Cognitive Behavioural Therapy for Obsessive Compulsive Disorder and Body Dysmorphic Disorder
|
|
- Dominic Gibson
- 5 years ago
- Views:
Transcription
1 Cognitive Behavioural Therapy for Obsessive Compulsive Disorder and Body Dysmorphic Disorder Dr R Arjundas Consultant in Medical Psychotherapy NTW NHS Trust Newcastle upon Tyne, UK
2 Aims Overview of OCD phenomenology Introduce Cognitive Models of OCD Assess OCD Treat OCD using Cognitive and Behavioural Approaches
3 OCD Prevalence 1-2% Early onset years Course chronic and fluctuating Significant reduction in functioning Burden of illness equivalent to Schizophrenia Respond to treatment Access to treatment Availability Engagement factors (therapist and patient factors) Adequacy of treatment
4 Definition of OCD (DSM V) Essential features of OCD are presence of obsessions, compulsions or both They are time consuming (take more that one hour a day) or cause clinically significant distress or impairment in functioning. Not attributable to medical condition or to a substance Not better explained by symptoms of another mental disorder Specify With good insight Poor insight Absent/delusional beliefs 08/10/2018 4
5 Phenomenology Ever had the impulse to: Jump off or push someone off a high bridge Swear or shout in a quiet public place Double check that you have locked the door, turned off the stove Wipe the toilet seat before you ve used it, avoid touching a door handle as you leave
6 Obsessions Recurrent and persistent thoughts, impulses or urges Intrusive or unwanted Cause marked distress or anxiety Sense of diminished control over obsession Individual attempts to ignore or supress thoughts or Neutralise them with other thoughts or action (by performing a compulsion)
7 Content of Obsessions Dirt/Contamination Doubts Harm/injury to others/self Hoarding, Saving, Collecting Religious obsessions, scrupulosity Somatic/Health Sexual Symmetry/exactness Somatic/health concerns
8 Compulsions Mental Acts Repeating words, not saying certain words, praying, counting Repetitive Behaviours Ordering, checking or hand washing Feels driven to perform in response to an obsession Function of compulsive ritual or behaviour is to prevent/reduce distress or dreaded event/situation Clearly excessive
9 Forms of Compulsions Rituals - Cleaning Urges - checking Neutralisation Reassurance seeking Avoidance
10 Nice Guidelines for OCD Mild Up to 10hrs of CBT with ERP using self- help materials, via telephone (with a healthcare professional) or Group therapy with a healthcare professional If not helpful An SSRI or More than 10 hours of CBT with ERP 08/10/
11 NICE Guidelines for OCD If symptoms more severe An SSRI or More than 10hrs of CBT with ERP If symptoms are very severe Combination of CBT with ERP together with an SSRI 08/10/
12 Cognitive Models for OCD Paul Salkovskis (1985) Inflated Responsibility Model Obsessions - normal intrusive thoughts In OCD these are misinterpreted Negative interpretation (high personal responsibility) leads to anxiety Results in Neutralising to reduce distress and perceived responsibility
13 Mood state Cognitive Model of OCD (Mark Freeston, 1997) Normal intrusions Beliefs/ Assumptions Misinterpretations (appraisal- importance/responsibility for harm Daily life events Anxiety Neutralization
14 Case Illustration Chris is a 25yr old man who experiences obsessional thoughts about hitting a child when driving his car. This concern started when he narrowly missed a young child while driving in the local area. This is particularly problematic for him when driving in built up areas where schools are located and at certain times of the day. At times Chris, believing he might have hit a child has returned to the scene resulting in him being late for work and picking his children up from school. He has also been warned about being late for work by his boss.
15 Formulation of OCD Situation Driving Intrusion: Hit the kid with the car Appraisal: What if the kid is fatally harmed I have to make sure he is ok Having the thought means it has happened Anxiety Neutralisation Go back and check Try not to have the thought
16 Cognitive Model of the Persistence of Anxiety: the vicious flower! (Paul Salkovskis) Events, stimuli and situations Anxiety negative physical interpretations reactions Safety seeking behaviour
17 Role Play
18 Obsessive Thoughts Form and Content Types of thoughts reported by most people in the population Similar Content Different reactions Less distress, shorter, less frequent in normal population In OCD more importance given to the thoughts
19 Obsessive Thoughts Coping Strategies Logical to try and do something about the thought if it is distressing Research suggests clinical and non-clinical use a similar range of techniques Rationalisation, reassurance seeking, distraction same frequency in OCD and non -clinical Thought stopping, mental checking, overt compulsions, reappraisal, worry more in OCD Do nothing more often in non clinical groups
20 Obsessional Thoughts - Coping Strategies Neutralisation/Compulsive Behaviour occurs, perhaps efficient in short term Based on the success of this technique the person may continue to utilise it and ATTACH significant importance to the technique in terms of coping with the thought
21 Cognitive Appraisal Theories of OCD Over importance of thoughts Inflated Responsibility Overestimation of threat Importance of Controllability of Thoughts Intolerance of Uncertainty Perfectionistic beliefs
22 Neutralisations Any mental or physical action, regardless of form, performed with the goal of - controlling or removing the thought - changing its meaning - preventing negative consequences - preventing future thoughts - decreasing negative thought (Freeston 2004)
23 Behaviour Therapy for OCD Developed in late 60s and early 70s Aim to modify behavior Directly targets obsessive compulsive behavior, esp compulsions Main ingredient is Exposure and Response Prevention (ERP) NICE (2005) Well established, proven effective for OCD Can be used alone or with medication
24 ERP for OCD Empirically supported treatment Effective in washing and checking compulsions Mild to moderate OCD (NICE 2005) With medication in severe OCD Shortcomings 20% to 30% refuse ERP 25% fail to improve For obsessions less than adequate Treatment factors such as low motivation, non compliance with homework reduce effectiveness
25 CBT for OCD Elements of both BT and CT Currently most popular form of therapy Strongest evidence base (NICE, 2005) Must include an active Behavioural component (ERP) This may be framed cognitively as behavioral experiments + consolidation of new behaviors More flexible than traditional BT without losing focus on changing behavior From Mark Freeston 2011
26 CBT of OCD In-depth assessment Socialisation to OCD model Focus on appraisal of intrusive thoughts and thinking styles Identify neutralisation strategies Exposure and Response Prevention (ERP) Relapse Prevention
27 Assessment Patient history Assessment of OCD Symptoms Obsessions and Compulsions Establish Disruption Rating Avoidance and Safety Behaviours Establish Frequency of Use Target OCD Symptoms and Avoidant Safety Behaviours Rating Scales Provide Information on OCD
28 Assessment - OCD Identify recent episode when patient had obsession Questions to identify Intrusions appraisal emotional and behavioural reactions How did reactions affect the patient
29 Assessment - OCD To identify dysfunctional appraisal When you had the thought what did you think was the worst thing that could happen? Could anything bad happen as a result of the intrusion? Do you do anything to prevent worst from happening? What is the worst that would happen if you did not check?"
30 Socialisation to OCD Model Begins at Session One! Key Components 1) Thinking is Normal! 2) There are two parts of the model that aren t under your control occurrence of thoughts camel effect 3) There are two parts that are under your control importance that you give to the thought neutralisation strategies
31 Camel Test Camel Effect How was that Was it difficult to keep the thoughts in mind Was it difficult to keep the thoughts away
32 Camel effect KEY MESSAGES You can t influence whether you have thoughts but you can influence whether you neutralise them Each time you neutralise you reinforce the importance that you give to your thoughts
33 Appraisal of Thoughts and Thinking Styles How does the person interpret the thought? How important is the thought to the person? There may be different types of misinterpretation Thinking about this means I must want to do it Having this thought means I m bad Thinking this thought can make it happen I should be able to control my thoughts
34 Questions To Identify Neutralising Behaviour Do you seek reassurance from others? Do you try and reassure yourself by saying certain things? Do you seek/refer back to information to try and convince yourself nothing bad will happen? Do you pray or use religious or spiritual things to cancel thoughts out? Do you distract yourself away from thoughts? Do you perform actions (mental or concrete/observable) to control your thoughts, cancel them out or control the emotions associated with the thoughts (anxiety or guilt)? Do you plan to avoid people, places, objects, types of information etc that might trigger the thoughts off?
35 Principles of CBT for OCD Normalisation of intrusions Role of dysfunctional appraisals Differentiating intrusive thought from the appraisal Neutralisation strategies Excessive mental control
36 Interventions Cognitive Restructuring Behavioural Experiments Doubt Reduction Rituals and Emotional Avoidance
37 Cognitive Restructuring Education about occurrence of obsessions Dysfunctional Thought Records Worry about intrusions (appraisals) Thought - action defusion Thought - event defusion Detached Mindfulness
38 Behavioural Experiments Exposure and response prevention Overestimation of threat Intolerance of anxiety Inflated responsibility Intolerance of Uncertainty Thought Action Fusion Bias Importance of Thoughts
39 Exposure and Response Prevention (ERP) Preparing the patient psycho-education In order to break the vicious circle the patient must tolerate the thought Deliberately thinking the thought (exposure) without neutralising (response prevention) Use examples to illustrate, How would you help a child overcome their fears Progressive Exposure
40 ERP (continued) Setting specific goals break into bite size pieces How to test it tapes, physical environment, accompanied, alone Setting the scene Therapist ensures that sequence of events is not contaminated by neutralisation Do it! Utilise exposure self-monitoring forms Repetition
41 Common Pitfalls Patients discovering new thoughts Avoidance Reassurance seeking behaviour (therapist or relatives, friends) Therapy induced neutralisations Making distinctions between believing something is so and fearing something is so Focus on modification of obsessional content
42 Relapse Prevention A clear understanding of the model is essential Possibility of setbacks What to do if setbacks occur The importance of managing the day to day stresses of life Lifestyle balance
43 Further Reading Clark, D.A (2004). Cognitive Behavioural Therapy for OCD. Guilford Press. Freeston, M.H & Ladouceur, R.(1997). The Cognitive Behavioural Treatment of Obsessions: A Treatment Manual Salkovskis, P.M. (1985). Obsessionalcompulsive problems: A cognitive behavioural analysis. Behaviour Research and Therapy 23(5):
44 Body Dysmorphic Disorder Mirror Mirror on the wall, how ugly am I... Is BDD common? 08/10/
45 Definition of Body Dysmorphic Disorder Preoccupation with an imagined defect in appearance or Markedly excessive concern with a slight physical anomaly Causes significant distress or impairment in functioning 08/10/
46 Clinical Features Preoccupations are obsessional in nature Concerns focus on any body part (several frequent) Most common - nose skin hair mouth lips jaw 08/10/
47 Clinical Features (continued) Behaviours - Mirror checking Skin picking Camouflaging Reassurance seeking Co morbidity - Depression OCD Social phobia Substance abuse Suicide risk high 08/10/
48 Assessment (NICE Guidance) Questions to ask Do you worry a lot about the way you look? What specific concerns do you have about your appearance? How many hours a day is your appearance on your mind? What effect does it have on your life? Does it affect your work or social life? 08/10/
49 Cognitive Behavioural Assessment Beliefs Checklist of different parts of body What is defective and associated distress Personal meaning/assumptions held about perceived defect 08/10/
50 Beliefs (continued) Self as aesthetic object Perfectionistic beliefs Social acceptance 08/10/
51 Common Beliefs in BDD I am worthless because of the way I look My worth depends on how I look I must look perfect I ll end up alone if I don t look good 08/10/
52 Cognitive Behavioural Assessment (Behaviours/Rituals) Mirror gazing - Desire to know exactly how they look Hope they will look different If camouflage has worked Feel worse if they do not gaze (Veale & Riley, 2001) Gazing at other reflective surfaces Comparing with others appearance Reassurance seeking Camouflaging Cosmetic surgery 08/10/
53 Social Anxiety and Avoidance Fear of negative evaluation by others Use of safety behaviours Avoidance of range of situations Rate degree of distress without use of safety behaviours 08/10/
54 Engagement Present patient with 2 hypotheses a) He / she is defective; Tries to change appearance b) Excessive worry about appearance. - Appearance the most important aspect of identity. To prove the second hypothesis: a) Give examples of selective attention b) Recommend reading about BDD. 08/10/
55 A Cognitive Behavioural Model of BDD ( David Veale) Trigger (external representation of appearance), e.g. reflection in mirror selective attention Mirror-checking Negative appraisal of internal body image Processing of self as an aesthetic object Avoidance and safety behaviours to change or camouflage appearance Mood (depression and disgust) 08/10/ Rumination on ugliness or defectiveness and comparison to ideal
56 Formulation of BDD Reflection in mirror Over focus on nose Mirror checking It looks like a man s nose I am ugly Nobody will like me I will end up alone Put make up on to make Shame it less prominent Distress Cover sides of face with hair 08/10/
57 Similarities between OCD and BDD Permanent persistent thoughts Compulsive behaviours (mirror checking) Avoidance Perfectionistic beliefs 08/10/
58 Differences between OCD and BDD Thoughts not experienced as intrusive Limited to imagined flaws Not resisted More suicidal ideas/attempts in BDD 08/10/
59 BDD - Treatment Response Prevention Exposure to social situations Cognitive restructuring Behavioural Experiment Mirror Retraining Refocusing Habit reversal 08/10/
60 Cognitive Restructuring Target assumptions/meaning about being defective Behavioural experiments to evaluate assumptions Target beliefs about self as aesthetic object Reverse role play 08/10/
61 Response Prevention Mirror Retraining Interrupts Selective Attention Look at entire face/body Full length mirror Objectively describe body from head to toe Do not check parts that are disliked Use mirror only for agreed purpose 08/10/
62 Suggested Reading 1. Veale D & Wilson R (2005) Overcoming Obsessive Compulsive Disorder 2. Veale D. (2010) Body Dysmorphic Disorder: A Treatment Manual. Wiley, Chichester 3. Katharine A Phillips (2005) The Broken Mirror, Oxford Press 08/10/
Obsessive-Compulsive Disorder MRCPsych Year II
Obsessive-Compulsive Disorder MRCPsych Year II Renuka Arjundas Renuka.Arjundas@ntw.nhs.uk Slides adapted (with permission) from Professor Mark Freeston Newcastle Cognitive and Behavioural Therapies Centre
More informationCBT Treatment. Obsessive Compulsive Disorder
CBT Treatment Obsessive Compulsive Disorder 1 OCD DEFINITION AND DIAGNOSIS NORMAL WORRIES & COMPULSIONS DYSFUNCTIONAL/ABNORMAL OBSESSIONS DSM IV DIAGNOSIS 2 OCD DIAGNOSIS DSM IV & ICD 10 A significant
More informationLet s Talk About Treatment
What Doesn t Work Let s Talk About Treatment Lisa R. Terry, LPC What we ve tried Talk therapy- You can t talk you way out of a medical disorder Play Therapy Family Therapy Psychoanalysis While these are
More informationObsessive Compulsive and Related Disorders
Obsessive Compulsive and Related Disorders Obsessive-Compulsive and Related Disorders Obsessive-Compulsive and Related Disorders Obsessive -Compulsive Disorder (OCD) Body Dysmorphic Disorder Hoarding Disorder
More informationObsessive Compulsive Disorder. David Knight
Obsessive Compulsive Disorder David Knight OCD is a serious anxiety-related condition a person experiences frequent intrusive and unwelcome obsessional thoughts followed by repetitive compulsions, impulses
More informationObsessivecompulsive disorder (OCD)
Obsessivecompulsive disorder (OCD) OCD is concerned with the inability of the person to inhibit fear and anxiety-reducing behavior. The person engages in repetitive fear-reducing attempts. Definitions:
More informationPsychological treatment of obsessive compulsive disorder
Psychological treatment of obsessive compulsive disorder Paul M Salkovskis Abstract NICE guidelines recommend psychological treatment (cognitive behavioural therapy, involving major elements of exposure
More informationA-Z of Mental Health Problems
Mental health problems can cover a broad range of disorders, but the common characteristic is that they all affect the affected person s personality, thought processes or social interactions. They can
More informationObsessive Compulsive Disorder: Advances in Psychotherapy
Obsessive Compulsive Disorder: Advances in Psychotherapy Question from chapter 1 1) All the following are Common obsessions EXCEPT a) Fear of becoming someone else b) Unwanted violent impulses c) Fear
More informationJamie A. Micco, PhD APPLYING EXPOSURE AND RESPONSE PREVENTION TO YOUTH WITH PANDAS
APPLYING EXPOSURE AND RESPONSE PREVENTION TO YOUTH WITH PANDAS Jamie A. Micco, PhD Director, Intensive Outpatient Service Child and Adolescent Cognitive Behavioral Therapy Program Massachusetts General
More informationObsessive Compulsive Disorder. Understanding OCD & Managing Reassurance
Obsessive Compulsive Disorder Understanding OCD & Managing Reassurance OCD What is it?? Small group brainstorm: What do you know about OCD? OCD in the Media A simplistic view How OCD are YOU? OCD obsessions
More informationMODULE OBJECTIVE: What is Obsessive- Compulsive Disorder? How would you describe OCD?
MODULE OBJECTIVE: What is Obsessive- Compulsive Disorder? Chapter 4-Anxiety Disorders How would you describe OCD? Watch the following video and evaluate what characteristics you were correct about 1 Both
More informationAwareness of Borderline Personality Disorder
Borderline Personality Disorder 1 Awareness of Borderline Personality Disorder Virginia Ann Smith Written Communication Sarah Noreen, Instructor November 13, 2013 Borderline Personality Disorder 2 Awareness
More informationTheory and Practice of Cognitive Behavioral Therapy
Theory and Practice of Cognitive Behavioral Therapy Shona N. Vas, Ph.D. Department of Psychiatry & Behavioral Neuroscience Cognitive-Behavior Therapy Program MS-3 Clerkship 2008-2009 Outline n What is
More informationWhat is Body Image What is Body Dysmorphic Disorder? Characteristics of BDD with Hair as a Primary Focus Identifying BDD Patients What to do with a
What is Body Image What is Body Dysmorphic Disorder? Characteristics of BDD with Hair as a Primary Focus Identifying BDD Patients What to do with a BDD Patient Body image: a subjective evaluation of your
More informationWho has Schizophrenia? What is Schizophrenia? 11/20/2013. Module 33. It is also one of the most misunderstood of all psychological disorders!
What is Schizophrenia? Module 33 It is also one of the most misunderstood of all psychological disorders! Who has Schizophrenia? A middle-aged man walks the streets of New York with aluminum foil under
More informationPsychological Treatment of OCD and Hoarding
Psychological Treatment of OCD and Hoarding Mabel Yum Principal Clinical Psychologist 23 April 2016 What is OCD? Anxiety Obsession Rituals Compulsions How much can you empathize the struggles that patients
More informationWestwood Institute For Anxiety Disorders, Inc. 921 Westwood Blvd., Suite 224 Los Angeles, CA Tel. (323)
Westwood Institute For Anxiety Disorders, Inc. 921 Westwood Blvd., Suite 224 Los Angeles, CA 90024 Tel. (323)651-1199 www.hope4ocd.com by Eda Gorbis, PhD, MFCC Assistant Clinical Professor, UCLA School
More informationUnderstanding Pediatric OCD. Jerry Bubrick, Ph.D. Senior Clinical Psychologist, Anxiety Disorders Center Director, Intensive Pediatric OCD Program
Understanding Pediatric OCD Jerry Bubrick, Ph.D. Senior Clinical Psychologist, Anxiety Disorders Center Director, Intensive Pediatric OCD Program Child Mind Institute The Child Mind Institute is an independent
More informationOCD without Compulsive Behaviors: What it is and how to treat it
OCD without Compulsive Behaviors: What it is and how to treat it Charles Brady, Ph.D, ABPP Director, LCOH OCD and Anxiety Treatment Program Vice President, OCD Midwest CBT Model of OCD Intrusive Thought
More informationWhat is Schizophrenia?
What is Schizophrenia? Module 33 What symptoms would you expect this person to display? It is also one of the most misunderstood of all psychological disorders! 1 Who has Schizophrenia? A middle-aged man
More informationObsessive-Compulsive Disorder
Obsessive-Compulsive Disorder When Unwanted Thoughts or Irresistible Actions Take Over Teena Obsessive-Compulsive Disorder: When Unwanted Thoughts or Irresistible Actions Take Over Introduction Do you
More informationUNDERSTANDING THE PSYCHOLOGICAL IMPACT OF A COLORECTAL CANCER DIAGNOSIS
UNDERSTANDING THE PSYCHOLOGICAL IMPACT OF A COLORECTAL CANCER DIAGNOSIS Dr Claire Delduca, Macmillan Clinical Psychologist Velindre Cancer Centre, Cardiff Aims Understanding the impact of a diagnosis of
More informationObsessive-Compulsive Disorder: Treating the Untreatable using CBT. Lynne M Drummond
Obsessive-Compulsive Disorder: Treating the Untreatable using CBT Lynne M Drummond Obsessive-Compulsive Disorder OBSESSIONS Recurrent Thoughts, ideas, images, impulses Invade consciousness ANXIOGENIC Senseless
More informationCBT for Hypochondriasis
CBT for Hypochondriasis Ahmad Alsaleh, MD, FRCPC Assistant Professor of Psychiatry College of Medicine, KSAU-HS, Jeddah Agenda Types of Somatoform Disorders Characteristics of Hypochondriasis Basic concepts
More informationOCD Recovery Centers of America. Name: Date: Age:
Name: Date: Age: INSTRUCTIONS Below you will find a list of some types of obsessions and compulsions. This is not a complete list, only examples of some of the more common types of obsessive thoughts and
More informationObsessive-Compulsive Disorder
Get into groups of 3-4 Decide how each of you will do a low-to midlevel fear exposure over the next 3 hours Be back at 1 pm, ready to discuss what you did and the results Obsessive-Compulsive Disorder
More informationOCD. Obsessive Compulsive Disorder (OCD)
OCD Obsessive Compulsive Disorder (OCD) What is Obsessive-Compulsive Disorder? Obsessive-compulsive disorder (OCD) is a condition that causes people to have upsetting thoughts and behaviours. People with
More informationFAMILY ACCOMMODATION SCALE FOR OBSESSIVE-COMPULSIVE DISORDER Patient Version (FAS-PV)
*Reprinted with the permission of the authors* FAMILY ACCOMMODATION SCALE FOR OBSESSIVE-COMPULSIVE DISORDER Patient Version (FAS-PV) Developed by: Anthony Pinto, Ph.D., Barbara Van Noppen, Ph.D., Monica
More informationA module based treatment approach
A module based treatment approach Heterogeneous Intimate relationship are important OCD and intimate relationships Functioning, marital distress, less likely to get married OCD symptoms impair relationship
More informationSuicide.. Bad Boy Turned Good
Suicide.. Bad Boy Turned Good Ross B Over the last number of years we have had a few of the youth who joined our programme talk about suicide. So why with all the services we have in place is suicide still
More informationCLASS OBJECTIVE: What is Obsessive-Compulsive Disorder? What is OCD? 2/8/2009. What Did you see? Obsessive-compulsive disorder involves unwanted,
CLASS OBJECTIVE: What is Obsessive-Compulsive Disorder? Chapter 4-Anxiety Disorders What is OCD? Obsessive-compulsive disorder involves unwanted, What Did you see? The obsessions are unwanted thoughts,
More informationPSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS
PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS Abbey Kruper, Psy.D. Assistant Professor Department of Obstetrics & Gynecology Medical College of Wisconsin OBJECTIVES 1. Overview of perinatal anxiety
More information4/3/2017 WHAT IS ANXIETY & WHY DOES IT MATTER? PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS OBJECTIVES. 1. Overview of perinatal anxiety
PSYCHOLOGICAL PERSPECTIVES PERINATAL ANXIETY DISORDERS Abbey Kruper, Psy.D. Assistant Professor Department of Obstetrics & Gynecology Medical College of Wisconsin OBJECTIVES 1. Overview of perinatal anxiety
More informationDoes anxiety cause some difficulty for a young person you know well? What challenges does this cause for the young person in the family or school?
John Walker, Ph.D. Department of Clinical Health Psychology University of Manitoba Everyone has the emotions at times. Signal us to be careful. Help us to stay safe. Most children and adults have mild
More informationExamples of Cognitions that can Worsen Anxiety:
Examples of Cognitions that can Worsen Anxiety: Cognitive errors, such as believing that we can predict that bad events will happen Irrational beliefs, such as bad things don t happen to good people, so
More informationThe Advocate. Obsessive-compulsive Disorder Post published by National Alliance on Mental Illness (NAMI) Special Interest Articles
The Advocate Summer 2016 Volume 1, Issue 17 Published By Sunpath, LLC (704) 478-6093 Special Interest Articles Obsessive-compulsive Disorder Helping Someone with Schizophrenia Dealing With Chronic Illnesses
More informationPTSD Ehlers and Clark model
Problem-specific competences describe the knowledge and skills needed when applying CBT principles to specific conditions. They are not a stand-alone description of competences, and should be read as part
More informationNever Just Right: Solving the Puzzle of Obsessive Compulsive Disorder
Never Just Right: Solving the Puzzle of Obsessive Compulsive Disorder Andrew Jacobs, Psy.D., C.Psych. Psychologist, Anxiety Disorders Program Jakov Shlik, MD, FRCPC Psychiatrist and Clinical Director,
More informationFAMILY ACCOMMODATION SCALE FOR OBSESSIVE-COMPULSIVE DISORDER Self-Rated Version (FAS-SR)
FAMILY ACCOMMODATION SCALE FOR OBSESSIVE-COMPULSIVE DISORDER Self-Rated Version (FAS-SR) Developed by: Anthony Pinto, Ph.D., Barbara Van Noppen, Ph.D., & Lisa Calvocoressi, Ph.D. Copyright and Permissions
More informationControlling Worries and Habits
THINK GOOD FEEL GOOD Controlling Worries and Habits We often have obsessional thoughts that go round and round in our heads. Sometimes these thoughts keep happening and are about worrying things like germs,
More informationBody Dysmorphic disorder. Let s be completely honest by also anonymous
Body Dysmorphic disorder Ch.7- Somatoform and Dissociative Disorders Let s be completely honest by also anonymous What would you change about the way you look? Most of us can appreciate the desire to change
More informationThe University of Manchester Library. My Learning Essentials. Now or never? Understanding the procrastination cycle CHEAT SHEET.
The University of Manchester Library My Learning Essentials Now or never? Understanding the procrastination cycle CHEAT SHEET @mlemanchester https://www.escholar.manchester.ac.uk/learning-objects/mle/counselling/
More informationYou Can Treat OCD. Treatment of OCD. ReidWilson, PhD. NoiseInYourHead.com 1. Objectives. BriefTherapy Conference December 9, 2018.
BriefTherapy Conference December 9, 2018 You Can Treat OCD ReidWilson, PhD Chapel Hill, NC, USA drwilson@anxieties.com www.anxieties.com NoiseInYourHead.com 1 Objectives 1. Defend the importance of altering
More informationOCD? parents guide. obsessive-compulsivedisorder
?? An Information Guide for Parents of Children and Teenagers with OCD obsessive-compulsivedisorder parents guide OCD? The leading national charity, independently working with and for young people affected
More informationIntroduction into Psychiatric Disorders. Dr Jon Spear- Psychiatrist
Introduction into Psychiatric Disorders Dr Jon Spear- Psychiatrist Content Stress Major depressive disorder Adjustment disorder Generalised anxiety disorder Post traumatic stress disorder Borderline personality
More informationCare of Patient with Obsessive-compulsive disorder
Care of Patient with Obsessive-compulsive disorder Introduction Obsessive-compulsive disorder (OCD) is categorized as an anxiety disorder. Obsessions are recurrent, intrusive thoughts or feelings, whereas
More informationBackground. Interoceptive Exposure: An Underused Weapon in the Arsenal against OCD. Outline. Exposure Therapy for OCD
Outline Interoceptive Exposure: An Underused Weapon in the Arsenal against OCD Shannon Blakey, MS & Jonathan Abramowitz, PhD University of North Carolina at Chapel Hill 30 July 2016 Background Anxiety
More informationAnxiety or Addiction Where Do We Draw the Line?
Anxiety or Addiction Where Do We Draw the Line? Linda Lewaniak, LCSW, CAADC Director of Intensive Outpatient Services Patrick B. McGrath, Ph.D. Center for Anxiety and Obsessive Compulsive Disorders AMITA
More informationOCD vs. Tics: What to Expect and Strategies to Help
OCD vs. Tics: What to Expect and Strategies to Help Jerry Bubrick, Ph.D. Senior Clinical Psychologist, Anxiety Disorders Center Director, Intensive Pediatric OCD Program Child Mind Institute The Child
More informationProblem Situation Form for Parents
Problem Situation Form for Parents Please complete a form for each situation you notice causes your child social anxiety. 1. WHAT WAS THE SITUATION? Please describe what happened. Provide enough information
More informationBorderline Personality Disorder (BPD) FACTS Families and Carers Training and Support Programme
FACTS : Participants handouts Module 2 Mindfulness and Emotion Management Borderline Personality Disorder (BPD) FACTS Families and Carers Training and Support Programme A short course for family members
More informationCreating suicide safer communities A N X I E T Y R E C O V E R Y C E N T R E V I C T O R I A
Creating suicide safer communities A N X I E T Y R E C O V E R Y C E N T R E V I C T O R I A Overview We will be talking about suicide What does a suicide safer community look like Australian Statistics
More informationDepression: what you should know
Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and
More informationManaging Fear of Cancer Recurrence: Coping with Fear and Uncertainty After Cancer
Managing Fear of Cancer Recurrence: Coping with Fear and Uncertainty After Cancer DR. PAMELA J. GINSBERG, PH.D. LICENSED PSYCHOLOGIST PRIVATE PRACTICE, DOYLESTOWN, PA STAFF PSYCHOLOGIST, DOYLESTOWN HOSPITAL
More informationA survey of 30,000 people found that 93% of women and 82% of men care enough about their appearance to improve it.
A survey of 30,000 people found that 93% of women and 82% of men care enough about their appearance to improve it. How does this feature affect you? How does this imperfection make you feel? Has it ever
More informationObsessing About Morality: Being Good Without Being Certain
Obsessing About Morality: Being Good Without Being Certain Anxiety Disorders and Mormonism Conference 2018 -Jon Hershfield, MFT Disclosure I wrote some books for New Harbinger Publishing Inc. and if you
More informationQuick Start Guide for Video Chapter 2: What Is Addiction?
Quick Start Guide for Video Chapter 2: What Is Addiction? Materials and Preparation Needed * Prepare to show the video on a TV or monitor. * Print the chapter 2 fact sheet, Addiction, for each client.
More informationObsessive compulsive disorder
University of Northern Iowa UNI ScholarWorks Graduate Research Papers Graduate College 2010 Obsessive compulsive disorder Angela Bigelow University of Northern Iowa Copyright 2010 Angela Bigelow Follow
More informationAnxiety- Information and a self-help guide
Anxiety- Information and a self-help guide Anxiety Anxiety can be a very normal and healthy response to stressful situations, such as paying bills or sitting an exam. However, it becomes a problem when
More informationA Parent s Guide to Evidence-Based Treatment. Rebecca Hardin PsyD Joanna Marino PhD
A Parent s Guide to Evidence-Based Treatment Rebecca Hardin PsyD Joanna Marino PhD What is Evidence-Based Treatment? EBT consists of three components: It is practice guided by the best available research
More informationUsing CBT techniques to support pa4ents with depression and anxiety
Using CBT techniques to support pa4ents with depression and anxiety Andrew Grimmer Counselling Psychologist BABCP Accredited CBT Therapist bristolcbt.email@gmail.com www.bristolcbt.co.uk www.onlinecbtresources.co.uk
More informationTreatment of Anxiety as a Cooccurring Disorder
Treatment of Anxiety as a Cooccurring Disorder John J. Arnold, Ph.D., Sanctuary at Lake Chelan Community Hospital Presented at the 2016 Washington Behavioral Healthcare Conference Learning Objectives Learn
More information02/19/02 OBSESSIVE-COMPULSIVE DISORDER SECTION
02/19/02 OBSESSIVE-COMPULSIVE DISORDER SECTION *O1. *O1a. Some people have repeated unpleasant thoughts or impulses that they can t get out of their heads that make these people feel compelled to behave
More informationObsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care
Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care CLINICAL ASSESSMENT AND DIAGNOSIS (ADULTS) Obsessive-Compulsive Disorder (OCD) is categorized by recurrent obsessions,
More informationHow Anxiety and Repetitive Behaviors Interact to Complicate a Child s Life. Topic Relevance. Webinar Goal: Simplification. Slide 1 Common Threads:
1 Common Threads: How Anxiety and Repetitive Behaviors Interact to Complicate a Child s Life 2 Topic Relevance Clinical Disorders F42.2 Obsessive-Compulsive Disorder F95.2 Tourette s Disorder F93.0 Separation
More informationSocial phobia Clark model
Problem-specific competences describe the knowledge and skills needed when applying CBT principles to specific conditions. They are not a stand-alone description of competences, and should be read as part
More informationAnxiety Disorders. Dr. Ameena S. Mu min, LPC Counseling Services- Nestor Hall 010
Anxiety Disorders Dr. Ameena S. Mu min, LPC Counseling Services- Nestor Hall 010 Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18
More informationMental Health. Borderline Personality Disorder
Mental Health Borderline Personality Disorder a) Borderline Personality Disorder b) I want to go into detail because I feel that many addicts with Complex Trauma have this i. BPD comes out of more severe
More informationCognitive Behavioral Therapy. A Brief Introduction
Cognitive Behavioral Therapy A Brief Introduction Cognition Re-enters Behaviorism focused on observable behavior (J.B. Watson, B.F. Skinner) Albert Bandura re-opened the door to cognitions with modeling
More informationCBT FOR ANXIETY (CBT-A): WHAT CAN I DO WITH MY PATIENT INSTEAD OF GIVING THEM A PRN BENZODIAZEPINE
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences CBT FOR ANXIETY (CBT-A): WHAT CAN I DO WITH MY PATIENT INSTEAD OF GIVING THEM A PRN BENZODIAZEPINE PATRICK J. RAUE,
More informationObsessive/Compulsive Disorder
Obsessive/Compulsive Disorder An Overview of the Diagnosis, Symptoms, Assessment and Treatment in Behavioral Health Martin J. Harrington M.D., Staff Child/Adolescent Psychiatrist Children s Hospital and
More informationDr Anita Rose Director of Clinical Service: Consultant in Neuropsychology & Rehabilitation
Dr Anita Rose Director of Clinical Service: Consultant in Neuropsychology & Rehabilitation Hope this finishes soon as I am hungry Did I lock my car when I left it in the car park? Will today finish in
More informationObsessiveCompulsive. Disorder: When Unwanted Thoughts Take Over. Do you feel the need to check and. re-check things over and over?
What is it like having OCD? I couldn t do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three
More informationFinding common ground with people who have diabetes
Finding common ground with people who have diabetes Dr Jess Brown Senior Clinical Psychologist Department of Psychological Medicine York Community Diabetes Team Aims for today Why common ground? What might
More informationThe Cognitive Model Adapted from Cognitive Therapy by Judith S. Beck
The Cognitive Model Adapted from Cognitive Therapy by Judith S. Beck Automatic Thoughts The Cognitive Model is based on the idea that our emotions and behaviors are influenced by our perceptions of events.
More informationBuilding Body Acceptance Therapeutic Techniques for Body Image Problems
Building Body Acceptance Therapeutic Techniques for Body Image Problems Susan J. Paxton La Trobe University Beth Shelton Victorian Centre for Excellence in Eating Disorders (with thanks to Siân McLean)
More informationLiving With Someone Who Has OCD: Guidelines for Family Members
Living With Someone Who Has OCD: Guidelines for Family Members (From Learning to Live with OCD) In an effort to strengthen relationships between individuals with OCD and their family members and to promote
More informationmaintaining gains and relapse prevention
maintaining gains and relapse prevention Tips for preventing a future increase in symptoms 3 If you do experience an increase in symptoms 8 What to do if you become pregnant again 9 2013 BC Reproductive
More informationQuality of Life and Stress among Obsessive Compulsive Disorder. Caregivers and General Population
The International Journal of Indian Psychology ISSN 2348-5396 (e) ISSN: 2349-3429 (p) Volume 3, Issue 2, No.4, DIP: 18.01.069/20160302 ISBN: 978-1-329-85570-0 http://www.ijip.in January - March, 2016 Quality
More informationSOMEONE I CARE ABOUT IS NOT DEALING WITH HIS OCD: WHAT CAN I DO ABOUT IT?
SOMEONE I CARE ABOUT IS NOT DEALING WITH HIS OCD: WHAT CAN I DO ABOUT IT? By Heidi J. Pollard, RN, MSN and C. Alec Pollard, Ph.D., Anxiety Disorders Center, Saint Louis Behavioral Medicine Institute and
More informationImproving Access to Psychological Therapies. Guidance for faith and community groups
Improving Access to Psychological Therapies Guidance for faith and community groups 1 The aims of this resource This document aims to improve faith communities understanding of the professional treatments
More informationModule 4: Case Conceptualization and Treatment Planning
Module 4: Case Conceptualization and Treatment Planning Objectives To better understand the role of case conceptualization in cognitive-behavioral therapy. To develop specific case conceptualization skills,
More informationPerfectionism and mindset
Perfectionism and mindset Perfectionism Being perfect sounds like a good thing, but perfectionism gets seriously in the way of learning. Rates of perfectionism are higher at Nossal than in other schools.
More informationMental Health ANXIETY
Mental Health ANXIETY My experience over 90% have mental health issues a) If addicts don t get help, their chances of remaining sober aren t good b) Most common depression and anxiety c) Many addicts used
More informationAnxiety & Cognitive Behavioral Therapy Module
The San Diego Center for the Treatment of Mood Disorders Dr. Craig Alan Brown March, 2016 Anxiety & Cognitive Behavioral Therapy Module Cognitive Behavioral Therapy Steps in Management of Anxiety Step
More informationManaging Negative or Unhelpful Thoughts
Managing Negative or Unhelpful Thoughts In Cognitive Behavioural Therapy, we give particular focus to the pattern, force, frequency and content of negative or unhelpful thinking. Thoughts play a key role
More informationAdolescence: A Visual Summary
1 OCD and Teens/Young Adults: How to Keep Them Engaged in Their Own Treatment, Symptoms, and Lives Martin E. Franklin, Ph.D. Associate Professor of Clinical Psychology in Psychiatry University of Pennsylvania
More informationProblem Solving
www.working-minds.org.uk Problem Solving Problem Solving The psychological importance of effective problem solving is very underestimated and is often taken for granted. As human beings, we assume that
More informationCourage is resistance to fear, mastery of fear not absence of fear. ~Mark Twain
Courage is resistance to fear, mastery of fear not absence of fear. ~Mark Twain Now that we ve learned about many of the skills you ll see in CBT, let s talk about how to put them all together. This section
More informationHelping Children and Youth with Obsessive-Compulsive Disorder (OCD): Information for Parents and Caregivers
Helping Children and Youth with Obsessive-Compulsive Disorder (OCD): Information for Parents and Caregivers He just can t stop washing William enjoys hanging out with his friends and family, and is a great
More informationIdentifying Your Problematic Thoughts
Identifying Your Problematic Thoughts It is important to look at the way you think and feel about problems. The way you think about things can dramatically affect the way you feel and the way you behave.
More informationSection 4 - Dealing with Anxious Thinking
Section 4 - Dealing with Anxious Thinking How do we challenge our unhelpful thoughts? Anxiety may decrease if we closely examine how realistic and true our unhelpful/negative thoughts are. We may find
More informationWORD WALL. Write 3-5 sentences using as many words as you can from the list below.
WORD WALL Write 3-5 sentences using as many words as you can from the list below. Suicide Phobia Bipolar Obsessive compulsive disorder(ocd) Anxiety Depression Mood Post traumatic stress disorder (PTSD)
More informationPost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,
More informationa guide to cognitivebehavioural (cbt)
a guide to cognitivebehavioural therapy (cbt) Cognitive-behavioural aims to help you to change the way that you think, feel and behave. It is used as a treatment for various mental health and physical
More informationHow to Help Your Patients Overcome Anxiety with Mindfulness
How to Help Your Patients Overcome Anxiety with Mindfulness Video 8 - Transcript - pg. 1 How to Help Your Patients Overcome Anxiety with Mindfulness Strategies for Working with Specific Anxiety Diagnoses
More informationObsessive-Compulsive Disorder (OCD)
Do you feel trapped in a pattern of unwanted and upsetting thoughts? A R E A L I L L N E S S Obsessive-Compulsive Disorder (OCD) Obsessive-Compulsive Disorder NIH Publication No. 00-4676 Does This Sound
More informationAdvocating for people with mental health needs and developmental disability GLOSSARY
Advocating for people with mental health needs and developmental disability GLOSSARY Accrued deficits: The delays or lack of development in emotional, social, academic, or behavioral skills that a child
More information