Cognitive-Behavioral Therapy (CBT) for Parkinson s disease & Movement Disorders
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1 Cognitive-Behavioral Therapy (CBT) for Parkinson s disease & Movement Disorders Tools for Thinking & Feeling Better Joe Barsuglia, M.A., Doctoral Psychology Intern USC Keck School of Medicine, Neurology Department Graduate Student at Fuller Graduate School of Psychology, Pasadena
2 "What gets us into trouble is not what we don't know. It's what we know for sure that just ain't so." ~ Mark Twain "There is only one person who could ever make you happy, and that person is you!" ~ David Burns, Intimate Connections The greatest weapon against stress is our ability to choose one thought over another. ~ William James
3 Overview Why Psychotherapy for PD & Movement Disorders? What is Cognitive-Behavioral Therapy? Applying CBT to PD & Movement Disorder Issues Demonstration
4 Why Psychotherapy for PD & Movement Disorders? Improve coping with disease Physical changes often produce emotional changes Help reduce depression & anxiety Research supported & effective Depressive disorders affect approximately 40% of patients with PD. They are linked to functional impairment, cognitive decline, and faster disease progression and are the main determinant for poor quality of life in PD. Charidimou, et al, 2011
5 Why Psychotherapy for PD & Movement Disorders? Control Self-Esteem & Identity Future Fears
6 Why Psychotherapy for PD & Movement Disorders? Coping With Pain Life Meaning & Purpose Depression
7 What is Cognitive-Behavioral Therapy? Background Epictetus, Greek philosopher (AD ) People are not disturbed by things that happen, but by the view they take of things that happen. Suffering arises when we attempt to control what is uncontrollable, or from neglecting what is within our power. Aaron Beck, MD Psychiatrist in the 1960 s. Leading developer of CBT Originally for treatment of depression Now used in treating anxiety, depression, addictions, OCD, eating disorders, trauma and others
8 What is Cognitive-Behavioral Therapy? Assumptions The way we feel and act is determined by how we perceive and structure our experience Internal process is accessible to introspection People s beliefs have highly personal meanings Faulty inferences can be traced to earlier experiences
9 What is Cognitive-Behavioral Therapy? Purpose Increase awareness of unhelpful or negative thinking Connect thoughts to feelings and behaviors View challenging situations more clearly Respond more effectively and with better coping Learn healthier skills and habits
10 What is Cognitive-Behavioral Therapy? Key Tools Thought record Behavioral Activation Guided Imagery, Breathing, & Relaxation
11 What is Cognitive-Behavioral Therapy? Thoughts Feelings Behaviors
12 Thoughts Behaviors Unconscious Feelings Schemas
13 What is Cognitive-Behavioral Therapy? A B C A = Activating Event B = Beliefs/Thoughts (Situation) (Response to Situation) C = Consequences (Feelings/ Behaviors)
14 Applying CBT to PD & Movement Disorders Thoughts Behaviors Feelings A = Activating Event B = Beliefs/Thoughts (Response) C = Consequences (Feelings/ Behaviors)
15 What is Cognitive-Behavioral Therapy? Behavioral Activation Identifying & engaging in pleasurable activities It is difficult to feel down, if you are regularly engaging in activities that bring you pleasure
16 What is Cognitive-Behavioral Therapy? Guided Imagery & Mindfulness Meditation Involves practice of paying attention to breathing and being fully in the present and self-compassionate Reduces stress, better ability to deal with feelings, increased sense of peace and well-being
17 What is Cognitive-Behavioral Therapy? Guided Imagery & Mindfulness Meditation PRACTICE
18 Resources - CBT Workbooks
19 Resources - Referrals for Psychotherapy For therapy in at USC Neurology clinic call: Kara Barton, MSW, LCSW Clinical Instructor/Social Worker USC Department of Neurology ph# (323) Contact Insurance company ask for: in-network referrals for a psychotherapist Follow link - Find a therapist
20 References R. D. Dobkin, M. Menza, and K. L. Bienfait, CBT for the treatment of depression in Parkinson s disease: a promising nonpharmacological approach, Expert Review of Neurotherapeutics,vol. 8, no. 1, pp , E. Sproesser, M. A. Viana, E. M. A. B. Quagliato, and E. A. P. de Souza, The effect of psychotherapy in patients with PD: a controlled study, Parkinsonism and Related Disorders, vol. 16, no. 4, pp , S. Ghazi-Noori, T. H. Chung, K. Deane, H. E. Rickards, and C.E. Clarke, Therapies for depression in Parkinson s disease, Cochrane Database of Systematic Reviews, vol. 3, Article ID CD003465, H. Dreisig, L. Wermuth, S. Skovlund, and P. Bech, Psychologic effects of structured cognitive psychotherapy in young patients with Parkinson disease: a pilot study, Nordic Journal of Psychiatry, vol. 53, no. 3, pp , R. D. Dobkin, L. A. Allen, and M. Menza, Cognitivebehavioral therapy for depression in Parkinson s disease: a pilot study, Movement Disorders, vol. 22, no. 7, pp , I. Leroi and P. King, Cognitive behaviour therapy for anxiety and depression in Parkinson s disease: a pilot study, The Movement Disorder Society, vol. 23, supplement 1, p. 276, 200 L. Fitzpatrick, J. Simpson, and A. Smith, A qualitative analysis of mindfulness-based cognitive therapy (MBCT) in Parkinson s disease, Psychology and Psychotherapy, vol. 83, part 2, pp , A. Gupta and S. Bhatia, Psychological functioning in patients with Parkinson s disease, Parkinsonism and Related Disorders, vol. 6, no. 3, pp , 2000 S. D. Hollon, R. C. Shelton, and D. D. Davis, Cognitive therapy for depression: conceptual issues and clinical efficacy, Journal of Consulting and Clinical Psychology, vol. 61, no. 2, pp , H. Nissenbaum, N. P. Quinn, R. G. Brown, B. Toone, A. M. Gotham, and C. D. Marsden, Mood swings associated with the onoff phenomenon in Parkinson s disease, Psychological Medicine, vol. 17, no. 4, pp , 1987.
Review Article The Role of Cognitive-Behavioural Therapy for Patients with Depression in Parkinson s Disease
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