Supplemental Materials for “What accounts for poor functioning in people with schizophrenia: a re-evaluation of the contributions of neurocognitive v. attitudinal and motivational factors” paper. For a look at the paper, click here

Evidence Supporting Tests of Neurocognitive Deficits

For the purposes of this review, we will focus on findings from the two test batteries that have been used most widely worldwide: Gur and colleagues’ Penn Computerized Neurocognitive Battery [CNB] (Gur et al., 2001) and the Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery (MCCB) (Kern, Green, Nuechterlein, & Deng, 2004). The CNB and MCCB are based on reliable and valid tests used to study brain damage (Heinrichs, 2001). The CNB assesses the domains of executive functioning, attention, word memory, facial memory, spatial memory, language, spatial abilities, and sensory-motor abilities (Gur et al., 2001; Gur et al., 2010), while the MCCB measures processing speed, attention, and vigilance, working memory, verbal learning and memory, visual learning and memory, reasoning and problem solving, and social cognition (Schulz & Murray, 2016). These domains have traditionally been identified in schizophrenia, dating back to Kraepelin and Bleuler.

Psychometric Properties of the MCCB and CNB

Reliability. The CNB demonstrates adequate internal consistency (Cronbach’s alphas are usually between 0.70 and 0.90 across studies) and comparable results from separate samples (Swagerman et al., 2016). Similarly, the MCCB exhibits adequate internal consistency (Cronbach’s alpha between 0.70 and 0.90; Kaneda et al., 2013), moderate to strong intercorrelations between the individual domains (August, Kiwanuka, McMahon, & Gold, 2012), and high test-retest reliability (r values greater than 0.70; Green, Harris, & Nuechterlein, 2014).

Convergent validity. The CNB correlates with traditional measures of neurocognition (Gur et al., 2001). The MCCB correlates with the IntegNeuro Test, a highly reliable and validated computerized neurocognitive test (Silverstein et al., 2010).

Criterion validity. The CNB is sensitive to key demographic variables linked with neurocognitive differences, including age and gender (Gur et al., 2001; Gur et al., 2010; Swagerman et al., 2016). Further, the CNB differentiates between individuals with schizophrenia, unaffected relatives, and healthy controls (Gur et al., 2007). Additionally, the test correlates with premorbid adjustment, age of illness onset, illness duration, quality of life, and symptom severity (Grant & Beck, 2009). The MCCB also demonstrates criterion validity, as it correlates with responsiveness to treatments such as cognitive remediation, neuroplasticity-based auditory training, and antipsychotic medication (Green et al., 2014).

Predictive validity. Scores on the CNB correlate with patient and parental education levels (Gur et al., 2010; Swagerman et al., 2016), while scores on the MCCB are associated with education level and employment status (August et al., 2012; Lystad et al., 2014). MCCB performance correlates with community functioning cross-sectionally and longitudinally (Bryson & Bell, 2003; Shamsi et al., 2011). The MCCB performance correlates with self-rated social functioning (Lystad et al., 2014), clinical ratings of social functioning (Shamsi et al., 2011), and social problem solving abilities (Quinlan, Roesch, & Granholm, 2014). Finally, meta-analyses indicate that performance on domains measured by the batteries is associated with functional outcomes (Heinrichs, 2001; Green, Kern, & Heaton, 2004).

Additionally, scores on the CNB and MCCB can predict conversion to psychosis. Individuals with psychosis spectrum disorders showed greater neurocognitive developmental lag on the CNB than individuals with subthreshold psychotic symptoms, detectable as early as age 8 (Gur et al. 2014). Similarly, at-risk individuals who later transitioned to a psychotic disorder exhibited poorer performance on the MCCB than controls and at-risk individuals who did not transition (Seidman et al., 2016). In another recent study, individuals in an at-risk mental state for psychosis performed significantly worse on the MCCB compared to controls (Eisenacher et al., 2016).

 References

August, S. M., Kiwanuka, J. N., McMahon, R. P., & Gold, J. M. (2012). The MATRICS

Consensus Cognitive Battery (MCCB): clinical and cognitive correlates. Schizophrenia Research, 134, 76-82. http://dx.doi.org/10.1016/j.schres.2011.10.015

Bryson, G., & Bell, M. D. (2003). Initial and final work performance in schizophrenia: cognitive

and symptom predictors. The Journal of Nervous and Mental Disease, 191, 87-92. Retrieved from http://journals.lww.com/jonmd/Pages/default.aspx

Eisenacher, S., Rausch, F., Ainser, F., Englisch, S., Becker, A., Mier, D., . . . Zink, M. (2016). Early cognitive basic symptoms are accompanied by neurocognitive impairment in patients with an ‘at-risk mental state’ for psychosis. Early Intervention Psychiatry. doi:10.1111/eip.12350

Grant, P. M., & Beck, A. T. (2009). Defeatist beliefs as a mediator of cognitive impairment, negative symptoms, and functioning in schizophrenia. Schizophrenia Bulletin, 35, 798-806. https://doi.org/10.1093/schbul/sbn008

Green, M. F., Harris, J. G., & Nuechterlein, K. H. (2014). The MATRICS consensus cognitive battery: what we know 6 years later. American Journal of Psychiatry, 171, 1151-1154. http://dx.doi.org/10.1176/appi.ajp.2014.14070936

Green, M. F., Kern, R. S., & Heaton, R. K. (2004). Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophrenia Research, 72, 41-51. http://dx.doi.org/10.1016/j.schres.2004.09.009

Gur, R. C., Calkins, M. E., Satterthwaite, T. D., Ruparel, K., Bilker, W. B., Moore, T. M., … & Gur, R. E. (2014). Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry, 71, 366-374. http://dx.doi.org/10.1001/jamapsychiatry.2013.4190

Gur, R. E., Nimgaonkar, V. L., Almasy, L., Calkins, M. E., Ragland, J. D., Pogue-Geile, M. F.,… & Gur, R. C. (2007). Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. American Journal of Psychiatry, 164, 813-819. http://dx.doi.org/10.1176/ajp.2007.164.5.813

Gur, R. C., Ragland, J. D., Moberg, P. J., Turner, T. H., Bilker, W. B., Kohler, C., … & Gur, R. (2001). Computerized neurocognitive scanning: I. Methodology and validation in healthy people. Neuropsychopharmacology, 25, 766-776.  http://dx.doi.org/10.1016/S0893-133X(01)00278-0

Gur, R. C., Richard, J., Hughett, P., Calkins, M. E., Macy, L., Bilker, W. B., … & Gur, R. E. (2010). A cognitive neuroscience-based computerized battery for efficient measurement of individual differences: standardization and initial construct validation. Journal of Neuroscience Methods, 187(2), 254-262.  http://dx.doi.org/10.1016/j.jneumeth.2009.11.017

Heinrichs, R. W. (2001). In search of madness: Schizophrenia and neuroscience. New York:Oxford University Press.

Kaneda, Y., Ohmori, T., Okahisa, Y., Sumiyoshi, T., Pu, S., Ueoka, Y., … & Sora, I. (2013). Measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery: validation of the Japanese version. Psychiatry and Clinical Neurosciences, 67, 182-188. http://dx.doi.org/10.1111/pcn.12029

Kern, R. S., Green, M. F., Nuechterlein, K. H., & Deng, B. H. (2004). NIMH-MATRICS survey on assessment of neurocognition in schizophrenia. Schizophrenia Research, 72, 11-19. http://dx.doi.org/10.1016/j.schres.2004.09.004

Lystad, J. U., Falkum, E., Mohn, C., Haaland, V. Ø., Bull, H., Evensen, S., … & Ueland, T. (2014). The MATRICS Consensus Cognitive Battery (MCCB): performance and functional correlates. Psychiatry Research, 220(3), 1094-1101. http://dx.doi.org/10.1016/j.psychres.2014.08.060

Quinlan, T., Roesch, S., & Granholm, E. (2014). The role of dysfunctional attitudes in models of negative symptoms and functioning in schizophrenia. Schizophrenia Research, 157, 182-189. http://dx.doi.org/10.1016/j.schres.2014.05.025

Schulz, S. C., & Murray, A. (2016). Assessing Cognitive Impairment in Patients With Schizophrenia. The Journal of Clinical Psychiatry, 77(Suppl. 2), 3-7. http://dx.doi.org/10.4088/JCP.14074su1c.01

Seidman, L. J., Shapiro, D. I., Stone, W. S., Woodberry, K. A., Ronzio, A., Cornblatt, B. A., … & Mathalon, D. H. (2016). Association of neurocognition with transition to psychosis: baseline functioning in the second phase of the North American Prodrome Longitudinal Study. JAMA Psychiatry, 73, 1239-1248. http://dx.doi.org/10.1001/jamapsychiatry.2016.2479

Shamsi, S., Lau, A., Lencz, T., Burdick, K. E., DeRosse, P., Brenner, R., … & Malhotra, A. K. (2011). Cognitive and symptomatic predictors of functional disability in schizophrenia. Schizophrenia Research, 126, 257-264. http://dx.doi.org/10.1016/j.schres.2010.08.007

Silverstein, S. M., Jaeger, J., Donovan-Lepore, A. M., Wilkniss, S. M., Savitz, A., Malinovsky, I., … & Zukin, S. R. (2010). A comparative study of the MATRICS and IntegNeuro cognitive assessment batteries. Journal of Clinical and Experimental Neuropsychology, 32, 937-952. http://dx.doi.org/10.1080/13803391003596496

Swagerman, S. C., de Geus, E. J., Kan, K. J., van Bergen, E., Nieuwboer, H. A., Koenis, M. M., … & Boomsma, D. I. (2016). The Computerized Neurocognitive Battery: Validation, aging effects, and heritability across cognitive domains. Neuropsychology, 30, 53-64. http://dx.doi.org/10.1037/neu0000248

Drs Beck and Grant give keynote address at NASMHPD

Drs Beck and Grant presented on recovery-oriented cognitive therapy at the National Association of State Mental Health Program Directors (NASMHPD) Annual Meeting on Sunday, July 30th, in Washington DC. Dr. Beck appeared via a pre-recorded video. See below to view the video

FELLOWSHIPS IN ADVANCED COGNITIVE THERAPY FOR SCHIZOPHRENIA WITH AARON T. BECK

We offer an exciting opportunity for postdoctoral applicants in the Aaron T. Beck Psychopathology Research Center at the University of Pennsylvania. Specifically, our mission is to develop professionals who will become leaders in the field of psychosocial approaches that promote recovery for individuals with schizophrenia. Under the direction of Aaron T. Beck, M.D., our program includes clinical trials of innovative treatments for the disorder, dissemination, and implementation of these treatment protocols into community mental health centers and psychiatric hospitals, as well as basic research. We have been recognized for our cutting-edge work in this field.

Applicants who have earned a Ph.D., Psy.D., or equivalent in psychology,  social work, medicine or other related field and have had previous training in cognitive therapy, severe mental illness, or recovery-oriented services are encouraged to apply. Bilingual candidates are especially encouraged to apply.

Please send a curriculum vitae with a cover letter and two letters of recommendation via email to Aaron T. Beck, M.D., at abeck@pennmedicine.upenn.edu by January 1st, 2018.

NOTES: 2 openings

Dr. Aaron T. Beck Speaks at Georgia State University

Dr. Aaron T. Beck made a special video appearance at the Georgia Beck Initiative Panel discussion. The event was put together to create an opportunity to discuss the current efforts in Georgia to build the capacity of community providers in addressing the needs of individuals with severe and persistent mental illness using Recovery-Oriented Cognitive Therapy.

Disclaimer: The cases discussed in this video are loosely based on actual cases and do not relate to any specific patients or contain any protected health information.

Dr. Aaron T. Beck speaks at 22nd Annual Rosalynn Carter Forum

 

Dr. Aaron T. Beck makes a special video appearance discussing the treatment of schizophrenia at the 22nd Annual Rosalynn Carter Georgia Mental Health Forum. The Carter Forum was established in 1995 and is held each May to address mental health policy issues facing the state of Georgia. Dr. Paul M. Grant was in attendance and presented on the continuing successful efforts to implement Recovery-Oriented Cognitive Therapy state-wide. This initiative empowers mental health providers to partner with individuals with severe mental illness to remain, participate, and flourish in the community.

 

The Aaron Beck Center Continues to have a Productive Year!!

Below find a list of peer-reviewed and non-peer-reviewed publications for 2016 into 2017 from our Center.

 Peer-Reviewed

  • Adler, A., Bush, A., Weissinger, G., Barg, F. K., Beck, A. T., & Brown, G. K. (2016). A mixed methods approach to identify cognitive warning signs of suicide attempts. Archives of Suicide Research, 20, 528-538, doi: 10.1080/13811118.2015.1136717.
  • Beck, A. T., & Bredemeier, K. (2016). A unified model of depression: Integrating clinical, cognitive, biological, and evolutionary perspectives. Clinical Psychological Science, 4(4), 596-619.
  • Bredemeier, K., Warren, S.L., Berenbaum, H., Miller, G.A., & Heller, W. (2016). Executive functioning deficits associated with current and past depressive symptoms. Journal of Affective Disorders, 204, 226-233. doi:10.1016/j.jad.2016.03.070
  • Boudreaux, E. D., Brown, G. K., Stanley, B., Sadasivam, R. S., Camargo, C. A., & Miller, I. W. (in press). Computer administered safety planning for individuals at risk for suicide: Development and usability testing. Journal of Medical Internet Research. doi:10.2196/jmir.6816.
  • Brown, G.K., Karlin, B.E., Trockel, M., Gordienko, M., & Taylor, B.C. (2016). Effectiveness of cognitive behavioral therapy for Veterans with depression and suicidal ideation. Archives of Suicide Research, 20, 677-682. doi: 10.1080/13811118.2016.1162238.
  • Brown, G.K., Thase, M.E., Vittengl, J.R., Borman, P.D., Clark, L.A., & Jarrett, R.B. (2016). Assessing skills comprehension, acquisition, and use with the Independent Observer Version of the Skills of Cognitive Therapy (SoCT) scale. Psychological Assessment, 28, 205-213. doi: 10.1037/pas0000080.
  • Buitron, V., Hill, R. M., Pettit, J. W., Green, K. L., Hatkevich, C., and Sharp, C. (2016). Interpersonal stress and suicidal ideation in adolescence: An indirect association through perceived burdensomeness toward others. Journal of Affective Disorders, 190, 143-149.
  • Chesin, M., Stanley, B., Haigh, E. A., Chaudhury, S.R., Pontoski, K., Knox, K. L., & Brown, G. K. (2017). Staff views of an emergency department intervention using safety planning and structured follow-up with suicidal veterans. Archives of Suicide Research, 21, 127-137. doi: 10.1080/13811118.2016.1164642.
  • Creed, T.A., Frankel, S.A., German, R., Green, K.L., Jager-Hyman, S., Pontoski, K., Adler, A., Wolk, C.B., Stirman, S.W., Waltman, S.H., Williston, M.A., Sherrill, R., Evans, A.C., & Beck. A.T. (2016). Implementation of transdiagnostic cognitive therapy in diverse community settings: The Beck Community Initiative. Journal of Consulting and Clinical Psychology, 84, 1116-1126. http://dx.doi.org/10.1037/ccp0000105.
  • Creed, T.A., Benjamin, C., Feinberg, B., Evans, A.C., & Beck, A.T. (2016). Beyond the Label: Relationship between community therapists’ self-report of a cognitive-behavioral therapy orientation and observed skills. Administration and Policy in Mental Health Services Research, 43, 36-43. doi 10.1007/s10488-014-0618-5.
  • Creed TA, Wolk CB, Feinberg B, Evans AC, Beck AT. (2016) Beyond the label: Relationship between community therapists’ self-repof of a cognitive behavioral therapy orientation and observed skills, Administration and Policy in Mental Health, 43, 36-43. doi: 10.1007/s10488-014-0618-5.
  • Ellis, T. E., Rufino, K. A., & Green, K. L. (2016). Implicit measure of life/death orientation predicts response of suicidal ideation to treatment in psychiatric inpatients. Archives of Suicide Research, 20, 59-68.
  • Grant, P. M., Bredemeier, K., & Beck, A. T. (In press). 6-month follow-up of recovery-oriented cognitive therapy for low functioning schizophrenia: Sustained gains and delayed response for more chronic cases. Psychiatric Services.
  • Green, K., Brown, G. K., & Jager-Hyman, S. (2016). Reply to Large and Ryan: Clinicians should not adopt a single self-reported item as a screener for suicide. Journal of Clinical Psychiatry, 77, 1087-1088.
  • Jenness, J., Jager-Hyman, S., Heleniak, C., Beck, A. T., Sheridan, M. A., & McLaughlin, K. A. (2016). Catastrophizing, rumination, and reappraisal prospectively predict adolescent PTSD symptom onset following a terrorist attack. Depression and Anxiety. doi: 10.1002/da.22548.
  • Kleiman, E. M., Chiara, A. M., Liu, R. T., Jager-Hyman, S., Choi, J. Y., & Alloy, L. B. (2017). Optimism and well-being: A prospective multi-method and multi-dimensional examination of optimism as a resilience factor following the occurrence of stressful life events. Cognition and Emotion, 31, 269-283.
  • Landa Y., Mueser K. T., Wyka K.E., Shreck E., Jespersen R., Jacobs M. A., Griffin K. W., van der Gaag M., Reyna V. F., Beck A. T., Silbersweig D.A., & Walkup J.T. (2016). Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. Early Intervention in Psychiatry, 10, 511-521. doi: 10.1111/eip.12204.
  • Lewis-Hatheway, F., & Eubanks, C. (2016). The impact of a mindfulness intervention on burnout levels in direct care staff. Psychotherapy Bulletin, 51, 27-34.
  • Perlis, M. L., Grandner, M. A., Brown, G. K., Basner, M., Chakravorty, S., Morales, K. H., Gehrman, P. R., Chaudhary, N. S., Thase, M. E., Dinges, D. F. (2016). Nocturnal wakefulness as a previously unrecognized risk factor for suicide. The Journal of Clinical Psychiatry. 77, 726-733. doi: 10.4088/JCP.15m10131
  • Perlis, M. S., Grandner, M. A., Chakravorty, S., Bernert, R. A., Brown, G. K., & Thase, M. E. (2016). Suicide and sleep: Is it a bad thing to be awake when reason sleeps? Sleep Medicine Reviews, 29, 101-107. doi: 10.1016/j.smrv.2015.10.003
  • Pontoski, K., Jager-Hyman, S., Cunningham, A., Sposato, R., Schultz, L., Evans, A. C., Beck, A. T., & Creed, T. A. (2016). Using a Cognitive Behavioral framework to train staff serving individuals who experience chronic homelessness. Journal of Community Psychology, 44, 674-680.
  • Riggs, S. & Creed, T.A. (2016) A model to transform treatment for psychosis using CBT informed interventions for the mental health milieu. Cognitive and Behavioral Practice. http://dx.doi.org/10.1016/j.cbpra.2016.08.001.
  • Rosenbaum, D.L., Schumacher, L.M., Schaumberg, K., Piers, A.D., Gaspar, M., Lowe, M.R., Forman, E.M., & Butryn, M.L. (2016). Energy intake highs and lows: How much does consistency matter in weight control? Clinical Obesity, 6, 193-201. doi: 10.1111/cob.12142.
  • Rosenbaum, D.L. & White, K.S. (2016). Does cognitive avoidance mediate the relation of anxiety and binge eating? Eating and Weight Disorders. doi:10.1007/s40519-016-0284-6.
  • Rosenbaum, D.L., Kimerling, R., Pomernacki, A., Goldstein, K.M., Yano, E.M., Sadler, A.G., Carney, D., Bastian, L.A., Bean-Mayberry, B.A., & Frayne, S.M. (2016). Binge eating among women veterans in primary care: Comorbidities and treatment priorities. Women’s Health Issues. doi: 10.1016/j.whi.2016.02.004.
  • Rosenbaum, D.L. & White, K.S. (2016). Understanding the complexity of biopsychosocial factors in the public health epidemic of overweight and obesity. Health Psychology Open, 3, 1-4. doi: 10.1177/2055102916634364.
  • Rosenbaum, D. L., Piers, A. P., Schumacher, L. M., & Butryn, M. L. (in press). Racial and ethnic minority enrollment in randomized clinical trials of behavioral weight loss utilizing technology: A systematic review. Obesity Reviews.
  • Schaumberg, K., Schumacher, L. M., Rosenbaum, D. L., Kase, C. A., Piers, A. D., Lowe, M. R., Forman, E. M., & Butryn, M. L. (2016). The role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibition. Eating Behaviors, 21, 129–134. doi:10.1016/j.eatbeh.2016.01.003.
  • Smith, T. L., Landes, S. J., Lester-Williams, K., Day, K. T., Batdorf, W., Brown, G. K., Trockel, M., Smith, B. N., Chard, K. M., Healy, E. T., & Weingardt, K. R. (in press). Developing alternative training delivery methods to improve psychotherapy implementation in the U.S. Department of Veterans Affairs. Training and Education in Professional Psychology.
  • Stanley B., Chaudhury, S. R., Chesin, M., Pontoski, K., Bush, A. M., Knox, K. L., & Brown, G. K. (2016). An emergency department intervention and follow-up to reduce suicide risk in the VA: Acceptability and effectiveness. Psychiatric Services, 67, 680-683. doi: 10.1176/appi.ps.201500082.
  • Stirman, S. W, Pontoski, K., Creed, T., Xhezo, R., Evans, A. C., Beck, A.T., & Crits-Christoph, P. (2017). A non-randomized comparison of strategies for consultation in a community-academic training program to implement an evidence-based psychotherapy. Administration Policy in Mental Health, 44, 55-66. doi: 10.1007/s10488-015-0700-7.
  • Talkovsky, A. M., Green, K. L., Osegueda, A., & Norton, P. J. (2017). Secondary depression in transdiagnostic group cognitive behavioral therapy among individuals diagnosed with anxiety disorders. Journal of Anxiety Disorders, 46, 56-64.
  • Thomas, E. C., Luther, L., Zullo, L., Beck, A. T., & Grant P. M, (2017). From neurocognition to community participation in serious mental illness: the intermediary role of dysfunctional attitudes and motivation. Psychological Medicine, 47, 822-836. doi: 10.1017/S0033291716003019.
  • Waltman, S. H., Creed, T. A., & Beck. A. T. (2016). Are the effects of cognitive therapy for depression falling? Review and critique of the evidence. Clinical Psychology: Science and Practice, 23, 113-122.
  • Waltman, S.H., Hall, B., McFarr, L., Beck, A.T., & Creed, T.A. (2016). In-session stuck points and pitfalls of community clinicians learning CBT: A qualitative investigation. Cognitive and Behavioral Practice. doi:10.1016/j.cbpra.2016.04.002.

 

Non-Peer Reviewed

  • Brown, G. K., & Karlin, B. E. (2017). Cognitive Behavioral Therapy for depression: A manual for Kaiser Permanente therapists. Waltham, MA: Education Development Center, Inc.
  • Brown, G. K., & Karlin, B. E. (2017). Cognitive Behavioral Therapy for depression: A manual for Kaiser Permanente training consultants. Waltham, MA: Education Development Center, Inc.
  • Chang, N. A., Jager-Hyman, S., Brown, G. K., Cunningham, A., & Stanley, B. (in press). Treating the suicidal patient: Cognitive Behaviroal Therapy and Dialectival Behavior Therapy. In O’Connor, R. C., Platt, S. & Gordon, J. (Eds.), International handbook of suicide prevention: Research, policy and practice (Second Edition). West Sussex, UK: Wiley & Sons.
  • Creed, T. (2016). Increasing access to high-fidelity Cognitive Therapy for underserved populations. American Psychological Association Division 12: Society of Clinical Psychology Clinical Bulletin. Retrieved from gra/
  • Creed, T.A. (February, 2017). Children’s Emotional Buckets: The Power of Positive Interactions. Cognitive Therapy Today.
  • Creed, T.A. & Waltman, S. H. Therapeutic alliance. (in press). In A. Wenzel (Ed.), The SAGE Encyclopedia of Abnormal and Clinical Psychology. Thousand Oaks, CA: SAGE.
  • Jager-Hyman, S., & Brown, G. K. (in press). Psychosocial treatment for suicide prevention. In A. Wenzel (Ed.), SAGE Encyclopedia of Abnormal and Clinical Psychology. New York: SAGE.
  • Waltman, S. H., Frankel, S. A., & Williston, M. A. (2016). Improving clinician self-awareness and increasing accurate representation of clinical competencies. Practice Innovations.
  • Wright, J. H., Thase, M. E., Bosco, M. R. & Brown, G. K. (2017). Learning Cognitive-Behavioral Therapy: An Illustrated Guide, Second Edition. Washington, DC: American Psychiatric Association Publishing.
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