Description and Demonstration of Cognitive Behavioral Therapy to Enhance Antiretroviral Therapy Adherence and Treat Depression in HIV-Infected Adults

Michael E. Newcomb; C. Andres Bedoya; Aaron J. Blashill; Jonathan A. Lerner; Conall O'Cleirigh; Megan M. Pinkston; Steven A. Safren

doi:10.1016/j.cbpra.2014.02.001

Description and Demonstration of Cognitive Behavioral Therapy to Enhance Antiretroviral Therapy Adherence and Treat Depression in HIV-Infected Adults

Michael E. Newcomb^*, C. Andres Bedoya, Aaron J. Blashill, Jonathan A. Lerner, Conall O'Cleirigh, Megan M. Pinkston, Steven A. Safren

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Furthermore, depression has been found to be associated with nonadherence to antiretroviral therapy (ART), as well as HIV disease progression. Cognitive behavioral therapy (CBT) has repeatedly been found to effectively treat depression in adult populations, and CBT for adherence and depression (CBT-AD) is an effective treatment for improving depressive symptoms and medication adherence in the context of various chronic health conditions, including diabetes and HIV-infection. This paper provides a description of the CBT-AD approach to treat depression and ART adherence in HIV-infected adults, which we have developed and tested in our clinic, and for which detailed therapist and client guides exist. To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment, including Life-Steps for medication adherence, orientation to CBT-AD and psychoeducation, and suggestions for adaptation of core CBT modules for HIV-infected adults. Discussion of video demonstrations highlights differences in patient presentations and course of treatment between HIV-infected adults receiving CBT-AD and HIV-uninfected adults receiving traditional CBT for depression. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.

Original language	English (US)
Pages (from-to)	430-438
Number of pages	9
Journal	Cognitive and Behavioral Practice
Volume	22
Issue number	4
DOIs	https://doi.org/10.1016/j.cbpra.2014.02.001
State	Published - Nov 2015

Keywords

Cognitive behavioral therapy
Depression
HIV/AIDS
Medication adherence

ASJC Scopus subject areas

Clinical Psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.cbpra.2014.02.001

Cite this

@article{00872d1b5f654869825ec85da23ce055,

title = "Description and Demonstration of Cognitive Behavioral Therapy to Enhance Antiretroviral Therapy Adherence and Treat Depression in HIV-Infected Adults",

abstract = "There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Furthermore, depression has been found to be associated with nonadherence to antiretroviral therapy (ART), as well as HIV disease progression. Cognitive behavioral therapy (CBT) has repeatedly been found to effectively treat depression in adult populations, and CBT for adherence and depression (CBT-AD) is an effective treatment for improving depressive symptoms and medication adherence in the context of various chronic health conditions, including diabetes and HIV-infection. This paper provides a description of the CBT-AD approach to treat depression and ART adherence in HIV-infected adults, which we have developed and tested in our clinic, and for which detailed therapist and client guides exist. To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment, including Life-Steps for medication adherence, orientation to CBT-AD and psychoeducation, and suggestions for adaptation of core CBT modules for HIV-infected adults. Discussion of video demonstrations highlights differences in patient presentations and course of treatment between HIV-infected adults receiving CBT-AD and HIV-uninfected adults receiving traditional CBT for depression. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.",

keywords = "Cognitive behavioral therapy, Depression, HIV/AIDS, Medication adherence",

author = "Newcomb, {Michael E.} and Bedoya, {C. Andres} and Blashill, {Aaron J.} and Lerner, {Jonathan A.} and Conall O'Cleirigh and Pinkston, {Megan M.} and Safren, {Steven A.}",

note = "Funding Information: Funding for creation of the video role-plays came from a grant from the National Institute of Mental Health ( R01MH084757 ; PI: Safren). During the preparation of this manuscript, Steven A. Safren was supported by a career development award from the National Institute of Mental Health ( K24MH094214 ; PI: Safren), and Aaron J. Blashill was supported by a career development award from the National Institute of Mental Health ( K23MH096647 ; PI: Blashill). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health. We acknowledge the important contributions of all study therapists on the trial from which this manuscript was based (in alphabetical order): C. Andres Bedoya, Aaron J. Blashill, Adam Gonzalez, Mark L. Hatzenbuehler, Ellen S. Hendriksen, Laura E. Knouse, Allison K. Labbe, Jonathan A. Lerner, Michael E. Newcomb, Megan M. Pinkston, Christina Psaros, Kelly Smith, and Lara Traeger. Publisher Copyright: {\textcopyright} 2014.",

year = "2015",

month = nov,

doi = "10.1016/j.cbpra.2014.02.001",

language = "English (US)",

volume = "22",

pages = "430--438",

journal = "Cognitive and Behavioral Practice",

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AU - Newcomb, Michael E.

AU - Bedoya, C. Andres

AU - Blashill, Aaron J.

AU - Lerner, Jonathan A.

AU - O'Cleirigh, Conall

AU - Pinkston, Megan M.

AU - Safren, Steven A.

N1 - Funding Information: Funding for creation of the video role-plays came from a grant from the National Institute of Mental Health ( R01MH084757 ; PI: Safren). During the preparation of this manuscript, Steven A. Safren was supported by a career development award from the National Institute of Mental Health ( K24MH094214 ; PI: Safren), and Aaron J. Blashill was supported by a career development award from the National Institute of Mental Health ( K23MH096647 ; PI: Blashill). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health. We acknowledge the important contributions of all study therapists on the trial from which this manuscript was based (in alphabetical order): C. Andres Bedoya, Aaron J. Blashill, Adam Gonzalez, Mark L. Hatzenbuehler, Ellen S. Hendriksen, Laura E. Knouse, Allison K. Labbe, Jonathan A. Lerner, Michael E. Newcomb, Megan M. Pinkston, Christina Psaros, Kelly Smith, and Lara Traeger. Publisher Copyright: © 2014.

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N2 - There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Furthermore, depression has been found to be associated with nonadherence to antiretroviral therapy (ART), as well as HIV disease progression. Cognitive behavioral therapy (CBT) has repeatedly been found to effectively treat depression in adult populations, and CBT for adherence and depression (CBT-AD) is an effective treatment for improving depressive symptoms and medication adherence in the context of various chronic health conditions, including diabetes and HIV-infection. This paper provides a description of the CBT-AD approach to treat depression and ART adherence in HIV-infected adults, which we have developed and tested in our clinic, and for which detailed therapist and client guides exist. To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment, including Life-Steps for medication adherence, orientation to CBT-AD and psychoeducation, and suggestions for adaptation of core CBT modules for HIV-infected adults. Discussion of video demonstrations highlights differences in patient presentations and course of treatment between HIV-infected adults receiving CBT-AD and HIV-uninfected adults receiving traditional CBT for depression. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.

AB - There are an estimated 1.1 million individuals living with HIV/AIDS in the United States. In addition to the various medical comorbidities of HIV infection, depression is one of the most frequently co-occurring psychiatric conditions among HIV-infected individuals. Furthermore, depression has been found to be associated with nonadherence to antiretroviral therapy (ART), as well as HIV disease progression. Cognitive behavioral therapy (CBT) has repeatedly been found to effectively treat depression in adult populations, and CBT for adherence and depression (CBT-AD) is an effective treatment for improving depressive symptoms and medication adherence in the context of various chronic health conditions, including diabetes and HIV-infection. This paper provides a description of the CBT-AD approach to treat depression and ART adherence in HIV-infected adults, which we have developed and tested in our clinic, and for which detailed therapist and client guides exist. To augment the description of treatment, the present article provides video component demonstrations of several core modules that highlight important aspects of this treatment, including Life-Steps for medication adherence, orientation to CBT-AD and psychoeducation, and suggestions for adaptation of core CBT modules for HIV-infected adults. Discussion of video demonstrations highlights differences in patient presentations and course of treatment between HIV-infected adults receiving CBT-AD and HIV-uninfected adults receiving traditional CBT for depression. This description and the accompanying demonstrations are intended as a practical guide to assist therapists wishing to conduct such a treatment in the outpatient setting.

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KW - HIV/AIDS

KW - Medication adherence

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Description and Demonstration of Cognitive Behavioral Therapy to Enhance Antiretroviral Therapy Adherence and Treat Depression in HIV-Infected Adults

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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