Behavioral Weight Management of Obese Patients with Mental Disorders
Susan L. McElroy, David B. Allison, George A. Bray in Obesity and Mental Disorders, 2006
The goal of behavioral treatment for obesity is to modify behaviors that adversely impact psychological and physical health and positively reinforce changes in diet and physical activity that can produce and maintain weight loss, or least prevent further weight gain. In addition to education about reducing calorie intake and increasing physical activity, cognitive-behavioral approaches include: self-monitoring of weight, eating habits, and physical activity; stimulus control training; problem solving; contingency management; cognitive restructuring; and enlisting social support. Cognitive-behavioral treatment can also be used to help obese and overweight individuals enhance their self-esteem, become more assertive in coping with the adverse effects of the stigma associated with obesity, and to reduce body image dissatisfaction (15). Behavioral treatments of obesity that have received systematic study have ranged from self-help and commercialized programs that provide some instruction about diet and physical activity to specialized cognitive behavioral therapies (CBT) targeted for weight loss and weight maintenance that incorporate dietary and physical activity components.
Eating Disorders
David F. O'Connell in Dual Disorders, 2014
An appreciable number of patients with eating disorders also report drug or alcohol addiction. Some studies suggest the rate of addiction is 25 percent or higher, especially for bulimic patients (Mitchell et al., 1985). The cause of eating disorders, like that of addiction, is unknown. Psychological theories have emphasized a disturbance in the formation of the self and identity as basic to the pathogenesis of eating disorders. Biological theories have focused on the role of neurotransmitters in the brain and have likened eating disorders to a form of affective or mood disorder. Family theorists have focused on the central role of pathological family processes in the development of eating disorders. A variety of treatment approaches have emerged from these theoretical viewpoints. Regardless of theoretical orientation, state-of-the-art treatment for eating disorders involves a combination of medical treatment to stabilize the patient, behavioral treatment to help maintain optimal weight and normalize eating habits, and psychotherapy to alleviate underlying personality defects.
Alcohol Problems, Marriage, and Treatment
Shulamith Lala Ashenberg Straussner, Christine Huff Fewell in Impact of Substance Abuse on Children and Families, 2012
The position of behavioral treatment was further supported in several reviews of research that were conducted through the late-eighties and early-nineties. Holder, Longabaugh, Miller, and Rubonis (1991) found that behavioral marital treatment was cost-effective compared to other forms of treatments. Miller and Hester (1980) had identified and reviewed 579 studies related to alcoholism treatment. One of the shortcomings of this review, as identified by Miller and Hester in 1995, was the lack of weighting which would have differentiated between the methodological qualities of the research conducted. Redressing this limitation, Miller and Hester (1995) defined 219 studies as being suitable for inclusion. The weighting was specifically related to the demands of quantitative research methods. This emphasis on positivistic rigor echoed the earlier problems identified with regard to systems-based marital treatments. Behavioral marital treatment was well represented in this review and performed favorably overall. The challenge of this type of review, however, is to represent the diversity of research methods across the quantitative/qualitative divide. Miller and Hester (1995) did not address this issue. As a result, the contribution of BMT may have been overvalued over other less-researched treatments or treatments that were inaccessible to mainstream quantitative methods, an issue raised as early as 1982 by McCrady.
Feasibility of an Integrated Treatment Approach for Youth with Depression, Suicide Attempts, and Substance Use Problems
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2021
David B. Goldston, John F. Curry, Karen C. Wells, Yifrah Kaminer, Stephanie S. Daniel, Christianne Esposito-Smythers, Otima Doyle, Jeffrey Sapyta, Angela M. Tunno, Nicole Heilbron, Michelle Roley-Roberts
Following the process for behavioral treatment development described by Rounsaville et al. (2001), a phased and iterative approach was taken to treatment development. First, the manual was developed, emphasizing an integrated approach with concepts from the relapse prevention model of Marlatt and Gordon (1985). This process included adapting modules from several sources to ensure consistency with an integrated approach and the relapse prevention model, as well as creating new modules. This draft manual was then shared with several clinicians and national experts who provided feedback that was then used to refine the manual. A small open trial with 13 cases was then conducted, in which study investigators served as therapists. To ensure that all participants in the trial received at least the level of mental health treatment they typically would receive in the community, the new therapeutic approach was developed as an augmenting intervention (i.e., as a complement to treatment as usually delivered). Based on experiences in the open trial, there were several additional revisions to the manual (e.g., addition of the possibility of more frequent sessions in first 2 weeks to address acute risk; new adolescent and parent modules).
Telephone-Based Versus In-Person Delivery of Cognitive Behavioral Treatment for Veterans with Chronic Multisymptom Illness: A Controlled, Randomized Trial
Published in Military Behavioral Health, 2018
Lisa M. McAndrew, Lauren M. Greenberg, Donald S. Ciccone, Drew A. Helmer, Helena K. Chandler
There have been few randomized controlled trials of cognitive behavioral treatment for veterans with CMI to treat this disability and to our knowledge there is only one published trial. The U.S. Veterans Affairs (VA) Cooperative Study #470 was a multicenter randomized clinical trial of cognitive behavioral treatment, aerobic exercise, or both among 1,092 veterans with CMI who had been deployed to Desert Shield/Desert Storm (Donta et al., 2003). Treatments lasted 12 weeks and adherence was low with only 36% of those in the cognitive behavioral treatment arm attending at least two-thirds of the sessions. Improvements were modest with 18.5% of those in the cognitive behavioral treatment arm meeting the study's primary outcome criterion for improvement in physical function (Donta et al., 2003).
A randomized controlled trial of acceptance and commitment therapy for psychological distress among persons with traumatic brain injury
Published in Neuropsychological Rehabilitation, 2021
Angelle M. Sander, Allison N. Clark, David B. Arciniegas, Kim Tran, Luis Leon-Novelo, Esther Ngan, Jay Bogaards, Mark Sherer, Robyn Walser
Acceptance and Commitment Therapy (ACT) is a psychotherapy derived from CBT but differs from it with respect to its approach to addressing thoughts and feelings (Hays et al., 2012). While traditional cognitive-behaviour therapy focuses on altering of maladaptive or irrational thinking, ACT focuses on helping clients simply experience their thoughts, without judging or assigning merit to them. ACT is based in a philosophy that approaches change in human behaviour by focusing on altering the context in which thoughts are experienced rather than focusing on change in the content of the thoughts themselves. A central tenet of ACT is that experiential avoidance – i.e., attempts to avoid or escape thoughts and feelings that are perceived as negative – is an obstacle to behaving in ways that help people to pursue personal values-based goals (Hays et al., 2012). The aim of ACT is to accept one’s thoughts and feelings, without judgment, and to commit to pursuing personal values-based activities. Changing one’s relationship to internal experiences, such as thoughts and feelings, is supported in the service of enhancing meaning in one’s life. Thus, ACT combines a change in approach to thoughts and feelings with behavioural activation. In parallel, ACT focuses on guiding clients in identifying their personal values (e.g., courage, independence, growth) and setting activity goals that are consistent with these values.
Related Knowledge Centers
- Behaviorism
- Classical Conditioning
- Cognitive Behavioral Therapy
- Cognitive Restructuring
- Cognitive Therapy
- Habituation
- Operant Conditioning
- Psychotherapy
- Licensed Behavior Analyst
- Reinforcement