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Full-Text Articles in Cognitive Behavioral Therapy

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef Jun 2026

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …


The Effectiveness Of Mode Deactivation Model Group Counseling In Improving The Emotional Wellness Of Junior High School Students, Ananda Dwi Rahmadanti, Muya Barida, Sri Hartini, Aprilia Setyowati Mar 2026

The Effectiveness Of Mode Deactivation Model Group Counseling In Improving The Emotional Wellness Of Junior High School Students, Ananda Dwi Rahmadanti, Muya Barida, Sri Hartini, Aprilia Setyowati

Buletin Konseling Inovatif

This study was motivated by the low level of emotional wellness among some junior high school students, characterized by difficulties in recognizing, understanding, and managing emotions adaptively, thereby impacting social behavior and learning processes at school. Previous studies have shown that emotion regulation-based interventions are effective in improving adolescents' emotional well-being. However, counseling interventions in schools that specifically target emotional regulation patterns to improve students' emotional wellness are still relatively limited in guidance and counseling services. Therefore, this study aims to examine the effectiveness of group counseling using the Mode Deactivation Counseling (MDC) model in improving the emotional wellness of …


Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano Apr 2025

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …


Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp Jan 2025

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …


Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood Jan 2025

Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood

Masters Theses

Mindfulness is a practice of intentionally paying attention to the present moment in a nonjudgmental way. Being more mindful can decrease symptoms of anxiety, depression, and stress, among other mental and physical health improvements. (Donald et al., 2016; Hofmann et al., 2010; Kabat-Zinn et al.,1992). This study examined if balanced time perspective (BTP) is one of the mechanisms of action of mindfulness in its relationship with depression, anxiety, and stress. BTP refers to a person’s ability to flexibly adapt their time perspective (attention to the past, present, or future, and positive or negative attitudes toward each) to suit the current …


Cognitive Behavioral Therapy (Cbt) Interventions For Group Therapy For College Students Experiencing Depression, Ty Ogren Dec 2024

Cognitive Behavioral Therapy (Cbt) Interventions For Group Therapy For College Students Experiencing Depression, Ty Ogren

Dissertations, Theses, and Projects

This group manual was created to support college students struggling with a depressive mood disorder such as Major Depressive Disorder. The instance of mental health concerns, including depression, have increased greatly over the last several years. Depression is the most common mental health concern for college students, and the rate at which they experience depressive symptoms has exceeded that of the general population. Depressive symptoms in college students can lead to many concerns like poor academic achievement, self-isolation, poor diet and nutrition, and suicidal ideation (Liu et al., 2022). This group manual aims to equip college students struggling with depression …


A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir Jul 2024

A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir

LSU Doctoral Dissertations

The factor structure of the Parenting Stress Index - Short Form (PSI-4-SF) was evaluated among parents of children with autism spectrum disorder (ASD). Two hypotheses were tested: (1) the original PSI-4-SF model would yield an unsatisfactory fit, and (2) a three-factor alternative model would improve fit compared to the original and other models. A sample of 205 parent-child dyads was analyzed using confirmatory factor analysis (CFA) with the lavaan package in R Studio. Preliminary analyses included descriptive statistics, normality checks, and assessments of skewness and kurtosis. Results supported the first hypothesis, showing poor fit indices for the original PSI-4-SF model. …


Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian, Jan 2024

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …


Cbt And Me: A Beginning Therapist's Journey Utilizing Client Feedback, Haley Scruggs Jan 2024

Cbt And Me: A Beginning Therapist's Journey Utilizing Client Feedback, Haley Scruggs

Theses and Dissertations--Family Sciences

Cognitive behavioral couple therapy (CBCT) is a model of therapy targeting cognitions, emotional responses, and behavioral interactions between couples experiencing relationship distress. Routine outcome monitoring (ROM) is a tool that clinicians can use to track the progress of their clients in therapy from the perspective of the client. This study aimed to use MFT-PRN, a type of ROM, to gather client progress throughout CBCT treatment. Prototypical change trajectories were created in Microsoft Excel for examination of presenting problem progress, couple satisfaction, and overall relationship functioning. It was found that small data sensitivity affected the trajectories immensely, though ROM outcomes revealed …


Moving At The Speed Of Trust, Sun Ho Lee Jun 2023

Moving At The Speed Of Trust, Sun Ho Lee

Masters Theses

Moving at the Speed of Trust is a workbook of strategies — practices, definitions, and techniques — to nurture community-building in support of inbetweeners who live between power structures and cultures and are often left out. Inbetweeners are those individuals whose lives are in transition through recent immigration or forced translocation from Asia to America.

These strategies revolve around threads of trust: kin, giggles, vulnerability, and shared experience. With these threads, we can question power. We can preserve stories, expand the ways we connect, shift perspectives on what is “standard,” and cultivate a community rooted in understanding. To understand each …


Rural Social Work Practice: Trauma-Focused Interventions Social Workers Use, Jose Carbajal Apr 2023

Rural Social Work Practice: Trauma-Focused Interventions Social Workers Use, Jose Carbajal

Journal of Human Services: Training, Research, and Practice

This research study examines rural social workers’ level of trauma knowledge and trauma treatment self-efficacy and the use of evidence-based interventions (CBT, TF-CBT, CPT, EMDR and PE). A retrospective design was used to examine Texas rural social workers’ use of evidence-based interventions. The Texas rural social worker sample (N=19) was extrapolated from a larger study (N=1007) conducted in 2014 examining Texas social workers’ trauma treatment and their use of evidence-based interventions. Descriptive and correlation statistical procedures were implemented to analyze the data for the current study. The results show social workers’ knowledge of trauma and treatment self-efficacy scores are above …


Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown Jan 2023

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …


Internalized Homonegativity And The Mental Health Of Lesbian, Gay, And Bisexual Individuals: An Integrative Treatment Approach, David Kearby Jan 2023

Internalized Homonegativity And The Mental Health Of Lesbian, Gay, And Bisexual Individuals: An Integrative Treatment Approach, David Kearby

DSW Capstone Projects

Lesbian, gay, and bisexual individuals (LGBI) have a higher rate of mental health disorders than the general population. The mental health disparities experienced by LGBI are positively correlated with higher internalized homonegativity (IH) levels, which impacts their functioning at the unconscious, cognitive, and interpersonal levels. Thus, effective interventions targeting the mental health of LGBI must consider IH's intrapsychic, cognitive, and interpersonal nature. An integrative psychotherapy approach addressing the mental health and IH of LGBI is needed to address the intrapsychic, cognitive, and interpersonal factors at play.

Product one of this capstone is a systematic literature review that identified psychotherapeutic interventions …


The Strong Black Woman Schema: A Proactive Approach To Conceptualizing And Providing Mental Health Treatment For Black Women Who Identify With The Strong Black Woman Schema, Kendra Mulder Jan 2023

The Strong Black Woman Schema: A Proactive Approach To Conceptualizing And Providing Mental Health Treatment For Black Women Who Identify With The Strong Black Woman Schema, Kendra Mulder

DSW Capstone Projects

The Strong Black Woman Schema is the ideology that Black women should display mental and physical strength, stoicism, and nurturer traits. While Black women who identify with this schema typically associate this term with a positive identity, there are adverse outcomes that stem from this identification. Black women who identify with the Strong Black Woman schema experience higher rates of depression, anxiety, and psychological distress. No treatment modality has been determined to treat Black women who identify with the Strong Black Woman Schema. This capstone presentation will present a systematic literature review that discusses how the Strong Black Woman Schema …


Finding A Middle Path: Using Expressive Arts Therapy To Engage Adolescents In Dialectical Behavior Therapy: A Literature Review, Rebecca Miller May 2022

Finding A Middle Path: Using Expressive Arts Therapy To Engage Adolescents In Dialectical Behavior Therapy: A Literature Review, Rebecca Miller

Expressive Therapies Capstone Theses

This critical literature review explores the limited research on integrating expressive arts therapy (ExTH) with dialectical behavior therapy (DBT). DBT, an evidence-based, third-wave cognitive-behavioral intervention, has been adapted for use with adolescents struggling with emotional and behavioral dysregulation. Yet, the didactic and almost rigid nature of DBT can feel more like a school lesson and less like therapy, making it difficult for adolescents to engage with the treatment. This is problematic as DBT's effectiveness requires the client to be fully committed and willing to engage in the therapy. This paper explores the literature on combining ExTH with DBT and conceptual …


Children Of Divorce Parents Group Manual, Sheyenne Hokit Apr 2022

Children Of Divorce Parents Group Manual, Sheyenne Hokit

Dissertations, Theses, and Projects

Divorce is something that is, unfortunately, becoming a commonality for a lot of children, and due to the complexity of divorce, many children struggle when trying to understand divorce and how it affects them. Some effects of divorce are various emotional and behavioral issues such as increased anger and decreased emotion regulation. Social, health, and academic concerns were also found. Counseling interventions like narrative therapy, emotion-focused family therapy, emotion-focused therapy, and play therapy were found to be effective with this population (Hirschfeld & Wittenborn, 2016, Thomas & Gibbons, 2009). The identified interventions provide peer-based social support, education on the misconceptions …


The Gender Freedom Model: A Framework For Helping Transgender, Non-Binary, And Gender Questioning Clients Transition With More Ease, Rae Mcdaniel, Laurel Meng Jan 2022

The Gender Freedom Model: A Framework For Helping Transgender, Non-Binary, And Gender Questioning Clients Transition With More Ease, Rae Mcdaniel, Laurel Meng

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Transgender/non-binary experiences and identities are often represented in academic literature through narratives of distress and are often pathologized through a medical lens. This holds implications for the field of psychotherapy, as interventions aimed to support transgender/nonbinary individuals often focus solely on risk mitigation. This article presents a therapeutic framework that rests on three pillars—Play, Pleasure, and Possibility—as the focal points for reimagining work with transgender/non-binary clients. This model aims to help this population explore gender transition with more ease through building practical skills, cultivating personal and collective pride, and centering pleasure equity.


Transforming Hurt Boys Into Restored Men: The Lack Of Mental Health Treatment For Black Male Trauma Survivors, Shericka Danielle Smith Jan 2022

Transforming Hurt Boys Into Restored Men: The Lack Of Mental Health Treatment For Black Male Trauma Survivors, Shericka Danielle Smith

DSW Capstone Projects

Trauma affects individuals differently, but the prevalence of trauma and its impact on Black males is detrimental. Black males are at higher risk for posttraumatic stress disorder (PTSD), depression, substance abuse, and violent crimes when trauma is left untreated by a mental health professional. As the number of traumatic events experienced by Black males continues to rise, the number of these males who seek mental health treatment remains stagnant and painfully low. Many factors play into these behaviors, yet very little data exists on what is being done to change them.

Product one is a systematic literature review in which …


Social And Cultural Considerations In Accessing Mental Health Treatment In The Gambia, West Africa, Safiya Njai Jan 2022

Social And Cultural Considerations In Accessing Mental Health Treatment In The Gambia, West Africa, Safiya Njai

Antioch University Dissertations & Theses

This study examines the social and cultural considerations in accessing mental health treatment in The Gambia, West Africa. Participants were recruited from The Gambia for a qualitative study that included semistructured interviews (N = 17). A team of analysts identified five themes. The results highlighted social and cultural conceptualizations of mental health and mental illness, sociocultural determinants of health, interventions, barriers to care, and the legal framework to support mental health change. These findings are important for counselors to understand different perceptions of mental health and mental illness and the associated stigma. Furthermore, several opportunities for advocacy in The Gambia …


Pornography: Social, Emotional And Mental Implications Among Adolescents, William Kelly Canady Mar 2021

Pornography: Social, Emotional And Mental Implications Among Adolescents, William Kelly Canady

National Youth Advocacy & Resilience Conference

This presentation will explain the historical development of pornography. It will highlight four segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention. 4- A review of interventions available to assist clients in navigating a lifestyle away from pornography.


Cognitive Behavioral Therapies For The Management Of Chronic Pain, Kira Swensen, Maren Wright Voss, Alise Williams Condie, Ashley Yaugher Sep 2020

Cognitive Behavioral Therapies For The Management Of Chronic Pain, Kira Swensen, Maren Wright Voss, Alise Williams Condie, Ashley Yaugher

All Current Publications

Chronic pain is pain that lasts longer than six months and may continue even after illnesses or injuries have healed (Cleveland Clinic, 2017). Pain signals in the nervous system can remain active for several years if they are altered in the spinal cord, becoming stronger than they normally would or should be (Reichling & Levine, 2009). Chronic pain can also occur without illness or injury (National Institute of Neurological Disorders and Stroke, 2019). Fortunately, many evidence-based strategies for managing chronic pain are available to ease the discomfort. This fact sheet reviews those strategies.


Mental Associations And Music Therapy: Including The History Of Associationism And The Neurology Of Associations, Dianna Rose May 2020

Mental Associations And Music Therapy: Including The History Of Associationism And The Neurology Of Associations, Dianna Rose

Expressive Therapies Capstone Theses

Associations are formed in our minds based upon three elements: sensory experience, emotions, and memories. These associations, unique to each individual, dictate thoughts, beliefs, behaviors, and actions. Some are necessary and supportive, while others can be maladaptive. Established associations can be changed, and new associations can be formed, to align with a client’s goals. The literature presents a strong history of associationism, as well as a body of research that demonstrates the neurological processes of how mental associations are formed. There are also studies showing how music activates the brain. However, there is a lack of research which draws direct …


Promoting Resilience In Self-Management (Prism): Adverse Childhood Experiences And Impacts On Emotion Regulation, Kasey Ann Macedo Apr 2020

Promoting Resilience In Self-Management (Prism): Adverse Childhood Experiences And Impacts On Emotion Regulation, Kasey Ann Macedo

Honors Scholar Theses

PRISM (Promoting Resilience in Self-Management) is a mindfulness-based intervention that aims to strengthen emotion regulation skills among individuals by employing cognitive behavioral therapy components. The purpose of the current study is to identify the relationship between adverse childhood experiences (ACEs) and depression, as well as to examine the changes in emotion regulation strategies of participants by comparing pre and post test data. The participants were voluntarily recruited from the Cornerstone Foundation, a homeless shelter, food pantry, and community center in Vernon, CT. The 13 participants completed PRISM through four weeks of two-hour workshop sessions in a small-group format. Results indicate …


Hoarding: Beyond The Mess, A Training For Mental Health Professionals, Kelsi Mcclaflin Apr 2020

Hoarding: Beyond The Mess, A Training For Mental Health Professionals, Kelsi Mcclaflin

Dissertations, Theses, and Projects

This literature review examines hoarding disorder with a close lens. This is a diagnosis that is new to licensed professionals across the helping professions. This training will allow participants to better understand what it means to be diagnosed with hoarding disorder, assessments that aid in detecting severity, best practices that are continually emerging, and the impact it can have on clients, their loved ones, and the community. This training takes a collaborative approach as an integrated way of treatment for all individuals involved in the process.

Keywords: hoarding, behaviors, treatment


Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor Oct 2019

Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor

Journal of Human Services: Training, Research, and Practice

This article explores the role of therapist self-disclosure in clinical settings. Distinctions are made between the enmeshed concepts of privacy, secrecy, and confidentiality to elucidate the role of ignorance in maintaining the power dynamics in therapeutic relationships. While some measure of privacy is essential to counseling practice, secretive behavior (in which the counselor divulges too little about themselves) can have a negative impact on the therapeutic relationship and the client’s therapeutic outcomes. There is, therefore, an under-appreciated and delicate balancing act between withholding information to protect the client and the counselor and revealing enough personal details to empower the client’s …


Unveiling The Mask:Sexual Trauma's Impact On Academic Achievement, Behavior, And Self-Identity, Teshaunda Hannor-Walker, Sarah Kitchens, Lacey Ricks Mar 2019

Unveiling The Mask:Sexual Trauma's Impact On Academic Achievement, Behavior, And Self-Identity, Teshaunda Hannor-Walker, Sarah Kitchens, Lacey Ricks

National Youth Advocacy & Resilience Conference

Sexual trauma is an unfortunate but a common and often masked experience for many students in America. While sexual trauma in itself is not a mental health disorder, it can become a risk factor for many academic and mental health problems. Trauma-informed schools can play an important role in helping students deal with the aftercare of a traumatic experience.


An Exploration Of The Lived Experience Of Women Who Had Abortions And The Effects Of The Abortion Secret On Their Relationships: An Interpretive Phenomenological Analysis, Marckdaline Johnson Jan 2019

An Exploration Of The Lived Experience Of Women Who Had Abortions And The Effects Of The Abortion Secret On Their Relationships: An Interpretive Phenomenological Analysis, Marckdaline Johnson

Department of Family Therapy Dissertations and Applied Clinical Projects

The United States Supreme Court decision in the Roe v. Wade (1973) case provides women with a right to privacy and the liberty to make decisions concerning their reproductive lives. With this, women who become pregnant are offered the right to choose between keeping their pregnancy and terminating the pregnancy by way of abortion. Since Roe v. Wade (1973), many women have exercised their reproductive liberties, as evidenced by the termination of over 60 million pregnancies via legal abortion in the United States. Still, secrecy among women with a history of abortion remains a common phenomenon. Studies conducted on abortion …


The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy Nov 2018

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …


Barriers To Change For Augmentative And Alternative Communication Use, Lauren E. Brown Nov 2018

Barriers To Change For Augmentative And Alternative Communication Use, Lauren E. Brown

Scholars Week

Title: BARRIERS TO CHANGE FOR AUGMENTATIVE AND ALTERNATIVE COMMUNICATION USE

Keywords: speech language pathology, augmentative and alternative communication, counseling, readiness to change, self-efficacy

In recent literature, there has been a marked increase in importance placed upon understanding what factors both positively and negatively impact the progress made by a client and that client’s family in response to speech and language therapy. Today, clinicians prioritize evidence based practice (EBP) when making clinical decisions, focusing on not only clinical expertise and best evidence, but also client and caregiver perspectives, or preferences (ASHA, 2018). In consideration of EBP for augmentative and alternative communication …


Social Work Trauma Interventions: Dialectical Behavioral Therapy, Kassie Baumann May 2018

Social Work Trauma Interventions: Dialectical Behavioral Therapy, Kassie Baumann

Senior Honors Theses

According to Lynne Weilart (2013), in her article on the reasons why people seek out therapy, trauma is the number one reason people attend counseling. Many different trauma-informed approaches are designed specifically to address the consequences of trauma and to facilitate healing. Some of these approaches are as follows: Cognitive Behavioral Therapy (CBT); Dialectical Behavioral Therapy (DBT);Mentalization Based Therapy (MBT); Trauma Systems Therapy (TST); Trauma Assessment Pathway (TAP); and Attachment, Self-Regulation, and Competency (ARC) (de Arellano, Danielson, Ko, & Sprauge, 2008). The effectiveness of each trauma intervention will be examined. DBT is one of these trauma interventions that is growing …