An Introduction to Modern CBT (eBook)

Psychological Solutions to Mental Health Problems

Stefan G. Hofmann (Autor)

eBook Download: EPUB

2011
John Wiley & Sons (Verlag)
978-1-119-95141-4 (ISBN)

Infos

An Introduction to Modern CBT provides an easily accessible introduction to modern theoretical cognitive behavioral therapy models. The text outlines the different techniques, their success in improving specific psychiatric disorders, and important new developments in the field.

• Provides an easy-to-read introduction into modern Cognitive Behavioral Therapy approaches with specific case examples and hands-on treatment techniques
• Discusses the theoretical models of CBT, outlines the different techniques that have been shown to be successful in improving specific psychiatric disorders, and describes important new developments in the field
• Offers useful guidance for therapists in training and is an invaluable reference tool for experienced clinicians

Stefan G. Hofmann, Ph.D. is Professor of Psychology and the Director of the Psychotherapy and Emotion Research Laboratory at Boston University. He has been a Board Member of the Academy of Cognitive Therapy and is an advisor to the DSM-V Development Process. He is the author of more than 170 peer-reviewed journal articles and book chapters, and has published seven books. His primary research interests focus on treatment research for which he has received many research awards. In addition to lecturing clinicians world-wide in cognitive behavioral therapy, he is a licensed psychologist and has a private practice.

Inhalt

About the Author ix

Foreword xi

Acknowledgment xiii

Preface xv

Chapter 1 The Basic Idea 1

Chapter 2 Empowering the Mind 23

Chapter 3 Confronting Phobias 47

Chapter 4 Fighting Panic and Agoraphobia 61

Chapter 5 Conquering Social Anxiety Disorder 79

Chapter 6 Treating Obsessive-Compulsive Disorder 93

Chapter 7 Beating Generalized Anxiety Disorder and Worry 105

Chapter 8 Dealing with Depression 121

Chapter 9 Overcoming Alcohol Problems 135

Chapter 10 Resolving Sexual Problems 151

Chapter 11 Managing Pain 165

Chapter 12 Mastering Sleep 177

References 191

Index 205

Rezensionen

An Introduction to Modern CBT by internationally known researcher and clinical psychologist Stefan Hofmann is exactly the right book for the busy clinician who wants to know the latest research, how it is relevant to clinical practice and what to do with patients who need help now. Written in a clear, compelling, and caring style, this book will be invaluable for graduate students interested in the application of empirically supported approaches - and for experienced clinicians who need to know the latest innovative CBT treatments. Each chapter provides a brief description of the disorder, relevant research findings, clear conceptualization of the problem, integrative CBT treatment drawing on the best practices available, and clinical case examples with helpful vignettes. This is a book that you will want to read - and use - on a regular basis. Hofmann is that unusual balance of scholar and clinician. You know from reading this book that his experience is with real people in the real world.
--Robert L. Leahy, Director, American Institute of Cognitive Therapy, New York

Instead of a detailed treatment manual or a long chapter in a handbook, this beautifully written, up-to-the-minute, but succinct description of CBT, complete with case studies, will be all that many clinicians need to know as they approach each new case. This resource will be valuable for training and should be on every clinician's bookshelf.
--David H. Barlow, Professor of Psychology and Psychiatry, and Founder and Director Emeritus, Center for Anxiety and Related Disorders, Boston University, USA

An elegantly simple book that takes a single model and shows students and professionals how to apply it to a range of common behavioral and mental health problems. Each disorder is fitted to the idea that maladaptive schemas and attention applied to triggering events can produce maladaptive cognitive appraisals that give rise to problematic emotion and behavior, and each intervention for these disorders are then placed in a particular part of the model. Clear, concise, and step by step, if you want to understand the cognitive model of psychopathology and treatment, there is no better book available.
--Steven C. Hayes, Foundation Professor of Psychology, University of Nevada, and author of 'Get Out of Your Mind and Into Your Life'

A world leader in the treatment of social phobia, Stefan Hofmann has written the ideal introductory guide to 21st century cognitive-behavior therapy. Lucid and accessible, An Introduction to Modern CBT will be especially valuable for students and for seasoned therapists keen to learn the latest evidence-based interventions for the most common problems therapists see today.
--Richard J. McNally, Professor of Psychology, Harvard University, and author of 'What is Mental Illness?'

While certain principles underlie the CBT treatment for the various psychiatric disorders, clinicians must understand the specific cognitive formulation of each disorder to understand how to implement effective treatment for a client with a given diagnosis. Dr. Hofmann provides such a guide in his excellent text. Both new and experienced clinicians will benefit from his clear explanations and guidelines for anxiety disorders, depression, alcohol abuse, sexual problems, pain, and insomnia.
--Judith S. Beck, President, Beck Institute for Cognitive Therapy and Research

Textauszug

1

The Basic Idea

Joe

Joe is a 45-year-old car salesman. He and his wife Mary live in a suburban home just outside Boston. They have two children, ages 9 and 12. The family had been doing well financially until Joe was laid off 3 months ago. Mary had been working part-time as a receptionist for a dentist and was able to upgrade this to a full-time job once her husband was out of work. Her income is enough to make ends meet, at least for now.

Since Joe was laid off, he has been staying home. He helps to get the kids ready for school, but then goes back to bed and stays there until 1 or sometimes 2 in the afternoon. He watches TV until his kids and wife come home. Sometimes, he doesn’t even have the energy to do that. He feels worthless and believes he will never find a job again. Mary cares deeply for Joe. Although his lack of motivation has created some conflict around doing household chores and cooking, she does whatever she can to make him feel better. However, the added responsibilities are at times burdensome for Mary.

Joe is depressed. He often struggles with his mood, motivation, and energy. But this time, his depression is more severe than usual. Getting laid off from his job apparently triggered the onset of a major depression. Anyone would be upset and sad after being laid off. But in Joe’s case, the level and duration of the sadness are clearly outside the normal range. This is not the first time Joe has felt like this. Shortly after the birth of his second son, he slipped into a period of severe depression that lasted for almost a year. There was no clear trigger, aside from having a second child. He was so depressed that he even thought about suicide by hanging himself. Fortunately, he did not act on these thoughts. He has tried various medications for his depression, but he did not find them to be helpful and did not like the side effects they caused.

Mary recently read about a form of talk therapy in a magazine. The therapy is called cognitive behavioral therapy (CBT). She was very excited and decided that Joe should try it. When she came home that day, she asked Joe to read the article in the magazine. Joe did not think that it could help him. The couple got into an unusually heated argument, and Mary made Joe promise that he would try this treatment. Mary arranged for an appointment with a psychologist in Boston who specializes in CBT.

During the course of sixteen 1-hour CBT sessions, Joe’s depression lifted. By the end of treatment, it had virtually disappeared. He developed a positive outlook on his life and a positive attitude toward himself. His relationship with his wife and children improved dramatically, and he started a new job as a car salesman within weeks after starting therapy.

Joe’s recovery after treatment is not at all unusual. The treatment that he received, cognitive behavioral therapy (CBT), is a highly effective, short-term form of psychotherapy for a wide range of serious psychological problems, including depression, anxiety disorders, alcohol problems, pain, and sleep problems, among many other conditions. The CBT strategies that target some of these common disorders are described in detail in the following chapters. The current chapter will review the guiding principles on which these disorder-specific strategies are based.

The Founding Fathers

Aaron T. Beck and Albert Ellis independently developed the therapy that later became known as CBT. Beck was trained in Freudian psychoanalysis and became dissatisfied with the lack of empirical support for Freudian ideas. In his work with depressed patients, Beck found that people who were depressed reported streams of negative thoughts that seemed to appear spontaneously. Beck called these cognitions automatic thoughts. These thoughts are based on general, overarching core beliefs, called schemas (or schemata) that the person has about oneself, the world, and the future. These schemas determine how a person may interpret a specific situation and thereby give rise to specific automatic thoughts. These specific automatic thoughts contribute to the maladaptive cognitive appraisal of the situation or event, leading to an emotional response. Based on this general model, Beck developed a treatment method to help patients identify and evaluate these thoughts and higher-order beliefs in order to encourage patients to think more realistically, to behave more functionally, and to feel better psychologically.

Like Beck, Ellis was trained in Freudian psychoanalysis, but later became influenced by the neo-Freudian Karen Horney. Similarly to Beck’s, Ellis’s treatment approach emphasizes the importance of cognitive processes and is an active and directive form of psychotherapy. Therapists help patients realize that their own beliefs contribute greatly to, maintain, and even cause their psychological problems. This approach leads patients to realize the irrationality and rigidity of their thinking and encourages them to actively change self-defeating beliefs and behaviors. Ellis initially named the treatment Rational Therapy, then Rational-Emotive Therapy, and finally Rational-Emotive Behavior Therapy to stress the interrelated importance of cognition, behavior, and emotion. Beck prefers the term maladaptive or dysfunctional, rather than irrational, to describe the nature of the distorted cognitions, since thoughts do not have to be irrational in order to be maladaptive. For example, some people with depression might have a more realistic assessment of the potential danger in life. However, this “depressive realism” is maladaptive because it interferes with normal life.

Sadly, Dr. Ellis passed away on July 24, 2007. Dr. Beck, now well into his 90s, is still an active practitioner and scientist with an insatiable thirst for knowledge. Beck and Ellis, who developed their two therapy approaches in the 1960s, have had an enormous influence on contemporary clinical psychology and psychiatry. In the face of the overwhelming dominance of psychoanalytic thinking, these two pioneers began to question some fundamental assumptions of psychiatry. Driven by their intuition that human problems are best solved by human solutions, Beck and Ellis began to use empirical methods to treat psychological problems and to critically study uncomfortable questions in psychiatry. Ellis, a practicing psychologist, set up his clinic in downtown Manhattan. Like many other places at that time, New York was heavily dominated by psychoanalysis. Similarly, Beck, an academic psychiatrist at the University of Pennsylvania, continued to pursue his quest in the face of strong resistance by the general psychiatric community, which was dominated by Freudian ideas. When he applied for research grants to test his ideas and was rejected, he assembled friends and colleagues to conduct his studies without financial support from the government or other funding agencies. When his papers were rejected by academic journals, he convinced open-minded editors to publish his writing in the form of books.

In recognition of his influence, Beck received the Lasker Award in 2006, a highly prestigious medical prize that is often bestowed on individuals who later win the Nobel Prize. The chairman of the Lasker jury noted that “cognitive therapy is one of the most important advances—if not the most important advance—in the treatment of mental diseases in the last 50 years” (Altman, 2006).

Despite the clear influence of the approach and the effectiveness of the treatment, the majority of people with psychological problems do not have easy access to CBT services. Unlike that involved with psychiatric medications, there is no sizable industry promoting CBT. In an attempt to increase the availability of CBT, politicians in some countries have decided to not let the fate of mental health care be ruled by the financial interest of drug companies and have taken matters into their own hands. In October 2007, the Health Secretary of the United Kingdom announced a plan to spend £300 million ($600 million) to initiate a six-year program with the goal of training an army of therapists to provide the British people with CBT for psychological problems. This change in health care delivery was based on economic data showing that provision of CBT for common mental disorders is overall less expensive than pharmacotherapy or psychoanalysis. Similarly, in 1996 the Australian government recommended the provision of CBT and introduced a plan to provide better access to these services.

A Simple and Powerful Idea

Although Beck and Ellis are rightly credited for their pioneering work, the basic idea that gave rise to the new approach to psychotherapy is certainly not new. It could even be argued that it is simply common sense turned into practice. Perhaps the earliest expression of the CBT idea dates back to Epictetus, a Greek stoic philosopher who lived from AD 55 to 134. He has been credited with saying, “Men are not moved by things, but by the view they take of them.” Later, Marcus Aurelius (AD 121–180) wrote in his Meditations, “If thou are pained by any external thing, it is not this thing that disturbs thee, but thine own judgment about it. And it is in thy power to wipe out this judgment now.” And William Shakespeare wrote in Hamlet, “There is nothing either good or bad, but thinking makes it so.” Other philosophers, artists, and poets have expressed similar ideas throughout history.

The central notion of CBT is simple. It is the idea that our behavioral and emotional responses are strongly influenced by our cognitions (i.e., thoughts), which determine how we perceive things....

Produkt-Details

• Erscheint lt. Verlag: 24.6.2011
• Vorwort: Aaron T. Beck
• Sprache: englisch
• Themenwelt: Geisteswissenschaften ► Psychologie ► Klinische Psychologie
• Themenwelt: Geisteswissenschaften ► Psychologie ► Persönlichkeitsstörungen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Schlagworte: accessible • basic idea • behavioral • behaviors • CBT • Clinical psychology • cognitions • Cognitive behavioral therapy (CBT) • Contribute • easily • effective form • Family • Influence • Interventions • Introduction • Klinische Psychologie • Kognitive Verhaltenstherapie • Maintenance • many • Models • Modern • Problems • Psychiatric • Psychologie • Psychology • psychotherapy • Reader • SHARE • therapy
• ISBN-10: 1-119-95141-0 / 1119951410
• ISBN-13: 978-1-119-95141-4 / 9781119951414