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Clinical techniques
Published in Robert McAlpine, Anthony Hillin, Interpersonal Psychotherapy for Adolescents, 2020
Robert McAlpine, Anthony Hillin
Secondly, Interpersonal Incidents can help the young person see his current problem from a different perspective. Many adolescents describe their interactions with significant others in very general terms, such as “Mum never lets me go out on Sundays”, “my maths teacher is always picking on me”, or “I can never be friends with them again”. These statements, although rarely accurate, derive from core beliefs and shape future expectations of others. In the above interchange, Tanya made it quite clear that she believed it was no use talking to her mother about her dilemma because, in Tanya’s words, “She’ll never change her mind”. The actual words or cognitions used by clients in their reports of Interpersonal Incidents give valuable information about how they see the world and, consequently, valuable information about the cognitive errors that reflect their beliefs about the world. Managing cognitive errors that occur within relationships with significant others through challenging their accuracy (disputing) and challenging their potency (decatastrophising) can provide a useful platform for interpersonal growth within the parameters of IPT-A.
Eating Disorders
Published in David F. O'Connell, Dual Disorders, 2014
Catastrophizing. This refers to the patient's tendency to react hysterically to real or imagined setbacks and view them as evidence that the worst will happen. This is the “Chicken Little” approach to personal problems; if an acorn falls, it means that the sky is falling. For example, a bulimic patient with strong conflicts about the expression of hostility may become convinced that the entire group and treatment community will reject her when she challenges another group member. The therapist can counter this distorted, irrational thought by decatastrophizing. Ask the patient, for example, “So what if your group rejected you? Would it really be the end of the world? Would you survive? Does the possibility exist that you could eventually talk to the group and regain their trust and acceptance?” By constantly challenging and exploring the patient's catastrophic fears, the therapist can help the patient see that the feared situation may not be so catastrophic.
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
The term CBT is used to describe a broad range of therapeutic modalities. Although most psychological treatments that have been shown to be effective for GAD carry the CBT label, they differ greatly from one another in terms of underlying models, treatment targets, and procedures. For example, in the CBT protocol “Mastery of Your Anxiety and Worry” (2nd Edition) developed by Zinbarg, Craske, and Barlow (2006), treatment components include relaxation, probability estimation, and decatastrophizing, all of which are considered cognitive behavioral interventions. However, none of these techniques is employed in our treatment package. This is due to several factors: first and foremost, we consider the process underlying excessive worry to be the primary focus of treatment, rather than worry itself. Given that worry content tends to shift daily for GAD clients, we view strategies that directly target the content of worry as akin to “chasing a moving target,” since they would need to be used for each subsequent worry. As such, although decatastrophizing and probability estimation can be helpful CBT strategies, they tend to be less effective as a whole when it comes to the excessive worry in GAD. Second, we view the associated symptoms of GAD (e.g., muscle tension, sleep disturbance) as being largely the result of pathological worry. The noteworthy consequence of such a conceptualization is that the treatment does not directly target the associated symptoms of GAD, and therefore strategies like applied relaxation and anxiety management training are not part of the treatment described in this book. Rather, all treatment modules bear directly on excessive worry and its underlying mechanisms, with concomitant reductions in associated symptoms expected to occur as a function of reductions in worry. Data from our clinical trials support this contention, as it was found that decreases in worry lead to decreases in the associated symptoms of GAD (see Chapter 6 for more detail).
Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence
Published in Psychiatry, 2021
Stevan E. Hobfoll, Patricia Watson, Carl C. Bell, Richard A. Bryant, Melissa J. Brymer, Matthew J. Friedman, Merle Friedman, Berthold P.R. Gersons, Joop de Jong, Christopher M. Layne, Shira Maguen, Yuval Neria, Ann E. Norwood, Robert S. Pynoos, Dori Reissman, Josef I. Ruzek, Arieh Y. Shalev, Zahava Solomon, Alan M. Steinberg, Robert J. Ursano
Decatastrophizing is another important intervention component that is critical to preserving and restoring hope. Many people catastrophize in order to adaptively prepare for the worst. Early CBT interventions have been found useful in counteracting these cognitive schemas (Bryant et al., 1998; Foa et al., 1995). Resick’s (Resick et al., 2002) Cognitive Processing Therapy works to correct erroneous cognitions related to catastrophizing and self–labeling with traits that spell ultimate failure in coping. Paradoxically, envisioning a realistic, yet challenging, even difficult outcome may actually reduce people’s distress, compared to envisioning an exaggerated catastrophic outcome. For instance, acknowledging that one’s home will take months to rebuild may need to be accepted, but the assertion that “I will never have a home again” is maladaptive. Hence, intervention at all levels should communicate that catastrophizing is natural, but that it should be identified and countered by more fact–based thinking.