What is Cognitive Behavioral Therapy?


Cognitive behavioral therapy (CBT) is a blend of two therapies: cognitive therapy (CT) and behavioral therapy. CT was developed by psychotherapist Aaron Beck, M.D., in the 1960's. CT focuses on a person's thoughts and beliefs, and how they influence a person's mood and actions, and aims to change a person's thinking to be more adaptive and healthy. Behavioral therapy focuses on a person's actions and aims to change unhealthy behavior patterns.
From the National Library of Medicine's description of CBT. Here is the link:
http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml

Index

Attention deficit and oppositional behavior

After appropriate evaluation, attention deficit and oppositional disorders in children and teens may be treated with a behavioral approach involving parents as well.  For parents, a background can be found in Dr. Russell Barkley's book, Your Defiant Child: 8 Steps to Better Behavior (New York: Guilford Press, 1998). The behavioral approach may be combined with referral for a medication evaluation.

For clinicians, Barkley's book ADHD and the Nature of Self-Control, New York: Guilford, 1997 describes research up to that time and speculates on the role of prefrontal cortex in attention and self-control. The other publications shown below provide structured recommendations on testing, diagnosis, medication, and behavioral treatment of ADHD and of Oppositional-Defiant Behavior, either for clinicians (1, 2, 5, 6, 7) or parents (3, 4, 8).

  1. Barkley, R. A. (1981). Hyperactive Children: A Handbook for Diagnosis and Treatment. New York: Guilford Publications.
  2. Barkley, R. A. (1990). Attention Deficit Hyperactivitv Disorder: A Handbook for Diagnosis and Treatment. New York: Guilford Publications.
  3. Barkley, R. A. (1995) Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. New York: Guilford Publications.
  4. Barkley, R. A., & Benton, C. (1998). Your Defiant Child: 8 Steps to Better Behavior. New York: Guilford.
  5. Mash, E. J. & Barkley, R. A. (Eds.) (1996). Child Psychopathology. New York: Guilford Publications.
  6. Barkley, R. A. (1997). Defiant Children: A Clinician’s Manual for Assessment and Parent Training (2nd ed.). New York: Guilford Publications.
  7. Barkley, R. A. & Murphy, K. R. (1998). Attention Deficit Hyperactivity Disorder: A Clinical Workbook (2nd ed.). New York: Guilford.
  8. Barkley, R. A. (2005) Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (3rd edition). New York: Guilford.

These books can be found at:

http://www.russellbarkley.org/barkley-books-videos.htm

Publications

Robert Lavine's recent publications include psychoeducational methods and factors that contribute to well-being and resilience in spite of challenges
  • Educational psychology-- "Guided Discovery Learning", Encyclopedia of the Sciences of Learning (Seele, N., ed., 2012, Springer)
  • Neuroscience and psychology-- "Engineering and Neuroscience Models in Professional Psychology," The Virginia Psychologist (2010)
  • Medical education--"Biomedical animations and video clips as educational tools," Medical Science Educator (21(2), 2011)
  • Psychology and health--
  • "The world's happiest people."  The Atlantic.com (June 6, 2011)
  • "Ending the nightmares...": research on new PTSD treatment.  The Atlantic (Feb. 1, 2012)
  • "Iceland: Superlative Happiness on a Cold Little Rock." The Atlantic (August 11, 2012)
  • Reviewer for applied psychology and physiology in the journal Aviation, Space, and Environmental Medicine

Treatment Guide for Complex Traumatic Stress Disorders

An excellent guide to evidence-based treatment utilizing CBT, pharmacotherapy, and other methods.  Christine A. Courtois, PhD and Julian D. Ford, PhD, eds. (2009), Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide (Guilford).

CBTLine

A blog on Cognitive-Behavioral Therapy topics and resources, for clients, psychologists, and professionals in related fields.

Engineering and Neuroscience Models


Engineering and Neuroscience  Models in Professional Psychology
 Robert Lavine, Ph.D.
The Virginia Psychologist 2010-2, Fall 2010.

Psychological models of human behavior can be compared in some ways with systems in engineering and neuroscience.  This article compares selective attention to an input filter, and interpersonal conflict to an interaction of unstable systems. 

A copy can be requested at drlavine1@verizon.net.

Brain Links to Anxiety

Brain links of PFC and amygdala in anxiety: Berkowitz, RL and others (2007), The human dimension: how the prefrontal cortex modulates the subcortical fear response, Reviews of  Neuroscience 18(191-207) in PubMed at www.ncbi.nih.gov/pubmed

CBT definition link from NIMH

Cognitive-Behavioral References

Here are some references for my talk on Cognitive-Behavioral Approaches to Anxiety at the VASGW Conference, March 2009. --  Dr. Lavine
  • Barlow, David H. (Ed.) (2006).. Treatments That Work. Oxford Press.
  • Berkowitz, R.L. et al. (2007). The human dimension: How the prefrontal cortex modulates the subcortical fear response. .Review of Neuroscience, 18 (191-207).
  • March, John S. and Mulle, Karen. (1998). OCD in Children and Adolescents: A Treatment Manual. Guilford Press.
  • Seligman, Linda and Reichenberg, Laurie (2007).  Selecting Effective Treatments, 3rd Edition. Wiley 

OCD Guidebook

A detailed guidebook on CBT of young people with OCD is by John S. March and Karen Mulle of Duke University Medical Center, titled OCD in children and adolescents: A cognitive-behavioral treatment manual. Guilford Press, 1998.

Anxiety, Cognitive-Behavioral Therapy, and Brain Functions

The prefrontal cerebral cortex (PFC) , in addition to its role in selective attention, working memory, planning, and problem-solving, interacts with and modulates the amygdala, the primitive subcortical structure associated with anxiety-provoking memories.  We can consider a hypothesis that this interaction may be involved in some therapeutic interventions such as cognitive reprocessing for anxiety disorders such as PTSD.  A neuroscience review of the PFC-amygdala interaction is this one:
Brain links of PFC and amygdala in anxiety: Berkowitz, RL and others, The human dimension: how the prefrontal cortex modulates the subcortical fear response, Review of Neuroscience. 2007 18(191-207) in PubMed at www.ncbi.nih.gov/pubmed/

Client manuals. CBT client manuals by David Barlow and others such as Mastery of Your Anxiety and Worry, 2nd ed. at http://www.ishk-ce.com/ . See New Harbinger publications for client manual by Edmund Bourne, The Anxiety & Phobia Workbook, and related CBT manuals at http://www.newharbinger.com/productdetails.cfm?PC=330
 
PTSD. New guidelines on PTSD treatments (APA Monitor on Psychology, January 2008 p. 40). Three of the effective treatments described were

1. Prolonged-exposure therapy in which traumatic memories are recalled in a controlled fashion to regain cognitive mastery
2. Cognitive-processing therapy that includes exposure but places emphasis on cognitive strategies to help correct maladaptive thoughts about the event
3. Stress-innoculation training that teaches methods to reduce anxiety such as breathing and muscle relaxation.