Dysfunctional cognitions such as irrational beliefs (IBs) of Ellis' rational emotive behavior therapy (REBT) model and cognitive distortions (CDs) or cognitive errors from Beck's cognitive behavioral therapy (CBT) model are known to correlate with depressive symptomatology. However, most studies focus on one cognitive theoretical model in predicting psychopathology. The current study examined the relationship between both IBs and CDs in predicting depression. A college-age sample of 507 participants completed the Attitudes and Beliefs Scale-2, the Cognitive Distortions Scale, and the Beck Depression Inventory-II. Half of the sample showed minimal depression, while the remaining sample exhibited mild-moderate (37.4%) to severe (11.1%) depression symptomatology. Through regression analyses, the study aimed to examine whether IBs accounted for more of the variance in depression symptomatology after the effects of CDs were considered. Moreover, it tested whether CDs served as a moderator or mediator between IBs and depression. Each of Ellis' IBs (demandingness, awfulizing, self-downing, and low frustration tolerance) accounted for significantly more variance in depression after the variance of CDs was entered with the IB of self-downing explaining the most variance in depression severity. Moreover, while no moderation effect was found, CDs partially mediated the effect of IBs on depression. Both IBs and CDs contributed unique variance in predicting depression. Findings support the clinical notion that IBs and CDs are associated as well as highlight the clinical utility of both conceptualizations of dysfunctional cognitions in explaining depressive symptomatology. Clinicians might consider that each dysfunctional cognition might not be subject to change if not directly targeted. Rather than choosing to focus exclusively on IBs or CDs underlying negative automatic thoughts, psychotherapeutic efforts might benefit from identifying and challenging both types of dysfunctional cognitions.

This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented.

The Coping Cat protocol has shown both efficacy and effectiveness in the treatment of youth anxiety across numerous randomized controlled trials (RCTs), leading to its designation as an empirically supported treatment. The treatment is completed in two phases. In the first phase, children are taught a series of coping skills outlined using the FEAR plan acronym. The FEAR plan is then practiced in exposure tasks during the second phase of treatment. To illustrate implementation of both phases, and highlight core treatment components (i.e., exposure, flexibility within fidelity), a case description is presented. Directions for future research are discussed.

There is a recognized overlap between eating disorders (EDs) and obsessive-compulsive disorder (OCD) in terms of diagnosis, phenomenology, epidemiology, and psychological characteristics related to the disorder. In light of these similarities, a cognitive inference-based therapy (IBT) program, shown to be effective in treating OCD, was adapted for EDs. This case study describes the application of IBT treatment for a 35-year-old woman diagnosed with bulimia nervosa who also demonstrated overvalued ideation related to her body weight and shape. Over a 20-week period, the client’s ED pathology significantly decreased. Notably, the frequency of binge episodes was reduced by 90% from pre- to posttreatment and by 100% at 6-month follow-up. Significant reductions were also observed in dietary restriction and overvalued ideation. This case study has important implications for the treatment of individuals with both an ED and strong overvalued ideas.

Pregnancy and postpartum periods are associated with increased risk for onset and exacerbation of obsessive-compulsive disorder (OCD) symptoms. Common themes of the obsessive thoughts in this period are fears of accidently or intentionally harming the baby. Postpartum OCD may go underdiagnosed or misdiagnosed due to lack of standardized screening and potential shame associated with reporting these symptoms. Without treatment, OCD symptoms often persist and continue to impair mother's quality of life and interactions with the child. Literature on treatment specific to postpartum OCD is limited to case series and small studies. Exposure and response prevention (ERP), a gold-standard treatment for OCD, seems to be effective for this particular manifestation of OCD. This article presents a case history and ERP treatment course for a patient presenting with sudden onset of OCD following the birth of her child. Key differential diagnostic features, specific treatment strategies, and practice points are also explored.

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

Although a wealth of evidence supports the use of evidence-based psychological practice (EBPP) for clients with diverse difficulties, from anxiety and depression to behavioral problems, the majority of training in EBPP takes place at the doctoral and postdoctoral level. This is problematic given that there are many more master’s level mental health professionals than doctoral ones, especially in rural and low-income areas. This article outlines a model for a 60-hour training program that focuses on preparing master’s students to become competent in the practice of EBPP in a relatively short period of time, while at the same time meeting requirements for licensure in most states. Course sequence, course content, clinical experience, and supervision issues are all addressed, as are challenges to implementation of the model.

The introduction to this special issue emphasizes that competent supervisors are made not born into their role. Earning supervisory competence is difficult work and requires a varied skill set. The contributions in the special issue help build this diverse skill set. Each contribution in the special issue is summarized and implications are delineated.

Among adolescents there is evidence that cognitive change partially mediates the effect of cognitive behavioral therapy (CBT) on depression outcome. However, prior studies have been limited by small samples, narrow measures of cognition, and failure to compare cognitive change following CBT to cognitive change following antidepressant medication. This study examined whether change in four cognitive constructs (cognitive distortions, cognitive avoidance, positive outlook, and solution-focused thinking) mediated change in depression severity in a sample of 291 adolescents who participated in the Treatment for Adolescents with Depression Study (TADS). TADS assessed the effects of CBT, fluoxetine, and their combination on depression severity. All three treatments were associated with change in the cognitive constructs and combination treatment produced the greatest change. Furthermore, change in the cognitive constructs partially mediated change in depression severity within all three treatments. Results implicated positive outlook as the construct most associated with change in depression severity over 36 weeks.

Objective: Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy (CBT) either as a monotherapy and in combination with antidepressant medication. Method: This study used data from the Treatment of Adolescents with Depression Study (TADS), which compared the efficacy of CBT, fluoxetine (FLX), the combination of CBT and FLX (COMB), and a pill placebo (PBO; TADS Team, 2003, 2004, 2005). Current analyses included only TADS participants in the CBT (n = 111) or COMB (n = 107) conditions. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality. Results: Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression—but not in evaluator-rated depressive symptoms—in adolescents treated with CBT only. These relationships were almost completely absent in the COMB condition. The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time. Conclusions: These findings suggest that the ability of therapists and clients to collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy.