Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial

Sönmez, Nasrettin; Romm, Kristin Lie; Østefjells, Tiril; Grande, Marit; Jensen, Lene Hunnicke; Hummelen, Benjamin; Tesli, Martin; Melle, Ingrid; Røssberg, Jan Ivar

doi:10.1016/j.comppsych.2019.152157

Cited by 22 publications

(23 citation statements)

References 56 publications

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“…Up until now, only five studies investigated the effect of psychological interventions on self-esteem in patients with a psychotic disorder. While three of these (pilot) studies reported positive effects on self-esteem [ 6 , 10 , 11 ], others found no such effect [ 12 , 13 ]. The investigated psychological treatments have similarities but differ with regard to their focus.…”

Section: Introductionmentioning

confidence: 99%

Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study

et al. 2021

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Background Patients with a psychotic disorder often suffer from low self-esteem, which has been related to higher suicidal risk, poor quality of life and, the maintenance of psychotic and depression symptoms. However, intervention studies are scarce and reported interventions concern individual therapies provided by highly educated psychologists. Both the individual setting and the required qualifications of the therapist may contribute to a low level of availability of an intervention. Therefore we aimed to investigate the efficacy of an easily accessible psychological group treatment targeting self-esteem in patients with a psychotic disorder. Methods Thirty patients with a psychotic disorder were included in this pilot study. All participants received nine weekly group sessions of 90 min. The therapy was offered in groups of six to eight patients and was provided by a psychiatry nurse and a graduate psychologist. To assess self-esteem the Rosenberg Self-esteem Scale and the Self-Esteem Rating Scale were used, to measure depression symptoms the Beck Depression Inventory-II was administered. Questionnaires were completed at baseline and post-treatment. Results Twenty-seven patients (90%) completed treatment. At post-treatment, self-esteem was significantly increased and depression symptoms were significantly decreased compared to baseline. Discussion This pilot study demonstrates the feasibility and treatment potential of a self-esteem group treatment provided by a psychiatry nurse and graduate psychologist in a patient population that receives little psychological treatment. Results suggest that this easily accessible intervention may be effective in improving self-esteem and reducing depression symptoms.

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Section: Introductionmentioning

confidence: 99%

Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study

et al. 2021

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“…In this way, the negative symptoms have been approached both directly and indirectly, distant from the conventional therapy in a therapists’ office. Another recent example of positive effect of CBT on negative symptoms in an indirect way (not included in the above meta-analysis) focused primarily on measures to improve functional outcome (GAF) [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

G-estimation of causal pathways in vocational rehabilitation for adults with psychotic disorders – a secondary analysis of a randomized trial

et al. 2021

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Background Vocational rehabilitation (VR) has increasingly become an important intervention targeting poor occupational functioning in schizophrenia. The Norwegian Job Management Program (JUMP), sought to enhance occupational outcomes by augmenting VR with either cognitive behavioral therapy (CBT) techniques aiming to improve psychotic symptoms or cognitive remediation (CR) aiming to improve cognition. CBT is standard treatment in schizophrenia, but recent meta-analyses question the effect of CBT on negative psychotic symptoms. It is of interest to study the causal role of psychotic symptoms and cognitive functioning on occupational functioning. Methods Data from the JUMP VR – program, was reanalyzed with a causal inference method to assess the causal effects of reduced symptoms / improved neurocognitive functioning on occupational functioning measured by number of working hours per week. Participants (N = 131) had been randomized to either VR + CBT (N = 68) or VR + CR (N = 63). Large improvements in number of working hours were demonstrated in both intervention groups (nonsignificant group difference). G-estimation was used to assess the strength and nature of the causal effects, adjusted for time-varying confounding and selection – bias from loss to follow-up. Results Significant causal effects of reduction in each of four dimensions of symptoms and improved neurocognition respectively, on number of working hours were found (separate models). The effect of negative symptoms was the strongest and increased in magnitude during the whole observation period, while the effect of two other symptoms and neurocognition was constant. Adjusted for confounding (including potential feedback), the causal effect of a hypothetical change in negative symptoms equal to the average improvement in the CBT group corresponded to an increase in working hours of 3.2 h per week (95% CI: 1.11, 5.35). Conclusion High performance of g-estimation in a small psychiatric data set with few repeated measures and time-varying confounding and effects, was demonstrated. Augmented vocational rehabilitation showed causal effects of intervention targets with the strongest and increasing effect from negative symptoms on number of working hours. Combination of therapy and activation (indirect and direct approach) might explain improvement in both cognition and negative symptoms, and shed some light on effective ingredients for improved treatment of negative symptoms.

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“…We argue that i-CBT program should include sessions on identifying and modifying wrong beliefs related to mathematics anxiety and issues related to low self-esteem and self-efficacy (e.g., "girls cannot do math" or "I am not a math person"), in individuals with erroneous beliefs about mathematics practices. Standard CBT often includes sessions on changing erroneous beliefs (Pittig et al, 2019), and exiting CBT interventions have also been used to increase self-esteem (Morton et al, 2012;Sonmez et al, 2020). Further, i-CBT should include sessions to target mathematics anxiety developed due to parental pressure and/or teachers' use of fear appeals.…”

Section: A Novel Individualized Cognitive Behavioral Therapy (I-cbt) For Mathematics Anxietymentioning

confidence: 99%

The Need to Develop an Individualized Intervention for Mathematics Anxiety

2021

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Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial

Cited by 22 publications

References 56 publications

Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study

Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study

G-estimation of causal pathways in vocational rehabilitation for adults with psychotic disorders – a secondary analysis of a randomized trial

The Need to Develop an Individualized Intervention for Mathematics Anxiety

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