Cognitive Challenging

Cognitive challenging is another useful treatment for anxiety disorders. Cognitive challenging is based on the assumption that thoughts play a powerful role in producing and maintaining anxiety, as in the spider bite example discussed earlier. The theory behind cognitive challenging suggests that people develop automatic thoughts that are often inaccurate. These thoughts are called automatic because people are usually unaware of them. A common automatic thought may be If I have a panic attack...

Cognitive Developmental Hypnotherapy

The model is quite new on the therapeutic scene, having been presented explicitly in two book chapters (Dowd, 1993, 1997), one book (Dowd, 2000), and one article (Dowd, 2001). It retains the cognitive-developmental emphasis on modifying cognitive structures (or core cognitive schemas) which are laid down developmentally early in life and thereafter progressively elaborated on and differentiated but not substantially changed. As these schemas become more organized and differentiated, they...

John H Riskind and David Black

Keywords cognitive vulnerability, cognitive bias, beliefs, cognitive structures Cognitive vulnerabilities are faulty beliefs, cognitive biases, or structures that are hypothesized to set the stage for later psychological problems when they arise. They are in place long before the earliest signs or symptoms of disorder first appear. These vulnerabilities are typically purported to create specific liabilities to particular psychological disorder after individuals encounter stressful events, and...

Research On

Cognitive behavior therapies are among the most empirically supported of psychotherapies. Research is ongoing in the use of CBT in numerous disorders including substance use (Carroll, 1999). In a review of research into cognitive behavior therapies as stand-alone treatments for alcohol abuse, Longabaugh and Morgenstern (1999) found that CBST delivered as a stand-alone treatment does not differ in effectiveness from these other treatment approaches. This also was true when CBST was used for...

Jan Scott

Keywords cognitive therapy, bipolar disorders, manic depression Until recently, bipolar disorders (BP) were widely regarded as a biological illness that should be treated with medication (Scott, 1995a). This view is gradually changing for two reasons. First, in the past three decades, there has been a greater emphasis on stress-vulnerability models. This has led to the development of new etiological theories of severe mental disorders that emphasize psychosocial and particularly cognitive...

References

Prisoners of hate The cognitive basis of anger, hostility, and violence. New York HarperCollins. Beck, R., & Fernandez, E. (1998). Cognitive behavioral therapy in the treatment of anger A meta-analysis. Cognitive Therapy and Research, 22, 63-75. Berkowitz, L. (1990). On the formation and regulation of anger and aggression A cognitive-neoassociationistic analysis. American Psychologist, 45, 494-503. Berkowitz, L. (1993). Aggression Its causes, consequences, and control....

CBT for Noncardiac Chest Pain

Noncardiac chest pain (NCCP) refers to persistent chest pain without an identifiable cardiac (e.g., ischemic disease) or psychiatric (e.g., chest pain related to panic disorder) etiology. Over 50 of patients referred to cardiology clinics have chest pain with no positive medical findings or known medical problems (e.g., mitrovalve prolapse). Symptoms often endure with about 75 of NCCP patients reporting continued chest pain at a 1-year follow-up. Persons with NCCP are more likely to have...

Cbt For Emotional Distress

CBT approaches are increasingly being evaluated as a means to decrease psychological distress symptoms (e.g., depression, anxiety) among cancer patients, as well as to improve their overall quality of life. This trend began with a landmark study conducted by Worden and Weisman (1984) in which they found an intervention package that included training in problem-solving and relaxation skills to promote effective coping and adaptation among newly diagnosed cancer patients. Behavioral stress...

Description Of Cbt Model For Adhd In Adults

The core symptoms of ADHD are developmentally inappropriate levels of impulsivity, inattention, and or hyperactivity that have been present since childhood. To make the diagnosis in adulthood requires clear evidence that these symptoms have caused enduring difficulties throughout the individual's development, although there can be great variability in the intensity of symptoms and in the settings in which they occur. Finally, it must be determined that the symptoms are not better accounted for...

Empirical Basis

Only a few empirical studies for childhood depression exist before 1990, in part due to the lack of recognition for depression as a clinical disorder in children before that time. These landmark studies incorporated treatment components that remain a cornerstone of treatment for childhood depression. Butler, Miezitis, Friedman, and Cole (1980) treated fifth and sixth graders with depressive symptoms in either role-play, cognitive restructuring, attention placebo, or control groups that met...

Empirical Evidence For Cbt For Adhd

Overall, the empirical literature on psychosocial treatments for adults with ADHD is sparse. CBT approaches have offered some encouraging preliminary results. Wilens et al. (1999) performed a chart review of 26 adults seeking treatment for ADHD. Clinical data were collected at baseline, at the point of medication stabilization, and at the end of CBT (introduced after medication stabilization). The findings indicated that CBT was associated with patient improvements on a measure of depression,...

Methodology Of Behavioral Assessment

There are many possible behavioral assessment tools available for use. The exact nature of these tools depends on the specific types of target problems being assessed. Methods of behavioral assessment include direct observation by another or self-observation in vivo, in vitro, or during performance on an analogue measure. Regardless of the specific tool selected or designed, a commonality across all tools is the monitoring of important and relevant aspects of the target response. For example, a...

Empirical Status Of Cbt For Older Adults With Depression And Personality Disorders

The efficacy of CBT for younger adults has a growing base of evidence. CBT has generally yielded effect sizes as large or larger than treatment with antidepressant medications or other forms of psychotherapy in the treatment of depression, and it may be more effective than other treatments for depressed individuals with personality disorders (APA, 2000). Presumably because of the emphasis on patient skill acquisition in CBT, patients are less likely to relapse after treatment to remission if...

Literature Review Of Cbt For Ptsd

These theoretical models led to the development of the three most widely used treatments for war-related PTSD today cognitive therapy, anxiety management therapy, and exposure therapy. Depending on individual differences and the ways in which people emotionally process traumatic experiences, a patient may respond differently to each type of treatment modality. However, new treatment alternatives are constantly being developed and their efficacy tested for example, eye movement desensitization...

Cbt For Obesity The Future

Does the CBT model of obesity require reformulation Cooper and Fairburn (2002) have agued for the need to reformulate the theory, aims, and procedures used in CBT for obesity. These authors maintain that the problem of poor long-term outcome following CBT for obesity may be attributed to two factors (a) inattention to the cognitive factors that contribute to weight regain and (b) ambiguity over treatment goals in long-term interventions. They note that long-term failure may be directly related...

Coping And Adjustment

In addition to dealing with the losses associated with the illness process, coping with the day-to-day problems that arise is important to individuals faced with this stressor. Many problems can present as a result of changing roles, financial status, medical treatment, and decreasing physical health. Lazurus and Folkman (1984) have proposed that there are two primary forms of coping emotion-focused and problem-focused coping. Although it may be tempting to view these forms of coping as...

Talia I Zaider and Richard G Heimberg

Keywords social anxiety disorder, social phobia, anxiety disorders, adults, children Social Anxiety Disorder (SAD), also known as social phobia, is characterized by an excessive and persistent fear of one or more social or performance situations. Individuals suffering from SAD endure these situations with acute discomfort, and a great many avoid them altogether. The anxiety and associated avoidance behavior can be crippling, making it difficult for those affected to sustain relationships or...

Thomas Dowd

Keywords hypnosis, hypnotherapy, imagery In its relatively short history, cognitive therapy has proved to be not only an efficacious treatment for a wide variety of psychological and behavior problems, but also an integrating theory of tremendous heuristic power (Afford & A. T. Beck, 1997). It originally began, independently by A. T. Beck (1976) and Ellis (1962), as a system of therapy based on changing maladaptive cognitions (automatic assumptions, irrational thoughts) in the here and now...

Directions For Anger Management Interventions With Youth

There is a general consensus that angry youth have parents who lack effective parenting skills and who evidence similar patterns of impulsive and aggressive responses to perceived provocations. Often there is an early use of extensive physical punishment and many aggressive youth have been victims of their parents' rage reactions. These youth develop in a home environment void of models of prosocial coping and with limited understanding of and communication about emotional expression. Their...

Criticisms Of Cbt

Literature specifically focusing on persons with AIDS, COPD, cardiac conditions, cancer, and others may offer support to cognitive-behavioral interventions for terminally ill persons. However, caution is warranted in generalizing across populations due to the inherent differences in disease processes, length of time from diagnosis to death, societal reactions to such illnesses, and medical technology and knowledge addressing such conditions. Cognitive-behavioral therapies have traditionally...

Stress Inoculation Training

Developed by Meichenbaum (1974), SIT is an anxiety management program that was modified for use with sexual assault survivors. SIT is made up of training in general anxiety management techniques to address the three channels of fear and anxiety (i.e., physical, behavioral, and cognitive). These techniques can then be applied in response to specific PTSD symptoms and in general. The rationale for SIT asserts that as clients are better able to use these techniques to manage their anxiety, their...

Negative Cognitive Styles As Vulnerabilities For Depression

Do negative cognitive styles actually increase people's vulnerability to depression Recent prospective studies have obtained considerable support for the cognitive vulnerability hypothesis (see Alloy et al., 1999). In the Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) Project (Alloy et al., 1999), nondepressed college freshmen, with no other mental disorders, were selected to be at hypothesized high risk (HR) or low risk (LR) for depression based on the presence versus absence of...

Brian Baucom

Keywords couples, relationship therapy, behavioral couples therapy Cognitive-behavioral couples therapy (CBCT) has been evolving since the late 1960s when the first study of a behav-iorally based treatment for couples was published. The first behavioral treatments for couples attempted to increase the frequency of discrete, desired behaviors by using direct reinforcement by partners. Since that time, CBCT has been refined as couples researchers have developed a better understanding of the ways...

Treating Low Selfesteem

The model forms a basis for an individually tailored cognitive conceptualization of the difficulties for which the patient has sought therapy. It is the foundation for an integrated program of cognitive-behavioral interventions, which draws on established protocols for treating depression and anxiety, as well as the clinical literature on changing schemas and core beliefs (e.g., Beck, Freeman, & Associates, l990 Young, Klosko, & Weishaar, 2003). The program is briefly summarized in Table...

Narcolepsy

Narcolepsy is a disorder characterized by four hallmark symptoms (1) excessive daytime sleepiness which is most prominent, (2) cataplexy, (3) sleep paralysis, and (4) hypna-gogic hallucinations. At times, the urge to sleep can be so irresistible that the individual experiences a sleep attack. It is primarily treated through the use of stimulants and antidepressants. Stimulants are the treatment of choice and are useful in keeping the individual awake but are not effective in relieving other...

Future Directions In Cbt For Bulimia Nervosa

Although CBT is currently the most effective form of treatment for BN with most clients exhibiting significant reductions in BN symptoms following treatment, only roughly 50 of clients treated with CBT are completely free of BN symptoms in the long term. Given this rate of full response, the need to improve the efficacy of CBT for BN is clear especially since administering an alternative therapy to those who do not initially respond to CBT for BN has, in most instances, not resulted in...

Empirical Support For Cbt With Children

Studies of treatment outcomes of CBT for youth, with both internalizing (e.g., anxiety disorders, depression) and externalizing difficulties (e.g., aggression), have provided some empirical support (i.e., the data document beneficial gains associated with CBT treatment). For example, randomized clinical trials of CBT for anxious youth (e.g., Kendall et al., 1997) have been reviewed and deemed as evidence that CBT is probably efficacious in treating anxiety disorders in youth (Kazdin & Weisz,...

Indications for and Limitations of CBT for Treating Childhood PTSD

Results from studies implementing cognitive-behavioral interventions for childhood PTSD demonstrate reduced symptomatology in all PTSD symptom clusters and suggest that intensive, short-term individual, parent, and group treatments are efficacious and safe in treating traumatized children across a range of developmental levels. In addition, while significantly reducing PTSD symptomatology in children, some trauma-focused CBTs also have proven equally effective at diminishing peripheral...

Social Avoidance And Anxiety

Beliefs about being defective and the importance of appearance to the self will drive varying degrees of social anxiety and avoidance. Thus, depending on the nature of their beliefs, patients will tend to avoid a range of public or social situations or intimate relationships because of the fear of negative evaluation of the imagined defects. Many patients endure social situations only if they use camouflage (for example, excessive makeup) and various safety behaviors. These are often...

Criticisms Of Cbt With Children

Despite the apparent effectiveness of combining education and graded exposure themes into one treatment package, it remains unclear which aspects of CBT are most active, and to what extent other factors (e.g., family dynamics, child demographics, order of treatment components) may influence treatment outcomes. With the exception of trials that have utilized structured manualized interventions, determining the efficacy of relative CBT components is difficult as the arrangement and emphasis on...

Presenting the Treatment Rationale

Once the appropriateness of IRRT has been established, the therapist educates the patient about the nature of trauma and how PTSD develops from inadequate emotional processing of traumatic events. A brief treatment rationale is then offered to the patient (see standard treatment rationale in Smucker & Dancu, 1999, pp. 42-44). Patients are fully informed of the emotional distress and heightened state of arousal that they are likely to experience when their traumatic memories are activated in...

James D Herbert and Kristy Dalrymple

Keywords social anxiety, social phobia, cognitive-behavior therapy, social skills, group therapy Social Anxiety Disorder (SAD also known as Social Phobia) is defined by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a marked and persistent fear of social or performance situations in which embarrassment may occur. These situations may include public speaking, eating in public, writing in public, speaking with authority figures, conversations, dating,...

Mark J Williams and Robin B Jarrett

Keywords depression, treatment, bipolar disorder, chronic depression, childhood depression Cognitive-behavior therapy (CBT) is a general term for psychosocial interventions designed to change responding and to improve symptoms and quality of life. Historically, the distinctions among cognitive behavior therapies for depression concern what type of responding (cognition or behavior) is targeted to change mood. Behavioral conceptualizations emphasize changing mood by first altering overt...

Christine Maguth Nezu and Michelle A Peacock

Keywords cognitive-behavior therapy, behavior therapy, mental retardation, developmental disabilities, dual diagnosis Compared to the general population, individuals with mental retardation are at increased risk for developing behavioral, psychological, and emotional disorders. Characteristics associated with mental retardation such as deficits in social-cognitive processing ability and communication skills may negatively influence their ability to cope with stress and increase their...

The Cognitive Hypnotherapeutic Treatment Of Psychological Disorders

Cognitive hypnotherapy has been applied to many problems, including anxiety and phobias, stress-related disorders, depression, and habit disorders, as well as general life-enhancing interventions (Dowd, 2000). More recently, it has been applied to pain reduction (Dowd, 2001) and obsessive-compulsive disorders (Dowd, 2003). In treating all these (and other) disorders, the model is the same. First the therapist must identify (in collaboration with the client as much as possible) the cognitive...

Building Support for Abstinence with the Recovery Contract

The therapist, with extensive input from the partners, develops and has the partners enter into a daily Recovery Contract (also referred to as a Sobriety Contract). As part of the contract, partners agree to engage in a daily Sobriety Trust Discussion, in which the substance-abusing partner states his or her intent not to drink or use drugs that day (in the tradition of one day at a time from Alcoholics Anonymous). In turn, the nonsubstance-abusing partner verbally expresses positive support...

Agoraphobia

Agoraphobia refers to fear of being in situations or places from which escape may be difficult or embarrassing or in which help may be unavailable in the event of a panic attack or panic-like symptoms (APA, 2000 Dziegielewski & MacNeil, 1999 Pasnau & Bystritsky, 1990). Agoraphobia may occur with or without the presence of full-blown panic attacks. Panic attacks, or panic-like symptoms usually lead to anticipatory anxiety about experiencing the panic and, consequently, avoidance behavior...

Cognitive Restructuring

Negative or maladaptive thoughts can be generated by caregivers in response to the challenges and stressors they face, thereby contributing to negative affective and emotional states. For example, in a qualitative study investigating the psychological effects of lay caregiving in a sample of 68 caregivers, Ruppert (1996) noted that guilt was a common emotion experienced and expressed by the caregivers in her sample. Ruppert cited examples of thoughts beginning with phrases such as I should have...

Cognitivebehavioral Assumptions And Aggression

The cognitive-behavioral framework assumes that aggression is not merely triggered by environmental events, but rather through the way in which these events are perceived and processed by the individual. This processing refers to the child's appraisal of the situation, anticipated reactions of others, and self-statements in response to particular events. A variety of cognitive and attributional processes have been found in aggressive youths. Deficits and distortions in cognitive problem-solving...

Empirical Status Of Cbt For Anorexia Nervosa

Empirical investigations of the efficacy of CBT for AN are just beginning to appear in the literature. Currently, only two controlled trials of CBT for AN have been published. Serfaty, Turkington, Heap, Ledsham, and Jolley (1999) randomized 35 persons with AN to either CBT or nutritional counseling. After 6 months of treatment, dropout rates were 8 for CBT and 100 for nutritional counseling. Those receiving CBT showed significant increases in body mass index, and significant decreases in eating...

Complex Clinical Presenting Problems

With regard to cognitive characteristics, individuals with autism, Asperger's Disorder, and PDD-NOS vary widely in terms of deficits, delays, and advanced skills. Some of these cognitive deficits include difficulty with categorical thinking, emotion recognition, rule-governed behavior, perspective taking, logical reasoning, executive functioning, and abstract and symbolic representations. Individuals with Asperger's Disorder often demonstrate minimal impairment compared to individuals with...

Cognitive Distortions And Treatment Interventions

Several cognitive and behavioral techniques can be used by the therapist to help to question both the distortions and the schema that underlie them. These techniques can be taught to patients to help them respond in more functional ways. The goals in using behavioral techniques within the context of CBT are manifold. The first goal is to utilize direct behavioral strategies and techniques to test dysfunctional thoughts and behaviors. A second use of behavioral techniques is to practice new...

Thomas E Joiner Jr and Foluso M Williams

Keywords cognitive-behavioral therapy, suicide, parasuicide, dialectical behavioral therapy Suicidality is undoubtedly a pressing clinical issue. Effective treatment of suicidal behavior can potentially save an individual's life. Therefore, it is imperative that the treatment of suicidality be grounded in empirical research. Cognitive-behavioral therapy (CBT) for suicidal behavior provides scientifically supported treatment for this serious condition. A recent review of the literature assessed...

Specific Phobia

Specific phobia refers to a persistent fear that is cued by the presence or anticipation of a specific object or situation (APA, 2000). When exposed to the situation or object, the individual experiences a panic attack or paniclike symptoms. As a result of anticipatory anxiety about experiencing further panic symptoms, the individual begins to avoid the phobic situation or endure it with great difficulty. The DSM-IV-TR (APA, 2000) identifies five subtypes that indicate the focus of fear in...

Frank M Dattilio

Keywords cognitive, behavioral, couples, family, schema While Albert Ellis has written that he adapted his model of rational emotive therapy (RET) to work with couples as early as the late 1950s, little has appeared in the professional literature on cognitive-behavioral marital and family therapy prior to the 1980s. Principles of behavior modification were initially applied to interactional patterns of family members only subsequent to their successful application to couples in distress. This...

Contemporary Views Of Cognitive Vulnerabilities

Today, most investigators recognize that most individuals who are exposed to precipitating stressful events do not develop clinically significant psychological disorders. Moreover, the specific disorder that emerges for different individuals is not determined just by the stressful event alone (i.e., precipitating stresses do not just occur in conjunction with any one clinical disorder), and is hypothesized to depend on their particular cognitive vulnerabilities (Riskind & Alloy, in press)....

Cognitive Model Of Low Selfesteem

The development and maintenance of low self-esteem can be understood in terms of a cognitive model (Fennell, 1997) closely based on A. T. Beck's original cognitive model of emotional disorder (Beck, 1976). The model, together with an example, is illustrated in Figure 1. It suggests that the essence of low self-esteem resides in negative core beliefs about the self (the Bottom Line), which derive from an interaction between inborn Lack of praise or validation, lack of interest, odd one out in...

Imagery In

In recent years, an increasing number of cognitive-behavioral oriented clinicians have elaborated on the clinical application of imagery as a means of modifying maladaptive cognitions schemas and restructuring disturbing events and associated meanings. Within the CBT family, behaviorists were the first to report the clinical use of imagery in their work with phobias. As part of their systematic desensitization treatment, covert desensitization was employed as a means of deconditioning and...

Uses Of Mi

MI or adaptations (Burke, Arkowitz, & Dunn, 2002) have been used both as a stand-alone intervention and as a means of preparing clients to effectively engage in treatments that are distinct from MI itself. Much of the original work on MI focused on brief interventions for problem drinkers in which a very short (often no more than 10-15 minutes) interaction, using the MI principles described above, was used to prompt change in alcohol use. MI has also been the core of stand-alone...

Marsha M Linehan and Eunice Y Chen

Keywords dialectical behavior therapy, DBT, bulimia nervosa, anorexia nervosa, eating disorders not otherwise specified, binge eating disorder, borderline personality disorder Dialectical Behavior Therapy (DBT) is a multimodal cognitive-behavioral treatment originally developed to treat chronically suicidal individuals meeting borderline personality disorder (BPD) criteria. DBT is informed by Eastern mindfulness practices and behavior therapy, and is conducted within the frame of a dialectical...

Cognitivebehavioral Model Of Anorexia Precipitation And Maintenance

Vitousek and Ewald (1993) proposed a cognitive-behavioral model that highlights common pathways in the precipitation and maintenance of AN. According to the theory, a confluence of individual variables (e.g., perfectionism, low self-esteem, compliance, preference for simplicity), sociocultural variables (i.e., an environment that equates thinness with beauty and worth), and personal stressors (e.g., loss, failure, onset of puberty or young adulthood) combine to create dysfunctional beliefs...

Criticisms Of Cbt For Schizophrenia And Directions For Future Research

The key assumption that the faulty logic associated with hallucinations and delusions is similar to that seen in other disorders has not been subjected to empirical evaluation, and runs counter to a large body of literature on the neurobiological basis of thought disorder in psychosis. While the validity of this assumption is an important issue for future research to address, CBT treatment strategies may nevertheless be effective in helping patients cope with symptoms. Results for acute...

Cognitive Formulation

Health anxiety is part of the anxiety spectrum of disorders. As such, cognitive behavioral formulations of this condition emphasize elements that are central to other experiences of anxiety. Specifically, perceptual and memory biases give rise to the cognitive distortion or magnification of problems, engagement in affective reasoning (e.g., If I feel it, it must be true), and underestimation of coping ability. Feelings of apprehension and worry are experienced as a result, which exacerbate...

Jesse H Wright and D Kristen Small

Keywords computers, computer-based therapy, treatment for depression The first computer programs for cognitive-behavior therapy (CBT) were developed in the 1980s by teams of investigators in the United Kingdom (Carr, Ghosh, & Marks, 1988 Ghosh, Marks, & Carr, 1984) and the United States (Selmi, Klein, Greist, & Harris, 1982 Selmi, Klein, Greist, Sorrell, & Erdman, 1990). Using the computer technology of the time, these researchers produced programs that relied on written text,...

Kelly L Gilrain and Jacqueline D Kloss

Keywords sleep disorders, sleep apnea, insomnia, jet lag, narcolepsy Millions of Americans suffer from sleep disorders including, but not limited to, sleep apnea, insomnia, narcolepsy, restless legs syndrome, and circadian rhythm disorders. While the quality, extent, and severity of these symptoms depend on the nature and course of each particular condition, sleep disorders pose a serious personal and public health concern. Individuals with sleep problems may encounter a myriad of adverse...

F

Phobia-related, 291 Fallacies, as cognitive distortions, 118 Family of mentally-retarded individuals, 181 of obsessive-compulsive disorder patients, 348 Family anxiety management (FAM) training programs, 40, 41, 42-43, 44 Family caregivers. See Caregivers Family education, for mentally-retarded adults, 245 Family pathology, as therapeutic obstacle, 337 Family sociability, as social anxiety disorder risk factor, 369 Family therapy, 136-139 for bipolar disorder, 77 for geriatric depression, 157...

Six Dimensions Of Interpretation

Interpretation of the Rorschach from a CBT perspective is best done by looking at the structural characteristics of the RIM. According to Weiner (1998), this structural approach is based on the belief that the Rorschach measures perception, and that the subject's test responses are a representative sample of his or her behavior. In this way, the RIM is seen as a problem-solving task. How the client responds to this perceptual-cognitive task provides therapists with information about how he or...

Elements Of Cbt For Adult Adhd

The elements of CBT that follow will be familiar to any clinician well-versed in the model. What differentiates CBT from being merely a collection of techniques is that, done rightly, it endeavors to enlighten the unique experience of a patient and to help her him explore possibilities for making desired changes. What follows represents a cross-sectional summary of ongoing efforts to modify CBT to the clinical needs of adults with ADHD (see McDermott, 2000 Ramsay & Rostain, in press)....

Empirical Support For Biofeedback

Scientific investigation of biofeedback has lagged behind its clinical application. This is true with both adult and child populations. Although a lot of literature on the topic has been published, empirical support for biofeedback has not clearly supported its widespread use. Research during the late 1970s and 1980s focused on the use of biofeedback with adult populations for a variety of disorders. This literature base has been criticized for lack of scientific rigor. From the empirical...

Arthur A Freeman and Bradley Rosenfield

Keywords self-help, therapeutic collaboration, coping activities homework. n. 1 an assignment given a student to be completed outside the classroom 2 preparatory reading or research The Merriam-Webster Dictionary (1995). Springfield, MA Merriam-Webster, Inc. Homework or self-help work is an essential part of cognitive behavioral work. Simply, when therapy ends, regardless of the number of sessions, focus of the sessions, or goals of the therapy, everything that the patient does must be viewed...

History And Overview Of Cognitive Distortions

Cognitive distortions were originally defined by Beck (1967) as the result of processing information in ways that predictably resulted in identifiable errors in thinking. In his work with depressed patients, Beck defined six systematic errors in thinking arbitrary inference selective abstraction overgeneralization magnification and minimization personalization and absolutistic, dichotomous thinking. Years later, Burns (1980) renamed and extended Beck's cognitive distortions to ten types...

Criticisms Of Cbt With Chronic Pain Clients

In summary, CBT has strong empirical support as an effective treatment for chronic pain clients. More research is needed to explore whether cognitive therapy or behavior therapy is superior with chronic pain clients in general and for what types of problems or outcomes. In addition, the benefits of adding CBT to active treatments for chronic pain clients, especially low back pain clients, demand further exploration. Some of the criticisms of the research on CBT or behavioral therapy with...

Assessment In Clinical Practice

Cognitive-behavioral clinicians commonly use self-report measures such as a thought record (e.g., Thought Record, Persons, Davidson, & Tompkins, 2001 Daily Record of Dysfunctional Thoughts, Beck et al., 1979) to identify automatic thoughts, underlying schema, and cognitive distortions. Successful use of the thought record depends on a number of factors the clinician's willingness to use this tool the clinician's knowledge about how to use this tool to help the patient identify cognitive...

Esther Deblinger and Melissa K Runyon

Keywords child sexual abuse, child physical abuse, posttraumatic stress disorder, parenting, cognitive-behavioral therapy Child maltreatment is a highly prevalent public health problem that results in short- and long-term emotional and behavioral consequences for children and their families. Based on recent statistics reported by the U.S. Department of Health and Human Services (USDHHS), 879,000 substantiated cases were reported to child protective service agencies across 50 states in 2000...

Types Of Cognitive Distortions

Cognitive distortions were originally identified in patients with depression. Since then, clinicians have expanded their identification and treatment of cognitive distortions to many other disorders (DiTomasso, Martin, & Kovnat, 2000 Freeman, Pretzer, Fleming, & Simon, 1990, 2004 Freeman & Fusco, 2000 Wells, 1997). Further, cognitive distortions have been found to play a role in sexual dysfunction (Leiblum & Rosen, 2000), eating disorders (Shafran, Teachman, Kerry, & Rachman,...

Melanie J V Fennell

Keywords low self-esteem, core beliefs, rules for living, anxious predictions, self-criticism Low self-esteem, a reflection of central negative beliefs about the self, seems a prime candidate for CBT. Yet until relatively recently it was rarely identified as a therapeutic target in its own right, perhaps because it is a transdiagnostic cognitive theme, and thus does not fit readily within the traditional psychiatric classifications that have shaped key developments in CBT. A negative sense of...

Terence M Keane and Meredith Charney

Keywords PTSD, zone stressors, combat stressors, war veterans, military, refugees, internally displaced persons Posttraumatic stress disorder (PTSD) is a disorder characterized by intrusive thoughts about, preoccupation with, and nightmares of an extremely stressful life event. Typically these events are life threatening either to the individuals themselves or their loved ones. Initially included in the diagnostic nomenclature in the third edition of the American Psychiatric Association's...

Jesse H Wright and David A Casey

Keywords pharmacotherapy, medication, combined treatment Cognitive therapy and pharmacotherapy have common attributes of being structured, problem-oriented interventions with well-defined theories and strong empirical support for efficacy. Although these major treatment methods are derived from different theoretical perspectives, they are often used together to offer patients a full range of biological, cognitive, and behavioral therapies for psychiatric disorders. Research studies have...

Application Of Cognitivebehavioral Therapy

Most notably, psychophysiologic insomnia is recognized for its complex multifaceted etiology and manifestation, and is effectively conceptualized and treated through a CBT model. Treatment for primary insomnia with cognitive-behavioral strategies is well-documented and continues to be a rapidly growing area of research Morin et al., 1999 . Therapies such as stimulus control, progressive muscle relaxation, paradoxical intention, and cognitive therapy for insomnia i.e., challenging dysfunctional...

Contributors

Abramson, Department of Psychology, University of Wisconsin-Madison, Madison, WI Lesley A. Allen, Robert Wood Johnson, Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, NJ Lauren B. Alloy, Department of Psychology, Temple University, Philadelphia, PA Martin M. Antony, St. Joseph's Healthcare, Hamilton, Ontario, Canada L. Michael Ascher, Department of Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA Tony Attwood, Asperger's Syndrome...

A CBT Protocol for Treating Perfectionism

This section describes an example of how CBT might be used to treat perfectionism. Although CBT has not been evaluated specifically for that purpose, these strategies are used extensively in empirically based psychological treatments for psychological disorders that are associated with perfectionism, including depression and various anxiety disorders. Typically, the initial treatment session would begin with presenting the rationale for the therapy. This would include some discussion of the...

The Measurement Of Treatment Fidelity

Treatment adherence and competence scales have been devised in recent years, typically for use in the evaluation of a clinical trial. The Collaborative Study Psychotherapy Rating Scale CSPRS Hollon et al., 1988 is a 48-item measure that rates therapists on whether or not they provided a number of treatment methods in a given session, including CBT techniques, general therapeutic skills, therapist directiveness, IPT techniques, and clinical management. The CSPRS has demonstrated adequate...

Lee Hyer and Steve Sohnle

Keywords posttraumatic stress, older adults Posttraumatic stress disorder PTSD is a stress reaction characterized by symptoms of reexperiencing, avoidance numbing, and hyperarousal following exposure of 1 month or more to an extreme trauma. In recent years there has been a spate of studies and meta-analyses on the treatment of this disorder, involving the key curative components of exposure and assimilative techniques, as well as secondary factors of relaxation and rescripting. Generally, these...

Treatment For Childhood Ptsd

Cognitive-behavioral therapy CBT is among the most widely investigated treatment for childhood PTSD. The theoretical model of CBT for treating PTSD draws on Mowrer's 1939 two-factor learning model, which integrates classical and operant conditioning approaches. In the classical conditioning model, neutral stimuli occur in close proximity to a traumatic event unconditioned stimulus , which results in a series of involuntary responses, including fight-or-flight reactions unconditioned responses ....

Anger Management Interventions

In order to prevent an aggressive reaction to a triggering stimulus, it is necessary for youths to manage their anger arousal and process the interpersonal exchange such that a more prosocial response is exhibited. The anger management treatment protocols focus on the three hypothesized components of the anger experience physiological responses, cognitive processes, and behavioral responses Novaco, 1979 . If anger reactions are comprised of heightened physiological arousal, cognitive...

Pcp Therapy

Kelly 1955 defined disorder as any personal construction which is used repeatedly in spite of consistent invalidation p. 831 . Thus, therapy can be seen as helping a person to reorganize and reconstrue even the most superordinate constructs. Basic features of the PCP therapeutic stance include the credulous approach and an invitational mode. Kelly first devised fixed role therapy as one therapeutic mode, and PCP has been elaborated along a number of other therapeutic dimensions. Credulous...

Dbt Model Of Eating Disorders

DBT for ED is based on a broadly defined affect regulation model of eating disorders. The basic premise of the theory is that disordered eating serves to regulate intolerable affective states in individuals with few or no other adaptive strategies for regulating affect. Bingeing or bulimic behavior is explained as a result of trying to escape or block primary or secondary aversive emotions that may be triggered by thoughts regarding food, body image, perfectionism, the self, or interpersonal...

Summary

Exposure therapy has increasingly been used in conjunction with other cognitive-behavioral therapies in a variety of formats and techniques, particularly in the treatment of anxiety disorders. Reasons for the addition of cognitive enhancements to exposure therapy include concerns for client well-being and or an interest in increasing client willingness to engage the treatment. Other newer therapies such as CPT, ACT, and EMDR, while based in differing theoretical paradigms, incorporate cognitive...

Definitions Of Cognitive Distortions

Arbitrary Inference Jumping to Conclusions. The process of drawing a negative conclusion, in the absence of specific evidence to support that conclusion Beck et al., 1979 Burns, 1980,1989,1999 . Example I'm really going to blow it. What if I flunk Burns, 1989 . Catastrophizing. The process of evaluating, whereby one believes the worst possible outcome will or did occur Beck et al., 1979 Burns, 1980, 1989, 1999 . Example I better not try because I might fail, and that would be awful Freeman amp...

Howard Kassinove and Raymond Chip Tafrate

Keywords anger, aggression, hostility, experiences, expressions, outcomes Anger is a basic human emotion Plutchik, 1980, 2000 . When it is mild, infrequent, and fleeting, it can be helpful as an alerting stimulus or a motivating force. In contrast, when it is strong, frequent, and enduring, anger is highly disruptive to effective functioning. Practitioners certainly know that strong anger is a major presenting and continuing problem in child, adolescent, and adult cases. Yet, much more of our...

Criticisms Of Biofeedback

The most significant criticism of biofeedback involves the limited amount of empirical data supporting its widespread clinical application. In some cases, the application of biofeedback to certain clinical problems has progressed with even limited theoretical rationale, let alone empirical support. Biofeedback by definition can involve a variety of physiological indicators, making its application highly variable. Thus, regardless of empirical findings, treatment using biofeedback is not well...

The Anger Episode Model

Models Anger

Kassinove and Tafrate 2002 developed a five-stage anger episode model to guide treatment Figure 1 . They recommend that the model be used as a reference point for joint practitioner-patient understanding of anger as well as an idiographic assessment strategy. Elements of the model have been validated by Kassinove, Sukhodolsky, Tsytsarev, and Solovyova 1997 and Tafrate, Kassinove, and Dundin 2002 . Triggers. Each episode begins with a triggering event. These triggers are usually unwanted...

Empirical Status Of Metacognitive Theory

Research on patients with GAD and worry-prone non-patients support several central aspects of this model. Individuals meeting criteria for GAD give positive reasons for worrying such that it contributes to motivation, preparation, and avoidance. Proneness to pathological worrying is positively associated with metacognitive factors including positive and negative beliefs about worrying. Patients with DSM-III-R-diagnosed GAD, compared to patients suffering from social phobia, panic disorder, or...

Hnv

Positive metabellefs activated Figure 1. The metacognitive model of GAD. Reproduced from Wells, 1997, with permission. Figure 1. The metacognitive model of GAD. Reproduced from Wells, 1997, with permission. be prepared. The person with GAD executes Type 1 worry sequences in which a range of what if questions are contemplated and potential strategies for dealing with these scenarios are generated. The content of Type 1 worrying focuses on external events and noncognitive internal events such as...

Raymond G Romanczyk and Jennifer M Gillis

Keywords autism, autism spectrum disorder, fears phobias, Asperger's disorder, social skills anxiety Currently, there are five different disorders under the category of Pervasive Developmental Disorders PDD in the DSM-IV-TR APA, 2000 . The term Autism Spectrum Disorders ASD is commonly used in place of PDD, particularly by the lay public. The most prevalent diagnoses in this category Autistic Disorder, Asperger's Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified PDD-NOS are...

Review Of Available Measures Of Cognitive Distortions

A review of available measures of cognitive distortions reveals five clinical instruments designed to measure the general construct of cognitive distortion within the cognitive therapy literature the Dysfunctional Attitude Scale DAS, Weissman, 1979 Weissman amp Beck, 1978 , Cognitive Error Questionnaire CEQ, Lefebvre, 1981 , Automatic Thoughts Questionnaire ATQ, Hollan amp Kendall, 1980 , Cognitive Distortion Scale CDS, Briere, 2000 , and Inventory of Cognitive Distortions ICD, Yurica amp...

Anorexia Treatment

Vitousek formerly Bemis has been the most prominent theorist with respect to cognitive-behavioral treatment for AN. In her treatment model, motivation becomes a focal point in therapy as most AN clients do not seek help voluntarily. Motivational and empathetic interventions are interwoven throughout treatment, which is designed to eliminate self-starvation, reduce dysfunctional attitudes regarding weight, shape, and worth, increase personal efficacy, and prevent relapse. Because of the...