Tag Archives: CBT

Where is the Evidence for Evidence Based Therapies?

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I invite discussion of this short article – and look forward to many responses. The author’s perspective is one that is supported through his research, and the suggested readings within the work speak to his knowledge of these areas of controversy.  The article also speaks to the ‘manualization’ of therapy…something we should all be concerned with in our clinical interests – and the best interests of our clients.  See the link below…

Excerpt:  “A study from a prestigious psychology journal recently crossed my desk. It found that clinicians who provide Cognitive Behavior Therapy or CBT—including the most experienced clinicians—routinely depart from the CBT techniques described in treatment manuals. “Only half of the clinicians claiming to use CBT use an approach that even approximates to CBT,” the authors wrote.”   http://www.psychologytoday.com/blog/psychologically-minded/201310/where-is-the-evidence-evidence-based-therapies

 

Just A Spoonful of Stress Hurts the Medicine

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Spoonful

Spoonful

A brand new study has been completed by a team of neuro-scientists at New York University with findings that point to the limits clinical techniques have over helping people manage their emotions even under the influence of mild stress. The study’s findings appear in the journal Proceedings of the National Academy of Sciences document how even mild stress can undermine therapies designed to keep emotions in check.

“In other words, what you learn in the clinic may not be as relevant in the real world when you’re stressed,” says Elizabeth Phelps, the study’s senior author and a professor in NYU’s Department of Psychology and Center for Neural Science.

The study’s main intent was to determine whether cognitive restructuring techniques, such as encouraging patients to change their thinking or approach toward a situation in order to change their emotional response, would hold up in the real world where everyday stress occurs.

If you would like to know particular details of the study, please write me personally and I will gladly provide you with them, but the main points are that the study was designed as a two-day experiment in which participants were taught cognitive strategies, collectively titled cognitive-behavioral therapy to use to decrease conditioned fear. They were exposed to the fear conditioning on the first day. They were also taught strategies for combating the fear that was produced on that first day.

On day two they were put in a situation where they were expected to rely on the fear-combatting-strategies in the ‘real world situation” they were placed in, AFTER having been exposed to a mild level of stress.

The participants in the ‘stress group’ were not able to reproduce or use the techniques to combat fear they had been taught the previous day. The ‘control group’ the participants who were not subjected to a mild level of stress, on the other hand, employed the techniques they were taught.

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Brain

The study linked to findings that show cognitive techniques used to control fear rely on regions of the pre-frontal cortex that have been proven to be functionally impaired by mild stress. This is what the study’s authors believe is the cause of the inability to learn to employ the fear decreasing techniques. But do not lose hope, because with practice or after longer intervals of cognitive training, the strategies may become more habitual and less sensitive to the effects of stress, according to the authors.

I am rephrasing here, but it seems that for some people, it will most likely never be a rational, natural type of reaction to fear and anxiety. These people will have to work harder and longer to turn these methods into habits in order for them to be effective for them. But, it can be done and the more studies that are funded to research emotion study, the more readily methods will be found to work with a variety of people in more individual and accurate ways that work best for them.

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

Try These Cognitive Restructuring Exercises to Improve Your Mood and Reduce Stress

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Try These Cognitive Restructuring Exercises to Improve Your Mood and Reduce Stress

Cognitive restructuring is a core part of Cognitive Behavioral Therapy (CBT). CBT is one of the most effective psychological treatments for common problems like depression, anxiety disorders, and binge eating. Here, clinical and social psychologist Alice Boyes shares some CBT techniques you can try at home to reduce problems with mood, anxiety, and stress.

Practice Noticing When You’re Having a Cognitive Distortion

lifeChoose one type of cognitive distortion to focus on at a time. Example: you recognize that you’re prone to “negative predictions.” For a week, just notice any times you find yourself making a negative prediction—for example, you might notice yourself expecting not to enjoy a party, expecting to feel too tired to exercise, expecting that your boss won’t like an idea, etc.

When you find yourself having the cognitive distortion, ask yourself: what other ways you could think? For the negative predictions example, you might ask yourself what other outcomes are possible. Try these three questions: What’s the worst possible thing that could happen? The best possible thing that could happen? The most realistic?

Track the Accuracy of a Thought

Example: Your rumination-related thought is “If I think a lot about my problem, it’ll help me find a solution.” For this example, you might write down each time you notice yourself ruminating (overthinking) in one column, and in a second column note if the rumination actually lead to useful problem solving.

At the end of the week, determine what percentage of the times you ruminated it led to useful problem solving? Another great idea is to record the approximate number of minutes you were ruminating each time you notice it. Then you can determine how many minutes of rumination you did for each useful problem solving idea.

Behaviorally Testing Your Thought

Example: Your thought is “I don’t have time to take breaks.” For a week (week 1), you could follow your usual routine and at the end of each day, rate your productivity on a 0-10 scale. For week 2, you could take a five minute break every 60 minutes and do the same ratings. You would then compare your productivity ratings across the two weeks.

Evaluate the Evidence For/Against Your Thought

Example: Your thought is “I can never do anything right.” You could write one column of objective evidence (column A) that supports the idea that you can never do anything right, and one column of objective evidence that your thought is not true (column B).

challThen, you’d write a couple of balanced thoughts that accurately reflect the evidence, for example: “I’ve made some mistakes that I feel embarrassed about but a lot of the time, I make good choices.” You don’t need to completely believe the new thoughts. For a start, just experiment with trying them on for size.

Mindfulness Meditation

Mindfulness meditation involves picking a focus of attention, such as your breathing. For a set number of minutes, you focus on experiencing the sensations of your breathing, as opposed to thinking “about” your breathing.

Whenever any thoughts come into your mind, gently (and without self-criticism) bring your attention back to experiencing the sensations of your breathing. Mindfulness meditation isn’t specifically a tool for cognitive restructuring but it’s a great way to train yourself to be mindful (aware) of when you’ve become lost in thought. Mindful awareness of what thoughts you’re having is an essential first step in cognitive restructuring.

Self-Compassion

Self-compassion involves talking to yourself kindly whenever you have a sense of suffering. Like mindfulness meditation, self-compassion isn’t specifically a tool for cognitive restructuring, but it has that effect.

Example: you’ve done something silly and normally you’d call yourself a “stupid idiot.” Instead you take a self-compassion approach. You acknowledge you’ve made a mistake, that you feel embarrassed, and that this is part of the universal human experience. Over time, if you replace self-criticism with self-compassion, your thoughts will change. As you do this, you might notice your thoughts about other people becoming kinder and more accepting too.

Cognitive Restructuring | Psychology Today


Dr Alice Boyes’ PhD research was published in the world’s most prestigious social psychology journal – Journal of Personality and Social Psychology. She is originally from New Zealand but is now a digital nomad. She writes about social, clinical, positive, and relationships psychology topics for various outlets including Psychology Today, Women’s Health, and on her own blog. Follow her on Twitter @DrAliceBoyes.