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Behavioral Therapy

Editor: Tyler J. Torrico Updated: 11/9/2024 9:40:09 PM

Introduction

Behavioral therapy, rooted in behaviorism, originated in the early 1900s with the work of Ivan Pavlov and John B Watson, who studied stimulus-response relationships.[1][2][1] BF Skinner later developed operant reinforcement theory, while Joseph Wolpe and Albert Bandura contributed to the understanding of phobias and social learning.[3][4][5][4][3] The field encountered resistance in the 1950s and 1960s but later gained recognition as a valid approach to mental health treatment. Incorporating cognitive elements gave rise to the second generation of behavior therapy, cognitive behavioral therapy (CBT).

Behavioral therapy aims to modify actions or reactions that negatively impact an individual's well-being or daily functioning. This approach is based on the premise that behaviors are learned from the environment. Unlike insight-based therapies, behavioral therapy is action-oriented, focusing on the behavior itself as the problem and teaching new behaviors to address the issue. As maladaptive habits are developed from past learning, new learning can help correct them.

Types of Behavioral Therapies

Behavioral therapy is not a one-size-fits-all approach. Various types exist, each with unique applications and adaptability to individual needs, as outlined below.

Applied behavior analysis: This analysis utilizes operant conditioning to reshape problematic behaviors. Numerous studies have evaluated its efficacy, particularly highlighting its benefits for individuals diagnosed with autism spectrum disorder and its cost-effectiveness of this treatment.[6][7] 

Cognitive behavioral therapy: CBT incorporates a cognitive component, targeting the thoughts underlying problematic behaviors. A study evaluated that the most significant reduction in depressive symptoms occurs during the early stages of CBT, suggesting that shorter interventions may be effective. Moreover, culturally adapting CBT is essential for providing effective psychological treatment for psychosis.[8][9]

Cognitive behavioral play therapy: This therapy uses play to assess, prevent, or treat psychosocial challenges. A study on elementary school boys with behavioral issues demonstrated that this intervention significantly reduced anxiety-based school refusal and behavioral problems, highlighting its effectiveness in addressing such challenges in primary grades.[10]

Dialectical behavior therapy: This therapy combines behavioral and cognitive interventions to help individuals manage emotions, cope with distress, and improve interpersonal relationships. Multiple studies indicate that self-reported symptoms of depression, emotional and behavioral dysregulation, and psychological inflexibility significantly decrease within the first 6 months of treatment. Patients also experience reduced use of dysfunctional coping skills and increased knowledge of emotion regulation and interpersonal effectiveness in psychiatric hospital settings. Additionally, one study highlights the use of telehealth for delivering dialectical behavior therapy, particularly for adolescent skills groups.[11][12]

Exposure therapy: This therapy uses behavioral strategies to help individuals overcome fears related to specific situations or objects.

Rational emotive behavior therapy: This therapy targets harmful or destructive thoughts and feelings, using concepts such as the ABC model ("A" stands for "activating event or adversity," "B" stands for "beliefs," and "C" stands for "consequences") to identify and dispute irrational beliefs. A study demonstrated that this intervention significantly improved self-control and reduced impulsivity among the participants. These changes were maintained during the follow-up period, potentially lowering recidivism rates. Additionally, another study found that a religious coping intervention within rational emotive behavior therapy serves as an effective alternative approach for enhancing mental health and mitigating the psychological effects experienced by adult learners with type 2 diabetes.[13][14]

Social learning theory: This theory emphasizes that individuals acquire knowledge and behaviors by observing others.[15]

The choice of therapy often depends on several factors, including the condition being treated and the severity of the individual's symptoms.[16]

Issues of Concern

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Issues of Concern

Time and Training

While behavioral therapy techniques have shown significant benefits across various professions, integrating them into patient or client interactions poses challenges. Learning, practicing, and sustaining behavioral changes require a substantial investment of time and resources from both professionals and patients. Unfortunately, these resources are often limited, especially in specific practices or communities.

A comprehensive study utilizing interviews explored the implementation and sustainability needs of evidence-based programs for racial and ethnic minority older adults in under-resourced communities with limited aging services. This research involved semi-structured interviews with representatives from 25 senior-serving agencies in Los Angeles County and revealed critical insights. The interviews indicated that the agencies implemented programs in 8 key areas—fall prevention, mental health, caregiver health, chronic disease management, diabetes management, arthritis management, physical activity, and management of multiple conditions. Each of these areas could significantly benefit from a team trained in behavioral therapy.[17]

The agencies faced challenges in tailoring interventions to the local community, cultural context, available resources, and administrative burdens, including limited resources and high staff turnover. However, the importance of cultural relevance and flexibility in programs for this community emerged as a key consideration. The document provides recommendations to address these challenges, including designing equity-focused interventions, incorporating cultural adaptations, and offering technical assistance for program adaptation.[17]

Emotional and Psychological Resistance

Behavioral therapy can sometimes result in increased resistance to change, causing clients to become more entrenched in their habits. Emotional barriers, such as fear and ambivalence toward change, can hinder positive behavior modifications, such as quitting smoking or managing weight. Patients frequently resist when confronted by authority figures, which can lead to avoidance of sensitive topics like mental health, sexual dysfunction, substance abuse, safety concerns, terminal illnesses, or self-confidence issues. This resistance can have serious consequences, adversely affecting health outcomes and increasing healthcare costs.[18]

Noncompliance with medical treatment is a significant barrier to effective care for many conditions, impacting nearly half of medical interactions and leading to poor health outcomes and higher costs. This highlights the urgency of addressing the issue. Delays in seeking help for severe symptoms, such as chest pain, can result in preventable deaths and increased morbidity, influenced by factors such as age, gender, and socioeconomic status. Reassurance for patients with unexplained symptoms often falls short, resulting in ongoing anxiety and severe consequences, such as persistent illness and issues with employment or insurance. This resistance can lead to further negative health outcomes.[18]

Barriers to Health Maintenance

Patients frequently face challenges in maintaining their health due to competing priorities, lack of motivation, limited access to resources, and ingrained behavioral patterns. Emotional and psychological barriers, such as fear or anxiety about medical procedures or lifestyle changes, further impede adherence to health maintenance routines. Socioeconomic factors, such as financial constraints and cultural influences, complicate efforts to prioritize and sustain healthy behaviors. These challenges underscore the need for personalized interventions, including tailored health plans, one-on-one counseling, and comprehensive support systems such as community health programs and telehealth services.[19]

Research has identified barriers and strategies to bridge the gap between patients and providers, emphasizing the engagement of stakeholders in evidence-based treatments within healthcare settings. Implementing these treatments is complex due to the diverse individuals involved at various management levels. Key strategies for stakeholder engagement include aligning time horizons, ensuring research questions are relevant, designing flexible interventions, and, most importantly, maintaining ongoing communication with patients and providers. Continuous engagement ensures that all stakeholders are involved and committed to the process. Community Advisory Boards have a crucial role in expanding the intervention's providers and exploring telehealth delivery options, thereby enhancing the intervention's feasibility, acceptability, and effectiveness within the local setting.[20]

Pilot trial data and feedback from Community Advisory Boards support the necessity of universal screening for posttraumatic stress disorder in primary care. The interdisciplinary healthcare team's implementation practices significantly impact a patient's commitment to their health choices. This implementation blueprint empowers the team by providing technical assistance, training, and support for screening and documentation. The research highlights the role of provider and patient Community Advisory Boards in addressing barriers to implementing evidence-based treatments for posttraumatic stress disorder in primary care.[20][19]

Clinical Significance

Behavioral therapy empowers individuals to replace detrimental behaviors with beneficial, systematic approaches. Research shows that these behavioral therapy strategies can effectively modify patients' actions, aiding in pain management and stress reduction, ultimately improving the management of chronic illnesses.[21][22] Many chronic conditions, such as diabetes, hypertension, and obesity, have behavioral components. Clinicians who understand behavioral principles can guide patients in lifestyle modifications, treatment adherence, and self-management, fostering a sense of optimism and hope for both patients and healthcare professionals.[23][24]

Behavioral therapy improves communication with clients, patients, and relatives. By understanding behavioral patterns, physicians can connect empathetically with patients, strengthening rapport and trust. This connection boosts patient compliance and outcomes while fostering empathy among healthcare professionals. Effective communication improves interactions between patients and providers, enhances team collaboration, and better addresses patient needs, ultimately leading to improved outcomes. Reframing and teamwork are essential for facilitating behavioral changes.[25]

The approach and integration of behavioral therapy foster a comprehensive, holistic care environment, enabling physicians to address both physical symptoms and psychosocial health aspects. This approach benefits patients and enhances healthcare professionals' sense of competence. By recognizing the interplay between behavior, emotions, the mind-body connection, and physical well-being, healthcare providers can deliver more effective care.[26]

Behavioral therapy enhances providers' understanding and methods for addressing ethical issues such as informed consent, confidentiality, and patient autonomy. The imperative role of behavior therapy techniques is particularly evident in the context of rare genetic disorders. These complex conditions require coordinated efforts from multiple providers, making the application of such techniques both essential and invaluable. Ultimately, behavioral therapy techniques are not merely tools; they are critical components of comprehensive care for these disorders.[27][28]

Enhancing Healthcare Team Outcomes

Behavioral therapy is essential for many health professionals, providing a patient-centered approach to modifying harmful behaviors through observation, assessment, and effective communication. These techniques are crucial for ethical practice, strategic care coordination, and addressing the whole patient. Integrating behavioral therapy into nursing, allied health, pharmacy, advanced practice, and physicians can enhance patient care, professional practice, and team dynamics, ultimately leading to improved health outcomes.[29]

Enhancing patient-centered care, outcomes, patient safety, and team performance through behavioral therapy techniques requires a cohesive approach from an interprofessional healthcare team. Physicians, advanced practitioners, nurses, pharmacists, and other healthcare professionals must work within a coordinated framework, relying on effective communication to optimize patient outcomes and safety. Clear and open dialogue is essential to achieving these goals and fostering collaborative care.[30]

Collaboration and Strategy

The interprofessional healthcare team collaborates by adopting integrated care models, ensuring that all members actively contribute to developing and executing care plans. Regular interdisciplinary meetings serve as the cornerstone of this collaboration, enabling team members to discuss patient cases, share insights, and collaboratively develop patient-centered strategies. This approach ensures comprehensive care by utilizing the unique expertise of each team member, addressing the patient’s condition from multiple perspectives.

For instance, physicians and advanced practitioners diagnose medical conditions and develop treatment plans, while nurses implement these plans through direct care and monitoring. Pharmacists oversee medication therapy, ensuring the safe and effective use of medications. Therapists and social workers provide counseling and support, focusing on the biopsychosocial aspects of patient care to enhance overall well-being and recovery.[30]

Communication and Creating Processes

Effective and clear communication is crucial for effective interprofessional collaboration. Using electronic health records and other communication tools enables seamless information sharing, ensuring all healthcare team members stay updated on the patient’s progress and any changes to the care plan. Regular updates and thorough documentation are critical for continuity of care. Additionally, establishing feedback mechanisms strengthens communication, allowing team members to refine their collaboration and care delivery, ultimately ensuring the patient receives optimal care.[29]

To maintain consistency and quality in patient care, the healthcare team establishes standardized processes, including care protocols, guidelines, and checklists for all members to follow. Care coordinators play a vital role in managing these processes, ensuring that care remains integrated and aligned with the patient’s needs. Effective coordination also involves overseeing transitions between care settings, such as from hospital to rehabilitation, to ensure patients receive continuous, cohesive care throughout their treatment journey.[30]

Nursing, Allied Health, and Interprofessional Team Interventions

Skills Development

In healthcare settings, specialized training in behavioral therapy equips healthcare professionals to enhance patient outcomes, safety, and team performance.

Nurses: Training in behavioral therapy techniques and communication skills enables effective collaboration with therapists and team members. This equips nurses to tailor individualized care plans, monitor progress, and adjust interventions as needed, which is vital in promoting patient safety and improving outcomes.[31]

Allied healthcare professionals: Participation in interdisciplinary workshops improves collaboration within the team and patient care. Occupational, physical, and speech therapists can incorporate behavioral therapy strategies into their practices to effectively address the behavioral components of various conditions.

Physicians and advanced practitioners: Advanced training in behavioral health assessment, evidence-based psychotherapeutic techniques, and psychopharmacology equips them to collaborate with other professionals in developing comprehensive treatment strategies that integrate medical and psychological care.[32]

Motivational Interviewing

Initially developed for substance use disorders, motivational interviewing is now applied to the primary and secondary prevention of various health behaviors and chronic illnesses. Key elements are mentioned below.

  • Collaboration, compassion, and education: Actively involving patients in their care.
  • Patient autonomy, empathy, and empowerment: Encouraging behavioral change across various conditions to positively impact morbidity and mortality associated with chronic illnesses.[33]

Effective Communication

Effective communication is essential for optimizing patient care, fostering interdisciplinary collaboration, and enhancing team performance. Key strategies are mentioned below.

Nurses: They utilize clear and concise communication techniques, such as active listening and assertiveness, to convey critical information and facilitate teamwork effectively.[31]

Allied healthcare professionals: They adapt communication styles to share observations, discuss treatment strategies, and coordinate care plans with healthcare team members.

Physicians and advanced practitioners: They provide clear instructions and timely updates to support collaborative decision-making and care coordination.[32]

Pharmacists: They engage proactively to exchange clinical information, clarify medication orders, and address potential concerns.

Structured approaches, including interprofessional rounds and regular team meetings, further enhance communication by improving information sharing and interdisciplinary collaboration. These approaches ultimately boost efficiency, responsiveness, and the delivery of behavior therapy.

Strategies for Care Coordination

Collaborative care models: These models emphasize teamwork among healthcare professionals, ensuring that patient care is seamless, comprehensive, and well-coordinated across different settings and specialties.

  • Proactive coordination: Nurses are pivotal in ensuring smooth transitions between care settings and facilitating access to patient support services.[34]
  • Streamlined coordination efforts: Allied healthcare professionals collaborate with nurses and other healthcare team members to identify resources and address barriers to treatment adherence.[35]
  • Leadership in coordination: Physicians and advanced practitioners take the lead in coordinating efforts, working collaboratively with multiple stakeholders to ensure seamless transitions and access to essential services.[36]
  • Medication management: Pharmacists support care coordination by reconciling medications, monitoring adherence, and facilitating communication among providers.[36]

Benefits of Interprofessional Collaboration

  • Shared goals and effective communication: These approaches enhance the quality of patient care, increase job satisfaction, and positively impact organizational outcomes.[35][34][36]
  • Structured frameworks: They align values, improve communication, and ensure comprehensive care delivery.[35]
  • Cultural competence and diversity: These values recognize and address the diverse backgrounds and needs of patients.[34][36]

Integrative Medicine Interventions

Patient-centered medical home: Integrating behavioral health care and techniques into the patient-centered medical home model is crucial for the below criteria.

  • Personal physician and whole-person orientation: They emphasize care coordination and integration across the healthcare system.[36]
  • Quality and safety: These help improve access to behavioral healthcare resources and incorporate behavioral health services into all benefit plans.[37]

Telehealth Services

Leveraging technology promotes a patient-centered approach to behavioral therapy.[38] An example is TeleTriage, which is an innovative method for remotely triaging eye care patients, and it demonstrates the factors mentioned below.

  • Value-based healthcare: This approach reduces planned care while ensuring continuity for urgent cases.[39][38]
  • Remote management: This uses conflict resolution skills and effective communication techniques.[39]
  • Ethical considerations: This helps uphold care quality and safety, encourages patient acceptance of remote care, and addresses technology adoption challenges.[39]

Patient and Family Engagement

Active involvement and caregiver role: The active involvement of patients and caregivers has a pivotal role in achieving optimal health outcomes, as mentioned below.

  • The International Classification of Functioning, Disability, and Health: This classification helps identify unique facilitators and barriers for both patients and caregivers.[40]
  • Biopsychosocial support system: This promotes the sustainability of interventions beyond physical therapy sessions.[40]

Use of Health Information Technology

Enhanced communication and care coordination: Health information technology enhances communication and care coordination through the steps mentioned below.

  • Improved communication: The seamless interaction between patients and providers fosters better engagement and understanding.[39]
  • Augmented predictive capabilities: This approach enhances clinical decision-making to predict better patient outcomes per their needs.
  • Personalized patient interventions: The streamlined communication and data tracking allow tailored care plans.[41]

Ethics and Responsibilities

Clarifying roles and responsibilities: Defining the specific contributions of each healthcare professional ensures cohesive teamwork, promotes accountability, and optimizes patient care by aligning responsibilities with individual expertise.

  • Nurses: They emphasize patient assessment, medication management, and psychosocial support while advocating for patient rights.
  • Allied healthcare professionals: They provide expertise in functional assessments and interventions, prioritizing cultural competence.
  • Physicians and advanced practitioners: They lead in medical expertise, treatment planning, and care coordination, adhering to ethical principles.
  • Pharmacists: They manage medication safety and collaborate with the healthcare team to optimize patient outcomes.[42]

Clear communication, structured protocols, and regular debriefings strengthen role clarity and collaboration among interprofessional healthcare providers, thereby maximizing efficiency in delivering behavioral therapy.

Team Dynamics

Conflict resolution and collaboration: Effective team dynamics rely on assertiveness, active listening, and structured conflict management to foster respectful communication and cooperation.

  • Assertiveness training and active listening: This approach fosters respectful dialogues and disagreements and promotes effective compromises.
  • Interprofessional conflict management: This approach implements structured strategies to identify and resolve underlying causes of conflicts for smoother collaboration.[43]

Team building and leadership development: Team dynamics and leadership skills can be strengthened through the below-mentioned strategies to enhance cohesion and communication.

  • Workshops and simulation training: This step helps boost confidence and leadership skills.[44]
  • Interprofessional collaboration: Collaboration among interprofessional healthcare providers enhances team cohesion and fosters effective communication.[36][43][44]

The Team Strategies and Tools to Enhance Performance and Patient Safety program, developed by the Agency for Healthcare Research and Quality, aims to reduce medical errors and improve communication among healthcare team members. Key foundations include leadership, situation monitoring, support system development, and effective communication strategies.[36][43][45][46][47][48][49]

Nursing, Allied Health, and Interprofessional Team Monitoring

Feedback and Continuous Improvement

Behavioral therapy encourages continuous learning and improvement through the methods mentioned below.

  • Self-reflection and feedback: This helps facilitate ongoing skill development and adaptation.
  • Training and professional development: This enhances team performance and improves the quality of patient care.[44]

Patient Care Coordination

Improved patient outcomes: Effective patient care coordination significantly enhances patient outcomes by ensuring timely interventions and addressing key health concerns.

  • Early recognition of mental health symptoms: This helps with timely intervention before issues escalate.
  • Addressing health anxiety: This helps bridge practice gaps in recognizing and treating psychiatric problems.[50]

Enhanced communication: Effective communication within healthcare settings fosters collaboration and promotes positive patient outcomes.

  • Assertiveness training: This strengthens communication skills and minimizes conflicts.
  • Patient education: This encourages necessary behavioral changes for improved health.

Training for Professional Practice

Continuous learning and skill development: Continuous learning and skill development are essential for enhancing job performance through workshops and training programs focusing on mindfulness, cognitive restructuring, communication, and coping skills.[44][51][19]

Evidence-based practice: Implementation-focused training enhances the adoption and delivery of evidence-based psychotherapies, improving patient outcomes and care quality.[38][19]

Interprofessional education: Reinforcement and motivational interviewing promote positive health behaviors and improve adherence to treatment plans.[19]

Implementing these strategies enables nursing, allied health, and healthcare teams to improve patient care, promote professional growth and development, and foster a positive, supportive, and collaborative environment among healthcare professionals that drives goal achievement.

References


[1]

Clark RE. The classical origins of Pavlov's conditioning. Integrative physiological and behavioral science : the official journal of the Pavlovian Society. 2004 Oct-Dec:39(4):279-94     [PubMed PMID: 16295771]


[2]

Watson JB. Reprinted from The British Journal of Psychology (1920), 11, 87-104: Is thinking merely the action of language mechanisms? British journal of psychology (London, England : 1953). 2009 Apr:100(Pt 1A):169-80. doi: 10.1348/000712608X336095. Epub     [PubMed PMID: 19351439]


[3]

Holland JG. B. F. Skinner, 1904-1990. Behavior modification. 1991 Apr:15(2):131-3     [PubMed PMID: 2039431]


[4]

Lieberman S. Psychotherapy by Reciprocal Inhibition: Joseph Wolpe. The British journal of psychiatry : the journal of mental science. 1986 Oct:149():518-9     [PubMed PMID: 3545355]


[5]

Guerrin B. [Albert Bandura and his work]. Recherche en soins infirmiers. 2012 Mar:(108):106-16     [PubMed PMID: 22616370]


[6]

Rodgers M, Marshall D, Simmonds M, Le Couteur A, Biswas M, Wright K, Rai D, Palmer S, Stewart L, Hodgson R. Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis. Health technology assessment (Winchester, England). 2020 Jul:24(35):1-306. doi: 10.3310/hta24350. Epub     [PubMed PMID: 32686642]

Level 1 (high-level) evidence

[7]

Hodgson R, Biswas M, Palmer S, Marshall D, Rodgers M, Stewart L, Simmonds M, Rai D, Le Couteur A. Intensive behavioural interventions based on applied behaviour analysis (ABA) for young children with autism: A cost-effectiveness analysis. PloS one. 2022:17(8):e0270833. doi: 10.1371/journal.pone.0270833. Epub 2022 Aug 16     [PubMed PMID: 35972929]


[8]

Jagtap S, Zahid A, Dere J, Gerritsen C, D'Arcey J, Romanowska S, Best MW. Culturally adapted cognitive behavioral therapy for psychosis (CaCBTp): A review of key features of cultural adaptation and considerations for psychologists. Psychological services. 2024 Jun 3:():. doi: 10.1037/ser0000875. Epub 2024 Jun 3     [PubMed PMID: 38829347]


[9]

Klein T, Breilmann J, Schneider C, Girlanda F, Fiedler I, Dawson S, Crippa A, Priebe S, Barbui C, Becker T, Kösters M. Dose-response relationship in cognitive behavioral therapy for depression: A nonlinear metaregression analysis. Journal of consulting and clinical psychology. 2024 May:92(5):296-309. doi: 10.1037/ccp0000879. Epub     [PubMed PMID: 38829329]


[10]

Shayganfard M, Kaboudi B, Arabsheibani K, Shakiba E, Cheshmekaboudi S. Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial. Archives of psychiatric nursing. 2024 Jun:50():108-114. doi: 10.1016/j.apnu.2024.03.019. Epub 2024 Mar 21     [PubMed PMID: 38789222]

Level 1 (high-level) evidence

[11]

Marshall L, Kletzka N, Kanitz J, Opperman KJ, Rockwell J. Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital. The journal of the American Academy of Psychiatry and the Law. 2024 Jun 4:52(2):196-206. doi: 10.29158/JAAPL.240009-24. Epub 2024 Jun 4     [PubMed PMID: 38834364]


[12]

Shaw AM, Hare MM, Conroy K, Kehrer SM, Cummings LR, Ramos MC, Comer JS. An exploratory study of service user and clinical outcomes in telehealth-delivered dialectical behavior therapy for adolescents skills groups. Psychological services. 2024 May 23:():. doi: 10.1037/ser0000863. Epub 2024 May 23     [PubMed PMID: 38780559]

Level 2 (mid-level) evidence

[13]

Shomali Ahmadabadi MS, Rezapour Mirsaleh Y, Yousefi Z. Effectiveness of Rational Emotive Behavior Therapy (REBT) on Self-Control and Impulsivity in Male Prisoners. Iranian journal of psychiatry. 2024 Feb:19(2):185-195. doi: 10.18502/ijps.v19i2.15104. Epub     [PubMed PMID: 38686305]


[14]

Okeke NM, Onah BN, Ekwealor NE, Ekwueme SC, Ezugwu JO, Edeh EN, Okeke PMD, Ndille R, Onwuadi CC, Amedu AN, Nwaogaidu JC, Nnamani RG, Okolie CN, Okoro K, Solomon KC, Owonibi OE. Effect of a religious coping intervention of rational emotive behavior therapy on mental health of adult learners with type II diabetes. Medicine. 2023 Sep 29:102(39):e34485. doi: 10.1097/MD.0000000000034485. Epub     [PubMed PMID: 37773818]


[15]

Strickland BR. Julian B. Rotter (1916-2014). The American psychologist. 2014 Jul-Aug:69(5):545-6. doi: 10.1037/a0036918. Epub     [PubMed PMID: 25046717]


[16]

Thoma N, Pilecki B, McKay D. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodynamic psychiatry. 2015 Sep:43(3):423-61. doi: 10.1521/pdps.2015.43.3.423. Epub     [PubMed PMID: 26301761]


[17]

Castellon-Lopez Y, Carson SL, Ward KT, Ramirez KD, Vo LP, Kuo T, Seeman T, Vassar SD, Trejo L, Eidem E, Aranda MP, Brown AF. Understanding the implementation and sustainability needs of evidence-based programs for racial and ethnic minoritized older adults in under-resourced communities with limited aging services. BMC health services research. 2024 Apr 13:24(1):466. doi: 10.1186/s12913-024-10925-0. Epub 2024 Apr 13     [PubMed PMID: 38614988]

Level 3 (low-level) evidence

[18]

McDonald IG, Daly J. On patient judgement. Internal medicine journal. 2001 Apr:31(3):184-7     [PubMed PMID: 11478348]


[19]

Ecker AH, O'Leary K, Fletcher TL, Hundt NE, York-Ward KM, Kauth MR, Kunik ME, Cully JA. Training and supporting mental health providers to implement evidence-based psychotherapies in frontline practice. Translational behavioral medicine. 2022 Jan 18:12(1):. pii: ibab084. doi: 10.1093/tbm/ibab084. Epub     [PubMed PMID: 34170325]


[20]

Valentine SE, Fuchs C, Carlson M, Elwy AR. Leveraging multistakeholder engagement to develop an implementation blueprint for a brief trauma-focused cognitive behavioral therapy in primary care. Psychological trauma : theory, research, practice and policy. 2022 Sep:14(6):914-923. doi: 10.1037/tra0001145. Epub 2021 Oct 18     [PubMed PMID: 34661421]


[21]

Ruano A, García-Torres F, Gálvez-Lara M, Moriana JA. Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis. Journal of pain and symptom management. 2022 May:63(5):e505-e520. doi: 10.1016/j.jpainsymman.2021.12.021. Epub 2021 Dec 22     [PubMed PMID: 34952171]

Level 1 (high-level) evidence

[22]

Yang J, Lo WLA, Zheng F, Cheng X, Yu Q, Wang C. Evaluation of Cognitive Behavioral Therapy on Improving Pain, Fear Avoidance, and Self-Efficacy in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Pain research & management. 2022:2022():4276175. doi: 10.1155/2022/4276175. Epub 2022 Mar 19     [PubMed PMID: 35345623]

Level 1 (high-level) evidence

[23]

Hsu HC, Lee YJ, Wang RH. [Holistic Person-Centered Care for Individuals With Type 2 Diabetes Mellitus]. Hu li za zhi The journal of nursing. 2023 Dec:70(6):82-91. doi: 10.6224/JN.202312_70(6).10. Epub     [PubMed PMID: 37981886]


[24]

Meng F, Jiang Y, Yu P, Song Y, Zhou L, Xu Y, Zhou Y. Effect of health coaching on blood pressure control and behavioral modification among patients with hypertension: A systematic review and meta-analysis of randomized controlled trials. International journal of nursing studies. 2023 Feb:138():104406. doi: 10.1016/j.ijnurstu.2022.104406. Epub 2022 Nov 14     [PubMed PMID: 36473304]

Level 1 (high-level) evidence

[25]

Spaeth M, Bleich S, Hillemacher T. [Motivational interviewing with alcohol-dependent patients]. Fortschritte der Neurologie-Psychiatrie. 2017 Sep:85(9):549-565. doi: 10.1055/s-0043-115216. Epub 2017 Sep 7     [PubMed PMID: 28881363]

Level 3 (low-level) evidence

[26]

Weaver JA, Richard AK, Press D, Gupta K, Schmid AA, Stephens JA. Participants With Acquired Brain Injury Realized They "Could Still Do Things" After a Yoga Intervention: A Qualitative Descriptive Study. The American journal of occupational therapy : official publication of the American Occupational Therapy Association. 2024 Mar 1:78(2):. doi: 10.5014/ajot.2024.050409. Epub     [PubMed PMID: 38345946]

Level 2 (mid-level) evidence

[27]

Birnkrant DJ, Bushby K, Bann CM, Apkon SD, Blackwell A, Colvin MK, Cripe L, Herron AR, Kennedy A, Kinnett K, Naprawa J, Noritz G, Poysky J, Street N, Trout CJ, Weber DR, Ward LM, DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. The Lancet. Neurology. 2018 May:17(5):445-455. doi: 10.1016/S1474-4422(18)30026-7. Epub 2018 Feb 2     [PubMed PMID: 29398641]


[28]

Kennedy D, Marten H, O'Sullivan C, Catrone R. Biological, Behavioral, and Ethical Considerations of Prader-Willi Syndrome: A Primer for Behavior Analysts. Behavior analysis in practice. 2022 Jun:15(2):562-570. doi: 10.1007/s40617-021-00618-z. Epub 2021 Jul 8     [PubMed PMID: 35692531]


[29]

Greidanus E, Warren C, Harris GE, Umetsubo Y. Collaborative practice in counselling: a scoping review. Journal of interprofessional care. 2020 May-Jun:34(3):353-361. doi: 10.1080/13561820.2019.1637334. Epub 2019 Aug 20     [PubMed PMID: 31429340]

Level 2 (mid-level) evidence

[30]

LaFrance DL, Weiss MJ, Kazemi E, Gerenser J, Dobres J. Multidisciplinary Teaming: Enhancing Collaboration through Increased Understanding. Behavior analysis in practice. 2019 Sep:12(3):709-726. doi: 10.1007/s40617-019-00331-y. Epub 2019 Mar 26     [PubMed PMID: 31976281]

Level 3 (low-level) evidence

[31]

Currid TJ, Nikcević AV, Spada MM. Cognitive behavioural therapy and its relevance to nursing. British journal of nursing (Mark Allen Publishing). 2011 Dec 8-2012 Jan 11:20(22):1443-7     [PubMed PMID: 22241494]


[32]

Dorflinger LM, Fortin AH 6th, Foran-Tuller KA. Training primary care physicians in cognitive behavioral therapy: A review of the literature. Patient education and counseling. 2016 Aug:99(8):1285-92. doi: 10.1016/j.pec.2016.02.014. Epub 2016 Mar 2     [PubMed PMID: 26979474]


[33]

Tuccero D, Railey K, Briggs M, Hull SK. Behavioral Health in Prevention and Chronic Illness Management: Motivational Interviewing. Primary care. 2016 Jun:43(2):191-202. doi: 10.1016/j.pop.2016.01.006. Epub     [PubMed PMID: 27262001]

Level 3 (low-level) evidence

[34]

Gilbert JH, Yan J, Hoffman SJ. A WHO report: framework for action on interprofessional education and collaborative practice. Journal of allied health. 2010 Fall:39 Suppl 1():196-7     [PubMed PMID: 21174039]


[35]

Wei H, Horns P, Sears SF, Huang K, Smith CM, Wei TL. A systematic meta-review of systematic reviews about interprofessional collaboration: facilitators, barriers, and outcomes. Journal of interprofessional care. 2022 Sep-Oct:36(5):735-749. doi: 10.1080/13561820.2021.1973975. Epub 2022 Feb 6     [PubMed PMID: 35129041]

Level 1 (high-level) evidence

[36]

Kirby MS, Spencer TD, Spiker ST. Humble Behaviorism Redux. Behavior and social issues. 2022:31(1):133-158. doi: 10.1007/s42822-022-00092-4. Epub 2022 Mar 25     [PubMed PMID: 38624848]


[37]

Working Party Group on Integrated Behavioral Healthcare. Joint principles: Integrating behavioral health care into the patient-centered medical home. Families, systems & health : the journal of collaborative family healthcare. 2014 Jun:32(2):154-6. doi: 10.1037/h0099809. Epub     [PubMed PMID: 24955691]


[38]

Maheu MM, Drude KP, Hertlein KM, Hilty DM. A Framework of Interprofessional Telebehavioral Health Competencies: Implementation and Challenges Moving Forward. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2018 Dec:42(6):825-833. doi: 10.1007/s40596-018-0988-1. Epub 2018 Oct 3     [PubMed PMID: 30284147]


[39]

Claessens J, Mueller-Schotte S, van Weerden J, Kort H, Imhof S, Wisse R. The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation. JMIR human factors. 2023 Jul 28:10():e46145. doi: 10.2196/46145. Epub 2023 Jul 28     [PubMed PMID: 37311121]


[40]

Miller KL. Patient centered care: A path to better health outcomes through engagement and activation. NeuroRehabilitation. 2016 Oct 14:39(4):465-470     [PubMed PMID: 27689606]


[41]

Samal L, Fu HN, Camara DS, Wang J, Bierman AS, Dorr DA. Health information technology to improve care for people with multiple chronic conditions. Health services research. 2021 Oct:56 Suppl 1(Suppl 1):1006-1036. doi: 10.1111/1475-6773.13860. Epub 2021 Oct 5     [PubMed PMID: 34363220]


[42]

Agar MR, Amgarth-Duff I. The Dilemma of Treating Delirium: the Conundrum of Drug Management. Current treatment options in oncology. 2022 Jul:23(7):951-960. doi: 10.1007/s11864-022-00987-9. Epub 2022 May 11     [PubMed PMID: 35543960]


[43]

van Klaveren LM, Geukers V, de Vos R. Care complexity, perceptions of complexity and preferences for interprofessional collaboration: an analysis of relationships and social networks in paediatrics. BMC medical education. 2024 Mar 25:24(1):334. doi: 10.1186/s12909-024-05304-6. Epub 2024 Mar 25     [PubMed PMID: 38528513]


[44]

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Implementing High-Quality Primary Care, Robinson SK, Meisnere M, Phillips RL Jr, McCauley L. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. 2021 May 4:():     [PubMed PMID: 34251766]

Level 2 (mid-level) evidence

[45]

Khoshnoodifar M, Emadi N, Mosalanejad L, Maghsoodzadeh S, Shokrpour N. A new practical approach using TeamSTEPPS strategies and tools: - an educational design. BMC medical education. 2024 Jan 4:24(1):22. doi: 10.1186/s12909-023-04803-2. Epub 2024 Jan 4     [PubMed PMID: 38178071]


[46]

Shi Y, Miao S, Fu Y, Sun C, Wang H, Zhai X. TeamSTEPPS improves patient safety. BMJ open quality. 2024 Apr 25:13(2):. doi: 10.1136/bmjoq-2023-002669. Epub 2024 Apr 25     [PubMed PMID: 38670556]

Level 2 (mid-level) evidence

[47]

Hassan AE, Mohammed FA, Zakaria AM, Ibrahim IA. Evaluating the Effect of TeamSTEPPS on Teamwork Perceptions and Patient Safety Culture among Newly Graduated Nurses. BMC nursing. 2024 Mar 13:23(1):170. doi: 10.1186/s12912-024-01850-y. Epub 2024 Mar 13     [PubMed PMID: 38481268]


[48]

Qiu T, Chen M, Gao S, Huang J, Wang W, Wang L, Li H. Application effect study of a combination of TeamSTEPPS with modularization teaching in the context of clinical instruction in trauma care. Scientific reports. 2024 Feb 27:14(1):4712. doi: 10.1038/s41598-024-55509-4. Epub 2024 Feb 27     [PubMed PMID: 38409342]

Level 2 (mid-level) evidence

[49]

Esperat MC, Hust C, Song H, Garcia M, McMurry LJ. Interprofessional Collaborative Practice: Management of Chronic Disease and Mental Health Issues in Primary Care. Public health reports (Washington, D.C. : 1974). 2023 May-Jun:138(1_suppl):29S-35S. doi: 10.1177/00333549231155469. Epub     [PubMed PMID: 37226954]


[50]

Tyrer P. Why health anxiety needs to be recognised in hospital practice. Clinical medicine (London, England). 2020 May:20(3):339-342. doi: 10.7861/clinmed.2019-0346. Epub     [PubMed PMID: 32414727]


[51]

Liu F, Liang W, Li H, Li Y, Zhang Y, Ding L, Zhang Q, Chen L. What can we learn about stress and sleep from COVID-19 pandemic-perspective from the theory of preventive stress management. Frontiers in public health. 2024:12():1383966. doi: 10.3389/fpubh.2024.1383966. Epub 2024 Apr 4     [PubMed PMID: 38638466]

Level 3 (low-level) evidence