Emotion Regulation Therapy

In book: Handbook of Emotion Regulation, Edition: 2nd, Chapter: 28, Publisher: Guilford Publishers, Editors: James J. Gross, pp.469-487

ABSTRACT Generalized anxiety disorder and major depression (often termed “distress disorders”; see Watson, 2005) are commonly comorbid and appear to be characterized by temperamental features that reflect heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss. Further, individuals with these disorders tend to perseverate (i.e., worry, ruminate) as a way to manage this motivationally relevant distress and often utilize these self-conscious processes to the detriment of engaging new contextual learning. Emotion Regulation Therapy integrates principles from traditional and contemporary cognitive behavioral treatments (e.g., skills training & exposure) with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding regulatory characteristics of individuals with distress
disorders. This emphasis on affect science permits identification of candidate mechanisms of treatment in terms of core disruptions of normative cognitive, emotional, and motivational systems, which in turn, helps generate more targeted solutions for clients to utilize adaptive ways to cope or compensate for these core deficits. In essence, contrasting a client’s difficulties with what we understand as normative functioning allows us to generate theory-driven hypotheses that form that basis of our case conceptualization and treatment planning. Outcome and mechanism data provide preliminary support for the use of ERT to treat distress disorders.

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    ABSTRACT: The National Institute of Mental Health recently launched the Research Domain Criteria (RDoC). RDoC is a framework that facilitates the dimensional assessment and classification of processes relevant to mental health (e.g., affect, regulation, cognition, social affiliation), as reflected in measurements across multiple units of analysis (e.g., physiology, circuitry, genes, self-reports). A key focus of RDoC involves opening new lines of research examining patients’ responses on biological measures, with the key goal of developing new therapeutic techniques that effectively target mechanisms of mental disorders. Yet, applied researchers and practitioners rarely use biological measures within mental health assessments, which may present challenges in translating RDoC-guided research into improvements in patient care. Thus, if RDoC is to result in research that yields clinical tools that reduce the burden of mental illness and improve public health, we ought to develop strategies for effectively implementing biological measures in the context of clinical assessments. In this Special Section, we sought to provide an initial step in this direction by assembling a collection of articles from leading research teams carrying out pioneering work on implementing multi-modal assessments (biological, subjective, behavioral) of affective processes in applied settings. In this commentary, we expand upon the work presented in this Special Section by making a series of suggestions for how to most parsimoniously conduct multi-modal assessments of affective processes in applied research and clinical settings. We hope that this approach will facilitate translations of the RDoC framework into applied research and clinic settings.
    Journal of Clinical Child & Adolescent Psychology 03/2015; 44(2):341-351. · 1.92 Impact Factor
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    ABSTRACT: How do people flexibly regulate their emotions in order to manage the diverse demands of varying situations? This question assumes particular importance given the central role that emotion regulation (ER) deficits play in many forms of psychopathology. In this review, we propose a translational framework for the study of ER flexibility that is relevant to normative and clinical populations. We also offer a set of computational tools that are useful for work on ER flexibility. We specify how such tools can be used in a variety of settings, such as basic research, experimental psychopathology, and clinical practice. Our goal is to encourage the theoretical and methodological precision that is needed in order to facilitate progress in this important area.
    Cognitive Therapy and Research 11/2014; · 1.70 Impact Factor
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    ABSTRACT: Rumination, worry, and other forms of negative self-referential processing are familiar to everyone, as reflecting on the self is perhaps our most human characteristic. However, for a substantial subgroup of patients, negative self-referential processing (NSRP) arises in response to intense emotionality, worsening the clinical presentation and diminishing the treatment response. The combination of emotionality and NSRP likely reflects the endophenotype of complicated and treatment refractory patients who fail to achieve a satisfactory treatment response in our trials and our clinics. An important next step is to personalize treatments by deliberately targeting NSRPs within established treatment protocols or in as yet novel treatments. Enriching treatments with mindfulness meditation is one possible avenue for personalized care of patients with this hypothesized endophenotype.
    Clinical Psychology Science and Practice 02/2013; 20:259-268. · 2.92 Impact Factor