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Publications
Publications (39)
The generic cognitive model has a robust research canon that draws on the scientific method to regularly update and correct shortcomings in its accuracy, a recent update is the construct of modes. Modes provide a model to understand the range of reactions in individuals, ranging from normal, strong reactions through serious psychopathology. The mod...
Background
On average, psychotherapy delivered on inpatient units produces clinical outcomes with smaller effect sizes than the same treatments in outpatient settings. The Collaborative Care CBT Milieu presents opportunities to extend the benefits of the therapeutic milieu by capitalizing on paraprofessionals who have the most interactions with pat...
Purpose of Review
It is vitally important that providers treating post-traumatic stress disorder continue to stay abreast of research advances in the treatment of this disorder. This article updates the reader about advances in research in PTSD treatment in the past four years as well as the evolving recommendations of clinical practice guidelines....
CBT has evolved and continues to evolve rapidly. This chapter covers the integration of Socratic Strategies with newer developments in the field involving Third-Wave Cognitive Behavioral Therapy generally, and Dialectical Behavior Therapy specifically. Specific examples and suggestions are made to the standard DBT therapist for the seamless integra...
This chapter focuses on teaching clinicians how to use Socratic strategies (i.e., Socratic questioning, guided discovery, and collaborative empiricism) to target core beliefs. Core belief work or schema work is not inherently different from working with other cognitions; however, it can be a longer process. Effectively targeting core beliefs and sc...
Socratic questioning is frequently identified as the most difficult CBT skill to acquire. Implications for improving Socratic questioning skill acquisition derived from an empirically supported educational method, Precision Teaching, are detailed in this chapter. Strategies specific to the respective perspectives of the therapist and the trainer ar...
The second step of the revised framework is the focus of this chapter. After we have identified a suitable target for Socratic questioning. We seek to develop understanding in both subjective and objective terms (i.e., phenomenological). We next want to focus on trying to understand how the thought or belief makes sense. Ideally, we want to underst...
This chapter focus is on the third step of the revised Socratic framework. This step represents an alternative to common pitfalls such as debating, arguing, or telling. This chapter teaches the therapist how to align with the client so that alternate perspectives can be jointly discovered (through Socratic questioning, guided discovery, and collabo...
This chapter emphasizes the importance of pinpointing key cognitive content for intervention. Specific procedures for identifying and uncovering strategic content are described. In this chapter, we have focused on reviewing how to focus in on the key content. We discussed breaking a situation down to its components, identifying the various thoughts...
Socratic procedures have much to offer the prescriber. Prescriber goals that may be achieved and enhanced are described and illustrated in context through case examples. There are some special considerations for Socratic strategies from the perspective of a prescribing provider. Namely, these relate to medication compliance (including motivational...
In an investigation (doi:10.1016/j.cbpra.2016.04.002) of the common difficulties clinicians have when learning CBT, Socratic questioning (also called guided discovery or collaborative empiricism) was identified as the hardest skill to learn. This finding led to a reformulation of how this skillset was taught. In doing so, a four-step model was deve...
This chapter addresses two common CBT strategies: thought records and behavioral experiments. Thought records and behavioral experiments are two central cognitive restructuring interventions. To optimize effective implementation of these procedures, they should be accompanied by sound Socratic strategies. Further, cognitive and behavioral means of...
Cognitive Processing Therapy (CPT) with traditional written thought records is an effective treatment for posttraumatic stress disorder (PTSD). A potential barrier to targeting trauma-related beliefs with traditional thought records is that typically the resulting behavioral avoidance from the trauma-related belief limits the experiences (i.e., evi...
Background
Thought records are a core component of Cognitive Behavior Therapy. Over time, thought records have been modified to suit various needs or preferences. A diversity of thought records have been developed, which include differing components and cognitive change strategies. Yet, due to a lack of specificity in the literature and field, diff...
Abstract
Purpose-The term catastrophizing was coined by Ellis (1962) and commented on by Beck (1979). Since that time, much research has been done on the topic and a recent review article postulated that catastrophizing served as a transdiagnostic mechanism across the psychiatric disorders (Gellatly and Beck, 2016). In rational emotive behavior th...
Purpose of Review
Post-traumatic nightmares (PTN) are a common and enduring problem for individuals with post-traumatic stress disorder (PTSD) and other clinical presentations. PTN cause significant distress, are associated with large costs, and are an independent risk factor for suicide. Pharmacological and non-pharmacological treatment options fo...
The Improving Access to Psychological Therapies initiative has a reported 50 percent recovery rate. Recently, Scott published a scathing report asserting that 9.2 percent is the correct rate. This alarming assertion requires a closer look and further scrutiny of the Improving Access to Psychological Therapies. Scott’s study is fundamentally flawed...
There has been an increased emphasis on the implementation of cognitive behavioral therapy (CBT) to community mental health (CMH) systems due to its broad efficacy. Previous research has highlighted the importance of ongoing consultation in this process. The current study clarifies the role and process of clinical case consultation in the implement...
Background: Over a number of decades, Cognitive Behavior Therapy has evolved and been modified by various theorists and researchers. Concerns regarding the integrity of cognitive and behavioral treatment in research studies, including fidelity, competence, and treatment differentiation, have been raised. Ensuring adequate treatment fidelity and com...
The Generic Cognitive Model both predates and relies on the vast research on single-diagnosis Cognitive Behavioral Therapy (CBT) protocols. In practice, CBT is a way of thinking that is driven by hypothesis testing and case formulation. Research has demonstrated that a case conceptualization-driven approach to CBT generally produces outcomes equiva...
In keeping with aspirational principles and adhering to the ethical standards of psychology, clinicians should strive to provide the highest possible quality of care and to represent their competencies accurately to potential clients. Yet how are clinicians to gauge their own competence in order to determine if they are adhering to these ethical st...
There is a great need for training in cognitive behavioral therapy (CBT) for community clinicians
who work in public mental health systems where resources are low and demands are
high. Researchers have found that simply attending intensive CBT workshops will not result in
adherent or competent CBT being delivered, rather ongoing CBT supervision/con...
Objective:
Progress bringing evidence-based practice (EBP) to community behavioral health (CBH) has been slow. This study investigated feasibility, acceptability, and fidelity outcomes of a program to implement transdiagnostic cognitive therapy (CT) across diverse CBH settings, in response to a policy shift toward EBP.
Method:
Clinicians (n = 34...
Johnsen and Friborg (Psychological Bulletin 2015; doi:10.1037/bul0000015) report that modern cognitive behavior therapy (CBT) clinical trials yield less relief from depression compared to seminal trials, but methodological limitations may qualify the conclusions. Given the empirical support for CBT for depression, a closer look is warranted. High I...
Given the preponderance of evidence supporting the efficacy of cognitive behavior therapy (CBT), there has been an increased emphasis on dissemination to community mental health systems (CMH). Trainers from two large-scale dissemination initiatives (n = 27) were surveyed regarding the common pitfalls and difficulties encountered by CMH clinicians l...
Cognitive Behavioral Therapy (CBT) is among the most studied EBPs with support for its efficacy across a range of presenting problems in youth, but broad uptake of traditional CBT in school-based settings has been slow. A review of CBT in schools is presented, which suggests that most school-based studies have examined the use of a protocol for a s...
The following case study examines the treatment of a man who presented with ambiguous concerns related to safety. Initially, diagnosis was unclear, and a psychotic disorder was hypothesized. Through the use of functional analysis (FA), it became clear that he met criteria for Posttraumatic Stress Disorder (PTSD) and was subsequently treated using C...
https://societyforpsychotherapy.org/the-role-of-vulnerability-and-peer-supervision-in-establishing-clinical-competency/
This paper addresses the question of how to approach religiosity and psychosis within a clinical context. A clinician who is tasked with the differential diagnosis of a client who is apparently either experiencing normative religious phenomenon or psychotic symptoms faces a difficult situation—as clinicians are generally ill-prepared to address top...
This study examined the habits of psychology graduate students with respect to measuring treatment outcome. Graduate students in doctoral psychology programs (N = 397) responded to an online survey, which entailed the rating of progress for a hypothesized client and the making of treatment recommendations. The results from this study were compared...
This article presents the case of a mindfulness-based group therapy that was implemented in a residential treatment facility. The case presented comprised a group of adolescent males with disruptive behavior disorders. The group was designed to be appropriate for the unique demographics of the clients, with the intent to help the clients enhance an...
Numerous psychometrically sound measures of psychotherapy outcome have been developed; however, few clinicians administer such tools, and when they do so, they rarely utilize these results to inform treatment. Moreover, studies have reported a discrepancy between therapists' judgment and clients' self-report of treatment outcome. The current study...
The goal of therapy is to have a positive outcome, but how should practitioners determine when a positive outcome occurs? Diverse methods of studying and defining treatment outcomes have been developed; however, research suggests the different methods do not measure the same construct. Numerous psychometrically sound tools for assessing treatment o...
Little is known about the relationship between the clinical judgment of licensed professionals and student clinicians. Understanding the clinical practice of psychologists in training is important as they are forming the habits which will guide their future practice. This study examined the habits of psychology graduate students with respect to mea...
Questions
Questions (2)
This question keeps coming up in conversation. Often managed care settings have such high-case loads that meeting weekly with psychotherapy patients is difficult. Is anyone aware of any literature that speaks to this issue? Or about the relationship between session frequency and outcome?
We're currently designing a study on the use of technology in treating insomnia. As a part of this we've planned to use wearable technology (e.g., a fitbit) to track sleep patterns. We're looking for a good way to gather the sleep data in a timely manner that doesn't involve hand-entering everything. If we could find an app or method to securely transmit the sleep data on a weekly basis that would be amazing. We'd welcome any help or leads.
Thanks!!
