Neurobehavioral/Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy
Neurobehavioral / Cognitive Behavioral Therapy (CBT)
The neurobehavioral / cognitive behavioral therapy (CBT) was developed by Dr. Donna J. Andrews and her associate Dr. Joel Reiter at the Andrews/Reiter Epilepy Research Program. The therapy focuses on identifying seizure triggers and learning techniques to prevent seizures through self control.
In private correspondence with Dr. Andrews, she related that:
| In the first 7 years the process was applied to all seizure types. We found that it worked well with uncontrolled Tonic/Clonic, Complex Partial, absence, and Secondary generalized, but it did not work well with myoclonic and atonic. |
Efficacy
Total seizure control was achieved by 18 of the 23 patients in the left-hemisphere group, or 78.2% of this sample and by 17 of the 21 patients in the right-hemisphere group, or 80.9% of this sample. Seizure control was achieved by 35 out of 44 patients in the two groups, or 79.5% for the total population treated in the brief therapy model. Those patients identified as having achieved control had been seizure-free for 6 months or longer. ...Both groups showed a significant reduction in seizure frequency following treatment. The proportional reduction in seizures was calculated for each patient, this proportion was converted to a percentage, and then computed as the mean per cent for each group of patients. The mean per cent of reduction of seizures in both groups is greater than 90%. The mean for the left-hemisphere group is 95.7% and the mean of the right-hemisphere group is 93.7%. |
|
In private correspondence with Dr. Andrews, she related that:
| We review records free of charge. After that review we tell the patient what category that they fall within (i.e. potential for full recovery vs. some percentage, or unknown). ... You might find it interesting that the people who fall in the better than 90% chance of recovery are often the patient who have the most seizures. |
Potential Adverse Events
There are no known adverse events. This therapy does not involve any invasive or unnatural processes.
Cost
At this point in time, it is not expected that insurance companies cover CBT for epilepsy. For the chart, I scored CBT with a 5 to reflect complete out of pocket expenses. If your insurance company will cover your treatments in whole or part, you might consider adjusting this score upwards accordingly when viewing the chart.
Type
Patients are required to take ownership of learned techniques for managing their own specific triggers. While it requires active participation at the initiation of the therapy, it is expected that the techniques eventually become a habitual and unconscious part of daily life. For the chart, CBT was scored as requiring continuous, passive participation.
Latency
According to the study published in Seizure (referenced above), ~50% seizure control is attained on average within 2-3 months and full seizure control can occur somewhere between 6-18 months.
Special Notes
The Andrews/Reiter Epilepy Research Program is a non-profit outfit.
You can also learn many of the neurobehavioral therapy techniques from this book: Epilepsy - A New Approach: What medicine can do, what you can do for yourself.
This page last modified September 9, 2019.