A Case Report of Cognitive Processing Therapy Delivered over a Single Week.

Although evidence-based treatments for posttraumatic stress disorder (PTSD), such as Cognitive Processing Therapy (CPT), have been developed and widely disseminated, the rate of veterans engaging in and completing these therapies is low. Alternative methods of delivery may be needed to help overcome key barriers to treatment. Delivering evidence-based therapies intensively may address practical barriers to treatment attendance as well as problems with avoidance. This report details the case of a combat veteran who received 10 sessions of Cognitive Processing Therapy delivered twice per day over a single, five-day work week (CPT-5). Post-treatment, the veteran reported large and clinically meaningful decreases in PTSD and depression symptom severity as well as in guilt cognitions, which is a purported mechanism of successful treatment. These effects persisted six weeks after treatment ended. Despite the intensive nature of the treatment, the veteran found CPT-5 tolerable and could cite many benefits to completing therapy in one work week. In conclusion, CPT-5 holds promise as a way to efficiently deliver an evidence-based therapy that is both clinically effective and acceptable to patients, although more rigorous clinical trials are needed to test this treatment delivery format

Understanding the nature of perceived control and its relationship with anxiety

Perceived control, or the psychological sense that one is able to personally influence events and outcomes in one\u27s life, has been identified as a potentially important risk factor for anxiety disorders. The present research was aimed at understanding the nature of perceived control as a risk factor for anxiety and how this construct is linked to a larger network of risk factors for anxiety. Study 1 showed that 6 cognitive appraisals known to predict anxiety, including measures of perceived control, loaded onto a single factor reflecting confidence in one\u27s coping ability. This confidence factor significantly predicted future state anxiety during a period of stress after baseline levels of trait anxiety and other possible confounds were controlled, suggesting that these appraisals may be used to identify those at risk. For Study 2, the Parental Facilitation of Mastery Scale (PFMS) was developed to assess parenting behaviors that may promote mastery experiences in childhood. A factor analysis of the PFMS revealed two components representing parental overprotection and parental challenge. Structural equation modeling revealed that perceived control mediated the relationship between these two parenting styles and anxiety. In Study 3 a factor analysis was used to demonstrate the distinction between masculinity (instrumentality) and mastery. Together these variables accounted for sex differences in anxiety. With social desirability and hassles controlled, mastery and masculinity were shown to contribute uniquely to the prediction of anxiety. Mastery mediated the relationship between masculinity and anxiety, suggesting that an important way in which masculinity may buffer against anxiety is through the development of a sense of control. Collectively, this research suggests that parenting and socialization experiences in childhood contribute to a psychological sense of control, which in turn establishes risk for anxiety. Implications for clinical interventions are discussed

Psychological mechanisms of effective cognitive-behavioral treatments for PTSD.

Several psychotherapies have been established as effective treatments for posttraumatic stress disorder (PTSD) including prolonged exposure, cognitive processing therapy, and cognitive therapy for PTSD. Understanding the key mechanisms of these treatments, i.e., how these treatments lead to therapeutic benefits, will enable us to maximize the efficacy, effectiveness, and efficiency of these therapies. This article provides an overview of the theorized mechanisms for each of these treatments, reviews the recent empirical evidence on psychological mechanisms of these treatments, discusses the ongoing debates in the field, and provides recommendations for future research. Few studies to date have examined whether changes in purported treatment mechanisms predict subsequent changes in treatment outcomes. Future clinical trials examining treatments for PTSD should use study designs that enable researchers to establish the temporal precedence of change in treatment mechanisms prior to symptom reduction. Moreover, further research is needed that explores the links between specific treatment components, underlying change mechanisms, and treatment outcomes

Psychological mechanisms of effective cognitive-behavioral treatments for PTSD.

Several psychotherapies have been established as effective treatments for posttraumatic stress disorder (PTSD) including prolonged exposure, cognitive processing therapy, and cognitive therapy for PTSD. Understanding the key mechanisms of these treatments, i.e., how these treatments lead to therapeutic benefits, will enable us to maximize the efficacy, effectiveness, and efficiency of these therapies. This article provides an overview of the theorized mechanisms for each of these treatments, reviews the recent empirical evidence on psychological mechanisms of these treatments, discusses the ongoing debates in the field, and provides recommendations for future research. Few studies to date have examined whether changes in purported treatment mechanisms predict subsequent changes in treatment outcomes. Future clinical trials examining treatments for PTSD should use study designs that enable researchers to establish the temporal precedence of change in treatment mechanisms prior to symptom reduction. Moreover, further research is needed that explores the links between specific treatment components, underlying change mechanisms, and treatment outcomes