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Use the Power of “And”
Published in Scott A. Simpson, Anna K. McDowell, The Clinical Interview, 2019
Every day, clinicians help patients make difficult decisions and change unwanted behaviors. Change is more difficult when patients see their choices as an all or nothing affair—for example, when one choice is entirely positive and the other choice is entirely negative. This rigid, dichotomous thinking acts as a roadblock to solving problems and leads patients to feel helpless. In fact, most decisions are difficult and nuanced. Having a tool to identify and validate patients’ ambivalence is invaluable in helping patients realize change.
Questions and Answers
Published in David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly, MRCPsych Paper I One-Best-Item MCQs, 2017
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly
Answer: E. Arbitrary inference means ‘jumping to conclusions’. Dichotomous thinking means ‘all or nothing’ or ‘black and white’ thinking. The identification and evaluation of negative automatic thoughts is central to CBT. Schemas are the deeply held beliefs which give rise to our personality and may be the target of later therapy. [W. p. 174]
Borderline Personality Disorder
Published in David F. O'Connell, Dual Disorders, 2014
According to Beck et al. (1990), three basic assumptions exert a strong influence on the borderline patient's emotions, perceptions, and interpretations of events. These are: (1) the world is a hostile, dangerous, evil place; (2) I am incompetent and powerless to deal with it; and (3) I am basically unacceptable. These beliefs put the patient in a constant state of turmoil and crisis. Because of these basic beliefs, the patient needs to be constantly wary and to avoid or minimize risk-taking in daily living. At this level of thinking, these basic schemas can result in a wide variety of cognitive distortions, the most prevalent being dichotomous thinking. With this distortion, the borderline patient views him/herself and the world as discontinuous and discreet rather than continuous. For example, the patient may see him/herself as totally worthless and the therapist as omniscient, all-loving, and completely competent. A minor rejection in a relationship may lead the patient to conclude that rather than love him/her, the other person hates him/her. Through dichotomous thinking, patients can conclude that they will always fail in life, there is no point in living, and they will always be dysfunctional, so that the therapy process and their lives in general are a waste of time.
An integrative review of the qualities of a ‘good’ physiotherapist
Published in Physiotherapy Theory and Practice, 2023
Michelle J. Kleiner, Elizabeth Anne Kinsella, Maxi Miciak, Gail Teachman, Erin McCabe, David M. Walton
In physiotherapy literature, qualities have been divided into: interpersonal and professional skills (Reeve and May, 2009); human and professional competence (Rossettini et al., 2018a); social characteristics, knowledge, and skills (Wijma et al., 2017); and interpersonal, communication, and practical skills (O’Keeffe et al., 2016). The current review’s findings point to a need to overcome dichotomous thinking, and to re-conceptualize assumed dualities as being intertwined; for instance, cure and care, professional and personal, competence and relationality, evidence and practical wisdom. Asking not only why we do what we do in the technical aspects of professional practice, but also asking who we are and what it means to be with our patients, helps to identify areas of practice that might be otherwise (Kayes and McPherson, 2012). While these reflections prompt physiotherapists to improve their practice by attending to a broader repertoire of considerations in what constitutes a ‘good’ physiotherapist, it also invites reflection on how biomedical perspectives may have privileged the development of technical over other dimensions of good practice (Nicholls and Gibson, 2010).
Perspectives of Integrative Body-Mind-Spirit Interventions Among Women with Substance Use Disorder: A Qualitative Study
Published in Alcoholism Treatment Quarterly, 2023
Eva Nowakowski-Sims, Stephen Ferrante
A theme of uncertainty was present as the women were initially unsure of the IBMS interventions’ purpose. They feared they were not doing it right, especially meditation, which required the women to observe wandering thoughts as they drift through the mind. Persons in early recovery tend to judge their choices as good or bad, experiences as pleasant or unpleasant. This dichotomous thinking makes it harder to find balance and inner peace, necessary components of successful meditation. IBMS interventions emphasize harmony as understood through the dynamic interplay of the opposing halves of the whole that seek an equilibrium, and it is that balance of the two halves that is most optimal for wellness (Lee et al., 2009, p. 14). Participants began to understand that the key to finding inner peace was letting go of the expectation there was a right vs. wrong way to participate in IBMS. As the weeks progressed, so did their comfort with the interventions. This mirrored the recovery process, whereby reaching for sobriety is difficult, but with time and through the support of others, it can be achieved and when it is achieved, clients find peace,
Wrestling with uncertainty after mild traumatic brain injury: a mixed methods study
Published in Disability and Rehabilitation, 2020
Deborah L. Snell, Rachelle Martin, Lois J. Surgenor, Richard J. Siegert, E. Jean C. Hay-Smith, Tracy R. Melzer, Tim J. Anderson, Gary J. Hooper
As shown in Table 4, participants who had not recovered from their MTBI at time of study participation differed significantly from those who had recovered, across most of the psychological measures. These participants, compared with the recovered group, endorsed higher levels of anxiety and depressive symptoms; held more negative expectations about their recovery (IPQ-R Consequences subscale); felt less in control of their symptoms (IPQ-R Personal Control subscale); felt less certain about their diagnosis (IPQ-R Identity subscale); endorsed greater use of avoidance and acceptance coping strategies (Brief COPE Avoidance Coping domain score; Brief COPE Acceptance subscale) and limiting behaviors (BRIQ Limiting Behaviours subscale); and endorsed lower general quality of life (QOLIBRI). In contrast, there were no differences between groups for measures evaluating dichotomous thinking and behaviors (BRIQ All or Nothing subscale); support seeking behaviors (BRIQ Support Seeking subscales, Brief COPE Help Seeking); use of positive coping and active strategies (Brief COPE Approach Coping); or beliefs about treatment effectiveness (IPQ-R Treatment Control subscale).