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Surviving and Thriving in Medicine
Published in Clare Gerada, Zaid Al-Najjar, Beneath the White Coat, 2020
‘Thinking’ one’s way out of psychological distress is efficacious. One of the most constructive coping mechanisms is called ‘cognitive reframing’. Much of the anxiety we feel in stressful situations is linked to how we interpret the threat we face. For example, if we haven’t obtained the necessary blood result needed for the ward round, our automatic thoughts might be something along the lines, ‘I am terrible, I am a bad doctor, I am never going to get passed as competent’. These thoughts are more than likely then to induce feelings of anxiety. Identifying and challenging these negative and largely irrational thoughts and replacing them with more realistic ones is the essence of cognitive reframing. It is the technique that underpins cognitive behavioural therapy (CBT). Many doctors fret about failing exams. Failure for them equates with imperfection and thoughts of being useless and undeserving. Reframing this cognitive distortion by perhaps thinking, ‘well, it was a very difficult exam’ or ‘others have failed exams before and gone on to have really good careers’, can help. I talk more about these techniques in Chapter 23.
Co-occurring Depression, Anxiety, and Chronic Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
A common factor in psychological interventions for chronic pain is emphasis on the consequences that pain has on one’s life (rather than on pain intensity) as a way of addressing adaptive behavioral change (Kerns, Sellinger, & Goodin, 2011). A randomized controlled trial conducted by Wetherell et al. (2011) comparing ACT and CBT for chronic pain found that both types of intervention improve pain interference, depression and pain-related anxiety in individuals with chronic pain. Notably, CBT and ACT are not clinically incompatible; some interventions share common processes, and interventions from both approaches can be utilized in treatment. For example, an individual must first be aware of, and observe, his/her thoughts before deciding whether to change them or mentally distance from them. Moreover, certain CBT techniques, such as cognitive reframing, may be viewed as a variant of the ACT technique of creating cognitive distance from thoughts and staying in the present moment (Heimberg & Ritter, 2008).
Does health promotion teaching make a difference to students, teachers, patients and populations? Where is the evidence?
Published in Ann Wylie, Tangerine Holt, Amanda Howe, Health Promotion in Medical Education, 2018
Nisha Mehta, Aliya Kassam, Ann Wylie
As research demonstrates the effectiveness of health promotion activity, healthcare professionals will need to consider what is generalisable, transferable and applicable in their context. The large-scale, multisite ‘DESMOND’ programme (diabetes education and self-management programme for people with newly diagnosed type 2 diabetes), for example, resulted in significant and sustained improvements for patients, using a structured group education programme. There were improvements in weight loss, smoking status, physical activity and depression.12 Such findings need to be given considerable attention of course, but what is important with this work is that it builds on evidence that educational programmes with a theoretical basis and using cognitive reframing are associated with improved outcomes. The philosophy was based on patient empowerment and incorporated theories such as self-efficacy and behavioural change.
A multimodal approach to cancer-related cachexia: from theory to practice
Published in Expert Review of Anticancer Therapy, 2021
Alice Avancini, Ilaria Trestini, Daniela Tregnago, Massimo Lanza, Jessica Menis, Lorenzo Belluomini, Michele Milella, Sara Pilotto
In this sense, psycho-educational and psychological intervention should favor action-orientated, brief interventions, delivering a condensed package of ‘core’ cognitive-behavioral skills [3,66,67]. Such strategies may include, but are not limited to, cognitive restructuring or cognitive reframing techniques, identification of dysfunctional thinking patterns, stress and relaxation management skills, behavioral activation, social skills improvement, and expressive supportive therapy [68]. The shift to the conscious control of eating is often useful, through a reframe of eating as a necessity, rather than a pleasure, for promoting health outcomes such as slowing the disease progression, tolerating the side effects of chemotherapy, and maintaining strength and resistance [69]. Teaching cognitive reframing strategies also permits patients to take control of eating habits, supporting self-efficacy, empowering themselves and improving their QoL [69]. Despite some trials have investigated the impact of psychotherapy in advanced cancer patients [70,71], currently ongoing studies may confirm the positive effect also in cachectic patients [72].
Shifting Maladaptive Fall Risk Appraisal in Older Adults through an in-Home Physio-fEedback and Exercise pRogram (PEER): A Pilot Study
Published in Clinical Gerontologist, 2020
Ladda Thiamwong, Helen J. Huang, Boon Peng Ng, Xin Yan, Mary Lou Sole, Jeffrey R. Stout, Steven Talbert
A systematic review also confirmed that engaging community-dwelling older adults with visual biofeedback was found to be effective and could improve balance capacity (Alhasan et al., 2017). Visual biofeedback supports older adults with information related to their body functions with a goal of developing a change in behaviors (Alhasan et al., 2017) or tasks that cause falls. The previous study indicated that older adults who received positive feedback reported greater levels of balance confidence (Lamarche, Gionfriddo, Cline, Gammage, & Adkin, 2014). Additionally, visual physio-feedback could help in shifting maladaptive beliefs and direct participants toward adaptive behaviors (e.g., regular exercise) in a safe manner. A systematic review suggested that interventions with feedback and monitoring tend to improve exercise adherence (Room, Hannink, Dawes, & Barker, 2017). Furthermore, we used cognitive reframing, which is a method for identifying maladaptive thoughts and for changing perception to more closely align with reality. A recent meta-analysis revealed that cognitive and behavioral treatment showed positive effects on fear of falling and falls efficacy outcomes immediately after treatment and over the longer term (Papadimitriou & Perry, 2019).
The Validated Features of Psychological Interventions for Weight Loss: An Integration
Published in Behavioral Medicine, 2022
Simon A. Moss, Duygu Serbetci, Kerry O’Brien, Nektarios Alexi
The suggested intervention comprised some key facets. For example, the proposed intervention first entailed activities and experiences that promote self-efficacy—such as anecdotes about plausible and dramatic weight loss39,41 as well as simple changes to the lives of individuals33—and openness to challenging information—such as exercises in which people clarify their values.18 Next, individuals should stipulate and publicly commit50 to ambitious targets,46 accompanied by precise, tangible descriptions452 on many distinct, but compatible, behaviors they will initiate to achieve these targets.48 Individuals in these programs should reward themselves when they achieve, or genuinely attempt to achieve, these goals,5,54 but not with food. The individuals should construct specific plans to clarify how they will respond to temptations, setbacks, failures, and negative emotions. They should develop implementation intentions, both alone56 and with their partner,57 to achieve their goals and implement their plans. In addition, to counteract setbacks and complications, individuals should learn the fundamentals of cognitive behavioral therapy to modify unhelpful thoughts63 together with self-hypnosis, cognitive reframing, distancing, and meditation to regulate emotions.52,64 Finally, if these attempts are unsuccessful, practices that demand more resources—such as group support,69 virtual environments,71 motivational interviewing,73 and customized programs76—might need to be considered.