Cognitive behavioural 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... 

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. 

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. 

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. 

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... 

Kuipers E, Fowler D, Garety D, et ai. London-East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis. Br J Psychiatry 1998 173 61-68. 

Thase ME, Fasiczka AL, Berman SR, Simons AD, Reynolds CF 3rd (1998) Electroen-cephalographic sleep profiles before and after cognitive behaviour therapy of depression. Arch Gen Psychiatry 55 138-144... 

Treatment of choice - an SSRI (plus cognitive behavioural therapy). 

Scott, J., Paykel, E., Morriss, R., Bentall, R., Kinderman, P., Johnson, T., Abbott, R., Hayhurst, H. 2006, Cognitive-behavioural therapy for severe and recurrent bipolar disorders randomised controlled trial, Br.).Psychiatry, vol. 188, pp. 313-320. 

A trial of low dose amitryptiline (10-25 mg at night) is worthwhile in patients who do not respond to antispasmodics, and associated depression will be helped by conventional doses of this or other antidepressants. Relaxation therapy, hypnotherapy and cognitive behaviour therapy have a place in selected cases. 

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