Behaviour therapy

Oude Voshaar RC, Gorgels WJ, Mol AJ, et al Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy three-condition, randomised controlled trial. Br J Psychiatry 182 498-304, 2003 Parry HJ, Balter MB, Mellinger GD, et al National patterns of psychotherapeutic drug use. Arch Gen Psychiatry 28 18-74, 1973... 

People with dementia and their carers require access to a variety of health and social care services for treatment, information and counselling, community-based support, respite care and long-term residential care. Treatment may include behavioural therapies (e.g. reality orientation, cognitive stimulation and validation therapy) or pharmacological treatment with acetylcholinesterase inhibitors. 

In 1976, Aaron Beck, a psychiatrist at the University of Pennsylvania, proposed a cognitive theory of emotions and emotional disorders - a theory that was to become the foundation for cognitive behavioural therapy for depression. According to Beck, fear is produced by the anticipation of harm, joy by the expectancy of positive events, and sadness by the sense that something important has for ever been lost. As a consequence, overcoming fear and depression requires changing the beliefs that have produced them. 

There is a wide range of treatment options provided by the social services and/or medical agencies. The most successful approaches are multi-component. They involve a psychosocial element to increase the appropriate life skills and a drug component to handle the immediate problems of drug withdrawal. Counselling and other behavioural therapies are useful components of most treatment programmes (Epstein et al., 2003). 

Epstein DH, Hawkins WE, Covi L, Umbricht A and Preston KL (2003). Cognitive behavioural therapy plus contingency management for cocaine use Findings during treatment and across 12-month follow-up. Psychology of Addictive Behavior, 17, 73-82. 

Ouimette PC, Finney JW and Moos RH (1997). Twelve-step and cognitive behavioural therapy for substance abuse A comparison of treatment effectiveness. J. Consult. Clin. Psychology, 65, 230-240. 

Exercises to strengthen the pelvic floor muscles Behavioural therapy Anticholinergic drugs Desmopressin... 

Remove the psychological factors that may have precipitated and maintained the disease. This may be as simple as establishing better relationships with family members or may require prolonged cognitive behavioural therapy. 

Loerch, B., Graf-Morgenstern, M., Hautzinger, M., Schlegel, S., Hain, C., Sandmann, J., and Benkert, O. (1999) Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia. Br J Psychiatry 174 205-212. 

Wardle, J. Behaviour therapy and benzodiazepines Allies or antagonists9 Br. J. Psychiatry 156, 163-168. 1990. 

Behaviour therapies range from feedback of results to systematic contingency management... 

There have unfortunately been very few systematic examinations of treatment of benzodiazepine misuse or dependence in the illicit drug population, and knowledge on the subject has been rather static over the last decade or so. When special programmes are tried the difficulties which seem inherent in this area are still apparent, such as in the randomized controlled study of reducing benzodiazepine dosing and cognitive behavioural therapy versus standard treatment by Vorma et al. (2002). The subjects were outpatients in clinics... 

Typically includes elements of cognitive-behavioural therapy, e.g. in dealing with cravings and trigger situations, and motivational interviewing... 

Jerrell and Ridgeley (1995) compared three approaches - case management, behaviour therapy, and the 12-step model - at a follow-up of two years, and there was a suggestion, within generally encouraging results over 18 months, that behaviour therapy had the most effect, and 12-step treatment the least. In a number of studies expertly provided ultra-specialist treatment along the lines described has been found to be superior to... 

Fals-Stewart W, O Farrell TJ Birchler GR (2001). Behavioral couples therapy for male methadone maintenance patients effects on drug-using behaviour relationship adjustment. Behaviour Therapy, 32, 391-411... 

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