Transcending self therapy: Four-session individual integrative cognitive-behavioral treatment: A case report.

Effective treatments for Substance Use Disorders (SUDs) are of critical importance, particularly among veterans. We present a successful application of Transcending Self Therapy: Four-Session Individual Integrative Cognitive Behavioral Treatment (Individual TST-I-CBT), that helped a male combat veteran with Alcohol Use Disorder, Severe, and PTSD enter recovery and reduce depressive symptoms. Session 1 focused on problem solving and behaviors; Session 2 centered on checking and changing thoughts; Session 3 emphasized behaviors, thoughts, and coping; and Session 4 consisted of review and finalizing the recovery plan. After the second Individual TST-I-CBT session, he was abstinent from alcohol use and remained abstinent throughout the remainder of treatment. At the end of treatment, his depressive symptoms declined substantially from pretreatment (from severe to low), his desire to stop using alcohol was 10/10, and his confidence in his ability to stop using alcohol was 10/10. He demonstrated personal growth and accomplishments throughout the course of treatment, such as improving his self-concept and relationships; living in accordance with his values; developing the passionate pursuit of being a productive member of society by holding a job; looking for a job; and taking steps to continue his education. Accordingly, he accomplished all of his identified treatment goals. This case suggests Individual TST-I-CBT is a potentially effective adjunctive treatment for SUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Program Evaluation of Group Transcending Self Therapy: An Integrative Modular Cognitive-Behavioral Therapy for Substance Use Disorders.

OBJECTIVES: Substance Use Disorders (SUDs) are increasingly prevalent among Veterans. Effective interventions for SUDs that also meet the clinical reality of open treatment groups are needed. Transcending Self Therapy: Group Integrative Cognitive Behavioral Treatment (Group TST-I-CBT) was developed to address this need. Group TST-I-CBT is a four-module, 20-session treatment designed so that a person can enter at any point in the treatment. We conducted a program evaluation of Group TST-I-CBT for veterans with SUDs. METHODS: Participants were N = 68 veterans enrolled in the 28-day Substance Abuse Residential Rehabilitation Treatment Program at an urban Veterans Administration Medical Center who received either Group TST-I-CBT (N = 34) or treatment-as-usual (TAU; N = 34). Medical records were reviewed and participant treatment outcome data was retrieved. Group TST-I-CBT clients completed a knowledge and feedback form at treatment completion. RESULTS: Compared to TAU participants, Group TST-I-CBT participants were significantly less likely to have a positive urine drug screen (UDS) during treatment (17.6% versus 0%; P = .01) and within one month post-discharge (50% versus 17.6%; P = .04). Among Group TST-I-CBT clients, Quality of Life Inventory scores significantly increased by an average of 14 points from pre- to post-treatment, t(15) = -3.31, P = .005, d = 0.83. Group TST-I-CBT clients displayed cognitive-behavioral therapy knowledge (mean correct answers ranged from 92%-100%) and rated Group TST-I-CBT as helpful, understandable, and useful (mean scores ranged from 9.3-9.6 out of 10). CONCLUSIONS: These preliminary data indicate that Group TST-I-CBT may be an effective group therapy as part of SUD treatment. A formal randomized controlled trial of Group TST-I-CBT may be warranted.

Yoga for warriors: An intervention for veterans with comorbid chronic pain and PTSD.

OBJECTIVE: Comorbid chronic pain and posttraumatic stress disorder (PTSD) is common in veterans; this comorbidity is associated with increased severity and poorer prognosis when compared to each outcome alone. Yoga has been shown to be effective for chronic pain and promising for PTSD, but yoga for comorbid pain and PTSD has not been examined. This article offers empirical support for a yoga intervention for comorbid chronic pain and PTSD in a veteran population. METHOD: Results are presented from a 4-year pilot yoga intervention for comorbid chronic pain and PTSD at a large, urban Veterans Affairs Medical Center. Based on the fear avoidance model of pain, the intervention used a cross-sectional, open-trial design with pre- and postmeasures. T test analyses were conducted on program completers (N = 49; out of 87 initially enrolled, 44% attrition rate), who were primarily African American (69%) and male (61%) and had a mean age of 51.41 years (SD = 11.32). RESULTS: Results indicated trend-level reductions in overall PTSD symptoms, as measured by the PTSD Checklist for DSM-5 (p = .02, d = 0.38) and in symptom cluster scores of negative alterations of cognitions and mood (p = .03, d = 0.36) and arousal and reactivity (p = .03, d = 0.35). Veterans reported significant improvement in ability to participate in social activities (p < .001, d = 0.44) and significant reductions in kinesiophobia (fear of movement or physical activity; p < .001, d = 0.85). On a satisfaction measure with a range of 1 (quite dissatisfied) to 4 (extremely satisfied), the mean rating was 3.74 (SD = 0.33). CONCLUSION: Yoga is a feasible and effective intervention for veterans with comorbid chronic pain and PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).