Treatment Cognitive-behavioral therapy

Anton RF, Moak DH, Latham PK, et al Posttreatment results of combining naltrexone and cognitive-behavior therapy for the treatment of alcoholism. J Clin Psycho-pharmacol 21 72—77, 2000... 

Kranzler HR, Del Boca F, Korner P, et ah Adverse effects limit the usefulness of flu-voxamine for the treatment of alcoholism.] Subst Abuse Treat 10 283-287, 1993 Kranzler HR, Burleson JA, Del Boca FK, et ah Buspirone treatment of anxious alcoholics a placebo-controlled trial. Arch Gen Psychiatry 31 720—731, 1994 Kranzler HR, Burleson JA, Korner P, et ah Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am] Psychiatry 152 391-397, 1995 Kranzler HR, Burleson JA, Brown J, et al Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res 20 1534-1341, 1996... 

Otto MW, Pollack MH, Sachs GS, et al Discontinuation of benzodiazepine treatment efficacy of cognitive-behavioral therapy for patients with panic disorder. Am J... 

Hall SM, Reus VI, Munoz RF, et al Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch Gen Psychiatry 55 683-690, 1998 Hall SM, Humfleet GL, Reus VI, et al Psychological intervention and antidepressant treatment in smoking cessation. Arch Gen Psychiatry 59 930-936, 2002 Hayford KE, Patten CA, Rummans TA, et al Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psychiatry 174 173-178, 1999... 

A number of psychosocial treatments for alcohol and other substance use disorders exist and are widely used. In this chapter, we discuss six of these psychotherapies as they are applied to alcohol, cocaine, and opioid dependence brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, behavioral treatments (including contingency management and community reinforcement approaches), behavioral marital therapy, and 12-step facilitation. We also describe studies that examined the efficacy of a medication in combination with one or more of the six psychotherapies. In the second section of the chapter, we highlight research that directly studied the interaction between psychosocial and pharmacological treatments. 

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. 

Anton RF, Moak DH, Waid LR, et al Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics results of a placebo-controlled trial. Am J Psychiatry 156 1758—1764, 1999... 

Interpersonal therapy and cognitive behavioral therapy are types of psychotherapy that have well-documented efficacy for the treatment of MDD. Psychotherapy alone is an initial treatment option for mild to moderate cases of depression, and it may be useful when combined with pharmacotherapy in the treatment of more severe cases of depression. In fact, the combination of psychotherapy and pharmacotherapy can be more effective than either treatment modality alone in cases of severe or recurrent MDD. Psychotherapy can be especially helpful for patients with significant psychosocial stressors, interpersonal difficulties, or comorbid personality disorders.16... 

Determine appropriate pharmacologic and psychological treatments (e.g., cognitive-behavioral therapy), including what has been helpful to the patient in the past. 

Goldapple, Kimberly, Zindel Segal, Carol Garson, Mark Lau, Peter Bieling, Sidney Kennedy and Helen Mayberg, Modulation of Cortical-Limbic Pathways in Major Depression Treatment-Specific Effects of Cognitive Behavior Therapy , Archives of General Psychiatry 61, no. 1 (2004) 34-41... 

Hall, S., Reus, V., Munoz, R. et al. Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch. Gen. Psychiatry. 55 683, 1998. 

In some cases, Narcissistic Personality Disorder can cluster with both drug abuse and antisocial behavior. People with this disorder typically display grandiosity, selfishness/self-centeredness, exploitation of others, beliefs about being gifted and special, arrogance, an excessive preoccupation with self and personal appearances, and the need to have others affirm how special they are. Sometimes these qualities are difficult to separate from antisocial behavior, but key differences center around the criminal behavior and the ability to inflict physical cruelty found in antisocial behavior. Effective treatment for Narcissistic Personality Disorder includes cognitive behavioral therapy as well. 

Twenty years ago the dislike of traditional treatment may have presented some real challenges. Today, however, there are many more treatment alternatives to which a client can be referred to if she or he would not match well with a traditional treatment facility. A good referral might be to a psychologist or other therapist who practices cognitive behavioral therapy for individuals. In addition, the advent of the Internet era allows for new and creative treatment alternatives even for people in small communities. 

Standardized cognitive behavioral therapy manuals, which ensure adherence to a treatment protocol, have been developed for many different anxiety disorders, including phobias, generalized anxiety, panic, social anxiety, Agoraphobia,... 

The hrst-line treatments for panic disorder are (1) cognitive-behavioral therapy (CBT), (2) benzodiazepines, and (3) SSRIs/SNRls. Each of these three treatment modalities can be nsed independently or in combination. The selection of the primary treatment depends on several factors inclnding severity and frequency of the panic attacks, comorbid illnesses, and patient preference. 

First-line GAD treatments include (1) cognitive-behavioral therapy (CBT), (2) antidepressants, (3) buspirone, and (4) benzodiazepines. Treatment selection is determined by the severity of the illness, the presence of any comorbid illnesses, previous patient treatment responses, and patient preference. When treating mild GAD, we recommend eschewing psychotropic medication altogether in favor of CBT. Moderate-to-severe GAD usually requires pharmacotherapy, though combined CBT-pharmacotherapy is highly encouraged. 

Acute Phase Treatment. There is considerable-evidence that cognitive-behavioral therapy (CBT) is effective in the treatment of OCD. Some studies have even suggested that CBT may provide enduring prophylactic benefit against OCD... 

Bernstein, G.A., Borchardt, C.M., Perwien, A.R., Crosby, R.D., Kushner, M.G., Thuras, P.D., and Last, C.G. (2000) Imipramine plus cognitive-behavioral therapy in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 39 276—283... 

---