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Treatment Overview
Published in Melisa Robichaud, Naomi Koerner, Michel J. Dugas, Cognitive Behavioral Treatment for Generalized Anxiety Disorder, 2019
Melisa Robichaud, Naomi Koerner, Michel J. Dugas
As important as it is for clients to display symptom improvement through the course of treatment, it is of even greater importance that those gains are maintained, and potentially improved upon, over time. This is particularly the case with our CBT protocol for GAD, given that the primary goal of treatment is a shift in beliefs about the perceived threat of uncertainty. Enduring cognitive change requires an abundance of evidence in favor of new and more balanced beliefs, which in this case is obtained through repeated behavioral experiments. Yet it is only time and experience that can provide enough compelling evidence for a true cognitive shift. With this in mind, our final treatment module is designed to help clients maintain their gains following treatment and to continue their progress over time.
Remediative approaches for cognitive disorders after TBI
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Mark J. Ashley, Rose Leal, Zenobia Mehta, Jessica G. Ashley, Matthew J. Ashley
Cognitive shift activities should adhere to the concepts of task complexity and presentation of external sensory stimuli. Activities should begin with two simple physical tasks, requiring the individual to shift from one activity to the other and back. Data collection includes response time to shift between tasks and accuracy of task completion. Once the individual demonstrates competency with physical tasks, task complexity should then progress to physical and mental, then to mental only. Tasks can be further complicated with the addition of external sensory stimuli. Table 27.1 can be referred to for the order of distractor presentation.
Brief History of Multidisciplinary Management of Chronic Pain, 1900–2000
Published in Michael E. Schatman, Alexandra Campbell, John D. Loeser, Chronic Pain Management, 2007
Chronic pain patients themselves may reject therapies predicated on their own behavior change. Often such patients have spent years seeking a passive medical “fix,” being offered diagnosis after diagnosis, drug after drug, surgery after surgery. They may have become depressed and disillusioned to the point where they no longer believe relief is possible; they may believe that opioids would provide the best help, if they could only get a long-term prescription; or they may simply believe that they have not yet found the right doctor, with the right diagnosis, drug, or treatment. But, for many, a major cognitive shift is necessary for them to see their own behavior as the agent of change in improving function and obtaining pain relief. Those patients who can successfully make the shift will often benefit from a multidisciplinary program; but, for others, the curative promise of modern biomedicine, even where it has failed, discourages them from making the investment required.
Psychological preconditions for flourishing through ultrabilitation: a descriptive framework
Published in Disability and Rehabilitation, 2020
In turn, self-care strategies, such as positive self-talk, could reinforce this cognitive shift. They could reveal and emphasize what persons believe they can choose to do, and have an appetite to do, in order to flourish. Reinforcement could come from clinicians using ambiguity and uncertainty as opportunities to foster growth that respects other subjectivities. For example, qualities such as faith, hope and trust in genuine possibilities of agency could be highlighted to indicate error in viewing recovery or normalcy as impossible or necessarily good enough. Clinicians could also introduce an action focus, motivating persons to use their autonomy to accept what they cannot change but also eschew rigid ideas about themselves. This development of flexible repertoires can enable persons to set and implement challenging but personally valued and achievable goals through action committed to behavior change.
Developing an evidence-based prehabilitation programme designed to improve functional outcomes after lumbar fusion surgery - A feasibility study using the Medical Research Council framework
Published in European Journal of Physiotherapy, 2020
Hanna Lotzke, Annelie Gutke, Marlies den Hollander, Rob Smeets, Mari Lundberg
To assess the feasibility of the Study Protocol version 2.0 and to look into the treatment differentiation (whether the treatment differed in an intended manner) between the pilot intervention and conventional care intervention, a SSRD study was performed. More specifically, we wanted to investigate the following questions:did the dependent variables that were measured daily (kinesiophobia, catastrophising, physical activity and functioning,) show any changes after the pilot intervention?did the dependent variables that were measured daily show any changes after conventional care intervention?could a cognitive shift be detected as shown by the dependent variable catastrophising, measured daily during the pilot intervention or during conventional care intervention?did a change occur in the dependent outcome measures after the SSRD study?
Benefits of Moral Elevation in Veterans with PTSD and Moral Injury: A Proposed Theoretical Framework and Pilot Study
Published in Military Behavioral Health, 2019
Adam P. McGuire, Elizabeth Nosen, Judith A. Lyons
Clinician-rated avoidance symptom severity negatively correlated with aggregate elevation; therefore, veterans who reported higher chronic levels of weekly elevation were rated as having less severe avoidance symptoms at posttreatment. Aggregate elevation also demonstrated medium-sized correlations (rs ≥ .30) with other clinician-rated symptom scores (intrusion, cognition/mood) and a large correlation (r ≥ .50) with the total CAPS score, but they were not statistically significant in this small pilot sample. These findings highlight the potential for elevation to impact PTSD symptoms. Considering the proposed framework, overcoming external avoidance symptoms could be related to a strong desire to emulate virtuous acts performed by fellow group members during treatment. For example, witnessing another member demonstrate bravery in completing a difficult exposure task may motivate a veteran to challenge themselves and increase treatment engagement with their own exposure exercises, which could ultimately lead to better treatment outcomes. Attempts to emulate other virtues may also encourage approach versus avoidant behaviors (e.g., completing an act of generosity or kindness), which may positively contribute to reductions in avoidance symptoms. In addition, increased elevation could potentially influence avoidance behaviors through a cognitive shift in how veterans perceive other people. Recognizing the virtuous acts of others and experiencing elevation in response could foster beliefs that some people are good or trustworthy and that the world is not necessarily an evil place. Such a cognitive shift might also increase the likelihood of socialization and decrease avoidance tendencies.