Clinical Cognitivism: proposals for clinical intervention and new perspectives in cognitive therapy- Editorial
Clinical Cognitivism 2019 closes with a number that includes interesting reviews, proposals for clinical intervention and new perspectives.
Advertising message The issue opens with two papers that focus on the effectiveness of two well-known therapeutic approaches on specific pathologies. The first work of Somma and colleagues, of the San Raffaele group in Milan coordinated by Prof. Fossati, is a thorough and accurate meta-analysis on the effectiveness of the Focused Therapy (SFT) Scheme in the treatment of Borderline Personality Disorder (DBP). The article uses the characteristics of DBP as a primary outcome indicator and acute symptomatology as a secondary outcome indicator. Despite a significant heterogeneity of the data, a high efficacy of SFT on both outcomes is detected, supporting their clinical utility for the treatment of DBP.
Cosentino and Mancini instead examine the Eye Movement Desensitization and Reprocessing (EMDR) as a protocol to be used in the treatment of obsessive-compulsive disorder (DOC). The authors after a review of the literature show that the data available to date are not sufficient to consider EMDR, used as a single intervention, an effective protocol in the treatment of this disorder. Therefore they propose how to integrate EMDR into the treatment protocol for the DOC described by Mancini (2016) for which efficacy data are already available. In particular, the authors believe that EMDR can be useful to desensitize and rework the memories of the experiences related to the sensitivity to guilt characteristic of these patients.
Perdighe et al. present a twelve-session intervention based on acceptance and commitment therapy (ACT), aimed at caregivers of patients with Alzheimer’s disease, in order to support and reduce their emotional discomfort related to the performance of this specific role. The work stems from a collaboration between the School of Cognitive Psychotherapy and the Fatebenefratelli Hospital in Rome and seeks to encourage acceptance of the disease and investment in personal values and purposes to improve the quality of life of caregivers.
In the following work Toso clearly illustrates the recent progress achieved in the areas of learning and extinction of fear that led to the formulation of a new conceptual model of exposure therapy. This model is based on two key points: 1) efficacy is linked to the creation of new antagonistic and inhibitory memories, rather than, as reported by old models, to the cancellation of the excitatory memories of fear. Consequently, 2) the reduction of fear, within each individual exposure session, is not in itself an index of therapeutic success, if not associated with the strength and recoverability of the new inhibitory associations that are formed and efficacy of the underlying neural regulation. The author then illustrates
Advertising message Bisogno et al. they dedicate their work to underlining the importance of implementing early interventions for the treatment of psychosis. It is known, in fact, how the duration of Untreated Psychosis (DUP) affects the outcome of the treatment and therefore, possibly, is linked to the chronicity of the disorder. The authors describe the need for a specific and immediate multidimensional intervention, illustrating the key points of the engagement and assessment procedure aimed at patients at onset, based on the Italian experience of progenitor projects that highlight how essential it is to provide health services. mentality of a multidisciplinary team dedicated to the beginnings.
The issue ends with an article by Mancuso which deals with a current topic, often the subject of debate, linked to the use of technology in the context of care. In particular, the article deals with the topic of online therapy, as a modality of remote psychological assistance that is increasingly spreading also in Italy. The use of virtual communication technologies can be particularly useful for the treatment of patients withdrawn or living in difficult geographical situations, but evidently presents clear differences with traditional therapy. The author illustrates the recent literature that describes the fields of effectiveness of this method of intervention, analyzes the limits and benefits of it and also exposes the legislative problems that may hinder the use of the remote therapy service.