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Addressing Problematic Behaviors Using Therapeutic Exposure
Published in Sheryl M. Green, Benicio N. Frey, Eleanor Donegan, Randi E. McCabe, Cognitive Behavioral Therapy for Anxiety and Depression During Pregnancy and Beyond, 2018
Sheryl M. Green, Benicio N. Frey, Eleanor Donegan, Randi E. McCabe
In the first part of this book, you learned to identify and challenge unhelpful thoughts that were contributing to your anxiety. You also learned to develop more helpful and more balanced thoughts that can decrease distress and promote a greater sense of confidence. In this chapter, we turned to a more behavioral approach to tackling anxiety. Specifically, you learned about a therapeutic exposure-based approach, in which you generated an exposure hierarchy. The idea behind this approach is that avoidance of situations that are associated with anxiety tends to maintain or prolong anxiety in the long run. A better approach is to gradually experiment with entering into, and staying in, situations that make you feel anxious, but in a gradual and systematic manner that is under your control. This gradual exposure gives you the chance to become used to being in these situations (i.e., habituation curve) and to challenge any catastrophic thoughts about the outcomes. Using this approach has the potential to help you build your self-confidence and the sense that you can cope in difficult situations.
Running
Published in Ira Glick, Danielle Kamis, Todd Stull, The ISSP Manual of Sports Psychiatry, 2018
If an athlete presents with panic attacks, and concomitant with development of that condition is discussing dropping out of running, the clinician should evaluate if their panic seems worse when exercising. In such a situation, treating the panic disorder, and not encouraging phobic avoidance of running, would be the recommended intervention. Continued running, in fact, could be used as exposure therapy to address the condition. In this instance, an exposure hierarchy, starting with slow jogging and leading up to full-intensity sprinting, could be undertaken. Cognitive restructuring could accompany the exposure to intervention. Similarly, exposure therapy is the behavioral approach of choice for most other anxiety disorders in athletes, as in any patients.
Acceptability and Effectiveness of Humor- and Play-Infused Exposure Therapy for Fears in Williams Syndrome
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2022
Bonita P. Klein-Tasman, Brianna N. Young, Karen Levine, Kenia Rivera, Elizabeth J. Miecielica, Brianna D. Yund, Sydni E. French
A structured functional assessment interview (FBA) designed specifically for this study was conducted via Zoom with parents to characterize the current behaviors, child functioning, child distress, parental distress and interference in daily living related to the child’s fears and phobias. The interview included questions about antecedents, behavioral descriptions, and consequences (e.g., Alter et al., 2008; O’Neill et al., 2014). Ratings of severity of fear and anxiety responses were also made to allow for the development of an exposure hierarchy as a context for the intervention and to aid in planning different approaches to playfully exposing the child to their feared stimulus. Narrative parent responses are recorded as well as ratings (0–10 Likert scale) for minimum and maximum distress associated with presence of feared stimulus, average level of distress when exposed to feared stimulus, level of interference in daily routines, avoidance of feared stimulus (child and parent), and parent distress level relating to child’s fear and anxiety.
Clinical Hypnosis in Postoperative, Adult-Onset Dysphagia: A 2-Year Empirical Case Study
Published in International Journal of Clinical and Experimental Hypnosis, 2019
Michael T. M. Finn, Lindsey C. McKernan
Given this framework, the therapist and patient collaboratively designed an exposure hierarchy of feared foods and contexts. At the low end of the hierarchy (less fear) were “no-chew” foods, and “safer” experiences such as eating eggs and cereal at home with her husband present. At the high end of the hierarchy were experiences such as going out to dinner in public with her husband and eating alone. The course of treatment involved stress reduction via establishing a comfortable and secure therapeutic alliance followed by imaginal exposure on items of the hierarchy, with instruction in self-hypnosis and application outside of session. In-vivo exposure aided by self-hypnosis for relaxation was encouraged during the week. The final two sessions were focused on maintenance of symptom reduction. In response to the patient’s request, self-hypnosis was briefly explored as a way help the patient manage anxiety with driving. This facilitated understanding of the flexibility of her self-hypnosis practice to other life domains.
Where should we go from here? Identified gaps in the literature in psychosocial interventions for youth with autism spectrum disorder and comorbid anxiety
Published in Children's Health Care, 2020
Alexandra M. Slaughter, Morgan M. McNeel, Eric A. Storch, Sarah S. Mire
Within each of the four broad intervention categories identified in the current review, it is important to consider commonalities and differences among the studies comprising the respective categories. Research on CBI used for ASD + anxiety (i.e., the 18 studies in Table 2) included youth ranging in ages 7–19 years who are described as “high functioning,” (in most cases IQ > 69, though details of each study’s criteria are included in Table 2) and the number of sessions ranged from 4 to 32. The majority of these studies were conducted in clinic settings and in both individual and group formats. Three story-based interventions, with sessions ranging from 15 minutes to 12 weeks and conducted in a variety of settings, were studied among youth ages 6–10 years and most participants were also high functioning. All story-based interventions in these studies were conducted in an individual format with participation from peers, teachers, and/or parents. The four exposure-only interventions (i.e., conducted apart from other CB elements) included in the evidence-based practice guides and/or websites included children 2–9 years old, and most of these participants were lower functioning. Exposure-only interventions were also conducted in a variety of settings, including clinic, home, school, and dental offices; and steps for an exposure hierarchy ranged from 13 to 22 steps. Finally, sensory-integrative interventions (i.e., the three studies listed above) included participants 2–8 years of age. Functioning ranged from being impacted by mild symptoms of autism to displaying severe developmental and language delays, and session duration ranged from 7 to 15 sessions.