Azizi, A., Drikvand, F. M., & Sepahvandi, M. A. (2020). Effect of cognitive-behavioral play therapy on working memory, short-term memory and sustained attention among school-aged children with specific learning disorder: A preliminary randomized controlled clinical trial. Current Psychology, 39(6), 2306-2313.
The study attempted to evaluate the impact of cognitive-behavioral play therapy (CBPT) on working memory (WM), short-term memory (STM) and sustained attention (SA) of school-aged children with learning disorders. Researchers used a randomized controlled clinical trial and measured the results via three specialized scales. In the end, the beneficial impact of CBPT intervention on SA was confirmed; however, CPBT was found ineffective in improving WM and STM in the intervention group. The study used previous works on CBPT, WM, STM, and SA as a theoretical framework. The authors did not express explicit hypotheses; the study had a clear research goal — the evaluation of CBPT efficacy for ameliorating WM, STM, and SA in the targeted population. The study was based on a randomized controlled clinical trial and quantitative research. In the first stage, the baseline data on WM, STM, and SA was obtained via the WISC-III, WMS-IV, and DAUF scales. Next, 18 children were randomly assigned to the CBPT group supervised by an independent coach, whereas 17 children received standard treatment. Finally, the post-intervention results were measured and compared against the baseline data. The findings confirmed CBPT’s efficacy in facilitating SA, but the intervention did not significantly impact WM and STM. In this regard, the study provided empirical evidence of CBPT’s positive influence on SA in school-aged children with learning disorders. Therefore, CBPT can be recommended for treating children with SA impairments which affect their ability to focus attention. Overall, the fundamental strength of the study was a solid research design with a small margin of bias. However, the study could benefit from extra follow-up checks and the addition of other population groups to generalize the results.
Giannaki, R., & Hewitt, O. (2021). A multiple methods evaluation of a cognitive behavioural therapy group for people with learning disabilities and anxiety. British Journal of Learning Disabilities, 49(1), 87-99.
The article evaluated the effectiveness of CBT for adults with learning disabilities and anxiety disorders. The existing literature showed mixed results of CBT intervention in these population groups, so the researchers conducted their own experiment in order to verify its efficacy in anxiety and psychological distress reduction. In the end, the effectiveness of CBT in anxiety treatment and distress reduction was confirmed. The quantitative analysis demonstrated distress reduction in participants, whereas the qualitative analysis showed a beneficial impact of group intervention. The study was primarily based on the CBT theory and empirical results of previous studies on CBT’s effectiveness. Regarding the research hypotheses, the authors did not express specific expectations but attempted to confirm one of the existing standpoints on CBT’s efficacy. Such an approach was justified by the ambiguity of results and the lack of literature on the subject. The study relied both on quantitative and qualitative research methods. Four participants with anxiety symptoms and mild to moderate learning disabilities attended a 7-week CBT group in the first stage. Each participant had a supporter who committed to the group with them. The anxiety and distress levels were evaluated via three standardized measures, such as the Glasgow Anxiety Scale. In addition, participants and their supporters have passed an interview about the perceived CBT results. Both quantitative and qualitative research results confirmed an overall positive impact of CBT intervention. Overall, the study contributed to the CBT theory by adding evidence of its efficacy in the targeted population. Based on the research results, CBT can be recommended for treating anxiety and achieving subsequent improvement in patients’ learning abilities. However, the article could be improved via the addition of a control group and replication on a larger sample of participants.
Knight, R., Jahoda, A., Scott, K., Sanger, K., Knowles, D., Dagnan, D., Hastings, R. P., Appleton, K., Cooper, S-A., Melville, C., Jones, R., Williams, C., & Hatton, C. (2019). “Getting into it”: People with intellectual disabilities’ experiences and views of behavioural activation and guided self‐help for depression. Journal of Applied Research in Intellectual Disabilities, 32(4), 819-830.
The study explored the potential benefits and patient-centered adaptations of specific CBT techniques, such as behavioral activation and guided self-help in adults diagnosed with depression. A purposively-selected sample of participants with intellectual disabilities shared their experiences in various categories, ranging from pre-therapy conditions to the application of learned coping techniques in post-therapy life. As a result, the researchers obtained multiple first-hand insights into how the CBT techniques can be adapted to suit the patient’s needs better. The study’s theoretical orientation was based on the existing CBT studies that include perspectives of patients with intellectual disabilities. The authors interviewed 25 participants who had undergone behavioral activation and guided self-help CBT interventions. The study attempted to synthesize a series of narratives from the patients’ responses, so the explicit hypotheses were not determined. A qualitative research method of semi-structured interviews and framework analysis was selected in accordance with the intended goal. The participants shared their intervention-related thoughts in six categories: experience before therapy, therapy process, relationships in therapy, experience after therapy, the impact of therapy, and overall view. The researchers found that the patients reported positive changes in their lives and associated them with CBT, even though quantitative data did not confirm such changes. In addition, the patients shared a self-perceived dissatisfaction with the abrupt end of the intervention. Overall, the study showcased the importance of empathy during the CBT intervention and demonstrated that CBT might positively impact the patients regardless of the quantitative measurements. In this regard, CBT techniques can be recommended for teaching coping mechanisms to adults diagnosed with depression. The key weakness of the study was the lack of dynamic perspective — it is unclear how participants’ views on the intervention evolved as the therapy progressed.
McCrae, C. S., Chan, W. S., Curtis, A. F., Nair, N., Deroche, C. B., Munoz, M., Takamatsu, S., McLean, D., Davenport, M., Muckerman, J. E., Takahashi, N., McCann, D., McGovney, K., Sahota, P., & Mazurek, M. O. (2021). Telehealth cognitive behavioral therapy for insomnia in children with autism spectrum disorder: A pilot examining feasibility, satisfaction, and preliminary findings. Autism, 25(3), 667-680.
The article examined the efficacy of telehealth CBT for childhood insomnia (CBT-CI) in children diagnosed with an autism spectrum disorder. In addition, to overall efficacy, the researchers assessed such metrics as treatment integrity and satisfaction. Overall, the pilot study confirmed the feasibility of telehealth CBT-CI since children and their parents learned and successfully applied techniques that led to sleep improvement. The theoretical framework was based on previous studies in the field, which confirmed the moderate to large improvements in subjective child sleep after the CBT-CI intervention. However, the researchers added an extra element by testing a remote mode of CBT-CI delivery. The study sample included 17 children (6-12 years) diagnosed with an autism spectrum disorder and their parents. Based on the existing research, the authors hypothesized that treatment delivery scores would reach at least 90%; in addition, treatment efficacy and satisfaction scores were expected to match the results of the in-person CBT-CI. The research design included subjective and objective sleep assessments via questionnaires, diaries, and Holter Monitors. Remote CBT-CI delivery was conducted via Zoom over the eight weeks. The results fully confirmed the hypothesized outcomes: treatment delivery score reached 98%; parents found CBT-CI helpful, age-appropriate, and autism-friendly. Therefore, the study confirmed the effectiveness of the CBT-CI intervention and provided evidence of remote care delivery efficacy. Given these findings, the application of CBT-CI for treating insomnia in children with autism spectrum disorder can be advised, regardless of care delivery mode. Overall, the article successfully combined objective and subjective assessment methods in a single research. The addition of a control group for a proper randomized controlled clinical trial could further reinforce the findings made in the study.
Mueller, R., & Moskowitz, L. J. (2020). Positive family intervention for children with ASD: Impact on parents’ cognitions and stress. Journal of Child and Family Studies, 29(12), 3536-3551.
The article examined the effects of positive family intervention (PFI), a CBT-based technique, on parents’ cognition and children’s problem behavior in families with children having autism spectrum disorder (ASD). The researchers assessed several metrics, such as parent self-reported stress, self-efficacy, and ratings of child problem behavior. A comparison of post-PFI scores against the baseline data demonstrated significant decreases in all ratings of problem behavior. The study took theoretical orientation from the previous research on behavioral parent training (BPT) and parental attributions. The scope of the research sample was relatively small and included three mothers who had a child diagnosed with ASD in the age range between 3 and 6 years. Furthermore, the authors hypothesized that PFI would decrease parental stress and pessimistic thoughts, decrease children’s problem behavior, and increase self-reported parental efficacy. The research design was based on a quantitative method: each mother completed six questionnaires of parental attributions before and after the PFI. In addition, the researchers conducted one pre-intervention and one post-intervention behavioral observation at participants’ homes. The findings were consistent with the hypotheses — a comparison of post-PFI results against the baseline data demonstrated significant decreases in parent ratings of problem behavior and negative parental attributions. As such, the study confirmed the promising efficacy of CBT-based PFI in helping children diagnosed with ASD and their parents. However, the evidence of PFI efficacy should be reinforced with a test on a larger sample before a firm recommendation for clinical practice could be given. Additionally, the article could benefit from an increased gender variety of the parents since the current scope included only females.