Table 1 CBT Content (60 min/session)
Session | Aim | Procedure |
|---|---|---|
1 | Health education and Focus on Distorted cognition | Health education about paroxysmal atrial fibrillation, explaining the theory of mind-body interaction to patients and the principles of CBT |
2 | Self-awareness training | ①Found ‘hot thought’, identifying automatic thinking ② Be aware of current cardiac symptoms, thoughts, feelings, and behavioral choices |
3 | Exposure training | Patients are invited to expose their bodies to feelings similar to atrial fibrillation symptoms (Heart rate becomes faster, etc.) by engaging in physical activities such as squatting. The purpose is to reduce patients’ fear of symptoms. |
4 | Habitual reversal training | Patients are encouraged to delay or turn past habitual heart rate measurement into irrelevant behaviors such as clenching fists. |
5 | Correcting cognitive distortion | â‘ Disturbed ideas about AF, depression, accompanying physical ailments, and mortality were all common cognitive distortions. Education and normalization, Socratic inquiry, and A-B-C approaches used in cognitive intervention (event-thought, secondary physiological and behavioral responses) â‘¡ Evidence testing to explore the supporting and non-supporting bases for adverse cognition. |
6 | Behavioral activation | Allowing patients to conduct activities that are both pleasurable and can be managed for behavioral activation using the behavioral activity record table. |
7 | For anxiety symptoms | Education and normalization, cognitive correction, relaxation training, role playing, and a problem-solving list for cognitive reconstruction and behavioral intervention |
8 | Practice and feedback | Therapists acknowledge distress, normalize feelings, check mood level, activate support system, and ask about current issues utilizing reflective listening when a patient is disturbed. |
9 | Relapse prevention | Identifying relapse precursors, establishing a list of relapse precursors, and problem-solving training designed to increase relapse prevention and positive coping methods. |
10 | Review | Identifying new questions, and preparing for end of study |