The purposes of the present study were to examine the effects of a program of cognitive-behavioral group therapy in a counseling room setting for patients with panic disorder (PD) with agoraphobia. The program was conducted like a seminar, with four 90-minute sessions. Sessions I and II were dedicated to patient education; Sessions III and IV included conducting exposure in the group. Patients were 10 women recruited through advertisements in a local newspaper in a suburb of Tokyo, all of whom were diagnosed as having panic disorder with agoraphobia according to the DSM-IV. The effect of the program was assessed by measuring anxiety, depressive mood, self-efficacy, avoidant behavior, and SUD. Blood pressure was measured in Sessions III and IV during in vivo exposure. The results showed that avoidance behavior and SUD improved after the seminar, and that those improvements were maintained at the time of follow-up measurement. Anxiety and depressive mood were also eliminated. Furthermore, changes in blood pressure showed that in vivo exposure resulted in physiological calming when the women were faced with anxious situations.

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The present article reports the use of cognitive behavior therapy (CBT) in two psychosomatic and psychiatric primary care settings, based on data from 121 patients visiting either a medical and psychosomatic clinic or a psychiatry and psychosomatic clinic during the past 5.5 years. It was found that although both clinics had many patients with anxiety disorders and adjustment disorders, those patients whose psychological factors affected a medical condition or who had somatoform disorders were more likely to visit the medical and psychosomatic clinic, whereas patients with eating disorders were more likely to visit the psychiatry and psychosomatic clinic. Mood disorders were generally treated by graded task assignment and cognitive behavior counseling; anxiety disorders, by exposure and autogenic training; somatoform disorders, sleep disorders, and psychological factors affecting medical condition, by autogenic training; and adjustment disorders, by cognitive behavior counseling. Patients who had psychological factors affecting a medical condition, adjustment disorders, or anxiety disorders were likely to complete the treatment and recover. These findings suggest that CBT is an efficient treatment for psychosomatic and psychiatric primary care.

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The present article reports a case study of the use of cognitive bibliotherapy for migraine headaches with dysthymia. The patient was a 24-year-old male graduate student who had suffered from migraine headaches with dysthymia for 2 years. Following 6 sessions of intervention with cognitive bibliotherapy, he reported that his depressive symptoms and the activity of his migraines had decreased. He became free from migraines and dysthymia, and at 5-month and 3-year follow-up interviews, reported that the improvement observed while he was in treatment had been maintained. These results suggest that cognitive bibliotherapy can be effective for patients with migraines with dysthymia.

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The present study examined the rationale conditions (lecture and practice conditions) needed in order to increase the tolerance time in a cold presser task, replicating the procedure used by Hayes et al. (1999). Adults (7 men, 21 women) were divided randomly into 3 groups, each with a different rationale: A-A group took its rationale from a lecture on the theory of acceptance and commitment therapy (ACT) and brief practice about acceptance; A-F group took a rationale that contained the theory of acceptance and commitment therapy and brief practice about the adverse effects of thought suppression (FEAR); the third group was a placebo group. In the posttest, the A-A and A-F groups showed significantly increased under-standing of the theory of acceptance and commitment therapy. Only the participants in the A-A group showed a significantly greater tolerance of pain, compared to the A-F and Placebo groups. From these results, we concluded that for longer tolerance in a cold presser task, not only knowledge of the theory of acceptance and commitment therapy but also experience, such as practice, is needed.

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The purpose of the present study was to examine the effect of a computer program for computer-assisted counseling based on rational-emotive behavior therapy. Fukui and Nishiyama (1995) developed a computer-assisted counseling program that modified clients' irrational beliefs to rational beliefs, using items from the Japanese Irrational Belief Test (Matsumura, 1991), but each session using that program takes a very long time. The revised program tested in the present study was more practical, including a mechanism that shortened each session to about 50 minutes, and adding instruction in the A-B-C model of rational-emotive behavior therapy, as well as homework. The homework assignments required the clients to think about the advantages and disadvantages of each irrational belief. The results suggested that the revised program decreased anxiety more than the Fukui-Nishiyama program.

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