Book: The Little CBT Workbook

Book Title:

The Little CBT Workbook: A Step-By-Step Guide to Gaining Control of your Life.

Author(s): Dr. Michael Sinclair and Dr. Belinda Hollingsworth.

Year: 2012.

Edition: First (1st), UK Edition.

Publisher: Crimson Publishing.

Type(s): Paperback and Kindle.

Synopsis:

Introducing essential Cognitive Behavioural Therapy (CBT) techniques, this practical workbook allows readers to explore the key principles behind CBT and discover how to apply them to improve their lives. With interactive exercises and checklists, this is suitable for self-teaching or for supplementing a CBT course.

On This Day … 24 February

People (Births)

  • 1900 – Irmgard Bartenieff, German-American dancer and physical therapist, leading pioneer of dance therapy (d. 1981).

Irmgard Bartenieff

Irmgard Bartenieff (1900 to 1981) was a dance theorist, dancer, choreographer, physical therapist, and a leading pioneer of dance therapy. A student of Rudolf Laban, she pursued cross-cultural dance analysis, and generated a new vision of possibilities for human movement and movement training. From her experiences applying Laban’s concepts of dynamism, three-dimensional movement and mobilization to the rehabilitation of people affected by polio in the 1940s, she went on to develop her own set of movement methods and exercises, known as Bartenieff Fundamentals.

Bartenieff incorporated Laban’s spatial concepts into the mechanical anatomical activity of physical therapy, in order to enhance maximal functioning. In physical therapy, that meant thinking in terms of movement in space, rather than by strengthening muscle groups alone. The introduction of spatial concepts required an awareness of intent on the part of the patient as well, that activated the patient’s will and thus connected the patient’s independent participation to his or her own recovery. “There is no such thing as pure “physical therapy” or pure “mental” therapy. They are continuously interrelated.”

Bartenieff’s presentation of herself was quiet and, according to herself, she did not feel comfortable marketing her skills and knowledge. Not until June 1981, a few months before she died, did her name appear in the institute’s title: Laban/Bartenieff Institute of Movement Studies (LIMS), a change initiated by the Board of Directors in her honour.

Dance Therapy

She held a position of dance therapy research assistant (1957-1967) to Dr. Israel Zwerling at the Day Hospital Unit of Albert Einstein College of Medicine. Zwerling, a psychiatrist […] was very receptive to further exploration of dance as a therapeutic tool for defusing aggression and anxiety. What particularly reinforced his interest in her was that she had a vocabulary and a notation for recording observations of movement. This became a vital factor in daily observations through the one-way screen, especially of family and therapeutic groups.

Dance therapy was then an emerging field of adjunctive therapy. Bartenieff’s special contribution was in bringing Laban’s work to a field very much in need of movement documentation: [It] provided a method of movement analysis and a system of notation which placed dance therapists on their own professional ground, giving them a language for describing patients’ movements, and eliminating the need to rely on less accurate jargon borrowed from other disciplines.

Book: Relaxation and Stress Reduction Workbook

Book Title:

Relaxation and Stress Reduction Workbook.

Author(s): Matthew McKay (PhD).

Year: 2019.

Edition: Seventh (7th).

Publisher: New Harbinger.

Type(s): Paperback and Kindle.

Synopsis:

The Relaxation and Stress Reduction Workbook broke new ground when it was first published in 1980, detailing easy, step-by-step techniques for calming the body and mind in an increasingly overstimulated world. Now in its seventh edition, this fully revised and updated workbook-highly regarded by therapists and their clients-offers the latest stress reduction techniques to combat the effects of stress and integrate healthy relaxation habits into every aspect of daily life.

This new edition also includes powerful self-compassion practices, fully updated chapters on the most effective tools for coping with anxiety, fear, and panic-such as worry delay and diffusion, two techniques grounded in acceptance and commitment therapy (ACT)-as well as a new section focused on body scan.

In the workbook, you will explore your own stress triggers and symptoms, and learn how to create a personal action plan for stress reduction. Each chapter features a different method for relaxation, explains why the method works, and provides on-the-spot exercises you can do when you feel stressed out. The result is a comprehensive yet accessible workbook that will help you to curb stress and cultivate a more peaceful life.

Book: Best Practices and Barriers to Engaging People with Substance Use Disorders in Treatment

Book Title:

Best Practices and Barriers to Engaging People with Substance Use Disorders in Treatment.

Author(s): Peggy O’Brien, Erika Crable, Catherine Fullerton, and Lauren Hughey.

Year: March 2019.

Edition: First (1st).

Publisher: US Department of Health and Human Services.

Type(s): eBook.

Synopsis:

In 2015, 20.8 million people aged 12 years or older (7.8% of the United States population) had a substance use disorder (SUD) in the previous year. Approximately 75% of this group, or 15.7 million Americans, had an alcohol use disorder,
2.0 million had a prescription opioid use disorder (OUD), and about 0.6 million had a heroin use disorder.

Since 1999, opioid-related overdose deaths in the United States have quadrupled, with more than 15,000 individuals experiencing prescription drug-related overdose deaths in 2015. Even though evidence-based SUD treatments are effective, rates of treatment receipt are quite low. In 2015, only 18% of the population with SUDs, or 3.7 million people, received SUD treatment – a number that has not increased significantly since 2002.

Only about 48% of patients who enter SUD treatment actually complete it.

You can access the book, for free, here.

Book: Approaches to Drug Abuse Counselling

Book Title:

Approaches to Drug Abuse Counselling.

Author(s): National Institute on Drug Abuse (NIDA).

Year: 2000.

Edition: First (1st).

Publisher: US Government Printing Office.

Type(s): eBook.

Synopsis:

Dual disorders recovery counselling (DDRC) is an integrated approach to treatment of patients with drug use disorders and comorbid psychiatric disorders.

The DDRC model, which integrates individual and group addiction counselling approaches with psychiatric interventions, attempts to balance the focus of treatment so that both the patient’s addiction and psychiatric issues are addressed.

The DDRC model is based on the assumption that there are several treatment phases that patients may go through.

You can access the book, for free, here.

Book: Integrating Behavioural Therapies with Medications in the Treatment of Drug Dependence

Book Title:

Integrating Behavioural Therapies With Medications in the Treatment of Drug Dependence (National Institute on Drug Abuse Research Monograph Series).

Author(s): Lisa Simon Onken (PhD), Jack D. Blaine (MD), and John J. Boren (PhD.

Year: 1995.

Edition: First (1st).

Publisher: US Government Printing Office.

Type(s): eBook.

Synopsis:

It is no revelation that drug dependence is a complex problem with behavioural, cognitive, psychosocial, and biological dimensions and may be treated with behavioural therapy (including behaviour therapy, psychotherapy, and counselling), and, where available, pharmacotherapy.

Drug use can be reduced behaviourally with appropriate manipulation of reinforcements within the environment (Higgins et al. 1993). Continued improvements over time in drug use can be initiated by cognitive behavioural psychotherapies to modify cognitions that perpetuate drug use (Carroll et al., submitted for publication), and a reduced likelihood of
relapse has been engendered by specialised training approaches (Rohsenow et al., in press).

Methadone, of course, has long been recognised as an effective pharmacotherapy to reduce opiate use, and its biological mechanism of action is well understood.

You can access the book, for free, here.

Book: Psychotherapy And Counselling In The Treatment Of Drug Abuse

Book Title:

Psychotherapy And Counselling In The Treatment Of Drug Abuse (National Institute on Drug Abuse Research Monograph Series).

Author(s): Lisa Simon Onken (PhD) and Jack D. Blaine (MD).

Year: 1990.

Edition: First (1st).

Publisher: US Government Printing Office.

Type(s): eBook.

Synopsis:

Drug abuse treatment occurs in a multitude of forms. It may be provided in outpatient or inpatient settings, be publicly or privately funded, and mayor may not involve the administration of medication. The differences among the philosophies of, and the services provided in, various drug abuse treatment programmes may be enormous. What is remarkable is that some form of drug abuse counselling or psychotherapy is almost invariably a part of every type of comprehensive drug abuse treatment. Individual therapy or counselling is available in about 99% of the drug-free, methadone-maintenance, and multiple-modality drug abuse treatment units in this country (National Drug and Alcoholism Treatment Unit Survey 1982). It is also available in approximately 97% of the detoxification units.

You can access the book, for free, here.

What is Exposure Therapy?

Introduction

Exposure therapy is a technique in behaviour therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalised anxiety disorder (GAD), social anxiety disorder, obsessive-compulsive disorder (OCD), post traumatic stress disorder (PTSD), and specific phobias.

Brief History

The use of exposure as a mode of therapy began in the 1950s, at a time when psychodynamic views dominated Western clinical practice and behavioural therapy was first emerging. South African psychologists and psychiatrists first used exposure as a way to reduce pathological fears, such as phobias and anxiety-related problems, and they brought their methods to England in the Maudsley Hospital training programme.

Joseph Wolpe (1915-1997) was one of the first psychiatrists to spark interest in treating psychiatric problems as behavioural issues. He sought consultation with other behavioural psychologists, among them James G. Taylor (1897-1973), who worked in the psychology department of the University of Cape Town in South Africa. Although most of his work went unpublished, Taylor was the first psychologist known to use exposure therapy treatment for anxiety, including methods of situational exposure with response prevention – a common exposure therapy technique still being used. Since the 1950s several sorts of exposure therapy have been developed, including systematic desensitisation, flooding, implosive therapy, prolonged exposure therapy, in vivo exposure therapy, and imaginal exposure therapy.

Medical Uses

Generalised Anxiety Disorder

There is empirical evidence that exposure therapy can be an effective treatment for people with generalised anxiety disorder, citing specifically in vivo exposure therapy, which has greater effectiveness than imaginal exposure in regards to generalized anxiety disorder. The aim of in vivo exposure treatment is to promote emotional regulation using systematic and controlled therapeutic exposure to traumatic stimuli.

Phobia

Exposure therapy is the most successful known treatment for phobias. Several published meta-analyses included studies of one-to-three hour single-session treatments of phobias, using imaginal exposure. At a post-treatment follow-up four years later 90% of people retained a considerable reduction in fear, avoidance, and overall level of impairment, while 65% no longer experienced any symptoms of a specific phobia.

Agoraphobia and social anxiety disorder are examples of phobias that have been successfully treated by exposure therapy.

Post Traumatic Stress Disorder

Virtual reality exposure (VRE) therapy is a modern but effective treatment of post-traumatic stress disorder (PTSD). This method was tested on several active duty Army soldiers, using an immersive computer simulation of military settings over six sessions. Self-reported PTSD symptoms of these soldiers were greatly diminished following the treatment. Exposure therapy has shown promise in the treatment of co-morbid PTSD and substance abuse.

Obsessive Compulsive Disorder

Exposure and response prevention (also known as exposure and ritual prevention; ERP or EX/RP) is a variant of exposure therapy that is recommended by the American Academy of Child and Adolescent Psychiatry (AACAP), the American Psychiatric Association (APA), and the Mayo Clinic as first-line treatment of obsessive compulsive disorder (OCD) citing that it has the richest empirical support for both youth and adolescent outcomes.

ERP is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears, but refrain from engaging in the escape response or ritual that delays or eliminates distress. In the case of individuals with OCD or an anxiety disorder, there is a thought or situation that causes distress. Individuals usually combat this distress through specific behaviours that include avoidance or rituals. However, ERP involves purposefully evoking fear, anxiety, and or distress in the individual by exposing him/her to the feared stimulus. The response prevention then involves having the individual refrain from the ritualistic or otherwise compulsive behaviour that functions to decrease distress. The patient is then taught to tolerate distress until it fades away on its own, thereby learning that rituals are not always necessary to decrease distress or anxiety. Over repeated practice of ERP, patients with OCD expect to find that they can have obsessive thoughts and images but not have the need to engage in compulsive rituals to decrease distress.

The AACAP’s practise parameters for OCD recommends cognitive behavioural therapy, and more specifically ERP, as first line treatment for youth with mild to moderate severity OCD and combination psychotherapy and pharmacotherapy for severe OCD. The Cochrane Review’s examinations of different randomised control trials echoes repeated findings of the superiority of ERP over waitlist control or pill-placebos, the superiority of combination ERP and pharmacotherapy, but similar effect sizes of efficacy between ERP or pharmacotherapy alone.

Techniques

Exposure therapy is based on the principle of respondent conditioning often termed Pavlovian extinction. The exposure therapist identifies the cognitions, emotions and physiological arousal that accompany a fear-inducing stimulus and then tries to break the pattern of escape that maintains the fear. This is done by exposing the patient to progressively stronger fear-inducing stimuli. Fear is minimised at each of a series of steadily escalating steps or challenges (a hierarchy), which can be explicit (“static”) or implicit (“dynamic” – refer to Method of Factors) until the fear is finally gone. The patient is able to terminate the procedure at any time.

There are three types of exposure procedures. The first is in vivo or “real life.” This type exposes the patient to actual fear-inducing situations. For example, if someone fears public speaking, the person may be asked to give a speech to a small group of people. The second type of exposure is imaginal, where patients are asked to imagine a situation that they are afraid of. This procedure is helpful for people who need to confront feared thoughts and memories. The third type of exposure is interoceptive, which may be used for more specific disorders such as panic or post-traumatic stress disorder. Patients confront feared bodily symptoms such as increased heart rate and shortness of breath. All types of exposure may be used together or separately.

While evidence clearly supports the effectiveness of exposure therapy, some clinicians are uncomfortable using imaginal exposure therapy, especially in cases of PTSD. They may not understand it, are not confident in their own ability to use it, or more commonly, they see significant contraindications for their client.

Flooding therapy also exposes the patient to feared stimuli, but it is quite distinct in that flooding starts at the most feared item in a fear hierarchy, while exposure starts at the least fear-inducing.

Exposure and Response Prevention

In the exposure and response prevention (ERP or EX/RP) variation of exposure therapy, the resolution to refrain from the escape response is to be maintained at all times and not just during specific practice sessions. Thus, not only does the subject experience habituation to the feared stimulus, but they also practice a fear-incompatible behavioural response to the stimulus. The distinctive feature is that individuals confront their fears and discontinue their escape response. The American Psychiatric Association recommends ERP for the treatment of OCD, citing that ERP has the richest empirical support.

While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms. Generally, ERP incorporates a relapse prevention plan toward the end of the course of therapy.

Mindfulness

A 2015 review pointed out parallels between exposure therapy and mindfulness, stating that mindful meditation “resembles an exposure situation because [mindfulness] practitioners ‘turn towards their emotional experience’, bring acceptance to bodily and affective responses, and refrain from engaging in internal reactivity towards it.” Imaging studies have shown that the ventromedial prefrontal cortex, hippocampus, and the amygdala are all affected by exposure therapy; imaging studies have shown similar activity in these regions with mindfulness training.

Research

Exposure therapy can be investigated in the laboratory using Pavlovian extinction paradigms. Using rodents such as rats or mice to study extinction allows for the investigation of underlying neurobiological mechanisms involved, as well as testing of pharmacological adjuncts to improve extinction learning.

Book: Therapy with a Map: A Cognitive Analytic Approach to Helping Relationships

Book Title:

Therapy with a Map: A Cognitive Analytic Approach to Helping Relationships.

Author(s): Steve Potter.

Year: 2020.

Edition: First (1st).

Publisher: Luminate.

Type(s): Paperback and Kindle.

Synopsis:

A therapeutic relationship is a web of interactions, tasks and processes in space and time. It is not easy to stay aware of the relationship in the thick of talking and trying to help someone; but doing so boosts flexibility and enables deeper formulation. A therapist who can attend not only to a specific therapeutic model, but also to relational factors underlying all therapy, has a far greater chance of enabling change.

Therapy with a Map sets out a therapeutic process of talking accompanied by visual conversation maps set down in real time on paper. Like all maps, these help us to find our way, notice when we are lost, track our route and survey the wider landscape. The book uses mapping to introduce the tools and concepts of Cognitive Analytic Therapy (CAT), along with other relational, conversational and narrative approaches. By mapping patterns of thinking and relating, therapists can help clients to develop self-understanding, solve problems, and take away a freer, more self-aware relationship with themselves in the world.

Book: Neurobiologically Informed Trauma Therapy with Children & Adolescent

Book Title:

Neurobiologically Informed Trauma Therapy with Children and Adolescents: Understanding Mechanisms of Change (Norton Series on Interpersonal Neurobiology).

Author(s): Linda Chapman.

Year: 2014.

Edition: First (1st).

Publisher: W.W. Norton & Company.

Type(s): Paperback and Kindle.

Synopsis:

The model of treatment developed here is grounded in the physical, psychological, and cognitive reactions children have to traumatic experiences and the consequences of those experiences. The approach to treatment utilises the integrative capacity of the brain to create a self, foster insight, and produce change. Treatment strategies are based on cutting-edge understanding of neurobiology, the development of the brain, and the storage and retrieval of traumatic memory. Case vignettes illustrate specific examples of the reactions of children, families, and teens to acute and repeated exposure to traumatic events.

Also presented is the most recent knowledge of the role of the right hemisphere (RH) in development and therapy. Right brain communication, and how to recognise the non-verbal symbolic and unconscious, affective processes will be explained, along with examples of how the therapist can utilise art making, media, tools, and self to engage in a two-person biology. 30 illustrations; 8 pages of colour.