Iony D. Ezawa

University of Southern California | USC · Department of Psychology

Background The metaverse is a promising avenue for accessible, effective digital mental health treatments. However, general attitudes toward peer-supported metaverse mental health interventions (MMHIs) remain largely unexplored. Objective This study examined the relation of sociodemographic, mental health, and technology factors in predicting atti...

Depression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments—a phenomenon known as the treatment–prevalence paradox. We co...

BACKGROUND The metaverse is a promising avenue for accessible, effective digital mental health treatments. However, general attitudes toward peer-supported metaverse mental health interventions (MMHIs) remain largely unexplored. OBJECTIVE This study examined the relation of sociodemographic, mental health, and technology factors in predicting atti...

This book is based on the assumption that skills and methods contribute to the outcome of psychotherapy in addition to many other elements, such as the client, the therapist, the therapeutic relationship, and external factors. We suggest that what therapists do makes a meaningful difference, although there are often a number of skills and methods t...

Background: Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through vari...

Introduction: Cognitive Behavioral Immersion (CBI) is a novel cognitive-behavioral skills program delivered by lay coaches in the metaverse through immersive virtual reality technology. Objectives: The objective for this study was to run a feasibility and pilot study of CBI for individuals in recovery from a substance use disorder. Methods: Data...

Clinical Impact Statement Questions: How robust is the relationship between cognitive restructuring (measured within session) and psychotherapy outcomes? Findings: Meta-analytic findings indicate there is a moderate positive relation between cognitive restructuring and psychotherapy outcomes. Meaning: The findings suggest cognitive restructuring (d...

Objective: The therapeutic alliance is a dyadic process involving both patient and therapist perspectives. We investigated the effect of patient and therapist agreement on the alliance in cognitive behavioral therapy for depression. Method: Patients (N = 191) were drawn from two studies of cognitive behavioral therapy for depression provided ove...

Background Although Cognitive behavioral therapy (CBT) appears to be an effective treatment for depression, studies of CBT have largely been composed of White patients. Whether the benefits or process of change in CBT differ among ethnic/racial minority patients requires further investigation.Methods We drew data from three previous studies to exam...

Whether and how therapists’ delivery of cognitive behavioral therapy (CBT) for depression differs by patients’ ethnicity or race remains unclear. In this study, 218 therapists were randomized to clinical vignettes that involved the same text but varied in whether the accompanying image depicted a Black or White patient. Therapists exhibited three k...

We examined interpersonal variables as moderators of the relation between therapists’ use of cognitive change (CC) strategies and CC in a sample of 125 adults who participated in cognitive behavioral therapy for depression. We measured self-reported maladaptive personality characteristics, interpersonal problems, and social skills at intake. Observ...

Cognitive Therapy or Cognitive Behavioral Therapy (CBT) for depression is a well-studied, research-supported treatment. Contrary to common misconceptions about manual-based treatments, CBT can be provided with considerable flexibility. As the first manual-based treatment to be developed, it is remarkable that it is so principle-based and flexible....

Background Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. Methods We did a systematic revi...

Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample o...

Depression is associated with unemployment and poor occupational functioning. Although cognitive behavioral therapy (CBT) has been shown to reduce depressive symptoms, the degree to which it improves occupational outcomes has received little attention. We investigated change in job status and presenteeism (i.e., the inability to focus on and accomp...

Importance Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depressi...

Background Depression is characterized by a tendency to overestimate the probability of negative life events and underestimate the probability of positive events. Although cognitive behavioral therapy (CBT) targets overly negative future expectations, research has yet to examine how such expectations change relative to one’s experiences. We examine...

Objective: Psychotherapy process research relies heavily upon trained raters to identify and code therapist and client behaviors. Raters are often selected out of convenience or availability with little research to inform what qualities are desirable for this role. In this study, we evaluated several rater characteristics as potential predictors of...

Objectives Internet‐based cognitive behavioral therapy (iCBT) is an effective treatment option for depression, but its long‐term effects are not well understood. We investigate for whom iCBT may have more enduring effects by evaluating dysfunctional attitudes as predictors of relapse. Methods The sample consists of 31 iCBT responders (20 women, av...

Internet-based cognitive behavioral therapy (iCBT), provided with guidance, has been shown to outperform wait-list control conditions and appears to perform on par with face-to-face psychotherapy. However, dropout remains an important problem. Dropout rates for iCBT programs for depression have ranged from 0 to 75%, with a mean of 32%. Drawing from...

Although cognitive change has long been posited to drive symptom improvements in cognitive therapy (CT) of depression, whether it does so remains controversial. Methodological challenges have contributed heavily to the lack of resolution on this issue. Using a patient-reported measure of cognitive change, we tested the role of cognitive change in c...

We report on two approaches to addressing the problem of low reliability in the assessment of therapist competence in cognitive therapy (CT). In Study 1, we utilized ratings of a session from each of six therapists and investigated how CT experts evaluate specific therapist behaviors in making ratings on the Cognitive Therapy Scale (CTS). Departure...