Cognitive-behavioral therapy group

The optimal treatment of aggressive youths requires the involvement of multiple professionals and agencies. Interventions include healthy peer activities, supportive adults, removal of weapons from the home, abstinence from substances, psychoeducation, individual and cognitive behavioral therapy, group and family therapies, school-based interventions, multisys-temic therapy, anger management techniques, and psychopharmacology. 

Therapy and/or counseling is also very important. Different therapy approaches used in substance abuse treatment include individual psychotherapy, behavioral therapy, cognitive-behavioral therapy, group therapy, and family therapy. Often, more than one therapeutic approach is used during drug rehabilitation. 

In other substance use disorders, the use of 12-step interventions is also popular, and participation in 12-step groups is correlated with better outcomes in cocaine abusers (e.g., McKay et al. 1994). However, a smdy of 128 cocaine abusers found that cognitive-behavioral therapy was more efficacious than 12-step facilitation in engendering cocaine abstinence (Maude-Griffm et al. 1998). Thus, the relative efficacy of 12-step approaches for drug use disorders requires further investigation. No known studies have systematically evaluated the efficacy of 12-step treatments in opioid-dependent patients, either alone or in conjunction with pharmacotherapies. 

While pharmacologic agents may help prevent relapse, psychotherapy should be the core therapeutic intervention. Motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), 12-step facilitation (TSF), behavioral couples therapy (BCT), community reinforcement approaches, and contingency management are the best-studied forms of psychotherapy in this group of patients. 

Psychotherapy (e.g., individual, group, and family), interpersonal therapy, and/or cognitive behavioral therapy / Stress reduction techniques, relaxation therapy, massage, yoga, etc. 

Silverman, W.K., Kurtines, W.M., Ginsburg, G.S., Weems, C.E, Lumpkin, P.W., and Carmichael, D.El. (1999b) Treating anxiety disorders in children with group cognitive behavior therapy a randomized clinical trial. J Consult Clin Psychol 67 995-1003. 

Gelernter et al. (1991) compared phenelzine, alprazolam, placebo, and cognitive-behavior therapy in social phobia. In those patients receiving alprazolam, only 38% improved, based on the Marks Fear Questionnaire [Marks and Matthews 1982) scores. In this study, the mean daily dose for alprazolam was 4.2 mg. At 2-month follow-up, after discontinuation of the drug, the improvement in the alprazolam group was no longer measurable. 

Otto MW, Pollack MH, Penava SJ, et al. Group cognitive-behavior therapy for patients failing to respond to pharmacotherapy for panic disorder a clinical case series. Behav Res Ther 1999 37 763-770. 

Wilfley, D. E., R. R. Welch, R. I. Stein, E. B. Spurrell, L. R. Cohen, B. E. Saelens, et al. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Arch Gen Psychiatry 59(8) 713-21. 

Individual, group, or family therapy, cognitive behavioral therapy, support groups, anger management, and assertiveness training... 

Naltrexone 100 mg/day-I-sertraline 200 mg/day was more effective than either drug alone in depression and alcohol abstinence/ delay before relapse. Alcohol-dependent depressed patients (n = 170) were randomly assigned to four groups naltrexone only, sertraline only, naltrexone-I-sertraline, and placebo. All received weekly cognitive behavioral therapy. The rate of adverse events was lower in the combination treatment group (12%) than in the other groups (naltrexone 27%, sertraline 38%, placebo 28%) however, more subjects withdrew seven patients compared with two, four, and one in the naltrexone, sertraline, and placebo groups respectively [213. ... 

In the Treatment of SSRl-Resistant Depression in Adolescents (TORDIA) study [7 ], 334 depressed adolescents, who had not responded to a previous trial with an SSRl antidepressant, were randomized to either another SSRl or venlafaxine, with or without cognitive behavioral therapy. There were no significant differences between the groups in the rates of suicidal and non-sui-cidal self-injury, although the significance of this was limited by the lack of a placebo comparison group [8 J. 

Alcoholics Anonymous (AA) is a self-help organization for people whose common goal is recovery from alcoholism, and it is the most widely accessed resource for individuals with alcohol problems (McCrady and Miller 1993). The philosophy is based on the concept of alcoholism as a chronic disease that cannot be cured, but one that can be halted by means of complete abstinence. AA has described 12 principles or steps to guide those in recovery. Twelve-step facilitation, a manual-based psychotherapy to promote AA participation (Nowinski et al. 1992), was equally efficacious, compared with cognitive-behavioral and motivational enhancement therapies, in a large study of treatments for alcohol dependence (Project Match Research Group, 1997). 

O Malley et al. (1992) conducted a double-blind study combining naltrexone and CBT for alcohohsm. Patients were randomly assigned to participate in cognitive-behavioral coping skills treatment or supportive therapy and to receive 50 mg/day of naltrexone or placebo. Naltrexone-treated patients who received supportive therapy had more continuous abstinence than the other treatment groups. However, naltrexone-treated patients who received CBT had a lower level of craving and lower risk of relapse than the other three groups. This interaction would not have been observed in a study that manipulated only psychosocial treatment or only medication. 

Hayward, C., Varady, S., Albano, A.M., et al. (2000) Cognitive-behavioral group therapy for social phobia in female adolescents results of a pilot study. / Am Acad Child Adolesc Psychiatry 39 721-726. 

This type of program should offer cognitive-behavioral group therapy and individual therapy. It should be able to provide medication if necessary, structured meals, and nutritional counseling and meal planning. Group therapies, e.g., social skills training, are also useful. 

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