Scientific Approach to CBT

Dr. Ari Zaretsky delivered a presentation entitled ‘Neuroscience Informed Cognitive Behaviour Therapy’ during the Grand Rounds held at Ontario Shores Centre for Mental Health Sciences on Tuesday, January 30.

Dr. Zaretsky, Psychiatrist-in-Chief and Vice-President of Education at Sunnybrook Health Sciences Centre, presented a scientific approach to Cognitive Behaviour Therapy (CBT), which is inspired by the work of Dr. Aaron Beck.

Dr. Beck is noted for his research in psychotherapy, psychopathology, suicide, and psychometrics, which led to his creation of cognitive therapy, for which he received the Lasker-DeBakey Clinical Medical Research Award.

Grand Rounds

Thanks to a greater understanding of the brain and recent advancements in research, Dr. Zaretsky said a scientific approach to CBT has opened doors for the treatment of several disorders.

“We now know a lot of how the brain works,” noted Dr. Zaretsky. “We also know how CBT and pharmacotherapy might work differently when it comes to treating conditions like depression.”

In a study cited by Dr. Zaretsky, patients being treated for depression with the anti-depressant Paroxetine were compared against those being treated with CBT. For both groups, there were positive results.

“Both got better, but in different ways,” said Dr. Zaretsky, who noted the areas of brain which experienced change following treatment were different for each group.

In discussing treatment of anxiety disorders, Dr. Zaretsky supported CBT as a treatment that holds its own against any treatment option.

“CBT has a monopoly in terms of effective treatment of anxiety,” said Dr. Zaretsky.

While pharmacotherapy is a viable treatment option, when combined with CBT to treat Panic Disorder, the treatment is not strengthened.

“There doesn’t seem to be a strong benefit for combining pharmacotherapy and CBT.”

In closing, Dr. Zaretsky presented findings on the use of D-Cycloserine in conjunction with exposure-based cognitive behavior therapy, which helps with fear extinction in an array of anxiety- and stress-inducing disorders.

Dr. Zaretsky cited a comparison of two groups being treated for Obsessive Compulsive Disorder (OCD). The group being treated with CBT and D-Cycloserine saw improvement quicker than the group being treated with only CBT.

While noting that timing and proper dosage is vital to its effectiveness, Dr. Zaretsky noted D-Cycloserine appears to enhance treatment and accelerate clinical improvement in exposure therapy for many different anxiety disorders.