Jesse H. Wright

Computer-assisted cognitive-behavioral therapy.

There has been a recent acceleration in the development and testing of programs for computer-assisted cognitive-behavioral therapy (CCBT). Programs are now available for treatment of depression, anxiety disorders, and other psychiatric conditions. Technology for delivery of CCBT includes multimedia programs, virtual reality, and handheld devices. Research on CCBT generally has supported the efficacy of computer-assisted therapy and has shown patient acceptance of computer tools for psychotherapy. Completion rates and treatment efficacy typically have been higher when clinicians prescribe and support the use of psychotherapeutic computer programs than when programs are delivered in a self-help format without clinician involvement. CCBT seems to have the potential to improve access to evidence-based therapies while reducing the demand for clinician time.

Computer-assisted cognitive-behavior therapy for depression.

This article reviews the use of computer technology in treating depression as a substitute or adjunct for standard therapy. It discusses advantages and disadvantages of introducing computer technology as a treatment option, problems and barriers to expanded use, the varieties of computer-assisted psychotherapy for major depression, and relevant research. Three specific Internet-based programs are described, assessed and compared: Good Days Ahead, Beating the Blues, and MoodGYM. The authors conclude that these and similar programs are promising. Preliminary outcome studies suggest that these programs produce outcome similar to standard therapy, although methodological shortcomings limit confidence in these findings. Suggestions are offered for practitioners considering the addition of computer assistance to their treatment of depression.

Cognitive behavior therapy manual for depressed inpatients: A treatment protocol outline *

In this report we present a brief treatment manual for the use of cognitive behavior therapy (CBT) as an inpatient treatment of nonpsychotic major depression. The manual was developed primarily for use by experiencenced therapists working on general, shortstay psychiatric inpatient units. Inpatient CBT differs from outpatient therapy in terms of the frequency of sessions, a relatively greater emphasis on behavioral strategies early in the course of treatment, and the need to integrate therapy within respect to a broader multidisciplinary treatment plan.

Combined Cognitive Therapy and Pharmacotherapy

Cognitive therapy and pharmacotherapy have developed as separate, and at times, competitive entities. Theoretical constructs and treatment strategies of the two approaches are quite different. Cognitive therapists seek to correct faulty patterns of thinking and behavior with psychological procedures, whereas pharmacotherapists attempt to regulate brain biochemistry with medication. Cognitive therapy has found its largest audience among professionals who are not licensed to prescribe drugs. Pharmacotherapy is largely the province of the physician.

The family drawing depression scale

Described the development of a standardized rating scale for scoring Kinetic Family Drawings of depressed patients. The Zung Self Rating Depression Scale (SDS) and a Kinetic Family Drawing (KFD) task were administered to hospitalized depressives who met the DSM-III criteria for Major Depression. Using the Family Drawing Depression Scale (FDDS), family drawings were analyzed in the depressed patients, pre- and posttreatment, and in a group of normal control Ss (N = 71). It is concluded that the FDDS is a useful and reliable measure of depression. Potential clinical and research applications are discussed.

Combining Cognitive Therapy and Pharmacotherapy for Schizophrenia

Cognitive therapy (CT) is now recognized as an effective intervention for schizophrenia in clinical guidelines developed in the United States (APA, 2006; Lehman et al., 2004) and Europe (e.g., National Institute of Clinical Excellence, 2002). However, empirical studies of CT for schizophrenia, cited as the evidence base for these recommendations, have been conducted solely with patients treated with concurrent medication. It has been a priority in some studies to enhance collaboration with the use of medication and insight into the illness for the individual patient (Kemp, Hayward, Applewhaite, Everitt, & David, 1996); and in most studies, such collaboration has been an integral part of the CT intervention. This article discusses potential interactions between medication and therapy, briefly outlines commonly used medication regimens for schizophrenia, details possible methods to improve adherence to pharmacotherapy, and explores issues encountered in collaboration in combined pharmacotherapy and CT. Finally, we discuss strategies for managing situations in which clients do not want to take medication.

Use of Computer and Mobile Technologies in the Treatment of Depression

Major depression (MDD) is a common and disabling disorder. Research has shown that most people with MDD receive either no treatment or inadequate treatment. Computer and mobile technologies may offer solutions for the delivery of therapies to untreated or inadequately treated individuals with MDD. The authors review currently available technologies and research aimed at relieving symptoms of MDD. These technologies include computer-assisted cognitive-behavior therapy (CCBT), web-based self-help, Internet self-help support groups, mobile psychotherapeutic interventions (i.e., mobile applications or apps), technology enhanced exercise, and biosensing technology.

Hepatic enzyme induction patterns and phenothiazine side effects.

D‐Glucaric acid excretion was followed in psychotic patients treated with phenothiazines for 12 days and in a control group of subjects who had no psychiatric disease. About half the psychiatric patients had a treatment‐related rise in D‐glucaric acid excretion compatible with enzyme induction. These patients had fewer and less severe neurologic side effects than those who did not have a significant rise in urinary D‐glucaric acid levels. It is concluded that individual differences in metabolism of phenothiazines may in part account for the variability in clinical response to these drugs.

Reliability and validity of the Japanese version of the Cognitive Therapy Awareness Scale: A scale to measure competencies in cognitive therapy

Aim:  This study aimed to test reliability and validity of the Japanese‐version Cognitive Therapy Awareness Scale, a self‐rating scale that measures basic knowledge of cognitive behavioral therapy (CBT) concepts and methodology. Furthermore, we explored optimal cutoff score to demonstrate required standard of CBT competency.

Examining the efficacy of d-cycloserine to augment therapeutic learning in depression

Despite advances in individual and combined treatments for major depression, issues with non-response and partial-response remain relatively common, motivating the search for new treatment strategies. This study aims to develop one such novel treatment. In this proof-of-concept study, we are investigating whether the treatment enhancing effects of d-cycloserine (DCS) administration can be extended outside the extinction-learning paradigms where they have been primarily examined. Using uniform delivery of cognitive behavioral therapy (CBT) content via computer-administered interventions for depression, we are assessing the value of pre-session administrations of DCS for retention of therapeutic learning. Recall of this information is evaluated in conjunction with performance on standardized tests of memory recall with both emotional and non-emotional stimuli. Specifically, in a randomized, double-blind trial we will compare the benefits of two pre-session administrations of DCS augmentation to those achieved by similar administrations of modafinil or placebo. Because modafinil is associated with a number of discriminable effects in addition to cognitive enhancement (e.g., feelings of vigor, alertness, positive mood); whereas these effects would not be expected with DCS, we will assess drug context effects in relation to memory augmentation effects.