Home > Alternative Therapies, Diet and Weight Loss, Mental Health > Cognitive Behavioral Therapy

Cognitive Behavioral Therapy

March 12, 2013 Written by JP    [Font too small?]

The clients I work with subscribe to a wide range of views about alternative and complementary medicine. Some are receptive to trying virtually any evidence-based modality I suggest. For them, I’ll sometimes recommend practices as diverse and unconventional as reflexology, Senobi breathing and Tai Chi. Other clients are more comfortable utilizing therapies that are generally accepted in the conventional model of modern health care. Progressive muscle relaxation, structured exercise routines and therapeutic diets fall into this category.

Every so often, certain clients require additional support for both physical and psychological challenges. Cognitive behavioral therapy (CBT) is an excellent option for those who fall anywhere along the “alternative” and “conventional” comfort spectrum. The esteemed Mayo Clinic defines CBT as “a common type of mental health counseling” in which you work with a psychologist or therapist “in a structured way, attending a limited number of sessions”. The word “limited” is rarely associated with traditional psychotherapy. The relative affordability and brevity of CBT places it high on my list of approved treatments. The Mayo Clinic goes on to state that cognitive behavioral therapy “helps you become aware of inaccurate or negative thinking, so you can view challenging situations more clearly and respond to them in a more effective way”. It’s difficult to argue or object with this no-nonsense, results based approach.

As you might expect, CBT is primarily used to address psychological issues. And, to that end, current studies continue to report very positive results in relation to depression, insomnia, sexual abuse trauma, schizophrenic symptoms and social anxiety disorder. But, the mind-body aspect of CBT is lesser known and equally important. Recent trials reveal that short term treatment with CBT has a long lasting influence on a number of primarily physical conditions, including diabetic peripheral neuropathy, fibromyalgia, headache pain, overweight and tinnitus. Please note that in almost all cases cognitive behavioral therapy was rightfully used in conjunction with other treatments. Because of this, CBT is generally considered an adjunct therapy that can be use alongside allopathic and/or alternative care. As such, it’s one of the better options available for those interested in economically, efficiently and safely finding coping methods and solutions for issues affecting the body and mind.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – The Effectiveness of Internet Cognitive Behavioural Therapy (iCBT) (link)

Study 2 – Randomized Controlled Trial of Telephone-Delivered Cognitive (link)

Study 3 – Impact Evaluation of a Cognitive Behavioral Group Therapy Model in (link)

Study 4 – Cognitive Behavioral Therapy for Negative Symptoms (CBT-n) in (link)

Study 5 – Group Cognitive Behavioral Therapy for Patients w/ Generalized Social (link)

Study 6 – A Randomized Controlled Pilot Study of a Cognitive Behavioral Therapy (link)

Study 7 – Mindfulness-based Cognitive Therapy for the Treatment of Headache (link)

Study 8 – Combining Cognitive-Behavioral Therapy and Milnacipran for (link)

Study 9 – Internet-Based Cognitive Behaviour Therapy for Tinnitus Patients (link)

Study 10 – Brief Cognitive-Behavioral Therapy for Weight Loss in Midlife Women … (link)

Cognitive Behavioral Therapy Reduces Clinical Depression

Source: PLoS ONE 8(2): e57447. (link)

Tags: , ,
Posted in Alternative Therapies, Diet and Weight Loss, Mental Health

5 Comments & Updates to “Cognitive Behavioral Therapy”

  1. JP Says:

    Updated 07/27/15:


    J Neuroimmunol. 2015 Aug 15;285:143-6.

    The effect of proinflammatory cytokines in Cognitive Behavioral Therapy.

    Major depressive disorder (MDD) is a debilitating disorder and its pathophysiology is associated with deregulation of the immune system. We investigated the changes in circulating levels of proinflammatory cytokines (specifically IL-6 and TNF-α) measured by the ELISA kit in two psychotherapeutic interventions for MDD: Narrative Cognitive Therapy (NCT) and Cognitive Behavioral Therapy (CBT). This is a randomized clinical trial including 97 individuals (18 to 29years-old) with MDD. In CBT there was a significant difference in serum levels of IL-6 and TNF-α, therefore indicating that CBT was more effective than NCT on serum levels proinflammatory cytokines.

    Be well!


  2. JP Says:

    Updated 07/27/15:


    Clin Psychol Psychother. 2015 Jul 20.

    Cognitive-Behavioural Therapy and Psychodynamic Psychotherapy in the Treatment of Combat-Related Post-Traumatic Stress Disorder: A Comparative Effectiveness Study.

    This study compared the effectiveness of two psychotherapy approaches for treating combat veterans with chronic post-traumatic stress disorder (PTSD): cognitive-behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). These treatments are routinely used by the Unit for Treatment of Combat-Related PTSD of the Israel Defense Forces (IDF). IDF veterans with chronic PTSD were assigned to either CBT (n = 148) or PDT (n = 95) based on the nature of their complaint and symptoms. Psychiatric status was assessed at baseline, post-treatment and 8-12 months follow-up using the Clinician-Administered PTSD Scale, the PTSD Questionnaire, the Montgomery and Asberg Depression Rating Scale and the Psychotherapy Outcome Assessment and Monitoring System-Trauma Version assessment questionnaire. Both treatment types resulted in significant reduction in symptoms and with improved functioning from pre-treatment to post-treatment, which were maintained at follow-up. No differences between the two treatments were found in any the effectiveness measures. At post-treatment, 35% of the CBT patients and 45% of the PDT patients remitted, with no difference between the groups. At follow-up, remission rates were 33% and 36% for the CBT and PDT groups, respectively. The study recommends further randomized controlled trials to determine treatment efficacy. Copyright © 2015 John Wiley & Sons, Ltd.

    KEY PRACTITIONER MESSAGE: Both cognitive-behavioural therapy and psychodynamic psychotherapy have to be treatments offered in clinics for treating PTSD. Therapists who treat PTSD should be familiar with cognitive-behavioural and dynamic methods. The type of treatment chosen should be based on thorough psychosocial assessment.

    Be well!


  3. JP Says:

    Updated 07/27/15:


    MIR Res Protoc. 2015 Jul 17;4(3):e87.

    Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders.

    BACKGROUND: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.

    OBJECTIVE: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone-delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.

    METHODS: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.

    RESULTS: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.

    CONCLUSIONS: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.

    Be well!


  4. JP Says:

    Updated 08/02/15:


    J Psychiatr Res. 2015 Sep;68:106-113.

    Internet versus face-to-face group cognitive-behavioral therapy for fibromyalgia: A randomized control trial.

    BACKGROUND: The aim of this study was to explore the effectiveness of Internet-delivered cognitive-behavioral therapy (iCBT) in treatingfibromyalgia (FM) compared with an identical protocol using conventional group face-to-face CBT.

    METHODS: Sixty participants were assigned to either (a) the waiting list group, (b) the CBT group, or (c) the iCBT group. The groups were assessed at baseline, after 10 weeks of treatment, and at 3-, 6-, and 12-month follow-ups. The primary outcome measured was the impact of FM on daily functioning, as measured by the Fibromyalgia Impact Questionnaire (FIQ). The secondary outcomes were psychological distress, depression, and cognitive variables, including self-efficacy, catastrophizing, and coping strategies.

    RESULTS: In post-treatment, only the CBT group showed improvement in the primary outcome. The CBT and iCBT groups both demonstrated improvement in psychological distress, depression, catastrophizing, and utilizing relaxation as a coping strategy. The iCBT group showed an improvement in self-efficacy that was not obtained in the CBT group. CBT and iCBT were dissimilar in efficacy at follow-up. The iCBT group members improved their post-treatment scores at their 6- and 12-month follow-ups. At the 12-month follow-up, the iCBT group showed improvement over their primary outcome and catastrophizing post-treatment scores. A similar effect of CBT was expected, but the positive results observed at the post-treatment assessment were not maintained at follow-up.

    CONCLUSIONS: The results suggest that some factors, such as self-efficacy or catastrophizing, could be enhanced by iCBT. Specific characteristics of iCBT may potentiate the social support needed to improve treatment adherence.

    Be well!


  5. JP Says:

    Updated 04/14/16:

    Psychosomatic Medicine: Post Author Corrections: February 9, 2016


    Internet-Delivered Cognitive-Behavior Therapy for Tinnitus: A Randomized Controlled Trial.

    Objectives: Tinnitus has a substantially negative impact on quality of life in up to 5% of the general population. Internet-based cognitive-behavioral treatment (iCBT) has been shown to be effective in a few trials. The aim of our study was to investigate iCBT for tinnitus by using a randomized controlled trial.

    Methods: Patients with severe tinnitus-related distress were randomly assigned to therapist-guided iCBT (n = 62) or to a moderated online discussion forum (n = 62). Standardized self-report measures for tinnitus-related distress (Tinnitus Handicap Inventory, Mini-Tinnitus Questionnaire) and associated symptoms (tinnitus acceptance, anxiety, depression, and insomnia) were assessed at pretreatment and posttreatment, 6-month-, and 1-year follow-up. Clinical significance was assessed with the Reliable Change Index.

    Results: Multivariate analyses of variance revealed significant main effects for time, group, and interaction in favor of the iCBT group. With regard to tinnitus-related distress, the significant univariate interaction effects (time by group) were supported by large effect sizes (Tinnitus Handicap Inventory: g = 0.83, 95% confidence interval = 0.47-1.20; Mini-Tinnitus Questionnaire: g = 1.08, 95% confidence interval = 0.71-1.64). For the secondary outcomes, significant interactions with small to medium effect sizes were found. Within-group effects for the iCBT, from pretreatment to follow-up, were substantial in regard to tinnitus-related distress (1.38 <= d <= 1.81) and small to large for secondary outcomes (0.39 <= d <= 1.04). Conclusions: Using a randomized controlled trial design, we replicated prior findings regarding positive effects of Internet-delivered CBT on tinnitus-related distress and associated symptoms. Implementing iCBT for tinnitus into regular health care will be an important next step to increase access to treatment for patients with tinnitus. Be well! JP

Leave a Comment