The University of Washington Risk Assessment Protocol (UWRAP) and Risk Assessment and Management Protocol (UWRAMP) have been used in numerous clinical trials treating high-risk suicidal individuals over several years. These protocols structure assessors and treatment providers to provide a thorough suicide risk assessment, review standards of care…

Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Health behavior theories, specifically the Health Belief Model, Stages of Change, and Theory of Planned Behavior, focus on individuals' beliefs, their readiness to change, their perceptions of illness severity and "threat," their…

Unipolar depression is one of the most disabling and costly medical illnesses in the world (Lancet Global Mental Health Group et al., 2007; Moussavi et al., 2007). Cognitive behavioral therapy (CBT), a widely studied and taught psychotherapeutic treatment for depression, is among the recommended evidence-based treatments. Although CBT and other…

This article outlines the conceptual and empirical basis for an inference-based approach (IBA) to treating obsessive-compulsive disorder (OCD). The IBA considers that in most cases the obsessional process begins with an initial doubt (e.g., "Maybe my hands are not clean"; "Perhaps the door was not locked"; "There's a chance I made an error"; "I…

Psychotherapy research studies, which balance the pursuit of knowledge with the provision of treatment, can place unique demands on clinicians, patients, and research staff. However, the literature on ethical considerations in psychotherapy trials is minimal. The current paper depicts CBT community standards of practice in the context of two…

Termination of psychotherapy has received less attention in the research literature than other aspects of the treatment process. This paper presents a structured framework emphasizing observable markers to indicate when termination with a client is appropriate during cognitive behavioral treatment. The 7 criteria that indicate when a client is…

In chronic fatigue syndrome (CFS), facilitating, initiating, and perpetuating factors are distinguished. Although somatic factors might have initiated symptoms in CFS, they do not explain the persistence of fatigue. Cognitive behavior therapy (CBT) for CFS focuses on factors that perpetuate and prolong symptoms. Recently it has been shown that,…

The practice of mindfulness is increasingly being integrated into contemporary clinical psychology. Based in Buddhist philosophy and subsequently integrated into Western health care in the contexts of psychotherapy and stress management, mindfulness meditation is evolving as a systematic clinical intervention. This article describes…

Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was developed specifically for the chronically depressed patient. CBASP has been shown to be as efficacious as medication singly, and in combination with antidepressant medication is associated with notably high response rates in chronic depression. CBASP's core procedure, "situational…

The Treatment for Adolescents With Depression Study (TADS) is an NIMH-supported multisite clinical trial that compares the effectiveness of a depression-specific cognitive behavioral therapy (CBT), medication management with fluoxetine (FLX), the combination of CBT and FLX (COMB), and medical management with pill placebo (PBO). TADS was…

The primary aim of this article is to describe modifications made to Dialectical Behavior Therapy (DBT) for a predominantly ethnic minority population of persons living with HIV/AIDS with substance-use diagnoses and borderline personality disorder (BPD) or three features of BPD plus suicidality (i.e., the triply diagnosed). Despite the myriad…

The Treatment for Adolescents With Depression Study (TADS) was designed to compare the relative and combined effectiveness of cognitive behavior therapy (CBT) and fluoxetine, each of which had demonstrated efficacy in carefully controlled single-site studies. Models of CBT from these efficacy studies served as the foundation for the TADS…