1. Coloring books make you feel better, but real art therapy much more potent

    December 24, 2017 by Ashley

    From the Drexel University press release:

    A new study shows that while those adult coloring books can reduce stress, they’re still not art therapy.

    Often, the now-ubiquitous adult coloring books will advertise themselves as “art therapy.” But actual art therapists contend that such a claim is misleading, that true art therapy is about growth and relationships and not simply about “feeling better.”

    In light of that, Girija Kaimal, EdD, assistant professor in Drexel University’s College of Nursing and Health Professions led a study that shows that while coloring alone does have some positive effect, it is not nearly as potent as involving an art therapist.

    “The main takeaway is that coloring has some limited benefits like reducing stress and negative mental states,” Kaimal said. “But it does not shift anything else of substance, develop relationships, nor result in any personal development.”

    Kaimal and her Canadian Art Therapy Association Journal study co-authors — Janell Mensinger, PhD, associate research professor in Drexel’s Dornsife School of Public Health, and doctoral students Jessica Drass and Rebekka Dieterich-Hartwell — ran two, separate 40-minute exercises, one consisting of pure coloring and the other involving direct input from an art therapist, to see if one of the other led to significant differences in mood and stress levels.

    The art therapists’ open studio sessions resulted in more empowerment, creativity and improved mood, which are significant for individuals striving to improve their quality of life and make lasting change,” Kaimal said.

    Every participant — of which there were 29, ranging in age from 19 to 67 — took part in each exercise. In the pure coloring exercise, the participants colored in a pattern or design. Although an art therapist was in the room, they did not interact with the person coloring.

    In the other exercise, participants were put in an “open studio” situation, where an art therapist was present and able to facilitate the session, as well as provide guidance and support to process the experience and artwork. The participants were able to make any type of art they wished, whether it involved coloring, sketching, doodling, or working with modeling clay. As the participants worked on their piece, the art therapists created art as well, and were available to assist the participants if they asked for it.

    Each person took standardized surveys before and after their sessions that ranked their stress levels and feelings.

    Perceived stress levels went down by at roughly the same levels for both exercises (10 percent for coloring; 14 percent for open studio). Negative mental states also showed similar decreases in levels (roughly a 7 percent decrease for coloring; 6 percent for open studio).

    But while the coloring exercise didn’t show significant changes for any other effects, the participants displayed an approximate 7 percent increase in self-efficacy, 4 percent increase in creative agency, and a 25 percent increase in positive feelings after their art therapist-aided open studio sessions.

    Many of the outcomes were enabled through the relational support from the art therapist,” Kaimal explained. “The art therapist-facilitated session involves more interpersonal interaction, problem solving around creative choices and expression, empowerment and perhaps more learning about the self and others. That all contributes to the outcomes we saw.”

    So while coloring did help alleviate bad feelings, it didn’t create good feelings in the way that actual art therapy might.

    “Coloring might allow for some reduction in distress or negativity, but since it is a structured task, it might not allow for further creative expression, discovery and exploration which we think is associated with the positive mood improvements we saw in the open studio condition,” Kaimal said.


  2. Study suggests cognitive behavioral therapy for children and adolescents with OCD works in the long run

    November 23, 2017 by Ashley

    From the Aarhus University press release:

    Some children and adolescents think that they will have an accident if they do not count all the lampposts on their way to school. Or cannot leave the house unless they have washed their hands precisely twenty-five times. They suffer from OCD, Obsessive Compulsive Disorder, which is an extremely stressful psychiatric disorder that affects between 0.25 and 4 per cent of all children.

    Fortunately, the treatment method — cognitive behavioural therapy — is both effective and well-documented. The hitherto largest research study of OCD treatment for children and adolescents aged 7-17 now shows that cognitive behavioural therapy also has a long-lasting effect. The Nordic research project, which involves researchers from Aarhus University and child and adolescent psychiatry clinics in Norway and Sweden, has shown that children and adolescents who benefited from the therapy were also free of patterns of compulsive behaviour and compulsive thoughts one year after the treatment ended.

    “The study makes clear that cognitive behavioural therapy reaches beyond the treatment period. This knowledge is important, both for the practitioners, but not least for the affected children and their families,” says Per Hove Thomsen, one of the researchers behind the study and professor at Aarhus University and consultant at the Centre for Child and Adolescent Psychiatry, Risskov. He is also the final author of the results, which have just been published in the scientific journal Journal of the American Academy of Child and Adolescent Psychiatry.

    “OCD is a very difficult disorder which demands a colossal amount of the child in question. It is almost impossible to live a normal life as a child and teenager with a normal level of development, if you need to wash your hands a hundred times a day in a particular way in order not to be killed, which is something that compulsive thinking can dictate. For the same reason, early intervention is necessary before the disorder has disabling consequences in adulthood,” says Per Hove Thomsen.

    The children from the study were treated with cognitive behavioural therapy, which is a behavioural psychological treatment. Fundamentally it involves getting help to refrain from acting on compulsive thoughts and instead incorporating new thought patterns. The method also involves the whole family, as the effect is strengthened by the mother and father supporting the methods that the child is given to overcome the OCD.

    Furthermore, according to Psychologist and PhD David R.M.A Højgaard, who is the lead author of the scientific article, once the treatment is completed a watchful eye should still be kept on the child or teenager.

    “The results of the study indicate that to maintain the effect in the longer term you need to remain aware and detect OCD symptoms so you can nip them in the bud before they develop and become worse. This is done by offering booster sessions to refresh the treatment principles and thereby prevent OCD from getting a foothold again,” says David R.M.A Højgaard.

    The collaboration with the Norwegian and Swedish child and adolescent psychiatry clinics has added knowledge that can be significant for the organisation of OCD treatment.

    “The biggest challenge facing OCD treatment is that there are not enough specially trained therapists and treatment facilities to meet needs. The study shows that if the level of training of therapists is consolidated and if supervision is provided, then it is possible to provide treatment in an isolated corner of Norway that is just as effective as the treatment provided at a university clinic,” says Per Hove Thomsen.

    The study is part of The Nordic Long Term OCD Treatment Study (NordLOTS) and comprises 269 children and adolescents with OCD from Denmark, Norway and Sweden.

    The results showed that 92 per cent of the 177 children and teenagers who immediately benefited from the treatment were still healthy and free of symptoms one year after the treatment ended. Of these, 78 per cent had no clinical symptoms of OCD.


  3. Study examines CBT use for chronic pain

    November 17, 2017 by Ashley

    From the Wolters Kluwer Health press release:

    By teaching patients better strategies for coping with chronic pain, cognitive behavioral therapy (CBT) is a valuable treatment alternative for the millions of Americans taking opioids for noncancer pain, according to an article in the Journal of Psychiatric Practice. The journal is published by Wolters Kluwer.

    “Cognitive behavioral therapy is a useful and empirically based method of treatment for pain disorders that can decrease reliance on the excessive use of opiates,” write Drs. Muhammad Hassan Majeed of Natchaug Hospital, Mansfield Center, Conn., and Donna M. Sudak of Drexel University College of Medicine, Philadelphia. They discuss evidence supporting the use of CBT to avoid or reduce the use of opioids for chronic pain.

    CBT Offers Effective, Safer Alternative to Opioids for Chronic Pain

    Rising use of opioid (sometimes called opiate) medications to treat chronic noncancer pain is a major contributor to the US opioid crisis. But despite the aggressive marketing and prescribing of these powerful painkillers, there has been little change in the amount and severity of pain reported by Americans over the past decade. “There is no evidence that supports the use of opioids for the treatment of chronic pain for more than one year, and chronic use increases the serious risks of misuse, abuse, addiction, overdose, and death,” Drs. Majeed and Sudak write.

    They believe that CBT is an important alternative to opioids for treatment of chronic pain. The goal of CBT is to help patients change the way they think about and manage their pain. The idea is not that pain (in the absence of tissue damage) “is all in your head” — but rather that all pain is “in the head.” Cognitive behavioral therapy helps patients understand that pain is a stressor and, like other stressors, is something they can adapt to and cope with.

    Interventions may include relaxation training, scheduling pleasant activities, cognitive restructuring, and guided exercise — all in the context of an “empathic and validating” relationship with the therapist. These interventions “have the potential to relieve pain intensity, improve the quality of life, and improve physical and emotional function,” according to the authors.

    “Therapy helps the patient see that emotional and psychological factors influence perception of pain and behaviors that are associated with having pain,” Drs. Majeed and Sudak write. “Therapy…puts in place cognitive and behavioral strategies to help patients cope more successfully.”

    The authors cite several recent original studies and review articles supporting the effectiveness of CBT and other alternative approaches for chronic pain. Studies suggest that CBT has a “top-down” effect on pain control and perception of painful stimuli. It can also normalize reductions in the brain’s gray matter volume, which are thought to result from the effects of chronic stress.

    Cognitive behavioral therapy is moderately effective in reducing pain scores, while avoiding or reducing the opioid risks of overuse, addiction, overdose, and death. It can be used as a standalone treatment; in combination with other treatments, including effective non-opioid medications; or as part of efforts to reduce the opioid doses required to control chronic pain.

    Unfortunately, CBT and other nondrug treatments are underused due to unfamiliarity, time pressure, patient demands, ease of prescribing medications, and low reimbursement rates. Drs. Majeed and Sudak note that significant investment of resources will be needed to train practitioners and to widely integrate the use of CBT into chronic pain treatment. The authors suggest that the President’s Commission on the opioid crisis might fund such training programs as a preventive strategy to curb opioid abuse.

    “There is a need for a paradigm shift from a biomedical to a biopsychosocial model for effective pain treatment and prevention of opioid use disorder,” Dr. Majeed comments. “Increased use of CBT as an alternative to opioids may help to ease the clinical, financial, and social burden of pain disorders on society.”


  4. Researchers develop psychotherapy treatment for refugees’ trauma

    November 13, 2017 by Ashley

    From the Bielefeld University press release:

    They are suffering from nightmares, flashbacks, depression, or anxiety disorders: refugees coming to Germany from conflict areas are frequently traumatized. ‘Realistic estimates state that up to 40 per cent of refugees have mental problems. Hence, for the period since 2015, we are talking about several hundred thousand people who are in real need of psychological support,’ says Professor Dr. Frank Neuner from Bielefeld University. The psychologist is one of the team responsible for developing ‘Narrative Exposure Therapy’ (NET). It has been applied over the last 15 years in conflict zones from East Africa to Sri Lanka. What is special about this therapy is that it shows success after only a few sessions. In a new ‘research_tv’ programme at Bielefeld University, Frank Neuner talks about NET and explains the consequences of leaving refugees without treatment.

    ‘I believe that a large part of the general population is willing to accept that we now need to invest substantially in dealing with these traumatized refugees and that the state must make money available for this,’ says Frank Neuner. ‘Due to the threats in their home countries, many refugees will be staying with us for a long time. By helping them now, we shall be warding off problems that will otherwise confront us unavoidably in 20 or 30 years time.’

    Neuner designed and tested NET together with Dr. Maggie Schauer and Professor Dr. Thomas Elbert from the University of Konstanz. By working with this method, hundreds of child soldiers, victims of political violence, and war refugees have been able to process their traumatic experiences.

    The key principle of NET is a highly valued practice in every culture: telling stories. ‘Whenever we have gone through an emotional experience, we try to tell stories. This is how we try to make what we have experienced comprehensible to others,’ says Neuner. ‘Refugees have experienced a whole series of traumatic events. We talk together with them about their entire life history and build up a kind of autobiography that enables them to embed the single traumatic experiences in a meaningful context and work out the significance they have in their own personal lives.’ Together with their therapist, traumatized persons work their way repeatedly and chronologically through the negative and positive events in their lives. ‘The idea is to historicize the traumatic events. This permits closure, so that they no longer threaten the present.’

    To deliver therapy to people in crisis zones, Neuner together with colleagues from the University of Konstanz and further supporters founded the aid organisation ‘Vivo’. It is training lay therapists in countries such as Sri Lanka, Ruanda, Uganda, and the Congo. Unlike Germany, the health systems of these countries do not provide access to professional therapists. ‘However, even Germany does not have enough therapists to treat all the refugees with traumatic disorders. Many people in Germany already have to wait months for a treatment slot with a therapist,’ says Neuner. ‘One step towards a solution could be to give NET training to refugees and migrants here in Germany and to employ them within a stepped care model supervised by psychotherapists. However, the German legal situation does not permit this at present.’

    NET is already being practiced by professional therapists in Germany. Bielefeld University’s psychotherapy clinic is applying the method in therapy studies not only refugees with but also with survivors of child abuse, rape victims, and former members of the German military. The scientific further education centres at Bielefeld University and the University of Konstanz are qualifying psychologists, medical doctors, and psychotherapists to work with NET.


  5. Study shows clear effect of art therapy on severe depression

    November 10, 2017 by Ashley

    From the University of Gothenburg press release:

    Create a picture of how you are feeling on this particular day, said the first exercise in the art therapy. After ten treatments the patients who suffered from severe or moderately severe depression had shown more improvement than the patients in the control group, shows research at Sahlgrenska academy.

    “The conclusion is that it was the art therapy that facilitated their improvement,” says Christina Blomdahl, PhD at the institute of health and care sciences, licensed occupational therapist and art therapist.

    As part of her dissertation she has allowed 43 patients with severe or moderately severe depression to undergo a manual-based art therapy that she has developed herself. The control group consisted of 36 people who all suffered from the same medical condition.

    In parallel with this, all participants were given different combinations of medication, cognitive behavioral therapy, psychodynamic therapy and physical therapy. The majority of the participants were so affected by their depression that they were unable to work.

    The individual art therapy took place in psychiatry or primary care and was conducted by a specially trained therapist. Each session began with a short briefing and a relaxation exercise. After that it was crayons, water colors and creation that was on the agenda, all based on a predetermined setup.

    “They followed the manual I had created in order to ensure that it was scientific, but although everyone was given the same theme to go on the patients responded very differently to the exercises. The materials were simple, allowing people to doodle and feel free to express themselves the way they wanted to, and then they would talk about the picture and its significance to the participant,” explains Christina Blomdahl.

    After ten hour-long treatment sessions the patients had improved on an average of almost five steps on a rating scale used for depression. A large leap that entails a considerable change to everyday life, and sometimes it may also mean that a patient is able to return to work.

    Anxiety, sleep, ability to take initiative and emotional involvement are some of the factors that are assessed. In the control group that had not undergone art therapy there was no definite change.

    “The focal point was that people felt like they were meeting themselves; that the picture served as a mirror where you could see and make new discoveries about yourself, a bit like coming to life, says Christina Blomdahl.

    “Even the people who did not experience any direct benefit from the treatment had shown improvement. Painting pictures based on themes and discussing the pictures with the therapist promotes self-reflection and brain stimulation that takes place outside of the conscious mind,” she continues.

    “It is my hope that art therapy will be used in healthcare again. Based on evidence requirements it has been more or less scrapped by psychiatry, but this is one of the largest studies that has been conducted in this area and it is a step that may lead to more people being trained in it and the method being used again,” Christina Blomdahl concludes.

    Further information: https://gupea.ub.gu.se/handle/2077/52419


  6. Researchers develop set of guidelines for art therapy for children with ASD

    August 9, 2017 by Ashley

    From the Florida State University press release:

    A Florida State University researcher is working with art therapists to find better ways to treat children who have Autism Spectrum Disorder (ASD).

    Theresa Van Lith, assistant professor of art therapy in FSU’s Department of Art Education, led a study that surveyed art therapists working with children with ASD to develop a clearer understanding of their techniques and approaches. The study was published this month in the journal Arts in Psychotherapy.

    “I had noticed that is there is a high number of art therapists working with people who have autism, but I wanted to understand what their practice wisdoms were in terms of how they go about facilitating art therapy sessions,” Van Lith said. “We want to make it a transparent process for the client or the parents of a client, so they know what to expect.”

    The Center for Disease Control and Prevention estimates that one in 68 children is diagnosed with Autism Spectrum Disorder by age 8 each year. As that population grows, more parents and educators are seeking out art therapists to address social development and sensory issues that generally accompany ASD.

    The research team compiled and analyzed the art therapists’ expert opinions on topics such as what worked with ASD clients, their objectives during a session, their most preferred theoretical approach and the considerations they had to make when working with children with ASD.

    “We realized there wasn’t a consensus with the theoretical approaches they used,” Van Lith said. “They were having to use a number of theoretical approaches together, and we wanted to understand what that would be like in practice.”

    While the survey results varied, the researchers were able to develop a set of guidelines for delivering art therapy to children who have ASD. The proposed guidelines will serve as a basis of successful practice for new art therapy professionals and for further studies.

    “We used these practice wisdoms from art therapists around the field to understand the most effective and beneficial way to use art therapy with child with ASD,” Van Lith said.

    Some of the best practices found were: use the same routine to begin each session, explain instructions in a consistent manner, spark curiosity to teach new skills and be aware of transitions between activities.

    The researchers also outlined aspects of practice that were found not to be useful. They warned art therapists on a handful of factors that could have adverse effects on clients such as being overly directive or too loose with direction, using over stimulating art materials and forcing or being restrictive with communication styles.

    “That’s important because sometimes there is the assumption of ‘why can’t anyone do these techniques?'” Van Lith said. “People wonder why art therapy can’t be conducted in a much less formal situation. However, they don’t realize there are nuances in the way we deliver the art therapy directive — a lot of that is about knowing the client and the way a client responds to communication.”

    Based on these guidelines and consensus, Van Lith is rolling out a larger study to demonstrate the efficacy of that working model.

    “The idea is that, over time, we can build up the evidence that art therapy is effective for these children, and we can demonstrate how and why that is the case,” Van Lith said.

    The ultimate goal is to educate art therapists about best practices as well as inform clients, parents and teachers about possible benefits of art therapy for children with ASD.

    “As a result of more transparency, the clients can appreciate or understand some of the changes that might be going on for them as they receive art therapy,” Van Lith said. “We don’t want it to be a mysterious process.”

    Van Lith co-authored the study with Jessica Stallings, associate professor at Emporia State University, and FSU alumna Chelsea Harris, who practices at the Emory Autism Center.


  7. Study suggests cognitive behavioral therapy improves functioning for people with chronic pain

    July 29, 2017 by Ashley

    From the American Pain Society press release:

    Cognitive Behavioral Therapy (CBT) is the most frequently used psychological intervention for people with chronic pain, and new approaches for improving CBT outcomes may be found in the psychological flexibility model and Acceptance and Commitment therapy (ACT), according to research reported in The Journal of Pain.

    Acceptance and Commitment Therapy (ACT) is based on the psychological flexibility model, which includes a therapeutic process known as “self-as-context” (SAC). Contextual self refers to a sense of self that is not based on self-evaluations. It is similar to being an observer of one’s own psychological experiences. Researchers in the United Kingdom writing in The Journal of Pain examined whether ACT influences SAC and if changes in measures of SAC are associated with treatment outcomes.

    Psychological flexibility is the ability to be more aware, more focused on goals and more engaged. Another aspect of psychological flexibility pertinent to chronic pain, and supported by SAC, is called committed action, which involves goal-directed, flexible persistence,” said co-author Lance M. McCracken, Professor of Behavioral Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London. “For pain management, ACT is an approach based on the psychological flexibility model and focuses on building effective patterns of behavior change rather than symptom reduction.”

    Four hundred twelve adults referred to a pain management center at Guy’s and St. Thomas’ Hospital in London were subjects for the study. They completed measures of treatment processes, such as SAC and committed action, and outcomes (pain-related interference, work and social adjustment, depression) before treatment, upon treatment completion and after nine months.

    Wider outcomes research suggests that ACT is effective for enhancing daily functioning and for decreasing psychological distress. A study published in 2011 assessed the long-term efficacy of acceptance and commitment therapy in more than 100 people with chronic pain. The evidence showed at three-year follow-up that 65 percent of study subjects had reliably improved in at least one key clinical domain, and improvements in psychological flexibility were associated with improvements in outcomes measures.

    Results of the current Kings College study showed that scores from both the process and outcomes measures significantly improved after treatment and were maintained at nine-month follow-up. The ACT-oriented treatment was associated with improved SAC as well as improved functioning. Changes in SAC were associated with changes in pain-related interference, work and social adjustment and depression.

    Greater psychological flexibility is associated with less pain-related anxiety and avoidance, less depression, less physical and psycho-social disability and other measures of patient function,” said McCracken. “Based on studies of forms of CBT that did not include ACT, acceptance of pain, one component of psychological flexibility, may be a general mechanism by which CBT treatments achieve improvements in functioning, and more specific targeting of pain-related acceptance may lead to further improvement is CBT outcomes.”

    The authors concluded that that the study results are consistent with an increasing number of longitudinal and mediation studies showing that ACT for chronic pain improves patient functioning, specifically through enhanced psychological flexibility.


  8. Study examines line between education and personal experience in the classroom

    June 29, 2017 by Ashley

    From the Concordia University press release:

    In the classroom, what’s the line between education and personal experience?

    This is a question addressed by Concordia alumnus Jason Butler (PhD 14) in an article recently published by The Arts in Psychotherapy.

    In the course of a North American and UK study, he found that the conflicting demands of education and therapy within the classroom can cause emotional stress and confusion among students in drama therapy and other professions using dramatic enactment.

    His conclusion? The use of personal material must be better defined to protect both students and faculty.

    “When educating therapists, particularly using experiential methods, things can become blurry,” Butler notes.

    “Instructors often take for granted that doing role-plays or other enactments within the classroom are relatively benign acts. However, this research shows that material can resonate with students in complex ways that often inhibit their learning and development.”

    Butler’s study offers eight recommendations for improving the practice of drama therapy education.

    These include increased transparency between teachers and students; clearer policies on the use of affective material in the classroom; guidelines for evaluating and assessing emotional performance; and discussions within the professions about ethical and pedagogical practices.

    “These findings point us in in the direction of creating better systems and pedagogical approaches to enhance the student experience and educate more effective therapists.”

    The impact of self-regulation

    In the study, students reported that they were asked to incorporate personal material into their assignments with the caveat that they avoid anything overwhelming.

    The expectation of self-regulation without clear guidelines for evaluating what was appropriate created stress and uncertainty.

    Some students also found the transition from mock therapy to teaching jarring, as it left emotional impacts insufficiently addressed or resolved. Others experienced uncertainty over how or if their emotional engagement would be graded.

    For example, in a teaching demonstration an instructor might ask a student to assume the role of a trauma survivor without knowing they have direct experience as such. The student may feel obliged to engage with potentially harmful material in an inappropriate setting due to classroom pressure and the potential for evaluation.

    Butler is quick to point out that affect is not the problem, however.

    Affective engagement can be a powerful tool for facilitating learning,” he notes.

    “Research has shown that therapists who are more aware of their own emotional experience are better equipped to work with the emotional experiences of their clients. The challenge here is to channel that affect in a responsible and transparent manner.”

    Better systems and pedagogical approaches

    Butler conducted interviews and focus groups with students and faculty members at three drama therapy training programs in North America and the United Kingdom.

    The data was sorted into themes and coded inductively to form a larger picture or research model of the student experience of affective engagement in the classroom.

    That model showed that students wrestle with expectations regarding the appropriate level of engagement. This often leads to strong emotional responses in the classroom, which in turn lead to negative consequences. Some students leave or fail out of the program; it is recommended that all seek therapy.

    For Butler, the findings suggest that more transparent communication is required between teachers and students.

    “Without an understanding of the processes at play, we are not able to capitalize on the strengths that come from these approaches to learning.”


  9. Study examines effect of CBT on chronic pain patients

    June 26, 2017 by Ashley

    From the European League against Rheumatism press release:

    The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.

    This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

    To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.

    For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).

    “To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.

    ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility”. ACT focuses on behaviour change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.

    In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients’ outcome measures were available for a retrospective analysis.


  10. Study suggests cognitive behavioral therapy could help stress in sport

    May 21, 2017 by Ashley

    From the Leeds Beckett University press release:

    Cognitive behavioural therapy (CBT) could be a powerful tool to help elite sportspeople improve their performance by handling stress more effectively, new research has found.

    The study, by Leeds Beckett and Loughborough Universities, is the first to show that CBT can change how high-level athletes respond to organizational stress within their sport, and that this can have significant benefits for their emotions and performance.

    Sport psychology researcher, Dr Faye Didymus, worked with four high-level female hockey players over nine months, using a CBT technique called cognitive restructuring to help them identify what put them under pressure, understand how they responded emotionally, and then consider more helpful alternative responses. The results were immediate: things that they had viewed as threats, players began to see instead as challenges, resulting in more positive emotions and higher satisfaction with their performance.

    Dr Didymus, from the Carnegie Research Institute at Leeds Beckett University, said: “Cognitive restructuring can help people take control of what they think about stress, which is incredibly empowering. This is particularly true in sport where individuals have to perform under pressure, either alone or as part of a team. CBT has been used in health and business settings to improve individuals’ wellbeing and performance but it’s wider use in sport is long overdue.”

    The players were from the Investec Women’s Hockey League, which, although amateur, includes the top teams in England, with players selected from the League to compete at international level. Although most players are also working or studying full-time, teams can have up to five training sessions and two competitive matches each week.

    Selection and deselection from their team and the presence of England selectors at a big game were some of the causes of stress — known as ‘stressors’ — identified by the players during the research. Others included lack of communication from the coach, issues with teammates or training, large crowds at matches and poor umpire decisions.

    The players were assessed before the CBT began to identify those who would be most likely to benefit from the programme. Each player then took part in an in-depth personalised programme of CBT to help them understand their current thoughts about stress, associated emotions, and how these might be changed by CBT. For example, for a player who was thinking ‘I must play well or I will ruin my chance of selection,’ an alternative would be suggested, such as: ‘If I play well, I’ve a good chance of being selected,’ which views selection as a challenge rather than a threat. Players would then be asked to think about how this different thought might change their feelings or emotions.

    Over the nine months, the players moved from considering these alternative responses theoretically and in discussion with Dr Didymus to coming up with their own ‘alternatives’ and integrating those into their thought processes whenever they trained or competed.

    An immediate positive impact was seen on all of the stress-related variables that Dr Didymus targeted: the players started to view more stressors as challenges than threats, positive emotions predominated, and the players’ performance satisfaction began to increase. When the players were assessed three months after the programme, these benefits had been maintained.

    One of the players who took part in the research explained her experiences as follows: ‘If I’m thinking about stressors as a challenge not a threat then I play better. I learnt how to see things as a challenge, which has helped my performance.’ Another said: ‘I practice thought adjustment in training like I do my hockey so it comes naturally in matches and nine times in ten I’m more satisfied with how I perform.’

    Given the success of the trial, Dr Didymus believes that the programme she’s developed should now be adapted and tested across a range of sports: “Ours was a small trial in one sport so we now need to see if this can replicated in other sports with the same positive effects,” she said. “We’d also like to integrate objective measures of performance within future trials, and to look at how improving individuals’ responses to stress can benefit the team as a whole.”