipitating and perpetuating role in PTSD, making
it an important target for therapy.

“Disturbed sleep is known to interact with depression and anxiety in a
vicious cycle,” said Cornelius.

“By reducing the severity and occurrence of sleep disturbances, it may
be possible to reduce the severity of symptoms such as anxiety and
depression in combat-related PTSD.”

The American Academy of Sleep Medicine reports that 70 to 90 percent of
people with PTSD describe subjective sleep disturbance. Recurrent
nightmares of the traumatic event represent one of the most problematic
and enduring symptoms of PTSD.

These nightmares may take the form of a realistic reliving of the
traumatic event or depict only some of its elements.

Bright light therapy exposes your eyes to intense but safe amounts of
light for a specific and regular length of time.

Typically it involves exposure to up to 10,000 lux of light for
scheduled periods of 20 minutes or more using a small light box.

In a 2007 study published in the journal BMC Psychiatry, Youngstedt
reported that bright light exposure may have an anxiolytic effect.

Three hours of exposure to 3,000 lux of bright light for three
consecutive days reduced anxiety in a group of low-anxiety adults.

The University of Rochester Medical Center issued the following news release:

Cognitive behavioral therapy for insomnia significantly improved sleep
for patients with chronic neck or back pain and also reduced the extent
to which pain interfered with their daily functioning, according to a
study by University of Rochester Medical Center researchers.

The study, published online by the journal Sleep Medicine, demonstrates
that a behavioral intervention can help patients who already are taking
medications for pain and might be reluctant or unable to take additional
drugs to treat sleep disturbance.

“This therapy made a major difference to these patients,” said Carla R.
Jungquist, F.N.P., Ph.D., of the Medical Center’s Sleep and
Neurophysiology Research Laboratory, who is the lead author of the Sleep
Medicine article.

(more…)

The new issue of *Behaviour Research and Therapy* (vol. 48, #2, pp.
152-157) includes a study: “When self-help is no help: Traditional
cognitive skills training does not prevent depressive symptoms in people
who ruminate.”

The author is Gerald J. Haeffela.

Here’s the abstract:

[begin excerpt]

A randomized trial was conducted to test the efficacy of three self-
directed prevention intervention workbooks for depression.

Cognitively at-risk college freshmen were randomly assigned to one of
three conditions: traditional cognitive, non-traditional cognitive, and
academic skills.

Consistent with hypotheses, participants who were high in rumination and
experienced stress exhibited significantly greater levels of depressive
symptoms after completing the traditional cognitive skills workbook than
after completing the other two workbooks.

This pattern of results held post-intervention and 4 months later.

These findings indicate that rumination may hinder ones ability to
identify and dispute negative thoughts (at least without the help of a
trained professional).

The results underscore the importance of identifying individual
difference variables that moderate intervention efficacy.

They also raise concerns about the potential benefits of self-help
books, an industry that generates billions of dollars each year.

[end abstract]

Here’s the contact info from the author note: Gerald J. Haeffela,
Department of Psychology, University of Notre Dame, Haggar Hall, Notre
Dame, IN 46556, < g h a e f f e l @ n d . e d u >.

Courtesy of Ken Pope

Next month’s issue of *Clinical Psychology Review* (February 2010,; vol.
30, #1) includes an article: “The efficacy of short-term psychodynamic
psychotherapy for depression: A meta-analysis.”

The authors are Driessen, Ellen; Cuijpers, Pim; de Maat, Saskia C. M.;
Abbass, Allan A.; de Jonghe, Frans; & Dekker, Jack J. M.

Here’s the abstract:

[begin abstract]

Objectives:

It remains largely unclear, firstly whether short-term psychodynamic
psychotherapy (STPP) is an effective treatment for depression, and
secondly, which study, participant, or intervention characteristics may
moderate treatment effects. The purpose of this study is to assess the
efficacy of STPP for depression and to identify treatment moderators.

Results:
(more…)

Next month’s issue of *Clinical Psychology Review (Feb, 2010; vol. 30,
#1) includes an article: “Psychotherapy for chronic major depression and
dysthymia: A meta-analysis.”

The authors are Cuijpers, Pim; van Straten, Annemieke; Schuurmans,
Josien; van Oppen, Patricia; Hollon, Steven D.; & Andersson, Gerhard.

Here’s the abstract:

[begin abstract]

Although several studies have examined the effects of psychotherapy on
chronic depression and dysthymia, no meta-analysis has been conducted to
integrate results of these studies.

We conducted a meta-analysis of 16 randomized trials examining the
effects of psychotherapy on chronic depression and dysthymia.

We found that psychotherapy had a small but significant effect (d =0.23)
on depression when compared to control groups. Psychotherapy was
significantly less effective than pharmacotherapy in direct comparisons
(d =-0.31), especially SSRIs, but that this finding was wholly
attributable to dysthymic patients (the studies examining dysthymia
patients were the same studies that examined SSRIs).

Combined treatment was more effective than pharmacotherapy alone (d
=0.23) but even more so with respect to psychotherapy alone (d =0.45),
although again this difference may have reflected the greater proportion
of dysthymic samples in the latter.

No significant differences were found in drop-out rates between
psychotherapy and the other conditions.

We found indications that at least 18 treatment sessions are needed to
realize optimal effects of psychotherapy.

We conclude that psychotherapy is effective in the treatment of chronic
depression and dysthymia but probably not as effective as
pharmacotherapy (particularly the SSRIs).

[end abstract]

The author note provides the following contact info: <p.cuijpers@psy.vu.nl>.

Courtesy of Ken Pope

The University of Warwick issued a news release:  “Therapy 32 times more
cost effective at increasing happiness than money.”

PLEASE NOTE:  Contact info for the study’s author appears at the end of
the news release.

Here’s the University of Warwick’s statement:

Research by the University of Warwick and the University of Manchester
finds that psychological therapy could be 32 times more cost effective
at making you happy than simply obtaining more money.

The research has obvious implications for large compensation awards in
law courts but also has wider implications for general public health.

Chris Boyce of the University of Warwick and Alex Wood of the University
of Manchester compared large data sets where 1000s of people had
reported on their well-being. They then looked at how well-being changed
due to therapy compared to getting sudden increases in income, such as
through lottery wins or pay rises. They found that a 4 month course of
psychological therapy had a large effect on well-being. They then showed
that the increase in well-being from an ?800 course of therapy was so
large that it would take a pay rise of over ?25,000 to achieve an
equivalent increase in well-being. The research therefore demonstrates
that psychological therapy could be 32 times more cost effective at
making you happy than simply obtaining more money.

(more…)

A short youtube clip from a Toronto therapist explaining from her perspective what happens in therapy – the first session, and overall.  It’s a bit general, but gives you some of the flavour.  Bear in mind that, as she says, all sessions differ.

Here’s the link:

http://www.gotosee.co.uk/healtharticles/2009/03/guide-to-psychotherapy/

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