Reduced therapist contact in the cognitive behavioral treatment of panic disorder
TL;DR: In this paper, the authors compared the effectiveness of two cognitive behavioral therapy programs for panic disorder: one involved reduced therapist contact; the other was entirely therapist directed, and found that both treatment procedures produced significant and comparable improvements on all the outcome measures that were maintained or furthered at follow-ups.
About: This article is published in Behavior Therapy.The article was published on 1994-12-01. It has received 68 citations till now. The article focuses on the topics: Panic disorder & Panic.
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TL;DR: A meta-analysis of high-quality studies published from 1990-1998 on the efficacy of manualized psychotherapies for depression, panic disorder, and generalized anxiety disorder suggests that a substantial proportion of patients with panic improve and remain improved.
Abstract: The authors report a meta-analysis of high-quality studies published from 1990-1998 on the efficacy of manualized psychotherapies for depression, panic disorder, and generalized anxiety disorder (GAD) that bear on the clinical utility and external validity of empirically supported therapies. The results suggest that a substantial proportion of patients with panic improve and remain improved; that treatments for depression and GAD produce impressive short-term effects: that most patients in treatment for depression and GAD do not improve and remain improved at clinically meaningful follow-up intervals: and that screening procedures used in many studies raise questions about generalizability, particularly in light of a systematic relation across studies between exclusion rates and outcome. The data suggest the importance of reporting, in both clinical trials and meta-analyses, a range of outcome indices that provide a more comprehensive, multidimensional portrait of treatment effects and their generalizability. These include exclusion rates, percent improved, percent recovered, percent who remained improved or recovered at follow-up, percent seeking additional treatment at follow-up, and data on both completer and intent-to-treat samples.
665 citations
TL;DR: Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post-assessment and at follow-up, with internet CBT better at improving physical health ratings and reducing GP visits.
244 citations
TL;DR: Estimates of the relative efficacy, acceptability, tolerability, and costs of these treatments are reviewed; empirically examine the costs and outcome of cognitive-behavioral and pharmacologic interventions as they are delivered in an outpatient clinic specializing in these treatments; and comment on how these data inform a stepped care model of treatment.
Abstract: Treatment outcome findings suggest that cognitive-behavioral therapy (CBT) and pharmacotherapy offer similar short-term treatment gains for panic disorder and that CBT may afford more optimal maintenance of treatment gains without the need for ongoing treatment. However, efficacy is not the only consideration for patients, and because of limited health care resources, evaluation of the cost-benefit ratio of these treatments is important. In this article, the authors review estimates of the relative efficacy, acceptability, tolerability, and costs of these treatments; empirically examine the costs and outcome of cognitive-behavioral and pharmacologic interventions as they are delivered in an outpatient clinic specializing in these treatments; and comment on how these data inform a stepped care model of treatment. Analysis of the "services" data indicated that CBT was at least equal to pharmacotherapy in terms of pretreatment severity and acute treatment outcome and that CBT is an especially cost-effective treatment option.
195 citations
TL;DR: The first generation of multisite studies examining the potentially synergistic effects of proven psychosocial treatments and proven drug treatments are examined, with some preliminary results reported.
Abstract: Recent developments in the psychosocial treatments for anxiety disorders suggest that we have reached an early plateau Evidence now exists on the effectiveness of psychosocial treatment approaches for every anxiety disorder when compared with no treatment or credible psychosocial placebos In many cases these procedures have limited clinical effectiveness and much remains to be learned about the disseminability and clinical utility of these approaches in the context of emerging national health care plans We are just beginning the first generation of multisite studies examining the potentially synergistic effects of proven psychosocial treatments and proven drug treatments These studies that have substantial significance for national health care are reviewed and some preliminary results are reported
148 citations
01 Jan 2015
TL;DR: The Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, Fifth Edition, is a valuable reference to help bridge this gap and is provided in this piece.
Abstract: The Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, Fifth Edition, is a valuable reference to help bridge this gap. posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and D. H. Barlow (Ed.), Clinical Handbook of Psychological Disorders, 5 th. Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, 5th ed. Because this piece does not have an abstract, we have provided. He is the Thaddeus L. Bolton Professor of Psychology and the Director of the In D. Barlow (Ed.), Clinical handbook of psychological disorders (5th edition, pp. Washington, DC, US: American Psychological Association. Clinical handbook of psychological disorders, Fifth Edition: A step-bystep treatment manual.
137 citations
References
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01 Dec 1969TL;DR: The concepts of power analysis are discussed in this paper, where Chi-square Tests for Goodness of Fit and Contingency Tables, t-Test for Means, and Sign Test are used.
Abstract: Contents: Prefaces. The Concepts of Power Analysis. The t-Test for Means. The Significance of a Product Moment rs (subscript s). Differences Between Correlation Coefficients. The Test That a Proportion is .50 and the Sign Test. Differences Between Proportions. Chi-Square Tests for Goodness of Fit and Contingency Tables. The Analysis of Variance and Covariance. Multiple Regression and Correlation Analysis. Set Correlation and Multivariate Methods. Some Issues in Power Analysis. Computational Procedures.
115,069 citations
11 Jun 2013
113,134 citations
TL;DR: An integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment is presented and findings are reported from microanalyses of enactive, vicarious, and emotive mode of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes.
Abstract: The present article presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from four principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. The more dependable the experiential sources, the greater are the changes in perceived selfefficacy. A number of factors are identified as influencing the cognitive processing of efficacy information arising from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. Possible directions for further research are discussed.
38,007 citations
TL;DR: In predicting the development of fears, and possibly other anxiety disorders, it may be more important to know what the person thinks will happen as a result of becoming anxious than how often the person actually experiences anxiety.
2,954 citations
TL;DR: Lifetime rates are presented for 15 DSM-III psychiatric diagnoses evaluated in three large household samples on the basis of lay interviewers' use of the Diagnostic Interview Schedule.
Abstract: • Lifetime rates are presented for 15 DSM-III psychiatric diagnoses evaluated in three large household samples on the basis of lay interviewers' use of the Diagnostic Interview Schedule. The most common diagnoses were alcohol abuse and dependence, phobia, major depressive episode, and drug abuse and dependence. Disorders that most clearly predominated in men were antisocial personality and alcohol abuse and dependence. Disorders that most clearly predominated in women were depressive episodes and phobias. The age group with highest rates for most disorders was found to be young adults (aged 25 to 44 years). Correlates with race, education, and urbanization are presented.
2,459 citations