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Vth World Congress of Behavioural and Cognitive Therapies Table of Contents Abstracts are grouped into topic areas and then into categories (invited addresses, symposia and open papers). Within each category abstracts are presented in the order in which they are likely to occur during the congress. Abstracts of the poster sessions are reproduced in a different booklet.

English Language Abstracts Addictive Disorders Invited Address:

Translational Research on Craving: Promises, Problems and Potential Peter Monti, Brown University, USA

Symposium 11: Symposium 25: Symposium 39: Symposium 72: Symposium 87: Symposium 100: Symposium 115: Open Papers 17:

Adolescent brain development and vulnerability for substance use disorders: Implications for early interventions Addictive Behaviours in Young People and Adolescents: Cognitive-Behavioural Predictors and Preventive Applications Advances in Treatment for Amphetamine Use Problems Cannabis Use Disorders: Cross-cultural Trends in Epidemiology, Comorbidity and Treatment Development Mental Health and Substance Use Comorbidity: Innovative, Integrated CBT Treatments Delivering Alcoholism Treatment in Novel Ways: Challenges and Solutions New developments in Cognitive Behaviour Therapy of Substance Misuse; the UK experience. Issues in Addiction

Anxiety Disorders Invited Addresses

Maximizing Useful Knowledge From Psychotherapy Research: Strategies For the More Rapid Development of Effective Interventions Thomas Borkovec, Penn State University, USA Developing and Disseminating Effective Cognitive Therapies for Anxiety Disorders David M Clark, Institute of Psychiatry at Kings College London, UK Anxiety Disorders; what now Paul Salkovskis, Institute of Psychiatry, UK. Twenty Years of White Bears: An Update on the Clinical Implications of Thought Suppression Daniel Wegner, Harvard University, USA

Symposium 7: Symposium 21: Symposium 34: Symposium 51: Symposium 64: Symposium 80: Symposium 84: Symposium 93: Symposium 97: Symposium 109; Symposium 156: Symposium 172: Panel Debate 9: Open Papers 32: Open Papers 40: Open Papers 44:

Innovations In The Treatment of Anxiety Disorders Social Anxiety disorder: New developments in models and treatment Cognitive Factors in the treatment of social phobia Unraveling interpersonal factors from a cognitive-behavioral perspective in Social Anxiety Disorder New ideas in OCD: The influence and inspiration of S. Rachman Role of cognition in treatment of OCD CBT on late-life anxiety disorders: empirical findings from recently conducted studies on treatment and phenomenology Disentangling the roles of safety and neutralizing behaviours: Helpful, harmful, both or neither? Beliefs of patients and therapists in social phobia: are they true? OCD: Treatment outcome in specialized populations and mechanisms of action Never mind the quality, feel the width - broadening our understanding of the treatment of obsessive-compulsive disorder Disgust and Anxious Psychopathology Anxiety Disorders Across the Lifespan: Multiple perspectives on predictors of symptom development and maintenance Cognitive Mechanisms in Anxiety Disorders Outcome in CBT for Anxiety CBT For Social Anxiety: Symptom Focus and Group Format

Adult Depression Invited Address:

Cognitive Therapy in the Treatment and Prevention of Depression Steven Hollon, Vanderbilt University, USA

Symposium 60: Symposium 76: Symposium 90: Symposium 105: Symposium 124: Symposium 140: Symposium 155: Symposium 171: Open Papers 9: Open Papers 13: Open Papers 18:

Psychological and psychobiological processes in vulnerability to depression Methodological Advances in the Study of Cognitive Vulnerability to Depression Depressive rumination: Nature, origins, and maintenance Ruminative processes across depression and anxiety Further frontiers in CBT for the Prevention of Relapse and Recurrence of Depression CBT for primary prevention & prevention of relapse in bipolar disorder, unipolar depressive disorder and suicidal depression Treatment-resistant depression| Mindfulness for Anxiety & Depression Depression, Cognition and Relationships CBT Interventions for Depression Cognitive Processes in Depression

'Adult Psychosis Invited Addresses:

Symposium Symposium Symposium Symposium

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Cognitive Processes Related to Mania and Depression within Bipolar Disorder Sheri Johnson, University of Miami, USA The psychology of bipolar disorder Richard Bentall, University of Manchester, UK Recent advances in cognitive models of psychosis Philippa Garety, Institute of Psychiatry, UK Psychosis in an interpersonal context: issues in familial and therapeutic relationships Theory and Practice in Social Recovery Based Interventions in Psychosis The PRP Trial Results: The Psychological Prevention of Relapse in Psychosis Cognitive behavioural approaches to the prevention of psychosis

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Symposium 135: Symposium 180: Roundtable 2: Panel Debate 6: Open Papers 16: Open Papers 19: Open Papers 43:

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CBT in Early Psychosis:what should the focus be? New developments in the psychology of bipolar disorder Enahnced Relapse Prevention for Bipolar Disorder Cognitive Remediation Therapy In The Treatment of Schizophrenia Advances in the understanding of paranoia It's the thought that counts: Appraisals in psychosis Cognitive behavioral approach to the psychology on symptoms of psychosis Certificate 18: the right to be lost to the system Innovations in Schizophrenia Treatment: New Concepts in CBT and Implementation Difficulties Issues in Psychosis Cognitive and Interpersonal Processes in Psychosis Advances in CBT with Pyschosis and Severe Mental Health Problems

Adult Trauma Invited Addresses:

Scientific Principles of CBT: Retrieval competition between multiple memories Chris Brewin, University College London, UK The Phenomenology, Theory and Treatment of Posttraumatic Stress Disorder Edna Foa, University of Pennsylvania, USA

Symposium 33: Symposium 50: Symposium 62: Symposium 78: Symposium 91: Symposium 107: Symposium 122: Symposium 138: Symposium 157: Open Papers 49:

Individual differences in vulnerability to Posttraumatic Stress symptoms Cognitive Mechanisms of Traumatic Experiences Cognitive processes in PTSD: Integrating and expanding cognitive models Intrusions as a transdiagnostic symptom: Recent developments on the etiology of intrusions in PTSD and other disorders Cognitive processes in posttraumatic stress disorder Enhancing Cognitive Behaviour Therapy of Posttraumatic Stress Disorder Integrating Imagery Interventions in Cognitive Therapy of Posttraumatic Stress Disorder Psychological treatment for severe, complex and chronic Posttraumatic Stress Disorder The role of case studies in the refinement of evidence-based practice in the treatment of posttraumatic stress disorder PTSD Interventions

Applied Behaviour Analysis & Acceptance and Commitment Therapy Invited Address:

The Implications of ACT and RFT for CBT Steven Hayes, University of Nevada, USA

Symposium 14: Symposium 28: Symposium 40:

Basic processes underlying the expansion and treatment of anxiety disorders Experimental analysis of several strategies to cope with aversive private experiences. Implications in the clinical context. Application of Acceptance and Commitment Therapy (ACT) to the prevention and treatment of health problems.

Basic Processes Invited Addresses:

Uncertainty in OCD Marcel van den Hout, Utrecht University, The Netherlands Metacognitive Therapy: Nature and effectiveness across disorders Adrian Wells, University of Manchester, UK Cognitive and Neural Systems Underlying the Control of Intrusive Memories: Implications for theories of thought suppression Michael C. Anderson, University of Oregon, USA

Symposium 5: Symposium 12: Symposium 13: Symposium 26: Symposium 27: Symposium 42: Symposium 43: Symposium 112: Symposium 121: Symposium 137: Symposium 154: Symposium 166: Symposium 169: Symposium 179: Panel Debate 2: Open Papers 2: Open Papers 4: Open Papers 28: Open Papers 37: Open Papers 38:

New advances in understanding key cognitive processes that maintain anxiety and depression Information-processing of emotion in depression: clinically relevant insights from cognitive neuroscience Why can't I stop thinking about it': The role of post-event processing in social anxiety Human fear conditioning: an excellent paradigm to study the basic processes of behaviour change. Dismantling Ruminative Thinking The Role of Mood in Perseverative Psychopathologies The Therapeutic, Organisational, and Conceptual Implications of Understanding the Nature of Perceptual Control The identification and modification of attentional bias to threat in anxiety: From cognitive science to clinical applications Metacognitive processes in OCD: theoretical and clinical perspectives. Information processing research in OCD: New advances and future directions Metacognition Across Disorders : Theory And Evidence Implicit cognitive processing in substance abuse and eating disorders Basic Processes in the Eating Disorders Maladaptive perfectionism: Recent developments in conceptualization, assessment and treatment When is Thought Suppression Dysfunctional? Basic Cognitive Processing in Anxiety and Trauma Personality and Emotional Regulation Basic Processes and Impulse Control Across Disorders Cognitive Biases in Anxiety and Depression Metacognition and Avoidance

Behavioural Medicine Invited Addresses:

CBT in Behavioural Medicine in the 21st Century Neil Schneiderman, University of Miami, USA Insomnia: Bridging the Gaps Between Research Evidence and Clinical Practice Charles Morin, Laval University, Canada

Symposium 71: Symposium 86: Symposium 99: Symposium 114: Symposium 123: Symposium 139: Symposium 158: Symposium 178: Open Papers 5: Open Papers 10: Open Papers 14:

Using cognitive behaviour therapy self-help: what works in practice? Advances in clinical interventions for sleep disturbance: Recent findings across disorders Are we pushing the right buttons? Recommendations for cognitive behaviour therapy in patients with chronic somatic complaints. Cognitive and behavioral interventions for family caregivers of stroke and dementia patients Gaining No Pain?: Cutting Edge Approaches to Chronic Pain and Disability Mindfulness & Health Tailored Cognitive Behavioural Therapy for Somatic Illnesses Cognitive Behavioural models and treatment of dizziness and syncope Health Problems and Insomnia CBT for Pain and Fatigue CBT for Nerve and Blood Disorders

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Challenging Behaviour and Personality Disorder Invited Address:

Cognitive Therapy for Borderline Personality Disorder Judith Beck, Beck Institute, Philadelphia, USA

Symposium 57: Symposium 74: Symposium 102: Symposium 117: Symposium 120: Symposium 136: Symposium 159: Symposium 175: Roundtable 8: Open Papers 50:

Measurement, Etiology and Treatent of Borderline Personality Disorder Early Maladaptive Schemas: from theory to empirical assessment Borderline Persoanlity Disorder: Connecting basic research to cognitive-behavioral treatment Comparing direct and indirect assessment of cognitions and emotions in patients with personality disorders and depression. Cognitive-Behavioral Therapies for Forensic Patients with Personality Disorders: Toward Evidence-Based Clinical Practice Recent developments in antisocial and borderline personality disorder: experimental and intervention studies Interventions for Anger and Violence Schema-focused therapy for borderline personality disorder State of the art of research into CBT treatment for personality disorders CBT, Forensic Issues and Drug Addiction

Children and Adolescent Mental Health Invited Addresses:

Evidence-Based Clinical Practice with Children and Adolescents: The Delicate Dance Tom Ollendick, Virginia Polytechnic Institute and State University, USA How Effective Are Interventions for Autism Spectrum Disorders Patricia Howlin Institute of Psychiatry at Kings College London, UK On the etiology of anxiety disorders: What can we learn from childhood studies? Silvia Schneider, University of Basel, Switzerland.

Symposium 1: Symposium 9: Symposium 16: Symposium 23: Symposium 29: Symposium 30: Symposium 45: Symposium 46: Symposium 58: Symposium 75: Symposium 89: Symposium 103: Symposium 118: Symposium 134: Symposium 152: Symposium 153: Symposium 168: Symposium 170: Symposium 182: Open Papers 12: Open Papers 22: Open Papers 23: Open Papers 25: Open Papers 29: Open Papers 34: Open Papers 39:

Child Anxiety; Theory and Treatment (CATTs) Epidemiology and acquisition Prevention and treatment of externalizing disorders in children and adolescents Child Anxiety; Theory and Treatment (CATTs): Understanding and treating anxiety disorders in children Mind Yourself”: A Strength Focused and Community Based Adolescent Suicide Prevention Project. New developments in research on the etiology of childhood anxiety disorders Evaluation of international research trials of the FRIENDS for Life program implemented as a universal prevention program Cognitive-behavioral therapy for children with anxiety disorders: The involvement and influence of parents. Impacting Children and Families Using Population-Based Intervention Strategies Obsessive compulsive disorder in children and adolescents: Issues in treatment Cognitive distortions in anxious children and adolescents Vulnerability to Depression in Adolescents The role of the father in the etiology, prevention and treatment of child psychopathology Recent Innovations in the Treatment of Child and Adolescent Anxiety Disorders What Research is Telling Us About the Treatment of Adolescent Depression Sleep problems in childhood and adolescence Prevention and Early Intervention in Child Anxiety - the role of parenting re-visited Cognitive-emotional factors in the development of childhood conduct problems: Implications for existing and innovative treatments Current trends in the treatment of social anxiety disorder for children and adolescents "Using computer and gaming technology to improve childhood disorders treatments." Dissemination of CBT, Parenting and Child Behaviour Child and Adult Mental Health: Risk of Anxiety and Depression Cogntive Behaviour Therapy Developments and Adolescent Problems Children and Adolescents: Treament of Anxiety and Depression Parenting and Schemas Parenting Cognition and Behaviour Problems Children and Adolescents: Health and Wellbeing

Cross Cultural and Global Issues Invited Address:

Cultural Contexts of Psychotherapy: A Good Therapy is Like a Good Japanese Restaurant Gordon Nagayama Hall, University of Oregon, USA

Symposium 70: Symposium 85: Symposium 98: Symposium 113: Symposium 127: Symposium 144: Symposium 161: Open Papers 47:

Social Anxiety around the World - Cultural Aspects of Social Anxiety Disorder Social Anxiety and Taijin Kyofusho in Adolescents and in Young Adults. A Cross-Cultural Perspective on Obsessions and Other Unwanted Intrusive Thoughts Cognitive behavioral therapies: theoretical and empiric aspects in focus What are health psychologists doing in Brazil and Portugal? Dissemination and maintenance of the spirit of motivational interviewing in non English speaking populations and in different contexts How Can We Train Competent Cognitive Behaviour Therapists? A Cross-Cultural Perspective Anxiety Across Cultures and CBT with Immigrant People

Eating Disorders Invited Address:

Trans-diagnostic Cognitive Behaviour Therapy for Eating Disorders: Clinical Experience and Research Findings Chris Fairburn, Oxford University, UK

Symposium 2: Symposium 17: Symposium 31: Symposium 47: Symposium 73: Symposium 88: Symposium 101: Symposium 116: Symposium 165: Open Papers 51:

Revolutionizing the treatment of eating disorders and obesity: the contribution of G. Terry Wilson Guided self-help for bulimia nervosa and binge eating disorder Predicting and Preventing Relapse in Eating Disorders Automatic approach-avoidance tendencies in anxiety, eating disorders, and addiction: Theoretical meaning and clinical implications. Core cognitive beliefs: are they still interesting? A symposium about perfectionism, control, and worry in eating disorders Attentional strategies and implications for treatment in eating disorders and body image disorders Food reward and reward sensitivity: Implications for understanding eating disorders and obesity Neuroimaging Approaches to Body Image Disturbances in Eating Disorders New developments in Body Dysmorphic Disorder Eating Disorders and CBT Interventions

Intellectual and Developmental Disabilities Invited Address:

Mindfulness-Based Therapy and Caregiving in Developmental Disabilities Nirbhay N Singh, ONE Research Institute, USA

Symposium 10: Symposium 24: Symposium 38: Symposium 55: Symposium 67: Symposium 95: Panel Debate 4:

Innovations in Formulation and Application of CBT for People with Intellectual Disabilities Therapy with people with intellectual disabilities: Models and evidence Mindfulness and Acceptance in Developmental Disabilities CBT,social cognition and motivation in sex offenders with intellectual disabilties. Challenges Associated with Providing CBT to Dually Diagnosed Individuals In Community Settings Trauma, PTSD and other psychological disorders, and effectiveness of treatment in people with IDD Can Residential/Institutional Treatment Be a Viable Part of the Continuum of Treatment for Individuals with Intellectual Deficits

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New Developments in Cognitive Behaviour Therapy Invited Address::

The training of attentional and interpretive bias in anxiety: A new approach to the advancement of theoretical understanding and the enhancement of therapeutic intervention. Colin Macleod, University of Western Australia, Australia

Symposium 19: Symposium 92: Symposium 130: Symposium 131: Symposium 148: Symposium 149; Symposium 151: Symposium 167: Symposium 173: Symposium 174: Symposium 181: Panel Debate 1:

From the Laboratory to the Clinic: Experimental Findings Informing Treatment Innovations Across Clinical Disorders Recent developments in research on Mindfulness-Based Cognitive Therapy (MBCT) Facilitating Therapeutic Contexts: The Application of D-Cycloserine for the Treatment of Anxiety Disorders. Putting a halt to negative thoughts, memories and emotions? New directions in thought suppression research New developments in the treatment of trichotillomania Personal meaning: Its disruption and re-establishment following major stressful life events Clinical cognitions and their modification in depression and worry Refining and enhancing methods of inducing more benign cognitive biases in anxiety Metacognitive Therapy : Outome Across Disorders International Negotiation and Psychotherapy Training of Information Processing Biases in Anxiety Self reported cognition in clinical psychology: Progressive or regressive?'

Sex, Marital and Family Relationships Invited Address:

Marriage Matters: Why and how we should help couples strengthen their relationships Kim Halford, Griffiths University, Australia

Symposium 15: Symposium 44: Symposium 69: Symposium 129: Symposium 147: Symposium 164: Roundtable 4: Roundtable 6:

The Restructuring of Family Schemas: A Cognitive-Behavioral Perspective The Long-Term Effects of Couple Education and Therapy Psychological Vulnerability Factors for The Development of Sexual Dysfunction: New Empirical Data Recent developments in aetiology and treatment of primary vaginismus Cognitive Processes and Sexual Dysfunction Recognition and treatment of sexual dysfunction within a CBT framework Extending Principles of Couple Interactions to Specific Populations Bridging the gap between family therapy research and treatment: A clinical roundtable discussion.

Therapeutic and Applied Issues Invited Addresses::

Symposium 6: Symposium 20: Symposium 37: Symposium 41: Symposium 49: Symposium 54: Symposium 56: Symposium 59: Symposium 63: Symposium 104: Symposium 108: Symposium 128: Symposium 132: Symposium 145: Symposium 150: Symposium 162: Open Papers 26: Open Papers 30: Open Papers 33: Open Papers 35: Open Papers 41: Open Papers 48: Panel Debate 3: Panel Debate 5

Beyond Rationality: Using Emotion in Cognitive Therapy Robert Leahy, American Institute for Cognitive Therapy, USA Cognitive therapy for depression: Towards a new synthesis? Melanie Fennell, Oxford Cognitive Therapy Centre, UK New Advances in Schema Therapy for Personality Disorder Jeff Young, Cognitive Therapy Center of New York, UK. New applications of Mindfulness-based Cognitive Therapy Is Laughter the Best Medicine: Using humor in Psychotherapy Increasing openness to empirically supported treatments Computer-assisted self-help in the treatment of psychological disorders Imagery, emotion and motivation: some research findings. Repeated Assessment and Modeling of Psychopathology and Treatment Using cognitive behaviour therapy self-help: what works in practice? Cognitive-behavioural Case Formulation: What can we learn from emerging research? The Therapeutic Relationship In Cognitive-Behavioral Psychotherapy The Cognitive Model of Aaron T. Beck: Its Impact and Future Direction Mindfulness and Meditation in various religious traditions to promote positive mental health Working Alliance and Restoration of Morale in CBT Cognitive Behaviour Therapy in the Acute Psychiatric Inpatient Unit. Implicit self-esteem in anxiety and depression Corpus delicti. Bodily preoccupations across psychopathological disorders Self-esteem as a predictor of improvement in Cognitive and Behavioural Treatment (CBT) with complex cases Mindfulness Based Cognitive Therapy Outcome Transdiagnostic Psychological Mechanisms Applying CBT in New Populations and Formats Extending Access to CBT Religion, Beliefs and CBT Causal Attributions and CBT Outcome Factors Cognitive-behavioural Case Formulation: Is the emperor clothed? The Importance of Theory to Stabilize the Science and Practice of Cognitive Therapy.

Training, Supervision and International Standards Invited Addresses:

Power Supervision: Training the next generation of CBT clinicians to excel in both technical merit and artistic impression Corey Newman, University of Pennsylvania, USA The Next Frontier: Building Positive Qualities with CBT Christine Padesky, Center for Cognitive Therapy, USA

Symposium 68: Symposium 96: Symposium 133: Symposium 146: Symposium 163: Symposium 177: Panel Debate 8: Roundtable 7: Roundtable 9: Open Papers 7:

Developing Interpersonal Competencies in Cognitive Behavioural Therapy: The Challenges for Trainers Training Cognitive Therapists Self-Experientially: The Theoretical and Empirical Case for incorporating Personal CBT Training - Meeting the Challenge Therapeutic Convergences And Divergences Of Cognitive Models: Implications For Training Let a hundred flowers bloom: varieties of training in CBT Supervision and Training in Cognitive Behavioural Psychotherapy: An International Structural Perspective How is personal experiential work and/or personal therapy best incorporated into the training of cognitive therapists? Cognitive-Behavioural Case Formulation: Strategies for Training, Supervision and Professional Development? The formation process for cognitive therapist Issues in CBT Training

SCRiTC Symposium & Invited Speakers Invited Addresses:

CBT progress in delivering self-help and in developing a common language Issac Marks, Institute of Psychiatry, London, UK

Symposium 79:

Noves Fronteres en Teràpia Cognitiva i Conductual New Frontiers in Cognitive Behaviour Therapy

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Spanish Language Abstracts Addictive Disorders Symposium 126: Symposium 142: Open Papers 15:

Aplicaciones de las técnicas cognitivo-conductuales en la prevención y tratamiento de las adicciones Eficacia del tratamiento psicológico en adicciones Conductas Adictivas

Adult Anxiety Symposium 66: Symposium 82: Panel Debate 7:

Nuevos planteamientos y avances en el campo de la ansiedad social Evaluación de la ansiedad social en España y Latinoamérica con implicaciones para su prevención y tratamiento Propuesta para un modelo de consenso sobre el papel y la definición de los subtipos en el trastorno de ansiedad social

Adult Psychosis Symposium 160:

Intervención familiar en la esquizofrenia:

Behaviour Analysis & Acceptance and Commitment Therapy Symposium 53: Open Papers 20:

Componentes básicos de ACT: Evaluación funcional e intervenciones eficaces para pacientes con problemas crónicos. Procesos Basicos

Behavioural Medicine Open Open Open Open

Paper Paper Paper Paper

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Psicologia de la Salud Psicología de la actividad física y el deporte Medicina Conductual (1) Medicina Conductual (2)

Challenging Behaviour and Personality Disorders Symposium 35: Symposium 52:

Mujeres víctimas de violencia doméstica: Realidad actual y líneas de actuación Innovaciones recientes en la aplicación del modelo de la terapia de esquemas

Child and Adolescent Mental Health Symposium 65: Symposium 111: Symposium 125: Symposium 141: Roundtable 10: Open Papers 21: Open Papers 24:

Nuevas estrategias en la intervencion cognitiva-comportamental con niños y adolescentes Hospitalizacion parcial de niños y adolescentes desde un modelo cognitivo-conductual Desarrollo y Evaluación de Programas de Intervención Breve en Adolescentes Consumidores de Alcohol Avances en la aplicación y depuración de la Intervención en Adolescentes Españoles con Fobia Social Generalizada La intervención cognitivo conductual para el tratamiento de la ansiedad infantil Salud Mental en Ninos y Adolocentes 1 Salud Mental en Ninos y Adolocentes 2

Cross Cultural and Global Issues Symposium 22: Roundtable 1: Open Paper 46:

Avances en latinoamerica de la terapia cognitivo-comportamental aplicada a los problemas afectivo-emocionales y adaptativos Aplicación de tratamientos cognitivos en la Argentina. Aspectos socioculturales

Eating Disorders Symposium 143:

Factores de riesgo específicos para Trastornos Alimentarios o Trastornos Relacionados con el peso

Intellectual and Developmental Disabilities Symposium 110:

Panorámica actual de los tratamientos en población infanto-juvenil con discapacidades

Sex, Marital and Family Relationships Symposium 81: Symposium 94: Roundtable 3: Open Papers 45:

Abordajes en la terapia sexual cognitivo-comportamental: contribuciones latinoamericanas Avances de la terapia cognitivo-comportamental para los problemas de pareja en latinoamérica La aplicación de la terapia de aceptación y compromiso en la superación de barreras psicológicas en la sexualidad Relaciones de pareja y familia

Therapeutic and Applied Issues Symposium 8: Symposium 36: Symposium 83: Symposium 176: Open Paper 8: Open Papers 27: Open Papers 31: Open Papers 36: Open Papers 42:

Aportaciones de las nuevas tecnologías en el campo de la Psicología Clínica y de la Salud Flexibilidad de los tratamientos cognitivos-conductuales manualizados y alcance a nuevas poblaciones y lugares de tratamiento Desarrollo del estilo personal del terapeuta Identificación de Cogniciones Disfuncionales en Profesionales de Educación Media Superior Salud Mental Adultos Desarrollos Terapéuticos (1) Desarrollos Terapéuticos (2) Desarrollos Terapéuticos (3) Desarrollos Terapéuticos (4)

Training, Supervision and International Standards Roundtable 5:

Formación y entrenamiento de psicoterapeutas cognitivos

Invited addresses La promoción del envejecimiento activo: la contribución de la Psicología de la Salud - Rocio Fernández-Ballesteros, ANALISIS Y MANEJO DE LOS TIEMPOS DE ESPERA EN PSICOLOGÍA DE LA SALUD - Ramón Bayés, VOLVER A LAS RAÍCES Y SEGUIR NAVEGANDO A ÍTACA - Miguel Costa, Ayuntamiento de Madrid, España LOGROS, DESAFÍOS Y PERSPECTIVAS DE LA MEDICINA CONDUCTUAL EN PAÍSES EN DESARROLLO - Juan Jose Sánchez Sosa, ABUSO Y VIOLENCIA PSICOLÓGICAS: NUEVOS RETOS PARA LA PSICOLOGÍA - José Antonio Carrobles, MIEDO, ANSIEDAD Y ESTRÉS: AVANCES CONCEPTUALES DESDE LA NEUROCIENCIA AFECTIVA - Jaime Vila

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Addictive Disorders Invited Addresses Translational Research on Craving: Promises, Problems and Potential Peter Monti, Brown University, USA This plenary session will review contemporary empirical research on craving for alcohol and tobacco with particular emphasis on craving's determinants, phenomenology, and neurobiological underpinnings. Cue exposure treatment, coping skills approaches, pharmacological approaches (i.e., naltrexone, nicotine replacement therapy) and combined behavioral and pharmacological approaches to craving will be presented and critiqued. Potential methods for enhancing these existing treatments as well as promising new treatments for adult and adolescent substance abusers will be discussed. More generally, the talk will highlight the need for transdisciplinary research that clarifies the genetic and neurobiological bases of craving and meaningfully translates these more basic advances into novel clinical approaches and enhanced clinical care.

Symposium 11 Adolescent brain development and vulnerability for substance use disorders: Implications for early interventions? Convenor: Reinout Wiers, Maastricht University, The Netherlands, The Netherlands Adolescent Brain Maturation: A Period of Vulnerabilities and Opportunities Ronald E. Dahl, M.D., University of Pittsburgh, U.S.A. This presentation provides an overview and conceptual framework for considering key aspects of adolescent brain maturation with an emphasis on understanding developmental pathways to substance use problems. Adolescent development is a period of special opportunities as well as vulnerabilities with respect to a wide range of behavioural and emotional health problems in youth. More specifically there are unique brain/behaviour/social-context interactions during pubertal maturation that can influence these developmental trajectories in positive and negative ways. A model will be described that focuses on neurobehavioral changes at puberty that lead to an increase tendency toward risk-taking and sensation-seeking in adolescence. These biologically-based changes in drives, emotions and motivations (“igniting passions”) often emerge early in adolescence. In contrast, the gradual and relatively prolonged maturation of self-regulatory skills and judgment continue to develop through late adolescence. This may be particularly relevant to individuals who enter adolescence with previous vulnerabilities, including those at biological, familial, or social risk-particularly youth living in social contexts that create challenges to the gradually emerging skills in self-control. Key features of the model will be illustrated through a consideration of brain/behaviour/social-context interactions in sleep/wake regulation in adolescence. The clinical and social policy implications of this model-and its relevance to early intervention and prevention of behavioural and emotional problems in youth, with an emphasis on early interventions for substance use problems-will be discussed. MRI Research on Adolescent Brain Development and Substance Use Susan F. Tapert, Ph.D., University of California, San Diego, U.S.A. Alcohol and marijuana are commonly used among adolescents worldwide. Technological advances in neuroimaging have facilitated an appreciation of ongoing neuromaturation during this developmental stage, and have provided tools for assaying brain functioning features associated with risk for substance use and the neural consequences of such behaviors. Dr. Tapert will describe the results of several functional magnetic resonance imaging (fMRI) studies conducted in adolescents aimed at uncovering these bidirectional relationships. First, she will review fMRI findings in adolescents with substance use disorder risk factors, including family history of alcoholism, positive alcohol expectancies, and low levels of response to alcohol. fMRI cue exposure paradigms in heavy drinking youth will be presented, showing that neural response to substance-specific stimuli appears to be a function of personal drinking. Next, she will review a set of fMRI studies, conducted with over 100 youths, that examine how heavy alcohol or marijuana use during adolescence may be linked to abnormalities in thinking and memory abilities and strategies. Heavy drinking during adolescence has been linked to abnormalities in brain response during working memory tasks, with indications of compensation and neural reorganization in frontal and parietal areas. Females appear somewhat more affected than males, and concomitant marijuana use is linked to further abnormalities, especially in prefrontal and temporal regions. Longitudinal studies are underway to evaluate abnormalities in conjunction with substance use changes across adolescence. Implications for prevention and intervention will be discussed, including dissemination of factual information to teens, motivational enhancement, and expectancy challenges. A developmental neurobiological model and substance use problems Monique Ernst, M.D., Ph.D., NIMH, Bethesda, USA Mature behavior requires the harmonious development of modular systems that underlie affective and cognitive function, along, of course, the elementary units of action linking sensory-perceptual input with motor-executive output. Adolescence is a prime period when affective and cognitive control systems show dramatic changes. These changes reflect plasticity and might augur vulnerabilities as well as opportunities for intervention. A developmental neurobiological model based on equilibrium among and within functional neural systems will be discussed and implications for age-appropriate safeguard policies as well as preventive interventions for the development of substance use problems will be addressed. Acute sensitivity to alcohol in young adults: impulsivity and substance abuse risk Mark T. Fillmore, Ph.D., University of Kentucky, U.S.A Impulsivity and under-controlled behavior are common characteristics associated with early-onset (i.e., adolescent) substance abuse. Although our understanding of the relationship between impulsivity and adolescent substance use remains unclear, there is growing evidence that prolonged drug exposure during adolescence could impede the formation of frontal lobe circuitry, resulting in impairments in the regulation and control of behavior. Moreover, such adverse effects might contribute to the maintenance and escalation of drug use. Adolescent drug users often develop alcohol use problems (e.g., binge drink) as young adults and are at greater risk for alcohol dependence. Alcohol is well-known for its acute disinhibiting effects on behavior and its chronic use is associated with sustained states of under-controlled behavior often described as impulsivity. Thus it is important to determine how prior drug exposure during adolescence might alter alcohol sensitivity in young adults. Lasting neurocognitive impairments owing to a history of adolescent drug use could increase the vulnerability of these individuals to the acute disruptive effects of alcohol. In this presentation, Dr. Mark Fillmore describes studies that examine the acute neurocognitive and subjective rewarding effects of alcohol in groups of young adults as a function of prior adolescent drug use history and other substance abuse risk factors, such as childhood Attention Deficit/Hyperactivity Disorder (ADHD). Dose-response studies are described that examine the magnitude of acute behavioral impairment and acute subjective rewarding effects in groups of young adults with and without histories of adolescent drug use and childhood ADHD. Adolescent brain development and vulnerability for substance use disorders: Implications for early interventions? Susan L. Ames, Ph.D. & Alan W. Stacy, Ph.D., University of Southern California, U.S.A Various associative memory measures have been used to assess processes that probably operate implicitly on behavior. These implicit processes are revealed on indirect measures of addictive behavior that tap into and activate pre-existing associations in memory. A review of findings on associative memory work in at-risk youth is presented including involvement of confounding and moderator effects. One study evaluated the mediating role of associative memory in the prediction of substance use among at-risk youth, examining relationships among dissociative experiences, sensation seeking, and spontaneous cognitions in the analyses. Findings from latent variable models revealed spontaneous cognitions independently predicted alcohol and marijuana use and mediated the predictive effects of sensation seeking on drug use. A second study compared indirect measures in an attempt to quantify the level of marijuana associations among at-risk adolescents. Automatic drug-relevant associations were assessed with a word association index, IAT and EAST. Measures of working memory capacity, sensation seeking, and explicit cognitions were also included in analyses as potential confounders. The word association index and IAT excited D-measure were significant predictors of marijuana use. Another study evaluated the interaction between working memory capacity and implicit cognition in the prediction of alcohol and cigarette use among at-risk youth, controlling for gender, ethnicity, and acculturation. Consistent with dual-process cognitive theories, drug-related associations in memory predicted drug use more strongly in youth with lower levels of working memory capacity. These findings add to the growing research that implicates the importance of implicit associative processes in risk and health behaviors in youth.

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A Model for the Development of Problematic Alcohol and Drug Use in Adolescence. Reinout W. Wiers (1, 2, 3), Carolien Thush (1), Jerry Grenard (4) Susan L. Ames (4) & Alan W. Stacy (4), (1) Maastricht University, The Netherlands (2) Radboud University Nijmegen; (3) IVO Addiction Research Institute Rotterdam; (4) University of Southern California A model is presented, which describes the development of addictive behaviors in (human) adolescents, with a focus on alcohol (Wiers et al., in press, Pharmacol, Biochem, Behav, available online). In essence, the model proposes that addictive behaviors develop as the result of an imbalance between two systems: an appetitive, approach-oriented system that becomes sensitized with repeated alcohol use and a regulatory executive system that is not fully developed and that is compromised by exposure to alcohol. Self-regulation critically depends on two factors: ability and motivation to regulate the appetitive response tendency. The motivational aspect is often still weak in heavy drinking adolescents, who typically do not recognize their drinking as problematic. Motivation to regulate use often develops only years later, after the individual has encountered serious alcohol-related problems. Unfortunately, at that point behavioral change becomes harder due to several neurocognitive adaptations that result from heavy drinking. As we document, there is preliminary support for the central elements of the model (appetitive motivation vs. self-regulation), but there is a paucity of research directly addressing these mechanisms in human adolescents. I will present data from two recent studies which both found that executive functions moderate the impact of automatic appetitive responses to addiction-related stimuli on behavior. In both studies we found that spontaneous appetitive reactions to addiction-related stimuli better predicted substance use in adolescents with relatively poor executive skills, as compared with individuals with relatively well developed executive skills. Finally, I will discuss implications of the model for interventions.

Symposium 25 Addictive Behaviours in Young People and Adolescents: Cognitive-Behavioural Predictors and Preventive Applications Convenor: Jose P. Espada, Spain The Motivation-Skills-Decision Making Model of Drug abuse Prevention Steven Sussman, University of Southern California, USA This presentation asserts that young people at risk for substance abuse will not use substances if they: 1) are motivated to quit through being aware of misleading information that facilitates substance use, reconciling their own equivocation about their substance use, and appreciate the consequences that substance use may have on their own and others lives, 2) have skills that help them lower their risk for use, including awareness of cessation strategies, and 3) have decision making skills to make personal commitments not to use substances. This is known as the Motivation, Skills, Decision- Making (MSD) Model. Motivation exists as a distance between what is and what could be, and people desire to reduce such discrepancies. For example, most youth plan to continue to attend school or job training. When prompted as part of a critical-thinking-like sequence one sees that drug use could interfere with achieving life goals. It is important for prevention programs to help youth connect the importance of health as a value to obtaining their life goals, and develop a sequenced plan so that they know how to proceed on step-by-step. Behavioral skills can buffer against the impact of risk factors, and permits the establishment of new pro-health social and other life options, if well-directed from motivational guides. For example, one type of behavioral skill is that of self-control. In self-control programming, youth learn to assess their self-control, particularly in social contexts. They learn the importance of thinking ahead and anticipating problem situations so that they are prepared beforehand to deal with problems that may arise. They also learn the importance of context (e.g., not laughing at a funeral). Finally, they learn assertiveness and anger management to help them better control their reactions in social settings. It is most wise to include behavioral skills training in conjunction with material addressing motivation and decision-making. Motivations regarding drug use need to be addressed, so behaviors learned are not misdirected. With motivational guides, and new behavioral options, one can decide how to act in specific situations through additional use of decision making and making a personal commitment not to abuse drugs. Training in decision-making operates on variables that are intermediate in the causal process, and thereby strengthen self-control abilities so that they are more resilient in the face of proximal risk factors for drug use such as life stresses and peer pressures. Integrating Cognitive, Behavioral, and Affective Skills Training As A Drug Abuse Prevention Approach Kenneth W. Griffin, Cornell University, New York, USA School-based drug abuse prevention programs for early adolescents are an efficient way to deliver prevention services to young people before they become heavy substance users or abusers. Contemporary prevention programs include social refusal skills training with training in more generic "life skills" using cognitive, behavioral, and affective skills training techniques. This type of programming typically teaches young people principles of cognitive reframing, behavioral self-control, coping, and relaxation skills, and how to apply these skills outside of the classroom in high risk situations. This presentation will review the concepts and empirical findings from the "Life Skills Training" prevention program, including short and long-term effects of substance use and related risk behaviors. One goal of the presentation is to suggest that broad-based competence enhancement prevention programs may be an efficient and effective way to prevent a variety of negative outcomes during adolescence. Substance use patterns and social phobia in Spanish adolescents José A. Piqueras, José Olivares, Luis-Joaquín García-López, Jose P. Espada and Mireia Orgilés., Universidad de Alicante, Spain This study aimed to analyze the comorbidity of different substance use problems and social phobia and study the relationship between social phobia, substance use patters and other related variables (social anxiety, comorbidity with other disorders, self-steem, etc).. The sample consisted of 116 Spanish adolescents ranged between 14 and 18 years, attending 15 high-schools in rural and urban areas of the south of Spain. After a screening assessment, 69 (59.5%) subjects fulfilled the criteria for the diagnosis of Social Phobia, 24 (20.7%) that for specific social phobia and 23 (19.8%) did not. Among them, 55 (47.4%) met criteria for substance use problems and 61 (52.6%) did not. Substance users took cannabis, cigarettes, or any other drugs. We selected two conditions in order to study the differences: substance users and non-substance users. To carry out the comparisons among them a one-way analysis of variance (ANOVA) for the quantitative information, and tests ?2 for the dichotomic data. Comparisons in psychopathological and demographic variables showed statistically significant differences among substance users and non-substance users in mean age, age of onset and chronicity of the disorder. Specifically, we found that substance users were more often older adolescents, had an early age of onset and a higher chronicity of social phobia. The current study establishes preliminary support for the relationship between social phobia and substance use problems in a Spanish sample of adolescents. Chronic cannabis use and cognitive performance. Daniel Lloret and M. Carmen Segura, Universidad Miguel Hernández, Spain Cognitive impairment due to the psychological residual effects of chronic cannabis use have not been yet clearly demonstrated. To determine whether such consequences occurred, this work compares the cognitive performance of college students cannabis users (n=28) and non users, in a battery of six tests of maintained attention, observation and reasoning. Mean of age was 20,7 years. Users had a regular consumption of cannabis for at least six months up to 10 years (73% more than 1 year of consumption). Users were tested after a period of abstinence of at least 1 day. Controls had neither current nor past experience with cannabis. Both, users and controls, were matched for age, educational level, sex, intellectual activity and labour activity. Other psychoactive drugs chronic experience, including alcohol, recent consumption of any abuse drug or psychiatric diagnosis was considered as exclusion criteria. The group of users was two-folded in heavy and light users. Heavy smokers were considered by using cannabis at least seven times per week. Preliminary findings suggest that light users of cannabis show no significant differences in the test scores. Further analysis are needed for heavy users. Comparison between two applications of LST program applied by experts vs teachers Jose P. Espada, Mónica Gázquez and Jose A. Garcia del Castillo, Universidad Miguel Hernandez, Spain In recent years advances have been made in the evaluation of substance abuse preventive programs at school. Researchers have centered their efforts in assessing the outcomes of preventive programs, concluding that generally they are effective in preventimg substance use and abuse. A strategy in the evaluation of behavioral interventions is the variation of the intervention parameters, as the characteristics of the therapist. Many studies indicate that the data on the differential effectiveness of the programs based on the applicators (expert versus teacher), are contradictory. The aim of this work was to compare the outcomes of the application of a program based on improving general skills of the adolescent (social skills, self-esteem, information, problem solving, etc.), comparing the effects when it is carried out by experts or teachers. A quasi experimental group design was used with a nonequivalent control group, repeated measures pretest, postest and follow up. The program was applied with a scholar sample of adolescents of secondary. The sample was composed by 324 students with an average age of 12,5 years. Experimental group received the intervention based on Life Skills Training program, whereas a control group didn´t received the intervention. The dependent variables were substance use, attitude towards drugs, intention of future use and abuse, and the level of information. Instruments were self reports. Inter-group and intra-group changes are analyzed. Preliminary results point at a greater effectiveness when the programs are applied by the experts. The benefits and limitations of the application of the programs by teachers and the implications for future preventive interventions will be discussed.

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Symposium 39 Advances in Treatment for Amphetamine Use Problems Convenor: Frances Kay-Lambkin, Centre for Mental Health Studies, University of Newcastle, Australia, Australia The effectiveness of cognitive behaviour therapy for amphetamine use problems Amanda Baker1, Nicole Lee2, Frances Kay-Lambkin1, Melissa Claire1, Linda Jenner3, 1 The University of Newcastle, Australia 2; Turning Point Drug and Alcohol Centre, Melbourne, Australia3 The University of Queensland, Brisbane, Australia This study sought to replicate and extend a small pilot study conducted by Baker, Boggs and Lewin (2001) which demonstrated that brief interventions consisting of motivational interviewing and cognitive-behaviour therapy (CBT) were feasible and associated with better outcomes compared with a control condition. Methods: This was a randomised controlled trial conducted in the Greater Brisbane Region of Queensland and Newcastle, NSW, among 214 regular amphetamine users. Results: The main finding of this study was that there was a significant increase in the likelihood of abstinence from amphetamines among those receiving two or more treatment sessions. In addition, the number of treatment sessions attended had a significant short-term beneficial effect on level of depression. Overall, there was a marked reduction in amphetamine use among this sample over time and, apart from abstinence rates and short-term effects on depression level, this was not differential by treatment group. Reduction in amphetamine use was accompanied by significant improvements in stage of change, benzodiazepine use, tobacco smoking, polydrug use, injecting risk-taking behaviour, criminal activity level, and psychiatric distress and depression level. Discussion: On the basis of these findings, a stepped care approach is recommended. The first step in providing an effective intervention among many regular amphetamine users, particularly those attending non-treatment settings, may include provision of: a structured assessment of amphetamine use and related problems; self-help material; and regular monitoring of amphetamine use and related harms. Regular amphetamine users who present to treatment settings could be offered two sessions of CBT, whilst people with moderate to severe levels of depression may best be offered four sessions of CBT for amphetamine use from the outset, with further treatment for amphetamine use and/or depression depending on response. Initial findings of a prospective study into amphetamine use and psychosis Sharon Dawe, Griffith University, Australia No abstract available Stepped care of cognitive behaviour therapy CBT for people with comorbid amphetamine use problems and depression Frances Kay-Lambkin1, 2, Amanda Baker1, Rebecca McKetin2, Maree Teesson2, Nicole Lee3, Robert Batey4, 1 University of Newcastle, Australia 2 National Drug and Alcohol Research Centre, University of NSW, Australia3 Turning Point Drug and Alcohol Centre, Melbourne, Australia4 Centre for Drug and Alcohol, NSW Health, Australia There is clear evidence to suggest that amphetamine use is common and increasing both in Australia and internationally, and has also been associated with increased psychological and social problems. An Australian study, found high rates of mood disorder among amphetamine users, with at least three quarters of the sample reporting symptoms of anxiety or depression. Depressive symptoms are higher among amphetamine users than cocaine and other drug users and depressive symptoms persist longer in amphetamine users compared to cocaine users. Despite this, very few treatment options exist that cater to the specific, cyclical and interactive nature of co-occurring mental health and amphetamine use problems. The net result is poorer outcomes, increased likelihood of psychiatric and amphetamine-related relapse, along with increased costs of care for the individual, families, services, etc. Significant research conducted previously by the members of this Symposium has attempted to develop a menu of cognitive behavioural treatment options for people with depression and AOD use comorbidity, including amphetamine use problems, with each treatment approach providing evidence for at least some benefit among the comorbid study participants. However, while encouraging, these results again raise the issue of how treatment may be incorporated into existing services (mental health, AOD use, primary care, etc.). A stepped care approach to treatment of comorbidity has been suggested as one model for the dissemination of such evidence-based treatments. Although stepped care approaches have received attention in recent commentaries within the research literature, almost no evidence exists to suggest how they might be implemented and evaluated in clinical practice. This paper will report on a pilot study of a stepped care approach to the treatment of amphetamine use and depression. The relationship between positive symptoms, impulsivity, and amphetamine use on aggressive behaviour. Kely Lapworth1, Sharon Dawe1, Penny Davis1, David Kavanagh2, 1 Griffith University, Australia; 2 The University of Queensland, Brisbane, Australia No abstract available

Symposium 72 Cannabis Use Disorders: Cross-cultural Trends in Epidemiology, Comorbidity and Treatment Development Convenor: Eva Hoch, Technische Universität Dresden, Germany, Germany From Epidemiological Evidence to Defining Priorities for Intervention in CUD Hans-Ulrich Wittchen & Silke Behrendt, Technische Universität Dresden, Germany There is an abundance of descriptive cross-sectional epidemiological studies that have highlighted that since the mid 80ies up to 50% of all adolescents have tried a cannabis product at least once in their life (lifetime users). There is also evidence that 20-45% of all lifetime users report a pattern of regular use for at least some time and that up to 10% of all lifetime users met criteria for cannabis use disorders. It is estimated that among 14-24 years olds about 5% of all adolescents meet lifetime criteria for either abuse or dependence. The prevalence of cannabis dependence is estimated to be 1.4% for the past 12 months and 3.1% for lifetime.Longitudinal studies have further started to describe the transitions from use to CUD also highlighting a wide range of variables that influence the probability of transitions from use to cannabis use disorders and vice versa from use to non use. Core variables that are associated with an unfavourable course are: access and availability, frequency and duration of use, concomitant use of other legal and illegal drugs, peer pressure, and preexisting as well as subsequent psychopathology (externalizing and internalizing disorders).In sharp contrast to these well established findings, the description of cannabis users needs for intervention remains incomplete. Although there is little doubt that there is a substantially increase in treatment demands among people with cannabis problems, the type and nature of their needs for intervention is unclear. The paper will present recent findings on problem profiles of cannabis users and those with cannabis disorders and will highlight to what degree community services are meeting the needs of these patients.This project was funded by the National Ministry for Education and Research. The Adolescent Cannabis Check-up Jan Copeland & Greg Martin, University of New South Wales, Australia Cannabis is the illicit drug most commonly used by adolescents in Europe, the US and Australia. There are, however, few interventions developed specifically for this group. This study assesses the efficacy of the Australian Adolescent Cannabis Check-up (ACCU); a brief intervention targeting non treatment-seeking adolescent cannabis users in a randomised controlled trial. The ACCU includes a single educational session for concerned parents; assessment and structured feedback sessions for young cannabis users. There were a total of 298 contacts to the study; 86 concerned parents and 126 young people were successfully screened and 40 young people randomised. The final three month follow-up rate was 80%. Data analyses showed significantly greater reductions in frequency of cannabis use and number of cannabis dependence symptoms reported for the participants in the active treatment group compared with the delayed treatment condition. Self-reported cannabis use in the preceding 30 days was validated by urinalysis. The intervention was acceptable to participants with a large majority rating the intervention as helpful and useful.This project was funded by the National Health and Medical Research Council. CANDIS- Targeted Treatment for Cannabis Disorders Eva Hoch, Heike Rohrbacher, René Noack & Jana Henker, Technische Universität Dresden, Germany In Europe the demand for treatment due to cannabis-related physical, mental, social, and legal problems has been rising in the past decade. Anyhow, there is still a considerably lack of treatment programs with established efficacy, that meet the specific poblems and needs of these patients. From January 2006 to March 2007 a randomized controlled intervention study was conducted at Dresden University, Germany. The three armes were 1.) a modular standardized treatment ST, including motivational enhancement, cognitive behavioural, and psychosocial problem solving components; 2.) a targeted standardized

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treatment, including the same components as the ST but being individually matched to the patients' specific problem profile; and (c) a delayed treatment control group. There were a total of 150 contacts to the study. 122 adolescents and adults participated at an information session, 102 subjects were successfully screened at baseline examination and 92 entered treatment. The majority of participantes were males, who used cannabis on a daily basis. Three out of four subjects met the criteria for cannabis abuse or cannabis dependence according to DSM-IV (last four weeks) (M-CIDI). Comorbid disorders were also frequent, especially affective disorders, anxiety disorders, alcohol dependence, nicotine dependence and dependence from illegal substances other than cannabis.CANDIS intervention was well accepted by patients and study therapists. Every second treatment completer (currently n=72) reported complete abstinence (self reports & urine sreenings), 33% reduced, 3% increased their cannabis use, 13% reported no change. This project was funded by the National Ministry for Research and Education.

Symposium 87 Mental Health and Substance Use Comorbidity: Innovative, Integrated CBT Treatments Convenor: Amanda Baker, Centre for Mental Health Studies, University of Newcastle, Australia, Australia A review of the evidence for the treatment of comorbid psychotic disorders and substance misuse problems David Kavanagh, The University of Queensland, Australia No abstract available Randomised controlled trial of computerised cognitive behaviour therapy for depression and substance use comorbidity Frances Kay-Lambkin1, 4, Amanda Baker, Brian Kelly, Terry Lewin1, Vaughan Carr1, 3., 1 The University of Newcastle, Australia; 2 The University of Queensland, Australia; 3 Neuroscience Institute for Schizophrenia and Allied Disorders;4 University of NSW, Australia; 5 Centre for Rural and Remote Mental Health, Orange, Australia This paper will report on the 12-month outcomes of the SHADE project (Self-Help for Alcohol/other drug use and DEpression), which offered integrated cognitive behaviour therapy to people with co-existing depression and alcohol and other drug (AOD) problems.Background: Despite the high co-occurrence of depression and AOD problems, an effective program of treatment is yet be developed and tested for people experiencing this comorbidity. In addition, access to psychological treatment for people with such co-existing problems is typically difficult. As such, it is important to focus efforts on developing treatments that not only target these problems, but that also address the important issue of treatment accessibility.Methods: 300 people with current depression and co-existing problematic use of alcohol, cannabis or amphetamines were recruited from the general community. Following a comprehensive assessment, participants received a one-session brief intervention, and were subsequently randomised to one of three treatment conditions: 9 sessions of SHADE therapy conducted by a psychologist, 9 sessions of SHADE therapy conducted via a therapist assisted computer program (CD-Rom), or 9 sessions of person-centre supported counselling. Blind follow-up interviews were conducted at post-treatment, 6- and 12-months.Results: Reductions in depression and AOD use were evident at the post-treatment assessment. Improvements were maintained at 6- and 12-months in the two active SHADE therapy conditions. Conclusions: People with co-existing depression and AOD use problems will attend a program of psychological treatment and report benefit from therapy that integrates depression and AOD-related strategies. Therapist assisted computerised treatment may help people to reduce levels of depression and AOD use. Further implications will be discussed. The Effectiveness of an Integrated CBT Intervention for Co-Occurring Depression and Substance Misuse in Young People: A Pilot Study Leanne Hides1, Dan I. Lubman1, Steve Carroll1 , Lisa Catania1, Frances Kay-Lambkin2, Amanda Baker2, & Nicholas Allen1, 1 University of Melbourne, Australia; 2 University of Newcastle, Australia Adolescents with a substance use disorder are at two to three times the risk of experiencing concurrent anxiety or mood disorders. Whilst there is a wellestablished evidence base for the use of CBT in the treatment of depression in young people, the majority of these studies exclude adolescents with drug and alcohol problems, despite increasing evidence for the efficacy of CBT for such problems amongst young people. More recently, there has been an emphasis on the need for more integrated approaches to the treatment of young people with co-existing depression and substance use problems, and preliminary evidence from two studies has reported positive outcomes for integrated CBT interventions for depression and alcohol dependence in adolescents. The aim of this study was to determine the effectiveness of an integrated cognitive behaviour therapy (CBT) intervention for co-occurring depression and substance misuse in young people.Methods: Participants consisted of 61 young people aged 15 to 25, with a major depressive disorder and concurrent substance misuse. Participants were provided with 10 sessions of CBT for co-occurring depression and substance misuse and case management over a maximum of 20 weeks. Partial or non-responders were provided with a randomised 10-week double-blind, placebo-controlled trial of sertraline.Results: Pre and post treatment and 6 month data on depressive and substance use symptoms will be presented. Preliminary results indicated positive outcomes on functioning and depression/anxiety symptoms but not substance use outcomes post treatment. Predictors of treatment response to the integrated CBT intervention at mid and post treatment will also be reported.Conclusions: Preliminary evidence from recently published pilot studies have demonstrated the efficacy of integrated CBT interventions in alcohol dependent adolescents with co-existing depression. The current paper reports preliminary support for the effectiveness of integrated treatment for depression and substance misuse amongst young people. Combined versus single focused interventions for co-morbid depression and alcohol problems: the DAISI project. Amanda Baker1, David Kavanagh2, Frances Kay-Lambkin1, Sally Hunt1, Terry Lewin1, Vaughan Carr1, 3, 1 The University of Newcastle, Australia; 2 The University of Queensland, Australia;3 Neuroscience Institute for Schizophrenia and Allied Disorders, Australia It has long been known that the co-morbidity of alcohol problems and depression is common, and that people experiencing these conditions concurrently have poorer treatment outcomes than those experienced by people with single disorders, resulting in greater use of services and medications. Despite this, effective evidenced-based treatments have yet to be developed and fully tested for this unique group. There is a need to explore interventions which acknowledge the co-morbidity and actively work to minimise the effect of both conditions. The DAISI study is one of the first to explore whether an intervention that integrates treatment for depression and alcohol would be superior in reducing alcohol use and symptoms of depression, when compared with a treatment that focuses on alcohol alone or depression alone. Participants will be randomly allocated to one of four treatment conditions which combine CBT and Motivational Interviewing strategies. The first three conditions offer 10 sessions which focus on a) depression; b) alcohol use; or c) integrated depression and alcohol focus. The remaining group will receive a single case formulation and assessment feedback session. Interim outcomes will be presented for a sub-sample, assessed prior to treatment, and again 3-months post initial assessment. It is predicted that this research will result in the development of an effective treatment program for people with alcohol and depressive disorders, and further, that the integrated CBT will produce greater, more sustainable reductions in both depressive and alcohol use outcomes relative to the other treatment conditions at the post-treatment follow-up assessments. Neuropsychological functioning in people with co-morbid depression and alcohol use. Sally Hunt1, Amanda Baker1, David Kavanagh2, Frances Kay-Lambkin1, 4, Terry Lewin1, Vaughan Carr1, 3., 1 The University of Newcastle, Australia; 2 The University of Queensland, Australia; 3 Neuroscience Institute for Schizophrenia and Allied Disorders;4 University of NSW, Australia As awareness of the complex needs of people with depression and alcohol use co-morbidity have increased, so too has the need to allocate clients to appropriate and effective treatments. Clinicians are often asked to predict whether a client will benefit from a psychological intervention such as Cognitive Behaviour Therapy (CBT) based on the client's level of cognitive functioning. Unfortunately, there is little empirical evidence for them to draw on in making this assessment, and therapeutic tools and strategies are often decided on after a process of trial and error. The DAISI study aims to clarify these issues by examining the neuropsychological profile of a sample of participants who are currently experiencing both depression and alcohol use above non-hazardous levels. Participants undergo neuropsychological testing prior to treatment, and again 12-months after baseline testing. Participants are randomly allocated to one of four treatments, the first three conditions offer 10 sessions of CBT and Motivational Interviewing (MI) which focus on a) depression; b) alcohol use; or c) integrated depression and alcohol focus. The remaining group will receive a single session of case formulation and assessment feedback. It is anticipated that the baseline neuropsychological test results will predict responsiveness to treatment and that the 12-month follow-up assessments will detect a relationship between change in cognitive functioning and change in symptom and/or alcohol use. Methodology and interim results will be discussed.

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Screening and integrated treatment of depression, anxiety and substance use disorders in a real world setting Nicole Lee, Jacqui Cameron, Tracey Brooke, Sandra Roeg, Turning Point Drug and Alcohol Centre, Melbourne, Australia Integrated treatment is now the recommended practice for patients with comorbid mental health and alcohol and drug disorders. Up to 80% of patients present to alcohol and drug services with mental health problems, primarily the higher prevalence disorders (anxiety and depression). Alcohol and drug workers do not always have extensive mental health experience and the focus of research and clinical programs is often on the more acute disorders, such as psychosis, meaning that few programs have been developed for this population. In order to provide truly integrated treatment, there is an urgent need to upskill alcohol and drug workers to both screen and intervene with both clinical and subclinical mental health disorders.The PsyCheck Project has proceeded in three phases: 1) the development of screening and intervention tools, 2) the evaluation of the implementation of mental health screening and cognitive behavioural intervention within a range of drug and alcohol settings, and 3) the best practice dissemination of the program. Each phase has undergone extensive evaluation. This presentation will overview the outcomes of Phases 1 and 2 and outline the dissemination strategy including early evaluation results.

Symposium 100 Delivering Alcoholism Treatment in Novel Ways: Challenges and Solutions Convenor: Peter Miller, Medical University of South Carolina, USA Computer based treatment documentation and feedback system for alcohol use disorders Gerhard Bühringer 1) 2)Johannes Lindenmeyer 3), 1) IFT Institut für Therapieforschung, Munich, Germany; 2) Technischen Universität, Dresden, Germany; 3) Salus Klinik, Lindow, Germany In Germany, the post-acute treatment of alcohol dependence is the responsibility of the Pension Insurance Scheme. About 28.800 cases are treated annually in inpatient centres; treatment standards are high and monitored by the funding agency. Aims: To describe (1) the video- and computer-based documentation system for all patient and treatment related information, (2) the utilisation by staff members and (3) the problems in the implementation period. Method: The intranet system covers the following components: (1) Standardised data collection of all relevant patient information during the total stay of 8-12 weeks. No further step in treatment is possible without the timely completion of all details. (2) Compiling a patient report after the 3rd day (history, test results, treatment targets). (3) Patient specific allocation of 45 possible treatment components, reaching from behaviour therapy programmes like stress management, to social or health related activities. The therapist "books" specific components in the system which helps the management to provide the necessary resources in time. (4) Access to relevant information by all staff members who are involved in the treatment of a specific patient. (5) Automatic creation of a final report for the funding agency. Conclusions: The system avoids traditional paper-based patient files, reduces time for staff meetings, improves the implementation of a highly individualised treatment programme, reduces the work for final responds and contributes to a quality assurance system. Problems in the implementation period had to be solved related to deficits of the staff to handle the system, and to find a balance between standardisation and individual freedom for the staff in the treatment process. Prevention of High-Risk Drinking among College Students: A Harm-Reduction Approach G. Alan Marlatt, University of Washington, USA Alcohol problems associated with high-risk drinking represent a leading health concern among college students. A variety of harmful consequences are reported, especially among students who engage in “binge drinking” (5 or more drinks on a single occasion for males, 4 or more for females), including blackouts, losing consciousness (“passing out”), sexual and aggressive problems, and in some cases, loss of life due to either injuries and accidents or alcohol overdose fatalities. Although abstinence is a legal requirement for underage drinkers (e.g., those under 21 years of age in the USA), the majority of students do engage in at least some alcohol consumption, with about 20% classified as frequent binge drinkers. Harm reduction is an alternative goal that may reduce the risks and harmful consequences of excessive drinking on college campuses. Two programs developed at the University of Washington (Seattle, USA) will be described: Alcohol Skills-Training Program, a six-session course that can be delivered in a group format, and BASICS (Brief Alcohol Screening and Intervention for College Students) that is designed to be delivered in two face-to-face interviews with a counselor trained in BASICS skills. Results from randomized clinical trials evaluating both programs will be presented, showing that the harm-reduction approach is associated with significant reductions in both consumption rates and negative consequences associated with drinking. Implementation of Screening and Brief Interventions for alcohol at a health systems level in Catalonia. Outcomes and pitfalls. Antoni Gual 1,2, Lidia Segura 1, Joan Colom 1, 1 Health Department, Government of Catalonia, Spain; 2 Neurosciences Institute, IDIBAPS. Barcelona, Spain There is consistent evidence on the efficacy of Screening and Brief Interventions (SBI) to identify hazardous drinkers and to reduce their consumption. Yet, dissemination of SBI at a population level has proven to be difficult. In the frame of the WHO Collaborative Study on Alcohol and Primary Health Care (PHC) we undertook the dissemination of SBI to all PHC centres, targeting 340 Centres that provide health care to the population of Catalonia (7.000.000 inhabitants).Aim: To evaluate if a training package (5 hours) based on the Skills for Change Module (WHO) improved knowledge, attitudes and clinical performance of PHC professionals concerning alcohol.Methods: A representative sample of the Centres (n=28) was randomly selected. Data on knowledge, attitudes and clinical behaviour were obtained before and 3 months after training through 3 different sources: interviews to professionals, audit of medical records and exit-poll interviews to patients.Results: The training package was highly valued by both trainers and trainees, and more than 80% of professionals attended at least 4 out of 5 sessions. Training increased the knowledge of PHC professionals and improved their willingness to treat alcohol problems (from 62,5% to 84,7%; p 15 sessions). Eleven subjects dropped out. The primary efficacy assessment is

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symptomatic and functional status in the 12-month-follow-up period (e.g. SCID I).Results: Prior analyses showed that at the 3- and 6-month follow-up there were no significant differences in relapse rates between treatment conditions. The question remains if CBT is superior to ST if one looks at the 12-month follow-up.. These results will be presented. Preventing relapse using diverse combinations with new forms of cognitive therapy in remitted recurrently depressed patients. Dr Claudi Bockting (The Netherlands):, No abstract available

Symposium 155 Treatment-resistant depression Convenor: Pétur Hauksson, Reykjalundur Rehabilitation Centre, Iceland Comparison of Individual and Group Cognitive Behaviour Therapy and Rehabilitation for Treatment-resistant Depression Pétur Hauksson, Sylvía Ingibergsdóttir, Thorunn Gunnarsdóttir, Inga Hrefna Jónsdóttir., Reykjalundur Rehabilitation Centre, Iceland Depressed patients do not all respond sufficiently to conventional therapy. Medication, psychotherapy or inpatient treatment do not allways sufficiently ameliorate the symptoms and consequences of depression. This lack of response puts a long-term burden on both the individual, family and society. Data will be presented on the results of individual and group CBT and control treatment for 204 patients with depressive disorder who had not responded to a full course of conventional therapy. They were all admitted to a rehabilitation centre and received 6 weeks of in-patient treatment, offering a wide range of treatment options, including supportive therapy or counselling as needed, individualised physical training and a progressive behaviour-modification programme. In addition, they were randomly allocated to individual, group or no CBT. CBT was provided by a multidisciplinary team. There was a 1 and 2year follow-up. CBT was manual-based, the same manual being used for individual and group therapy. There were 12 sessions, 2 per week. Group sessions were 90 minutes, individual sessions 50 minutes. Groups had 12-15 participants and 2 therapists. Results indicated that individual CBT was superior to group CBT and control treatment. Group CBT, however, was not statistically superior to control treatment and thus did not add significantly to the relatively intensive and programmed inpatient treatment at a rehabilitation establishment, although individual CBT did. Limitations are the large and diverse groups and incomplete randomization. The importance of the therapeutic relationship formed in individual CBT is evident, especially as regards decreasing hopelessness and automatic thoughts. Cognitive Behaviour Group Therapy for Depressed Inpatients: Outcome Related to Comorbidity. Inga Hrefna Jónsdóttir, Sylvía Ingibergsdóttir, Thórunn Gunnarsdóttir, Pétur Hauksson, Reykjalundur Rehabilitation Centre, Iceland Depression resistant to treatment is a persistent problem for many patients suffering from medical and psychiatric conditions. Cognitive behaviour group therapy is a cost-effective choice to be considered in an inpatient setting as well as for outpatients. To be able to choose effectively who will benefit most from a CBT group therapy versus individual therapy, it can be useful to look into the comorbidity of depression. Cognitive behaviour therapy has wellestablished efficacy for depression but less is known about its efficacy for chronic or treatment-resistant depression with psychiatric comorbidity. In the current study, inpatients at a rehabilitation centre, meeting full criteria for major depression, either received CBT in groups or individually. The treatment included 12 sessions of manual-based CBT, delivered by an interdisciplinary team of therapists trained in CBT; psychologists, psychiatrists, nurses, social workers and occupational therapists. All the patients also received conventional interdisciplinary rehabilitation treatment-as-usual for 6 weeks including supportive therapy/counselling, physical endurance and fitness training, psycho-education, and physical- and occupational therapy. Outcome measures were analysed at the start of treatment and at the end, after six weeks of rehabilitation. Follow-up was at one and two years. Preliminary results suggest a high rate of comorbidity in this sample. In an effort to examine the relationship between depression and multiple comorbidity, the pattern of comorbidity and outcome will be studied and compared to outcome data obtained from group versus individual CBT treatment. The treatment implication of these results will be discussed. Effect of Cognitive Behavioural Therapy on Hopelessness in Depressed Patients Rósa M. Gudmundsdóttir, Marga Thome, Pétur Hauksson, Reykjalundur Rehabilitation Centre. University of Iceland, Iceland There is scarce evidence on the effects of cognitive behavioural therapy (CBT) on hopelessness in depressed patients, despite a well established link between hopelessness and suicidal behaviour. The study was carried out in an open-ward rehabilitation institute offering a wide range of treatment options and training, individualised for each patient. CBT was provided by a multidisciplinary team. The purpose of this study is to evaluate the effect of individual and group CTB on hopelessness in patients who have a history of treatment-resistant depression. After obtaining informed consent, a sample of inpatients (n= 170) was allocated randomly to three treatment modalities: 1) individual CBT , 2) group CBT and 3) control: usual rehabilitation. The Icelandic version of Beck´s Hopelessness Scale (BHS) was filled in before and after treatment. Demographic information was obtained from patients' records. Results showed that the majority of patients (71%) were moderately to severely hopeless (M = 12,06, SD = 5,53). The number of diagnoses had a significant effect on the severity of hopelessness. A significant association was found between the severity of hopelessness and age, r = -0,239, p