Doctoral Program in Clinical Psychology The Graduate Center of the City University of New York

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1 Doctoral Program in Clinical Psychology The Graduate Center of the City University of New York Cognitive Behavioral Treatments Course # Fall, 2012 Professor: Deidre Anglin, PhD danglin@ccny.cuny.edu Day & Time: Tuesdays 2:00pm-3:50pm in NAC Room 7/308 Office Hours: Room 8/125, By appointment Course Description This doctoral-level graduate course is designed to enhance the depth to which clinical psychologists in training understand and can implement cognitive behavioral techniques in clinical practice. Course material will focus largely on cognitive behavioral theoretical models of psychopathology and intervention for a wide range of disorders including anxiety, mood, and psychotic disorders. The first third of the course will introduce students to the basic principles of cognitive behavior therapy (CBT) through an illustrated workbook that incorporates videos, learning exercises, and in the moment troubleshooting exercises. Students will learn how to assess and formulate cases using a cognitive behavioral theoretical framework and will learn specific CBT methods of intervention (e.g., working with automatic thoughts, breaking patterns of anxious avoidance, modifying schemas). The remainder of the course is focused on empirically supported CBT approaches for several disorders including social anxiety disorder, depression, and PTSD. In addition to the primary required CBT textbook around which the second half of the course is organized, readings will be drawn from empirical articles that critique the efficacy of CBT methods of intervention, comparing these methods to alternative approaches (i.e., psychodynamic, family systems, and interpersonal models of intervention). Given most students in this doctoral program obtain substantial exposure to psychodynamic theoretical models of psychopathology and intervention, this course will require students to reconceptualize current cases using a cognitive behavioral framework and reflect upon (in writing) how their treatment would be different using a CBT approach. The goal is to illustrate how sophisticated in depth critical thinking about patients can also be achieved using CBT models of case formulation and treatment. The structure of most classes will consist of a didactic lecture based on assigned readings, and group discussion. The content of the course will also focus on clinical case material presented by students who will have ample opportunity to critically think through existing cases treated psychodynamically through a cognitive behavioral lens. Course Objectives After completing this course students should be able to: 1) Formulate cases from a cognitive behavioral perspective orally and in writing, and articulate the specific ways CBT and psychodynamic approaches are similar and different.

2 2) Have a preliminary understanding of how to treat various psychiatric disorders using a cognitive behavioral approach and techniques. 3) Think critically about the efficacy and effectiveness of cognitive behavioral approaches for treating various disorders. 4) Discuss the advantages and disadvantages of using a cognitive behavioral approach vs. a psychodynamic approach to treat certain disorders. Required Readings: Wright, J. H., Basco, M. R., & Thase, M. E. (2006). Learning cognitive-behavior therapy: An illustrated guide. Washington, D.C.: American Psychiatric Publishing, Inc. Barlow, D. (Ed.) (2008), Clinical handbook of psychological disorders (4 th edition). New York: Guilford Publications. Reading Coursepack: Packet of articles and chapters to be downloaded from Blackboard. Class Requirements and Grading Class Assignments And Assessment: 1. Reaction Papers (5) 20% In order to enhance in class group discussion, students will complete five 2 page (double-spaced) reaction papers on selected readings. The goal of the reaction paper is to reflect on your thinking about the readings in written form and prepare thoughts and questions for class discussion. They should briefly (one paragraph) state the main point of the readings and then reflect on your personal reactions to any part or parts of what you read. This may include criticisms, aha moments, and questions. Students are encouraged to incorporate their own clinical experience as therapists and their own personal experiences as clients into the reactions papers as applicable. Just be sure to connect your reactions to the readings. Your grade for these assignments will be primarily based on the depth of thought you put into the readings. 2. Individual Oral Clinical Case Presentation 20% Students will prepare an oral case presentation based on a case that they are currently working with or have recently counseled. They will provide the background, presenting problem, history of presenting problem, psychodynamic case formulation, diagnosis and approach to treatment undertaken. Using the same background information from the intake, students will reconceptualize the case using a cognitive behavioral case formulation, provide the diagnosis again, and describe in detail what a CBT approach to treatment with their client would look like. The presentation should highlight the rationale for approaching the cognitive-behavioral treatment of the client in a particular fashion. The hypothetical CBT approach to treatment of the client should include a description of the technical aspects of treatment of specific target behaviors of the client. Be sure to provide rich examples which are based on what you already know about your client. This is also a good place for the discussion of issues of individual and cultural diversity as they may influence the presentation or treatment of the disorder under discussion. 3. Term paper 50%

3 Students will complete a term paper on the treatment of a specific disorder of interest that is different from the disorder presented in their clinical case presentation. The paper should describe in detail research findings on the application of a particular empirically-supported approach to the treatment of the selected disorder. Present an analysis of why the technique should be efficacious and effective with the disorder and how and why it works. Be sure to review the research studies included in the term paper with a critical eye. Present a review of the evidence for the efficacy and effectiveness of the technique(s), where it works, where it doesn't, how it interacts with other treatment modalities, reasons for failure in the administration of the technique, evidence for the generality and maintenance of treatment gains, evidence for clienttreatment interactions, and knowledge regarding prediction of treatment outcome. As much as the literature allows, pay attention to issues of individual and cultural diversity and how these may be related to the outcomes of treatment. Describe in detail the kinds of research data that must be collected before a thorough evaluation of the technique may be accomplished. Proposed paper topics should be submitted in writing in a brief one page summary and should include a minimum of 7 references to demonstrate the viability of the literature on which your paper will be based. 4. Active Participation 10% Students are required to attend all scheduled class meetings AND to actively participate in class discussions or in-class assignments. The Professor reserves the right to assign in-class critiques of assigned readings, especially if students are seemingly unprepared for in-class discussions. Grading System: The grading scheme below will be used in assigning final grades. Class participation and attendance can be used to adjust final grades upward (for students who attend class regularly and participate frequently), or downward (for students who miss more than one class and/or do not participate). A = 93+ (Exceptional work) A- = (Great work, but not exceptional) B+ = (Good work, but not great) B = (Average work) B- = (Below expectation) C+ or below = <80 (Significantly below expectation) Weekly Reading Assignments and Class Topics: The following is an outline of the order with which we will cover topics. THIS SCHEDULE IS SUBJECT TO CHANGE as a result of relevant current events or other factors. ANY CHANGES WILL BE ANNOUNCED AT THE BEGINNING OF CLASS. Some additional readings may be made available through the internet or through distribution in class. WEEK (Tuesdays) TOPICS and Readings/Assignments

4 1 Course Introduction Topic: SELECTED ISSUES IN COGNITIVE BEHAVIOR THERAPY I: The basic principles of CBT including the nature of the therapeutic relationship and assessment and formulation of cases -Wright et al., Chapters 1-3 -Persons, J.B. (2008). Monitoring progress. The case formulation approach to cognitive behavior therapy (pp ). New York: Guilford. 2 Topic: SELECTED ISSUES IN COGNITIVE BEHAVIOR THERAPY II: Automatic thoughts and modifying schemas in CBT -Wright et al., Chapters Topic: SELECTED ISSUES IN COGNITIVE BEHAVIOR THERAPY III: behavioral methods of breaking anxious avoidance and and completing tasks in CBT -Wright et al., Chapters Topic: SELECTED ISSUES IN COGNITIVE BEHAVIOR THERAPY IV: common pitfalls and challenges in learning CBT and how to build competence -Wright et al., Chapters Butler, A.C. et al. (2006). The empirical status of cognitive behavioral therapy: A review of metaanalysis. Clinical Psychology Review, 26, Persons, J. B., Curtis, J.T., & Silberschatz, G. (1991). Psychodynamic and cognitive behavioral formulations of a single case. Psychotherapy, 28, Topic: DEPRESSION -Barlow, Chapters 6, 8 (Chapter 7 optional) 6 Topic: PANIC DISORDER & AGORAPHOBIA -Barlow, Chapter 1 7 Topic: SOCIAL ANXIETY DISORDER --DUE: 1-page description of paper topic--

5 -Barlow, Chapter 3 8 Topic: OBSESSIVE COMPULSIVE DISORDER -Barlow, Chapter 4 9 Topic: POST-TRAUMATIC STRESS DISORDER -Barlow, Chapter 2 10 Topic: COUPLES DISTRESS/DYSFUNCTION -Barlow, Chapter 16 (Chapter 15 optional) 11 Topic: The use of CBT for cognitive deficits of schizophrenia -Rathod S, Turkington D. (2005). Cognitive-behaviour therapy for schizophrenia: a review. Current Opinions in Psychiatry, 18(2): Turkington D, Morrison AP (2011). Cognitive therapy of negative symptoms of schizophrenia. Archives of General Psychiatry, Oct Topic: ALCOHOL AND SUBSTANCE USE DISORDERS --Term Paper Due-- -Barlow, Chapters Topic: Borderline Personality Disorder Barlow, Chapter 9 -Linehan, M.M. et al. (2006). Two-year randomized controlled trial and follow-up of DBT versus therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63,

6 14 Topic: Discussion about psychotherapy integration -Goldfried, M. R. (2010). The future of psychotherapy integration: Closing the gap between research and practice. Journal of Psychotherapy Integration, 20, WRAP UP