In Memoriam – Thomas E. Dowd
We have just learned with deep sorrow that our colleague and friend – Professor, Ph.D., Thomas E. Dowd, from Kent State University, USA (https://www.kent.edu/psychology/profile/e-thomas-dowd) – has just passed away!
As our academic and professional community knows very well, professor Dowd was a world-class innovator in the field of cognitive-behavioral therapy/evidence-based psychotherapy. His book – Cognitive Hypnotherapy – is the classic book in the field, integrating CBT and hypnosis/hypnotherapy, and his work in immersing implicit learning research in the psychotherapy field was also a pioneering one.
Professor Dowd was also a faculty member of our International Institute for the Advanced Study of Psychotherapy and Applied Mental Health (International Psychotherapy Institute) at the Babes-Bolyai University, Cluj-Napoca, Transylvania, Romania, having a key contribution in launching the UBB School of Clinical Psychology and Psychotherapy in 2004/2007. He visited us several times, offering academic courses, psychotherapy training, and various professional workshops. In one of his last visits, in June 2017, he was involved in the organization of the 9thCongress of the International Association of Cognitive Psychotherapy, which took place in Cluj-Napoca, Transylvania, Romania.
He was a top scientist, a sensitive supervisor, and a very, very good friend, enchanted with Transylvania!
Rest in peace, dear friend and colleague, and thank you for everything! We will miss you, but you will stay alive in our memories and academic activities.
Albert Ellis Award for Research 2018
Albert Ellis Institute are plăcerea de a anunța apelul pentru aplicațiile „Albert Ellis Award for Research 2018”. Termenul limită pentru trimiterea acestora este 15 Februarie 2018. Mai multe detalii pot fi accesate pe pagina Albert Ellis Institute: http://albertellis.org/albert-ellis-award-for-research/
Albert Ellis Institute: Ellis Scholars Program – 2018
For the Ellis Scolars Program of the Albert Ellis Institute, please check: http://albertellis.org/ellis-scholars/
Albert Ellis Institute anunță „Ellis Scholars Program” pentru anul 2018, având scopul de a promova Terapia Rațional-Emotivă și Comportamentală în mediul academic. Dedadline-ul pentru aplicații este 16 Februarie 2018. Pentru mai multe detalii accesați site-ul Albert Ellis Insititute: http://albertellis.org/ellis-scholars/
Babes-Bolyai University and its International Institute for the Advanced Study of Psychotherapy and Applied Mental Health honor Professor Aaron T. Beck on his 95th birthday!
Professor Aaron T. Beck has turned 95 on the 18th of July 2016! In 2012, Professor Beck received the highest distinction of our university – Doctor Honoris Causa of Babes-Bolyai University – becoming part of our academic community (see here). Our university also holds an Aaron T. Beck Professorship position, in recognition of the scientific stature of Aaron T. Beck and of his contribution to the development of the clinical and psychotherapy program at Babes-Bolyai University.
As we all know, Professor Beck, now emeritus professor of the Ivy League University of Pennsylvania, USA, is recognized world-wide for his “cognitive revolution” in the mental health field, which has changed the face of clinical science and clinical practice. He has influenced a huge number of scientists in the academic field, and millions of people all over the world have benefitted from this innovative treatment (i.e., cognitive therapy). Over the years, he has received many awards and distinctions for his tremendous contributions to clinical science and practice. For example, when he was awarded the Lasker Award, considered by many “the American Nobel in Medicine”, Dr. Joseph L. Goldstein, the chairman of the Lasker committee, said: “…Cognitive therapy is one of the most important advances — if not the most important advance — in the treatment of mental diseases in the last 50 years.”
In our view, Professor Beck set the stage for “modern psychotherapy” in the history of the field, radically changing the way we see and practice psychotherapy. Before him, we had mainly “grand theories”, associated to various more or less charismatic founders. He is a charismatic scientist, who has changed the paradigm and has taken psychotherapy as a science into the evidence-based field. It is our strong belief that we owe it mainly to Professor Beck that psychotherapy is well-integrated today in the evidence-based movement in mental health and that it has a strong scientific profile!
Thank you and Happy Birthday, dear professor and colleague!
Professor, Ph.D., Daniel David
Director of the International Institute
Vice-rector for research, competitiveness-excellence, and scientific publications of Babes-Bolyai University
Press release – DREAM Project
Please find here a press release on the DREAM Project (www.dream2020.org) implemented by the Institute/Department in a larger European consortium coordinated by Skövde University, Sweden (Tom Ziemke,Ph.D.). Here you can find several pictures and videos presenting our new ROBOmembers.
New clinical trial investigating comparatively the efficacy of rational-emotive & cognitive-behavior therapy (REBT/CBT) and medication (sertraline) in youth depression
Results of a new clinical trial investigating comparatively the efficacy of rational-emotive & cognitive-behavior therapy (REBT/CBT) and medication (sertraline) in youth depression have been accepted for publications in the prestigious journal Psychiatry Research. A preview – already presented over the time at various scientific conferences – of the results/conclusions is presented below. The details will/can be found in the full article; we will keep you updated about its publication. And please don’t forget to suscribe to our newsletter, you will receive a free coupon for a free elo boosting service.
I. REBT/CBT for Major Depression in Youth. Results of a New Clinical Trial.
- Citation: Iftene, F., Stefan, S., Predescu, G., & David, D. (in press). Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; A randomized clinical trial. Psychiatry Research.
- Correspondence for this article should be addressed to david@ubbcluj.ro and/or iftenef@providencecare.ca
- Authors:
- Felicia Iftene, MD, Ph.D., Department of Psychiatry, Queens University, Canada
- Simona Stefan, Ph.D., Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Romania
- Georgiana Predescu, MD, PH.D., Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Romania
- Daniel David, Ph.D., Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Romania
Introduction: Eighty-eight (N=88) depressed youths (i.e, major depressive disorder patients) were randomly allocated to one of the three treatment arms (i.e., randomized clinical trial/RCT): (1) group Rational Emotive Behavior Therapy (REBT) (i.e., a form of cognitive-behavior therapy/CBT; 16 weekly group sessions); (2) pharmacotherapy/medication (i.e., sertraline), and (3) group REBT/CBT plus pharmacotherapy.
Clinical REBT/CBT Protocol: Group REBT/CBT used behavior activation and cognitive restructuring techniques to address the core irrational beliefs (i.e., demandingness and self-depreciation, but also catastrophizing/awfulizing and frustration intolerance, if they appeared) and restructure them into rational beliefs (e.g., flexibility in the form of preference/acceptance rather than demandingness; self-acceptance rather than self-depreciation). Indeed, group REBT/CBT was focused on: (a) restructuring particularly the irrational beliefs of demandingness and self-depreciation; (2) developing unconditional self-acceptance; and (3) secondary problems like depression about depression (i.e., meta-emotions). Negative automatic thoughts were not specifically targeted first in psychotherapy (as in other CBT strategies), but they were identified, analyzed, and used to access and then change core irrational beliefs.
Results: The results – for details see below the Figure 1 – showed that all outcomes (i.e., subjective – depressed symptoms and general distress; cognitive – negative automatic thoughts; and biological – serum serotonin and norepinephrine) significantly change from pre- to post-treatment in all treatment conditions, with no difference among conditions at post-treatment. Remission rate at post-treatment was defined as scores lower that 19 on the CDI (Children’s Depression Inventory), meaning that the patients do not meet the criteria for clinical depression anymore; we found the following remissions rates: 67.85% for group REBT/CBT, 60.60% for pharmacotherapy, and 53.84% for group REBT/CBT plus pharmacotherapy (there were no significant differences among groups). Suicidal ideation significantly decreased from pre to post-treatment (p < .05), but there were no differences across groups (p > .05). General distress (Profile of Mood States/POMS-SV) was similarly reduced in all three conditions, thus potentially impacting the improvement of the quality of life/social functioning of the participants. Consistent to REBT/CBT theory, pre-mid (8 weeks) changes in negative automatic thoughts (ATQ – Automatic Thoughts Questionnaire) were prospectively associated to the pre-post changes in depressive symptoms (CDI): r = 0.22, p = 0.026.
Conclusions and implications: To our knowledge, this is the first RCT comparing psychotherapy (i.e., group REBT/CBT), pharmacotherapy/medication, and their combination for depressed youth, assessing multi-level outcomes (e.g., subjective – depressive symptoms and general distress; cognitive – negative automatic thoughts; and biological outcomes: serum serotonin and norepinephrine) in the same RCT design. At a theoretical level, the results of our RCT indicate that administering group REBT/CBT, sertraline, or a combined intervention for depressed youth generates similar results (i.e., in terms of subjective, cognitive, and biological markers of depression); this opening interesting questions about clinical strategies, mechanisms of change, and cost-effectiveness. At a practical level, group evidence-based REBT/CBT protocols are now available to mental health professionals dealing with depression in youth; therefore, children with depression, their families, and clinical professionals have now even more treatment options to choose for depression.
II. OTHER RELATED INFO.
II.1. REBT and depression in adults:
- David, D., Szentagotai, A., Lupu, V., & Cosman, D. (2008). Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: A randomized clinical trial, post-treatment outcomes, and six month follow-up. Journal of Clinical Psychology, 64, 728-746.
- Sava, F., Yates, B., Lupu, V., Szentagotai, A., & David, D. (2009). Cost-effectiveness and cost-utility of cognitive therapy, rational emotive behavior therapy, and fluoxetine (Prozac) in treating depression: A randomized clinical trial. Journal of Clinical Psychology, 65, 36-52.
- Szentagotai, A., David, D., Lupu, V., & Cosman, D. (2008). Rational Emotive Therapy, Cognitive Therapy and medication in the treatment of major depressive disorder: Theory of change analysis. Psychotherapy: Theory, Research and Practice, 4, 523-538.
- Macaskill, N.D. & Macaskill, A. (1996). Rational-emotive therapy plus pharmacotherapy versus pharmacotherapy alone in the treatment of high cognitive dysfunction depression. Cognitive Therapy and Research, 20 (6), 575-592.
- Wang, C. et al. (1999). Comparative study of rational emotive therapy for 95 patients with dysthymic disorder. Chinese Mental Health Journal, 13, 172–183.
- See also here: http://albertellis.org/rebt-depression-manual/
II.2. Meta-analysis about the evidence-based status of REBT/CBT as psychological treatment for children:
- Gonzalez, J. E., Nelson, J. R., Gutkin, T. B., Saunders, A., Galloway, A., & Shwery, C. S. (2004). Rational Emotive Therapy with Children and Adolescents: A Meta-Analysis. Journal of Emotional and Behavioral Disorders, 12, 222-235.
II.3. For the evidence-based status of REBT theory and practice see here:
II.4. The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health is the original site for the group REBT/CBT arm (see at http://psychotherapy.psiedu.ubbcluj.ro).
- The Institute is included in the MERIL Platform (http://portal.meril.eu/converis-esf/publicweb/research_infrastructure/3446). The MERIL Platform is an inventory of “…the most excellent research infrastructures in Europe, of more-than-national relevance, across all scientific domains…”.
Instrumente de evaluare clinica
Impreuna, Intervurile Clinice Structurate – SCID [SCID-I CV, SCID-I RV/P, SCID-I RV/NP, SCID-I RV/PS, SCID-II (incluzand chestionarul de personalitate), KID-SCID] si Sistemul de Evaluare Clinica – SEC constituie o Platforma de Psihodiagnostic si Evaluare Clinica Validate Stiintific (evidence-based assessment) (PEC), cu implicatii majore asupra tratamentului tulburarilor mentale, a tulburarilor care cuprind In etiopatogeneza factori psihologici si In optimizarea si promovarea sanatatii. Ea reprezinta the state of the art In acest domeniu, In acest moment. Universitatea Babes-Bolyai – International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health – are drepturile exclusive pentru Romania pentru toate variantele de SCID, pentru SEC si platforma PEC.
SCID si SEC (PEC) se constituie Intr-o tehnologie avansata In domeniul clinic (cercetare si practica) care permite diagnosticul si evaluarea clinica validate stiintific, ancorand utilizatorul In paradigma „scientist-practitioner”, paradigma care Ii asigura o practica clinica validata stiintific cu eficienta maxima pe care o permite cunoasterea actuala din domeniu.
I. Interviurile clinice structurate (SCID) pentru tulburarile clinice cuprinse In Manualul de Diagnostic si Statistica a Tulburarilor Mentale (DSM)
In domeniul tulburarilor mentale si de comportament unul din repere fundamentale In diagnosticul tabloului clinic Il constituie „Manualul de Diagnostic si Statistica a Tulburarilor Mentale” (Diagnostic and Statistical Manual of Mental Disorders; DSM), publicat de „American Psychiatric Association”. El a ajuns la editia a patra revizuita si se asteapta ca a cincea editie sa fie publicata In 2013. La noi in tara (DSM-IV-TR) a fost tradus de „Asociatia Psihiatrilor Liberi din Romania”, In anul 2003. Pentru a putea utiliza corect diagnosticul pe baza DSM este necesara utilizarea unor interviuri clinice structurate. Trei astfel de interviuri sunt fundamentale, acoperind prin module specifice categoriile de diagnostic cuprinse In DSM.
1. Interviul Clinic Structurat pentru Tulburarile de pe Axa I a DSM (SCID-I);
- SCID-I CV (Versiunea Clinica/Clinician Version)
- SCID-I RV/PE (Versiunea Cercetare /Research Version, Patient Edition)
- SCID-I RV/NP (Versiunea Cercetare /Research Version, Non-Patient Edition)
- SCID-I RV/PS (Versiunea Cercetare /Research Version with Psychotic Screening)
2. Interviul Clinic Structurat pentru Tulburarile de pe Axa II a DSM (SCID-II);
- SCID-II – Interviul
- Chestionarul de Personalitate
3. Interviul Clinic Structurat pentru Tulburarile Sugarului, Copilului si Adolescentului (KID-SCID).
SCID-I CV (Versiunea Clinica/Clinician Version)
Interviul Clinic Structurat pentru Tulburarile de pe Axa I a DSM-IV (SCID-I) este un interviu semistructurat In vederea diagnosticarii principalelor tulburari de pe Axa I a DSM-IV (American Psychiatric Association, 1994). Interviurile clinice structurate au fost elaborate cu scopul de a creste fidelitatea diagnostica prin standardizarea procesului de evaluare si de a spori validitatea prin facilitarea aplicarii criteriilor de diagnostic din DSM-IV si aprofundarea unor simptome care altfel ar putea fi trecute cu vederea. In ciuda importantei acestor scopuri, atat In context clinic cat si de cercetare, complexitatea si lungimea majoritatii interviurilor structurate au limitat utilizarea lor la studii de cercetare. Unul dintre obiectivele elaborarii SCID a fost producerea unui instrument eficient si usor de utilizat care sa permita transpunerea avantajelor interviului structurat In context clinic.
SCID-CV a fost elaborat pentru ca o modalitate de asigurare a unor evaluari standardizate. El include o Brosura de Administrare care poate fi reutilizata si o Fisa de Evaluare de unica folosinta. SCID-CV acopera doar categoriile diagnostice cel mai frecvent Intalnite In practica clinica si exclude majoritatea subtipurilor si specificantilor cuprinsi In Versiunea de Cercetare
Componente:
- Manual de utilizare
- Brosura de Administrare
- Fisa de Evaluare
SCID-I RV (Versiunea de Cercetare/Reseach Version)
Versiunea de cercetare a SCID (SCID-I RV) este mai lunga decat cea Clinica (SCID-I CV) deoarece ea cuprinde evaluari ale unor subtipuri clinice, a severitatii, specificantilor de evolutie si tulburari care sunt utile din punct de vedere diagnostic pentru cercetatori, dar pot sa nu prezinte interes pentru clinicieni (vezi mai jos).
Ordinea Intrebarilor din SCID-RV este astfel gandita Incat sa aproximeze procesul de diagnostic diferential al unui clinician cu experienta. Tinand cont de faptul ca criteriile de diagnostic din DSM-IV sunt Incorporate In SCID-RV si evaluate pe masura ce interviul progreseaza, clinicianul testeaza In permanenta ipoteze diagnostice. In cazul unora dintre tulburari, criteriile de diagnostic nu sunt prezentate In ordinea din DSM-IV, ci au fost reordonate pentru ca interviul sa fie mai eficient si mai usor de realizat.
Continut SCID-I RV
Acest pachet contine toate materialele de care aveti nevoie pentru a elabora o versiune SCID adaptata scopurilor dumneavoasta. Ele sunt incluse In urmatoarea ordine:
- Fisa de Evaluare (Fisa Rezumativa) SCID-P
- Imagine de Ansamblu SCID-P
- Modulele A – J
- Lista Substantelor pentru Subiect
- Tulburari In Legatura cu o Substanta – Versiune Alternativa (paginile E10-E20)
- Fisa e Evaluare (Fisa Rezumativa) SCID-NP
- Imagine de Ansamblu SCID-NP
- Modulul B/C (Screening Psihotic)
- Fisa de Evaluare (Fisa Rezumativa) SCID-P cu Screening Psihotic
SCID-II (Interviul Clinic Structurat pentru Tulburarile Clinice de pe Axa II a DSM)
Interviul acopera 11 Tulburari de Personalitate din DSM-IV si categoriile din anexa: Tulburarea de Personalitate Depresiva si Tulburarea de Personalitate Pasiv-Agresiva.
Chestionarul de Personalitate SCID-II este utilizat ca instrument de evaluare pentru a scurta timpul de evaluare necesar administrarii SCID-II. Dupa completarea chestionarului de catre pacient (durata: 20 de minute), evaluatorul Incercuieste numerele aflate In stanga itemilor SCID-II care corespund itemilor din chestionar la care s-a raspuns cu “da”. Cand este utilizat testul SCID-II evaluatorul trebuie sa noteze doar itemii la care s-a raspuns afirmativ, considerand ca raspunsul “nu” la chestionar presupune acelasi raspuns si la Intrebarea pusa de elvaluator.
Manualul contine informatii utile:
- Face o prezentare a fiecarui item referitor la aspecte ce trebuie luate In considerare In evaluarea itemilor prentru Tulburarile de Personalitate din DSM-IVa;
- Include un caz prezentat, alaturi de chestionarul SCID-II completat
- Descrie modul de diagnostic conform criteriilor generale din DSM-IV pentru Tulburarile de Personalitate.
Componente:
- Manual de utilizare
- SCID-II – Interviul
- Chestionarul de Personalitate
KID-SCID (Interviul Clinic Structurat pentru Tulburarile Sugarului, Copilului si Adolescentului)
Interviul Clinic Structurat pentru DSM-IV, versiunea pentru Copii (KID-SCID), este un instrument semistructurat nou, proiectat pentru a genera diagnostice pediatrice conform Manualul de Diagnostic si Statistica a Tulburarilor Mentale, care are la baza varianta pentru adulti a SCID. Aceasta prima versiune contine module pentru Tulburarile de Comportament Disruptiv, Episoadele Afective si Psihotice, Tulburarile Afective si Psihotice, Tulburarile Anxioase, Tulburarile In Legatura cu Alcoolul si Substantele si Tulburarile de Adaptare.
KID-SCID este destinat spre a fi administrat de catre clinicieni specializati In sanatate mintala si permite diagnosticarea unor tulburari psihiatrice generale si pediatrice In conformitate cu DSM-IV. Interviul este Impartit In mai multe module, fiecare modul evaluand o anumita clasa de tulburari. Dupa sectiunea de cotare exista un interviu general, urmat de modulele de diagnostic propriu-zise.
Componente:
Module de interviu diagnostic pentru fiecare Tulburarile de Comportament Disruptiv, Episoadele Afective si Psihotice, Tulburarile Afective si Psihotice, Tulburarile Anxioase, Tulburarile In Legatura cu Alcoolul si Substantele si Tulburarile de Adaptare.
II. Sistem de Evaluare Clinica (SEC)
Probele psihologice cuprinse In SEC (adresate copiilor, adolescentilor sau adultilor) au fost selectate pornind de la paradigma psihodiagnosticului si evaluarii clinice validate stiintific. Astfel SEC cuprinde:
- probe psihologice (5 scale clinice) care evalueaza tabloul clinic, focalizate pe cele mai importante componente ale acestuia: distresul, tabloul de tip depresiv si de tip anxios. Unele scale (ex. PDA, SRGS) evalueaza si aspectele care tin de starea de sanatate (ex. emotii pozitive, emotii functionale negative etc.), lucru ignorat In majoritatea sistemelor de evaluare clinica existente. Toate aceste probe psihologice au calitati psihometrice foarte bune, acopera cea mai mare si relevanta parte din tulburarile clinice si starea de sanatate si sunt complementare SCID-ului.
- probe psihologice (15 scale clinice) care evalueaza mecanismele etiopatogenetice/de sanogeneza asociate tablourilor clinice (din DSM)/starii de sanatate. Aceasta asociere a fost stabilita dupa analizele comprehensive ale literaturii de specialitate (ex. Cochrane Review, Pubmed, PsycInfo), ceea ce Ii confera o validitate stiintifica remarcabila. Ele se clasifica In probe psihologice care vizeaza:
- mecanisme etiopatogenetice generale (12 scale clinice), cu rol de vulnerabilitate generala (ex. scheme cognitive, cognitii irationale etc.).
- mecanisme etiopatogenetice specifice (3 scale clinice), implicate In tulburari specifice (ganduri automate etc.).
Unele scale incluse In SEC masoara constructe identice si/sau similare; ele pot fi utilizate ca modalitati alternative de evaluare, atunci cand: (1) masuratorile repetate cu aceeasi scala pot fi distorsionate si (2) se doreste confirmarea unui rezultat din surse multiple (lucru important In domeniul clinic). Asadar, SEC, prin modul In care a fost elaborat, reprezinta astazi unul dintre cele mai avansate – the state of the art – sisteme de psihodiagnostic si evaluare clinica validate stiintific. Noi scale/probe psihologie pot fi adaugate acestui sistem – SEC – doar daca: (1) ele evalueaza noi componente validate stiintific ale starii de boala/sanatate si/sau ale mecanismelor de patogeneza/sanogeneza, identificate prin studii de specialitate, care aduc un plus de cunoastere semnificativ clinic fata de cele deja incluse In SEC; (2) au calitati psihometrice foarte bune. Utilizarea SEC presupune cunostinte fundamentale de psihologie clinica si psihodiagnostic si se face In conditiile respectarii stricte a deontologiei profesionale.
Componente:
- Manual de utilizare (20)
- Itemi teste
- Foi de raspuns
Pentru comenzi vezi la www.rtscluj.ro
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