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Why Exercise May Be the Best Fix for Depression - Scientific American

in 2015, Swedish scientists assigned 946 patients with mild to moderate depression to one of three 12-week treatments: thrice-weekly sessions of yoga, aerobics or strength training; Internet-based cognitive-behavioral therapy; or standard counseling plus medication. Patients in all groups improved, but those engaging in exercise experienced the greatest benefits. Internet-based therapy came in as a close runner-up, but the typical treatment plan lagged behind both alternatives.

Look at the ends -- what's being controlled -- not the means

HomeFeatured Study Reveals How Little We Know About Each Other’s Intentions Neuroscience NewsJanuary 19, 2017 FeaturedNeuroscience VideosOpen Neuroscience ArticlesPsychology5 min read Summary: Researchers report people need to understand what a person is trying to control by using a certain behavior, rather than trying to change the behavior itself. Source: University of Manchester. Psychologists from The University of Manchester have shown how difficult it is for us to guess the true intention of each other’s behaviour. The study, published today in Attention, Perception, and Psychophysics, has important implications on public policies designed to impact on areas such as smoking, obesity, eating disorders, self-harm, alcohol use and gambling. Clinical psychologist Dr Warren Mansell, who led the study, says policy makers need to accurately understand what a person is trying to control using their behaviour, rather than trying to change the behaviour itself. He said: “We think we know what someone is doing just by observing them. For example if we see someone move a steering wheel of their car, we assume they are aiming to keep their car in the centre of the lane. “But our study shows that it is incredibly easy to be mistaken – and that has important implications on anyone whose task is to change human behaviour. “In psychological research, for example, this study suggests that some behaviour studied may be no more than a side effect of participants’true intentions. “We should therefore avoid focusing on people’s behaviour itself . That would lead to multiple and inevitably futile interventions for each and every problem.” He added: “In terms of public policy, we frequently we see money spent on another new initiative for ‘behaviour change’. “Yet if these behaviours are just side effects of people trying to exert control, then this multi-pronged approach to health is highly inefficient and fails to address the common root cause of people’s difficulties. “You need to ask people what they want in their life and how they solve their problems. Smoking, for example, is just one of many different ways in which a person might try to control something important to them – such as their social confidence, or emotional state.”

CBT creates lasting changes in connectivity, drugs do not

In the original study, participants underwent fMRI imaging to assess the brain’s response to images of faces expressing different emotions, before and after six months of CBT. Participants were already taking medication when they took part in the study, and so were compared to a group receiving medication only. The group receiving medication only did not show any increases in connectivity, suggesting that the effects on brain connections could be attributed to the CBT. For the new study, the health of 15 of the 22 participants who received CBT was tracked for eight years through their medical records. They were also sent a questionnaire at the end of this period to assess their level of recovery and wellbeing. The results show that increases in connectivity between several brain regions – most importantly the amygdala (the brain’s threat centre) and the frontal lobes (which are involved in thinking and reasoning) – are associated with long-term recovery from psychosis. This is the first time that changes in the brain associated with CBT have been shown to be associated with long-term recovery in people with psychosis.

Talking therapy changes the brain's wiring, study reveals for first time -- ScienceDaily

CBT -- a specific type of talking therapy -- involves people changing the way they think about and respond to their thoughts and experiences. For individuals experiencing psychotic symptoms, common in schizophrenia and a number of other psychiatric disorders, the therapy involves learning to think differently about unusual experiences, such as distressing beliefs that others are out to get them. CBT also involves developing strategies to reduce distress and improve wellbeing. The findings, published in the journal Translational Psychiatry, follow the same researchers' previous work which showed that people with psychosis who received CBT displayed strengthened connections between key regions of the brain involved in processing social threat accurately. The new results show for the first time that these changes continue to have an impact years later on people's long-term recovery.

Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression

Within-patient Socratic questioning significantly predicted session-to-session symptom change across the early sessions, with a one standard deviation increase in Socratic-Within predicting a 1.51-point decrease in BDI-II scores in the following session. Within-patient Socratic questioning continued to predict symptom change after controlling for within-patient ratings of the therapeutic alliance (i.e., Relationship and Agreement), suggesting that the relation of Socratic questioning and symptom change was not only independent of stable characteristics, but also within-patient variation in the alliance.

Socratic questioning

If you’re having trouble challenging your negative thoughts, try this approach. Imagine that your friend is the one who received the bad news. What advice would you give him or her? Now think of how that advice might apply to you. A study conducted at Ohio State University found that this method — known as Socratic questioning — was a simple way to reduce depressive symptoms in adults. In the study, 55 adults were enrolled in a 16-week course of cognitive therapy sessions. Researchers studied videotapes of the sessions and found that the more frequently therapists used Socratic questioning, the more the patients’ depressive symptoms lessened. The study’s authors theorized that Socratic questioning helped patients examine the validity of their negative thoughts and gain a broader, more realistic perspective on them.

The Lancet: Simpler, cheaper psychological treatment as effective as cognitive behavioural therapy for treating depression | EurekAlert! Science News

"Behavioural activation is an 'outside in' treatment that focuses on helping people with depression to change the way they act. The treatment helps people make the link between their behaviour and their mood. Therapists help people to seek out and experience more positive situations in their lives. The treatment also helps people deal with difficult situations and helps them find alternatives to unhelpful habitual behaviours," explains Professor Richards. "In contrast, CBT is an 'inside out' treatment where therapists focus on the way a person thinks. Therapists help people to identify and challenge their thoughts and beliefs about themselves, the world, and their future. CBT helps people to identify and modify negative thoughts and the beliefs that give rise to them."[1]

The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses

Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.
For example, cognitive-behavioral therapy (CBT) has been shown to be the most effective treatment for PTSD and has the fewest side-effects, yet many psychologists do not use this method. Baker and colleagues cite one study in which only 30 percent of psychologists were trained to perform CBT for PTSD and only half of those psychologists elected to use it. That means that six of every seven sufferers were not getting the best care available from their clinicians. Furthermore, CBT shows both long-term and immediate benefits as a treatment for PTSD; whereas medications such as Paxil have shown 25 to 50 percent relapse rates.