Homework Use in Cognitive Therapy for Psychosis: A Case Formulation Approach

Based upon empirically supported cognitive-behavioral treatment approaches, this paper aims to outline the use of homework to enhance the therapeutic relationship, patient motivation, and skills for managing delusions, hallucinations, and negative symptoms. The nature and timing of homework is outlined for the different phases of treatment. Frequent barriers that emerge during the setting and reviewing of homework are described, followed by strategies to enhance motivation and homework compliance. The paper concludes with a demonstration of how homework is optimized within a case formulation approach for persistent symptoms of psychosis.     

A Novel Approach to the Assessment of Fidelity to a Cognitive Behavioral Therapy for PTSD Using Clinical Worksheets: A Proof of Concept With Cognitive Processing Therapy

Fidelity monitoring is a critical indicator of psychotherapy quality and is central to successful implementation. A major barrier to fidelity in routine care is the lack of feasible, scalable, and valid measurement strategies. A reliable, low-burden fidelity assessment would promote sustained implementation of cognitive behavioral therapies (CBTs). The current study examined fidelity measurement for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) using clinical worksheets. External raters evaluated patient worksheets done as a part of treatment, both guided by the therapist and completed independently as homework. Results demonstrated that fidelity ratings from CPT session worksheets were feasible and efficient. Notably, they were strongly correlated with observer ratings of the fidelity of CPT strategies that were present on the worksheets. Agreement among ratings conducted by individuals with a range of experience with CPT was acceptable to high. There was not a main effect of therapist-guided, in-session worksheet ratings on PTSD symptom change. However, patient competence in completing worksheets independently was associated with greater PTSD symptom decline and in-session, therapist-guided worksheet completion was associated with larger symptom decreases among patients with high levels of competence. With further research and refinement, rating of worksheets may be an efficient way to examine therapist and patient skill in key CPT elements, and their interactions, compared to the gold standard of observer ratings of therapy video-recordings. Additional research is needed to determine if worksheets are an accurate and scalable alternative to gold standard observer ratings in settings in which time and resources are limited.     

Empathy: A Social Cognitive Neuroscience Approach

There has been recent widespread interest in the neural underpinnings of the experience of empathy. In this review, we take a social cognitive neuroscience approach to understanding the existing literature on the neuroscience of empathy. A growing body of work suggests that we come to understand and share in the experiences of others by commonly recruiting the same neural structures both during our own experience and while observing others undergoing the same experience. This literature supports a simulation theory of empathy, which proposes that we understand the thoughts and feelings of others by using our own mind as a model. In contrast, theory of mind research suggests that medial prefrontal regions are critical for understanding the minds of others. In this review, we offer ideas about how to integrate these two perspectives, point out unresolved issues in the literature, and suggest avenues for future research.     

Recreating Near-Death Experiences: A Cognitive Approach

I describe a guided meditation that, when used by near-death experiencers (NDErs), recreates fragments of their NDEs. The meditation is based on Michael Persinger's neurological theory regarding the God Experience, and its success supports that theory. The present study included too few subjects to support quantitative analysis, and must be regarded as a pilot study.     

A Cognitive Therapy Approach to Increasing Father Involvement by Changing Restrictive Masculine Schemas

Cognitive therapists may be able to help fathers increase their involvement with their children by identifying and changing restrictive masculine schemas that interfere with men's parenting roles. In this paper, we (a) discuss the development of restrictive masculine schemas, (b) explain how these schemas may affect men's involvement in fathering roles, (c) offer a cognitive therapy approach for enhancing father involvement, and (d) illustrate the approach with a case example.     

Multi-Family Group Therapy: A Multidimensional Approach

The procedures, dynamics, and process of multi-family group therapy are presented with case examples from the authors' practice.     

Remediating Reading Comprehension Difficulties: A Cognitive Processing Approach

The efficacy of a cognitive-based remediation program was investigated with 14 English-as-a-second-language (ESL) poor readers in Grade 4 who had significant difficulty in comprehension and 14 normal ESL readers in Grade 4 who received no remediation. Both groups were selected from 2 English-medium schools in India. We examined pretest-to-posttest changes in word reading, comprehension, and planning–attention–simultaneous–successive cognitive processes. Analyses of variance (ANOVAs) showed marked improvement in comprehension and some improvement in simultaneous processing for the treated group. The results indicate that the cognitive-based remediation program has potential for substantially improving comprehension and its underlying cognitive process among ESL children.     

具身认知:认知心理学的新取向

具身认知强调身体在认知的实现中发挥着关键作用。其中心含义包括:(1)认知过程的进行方式和步骤实际上是被身体的物理属性所决定的;(2)认知的内容是身体提供的;(3)认知、身体、环境是一体的,认知存在于大脑,大脑存在于身体,身体存在于环境。具身认知最初仅仅是一种哲学思考,有深刻的哲学思想渊源,但是现在这种哲学思考已经开始走向实证领域,实验的认知心理学家开始从具身的角度看待认知,形成了具身认知研究思潮。但是具身认知研究也面临着许多亟待解决的问题。     

Cognitive Therapy for Suicidality: An Integrative, Comprehensive, and Practical Approach to Conceptualization

A model of suicidality based in cognitive therapy is offered. The conceptual framework, referred to as the suicidal mode, incorporates the various systems of personality into an integrative theory with direct application for clinical care. Application of the suicidal mode to treatment of patients struggling with suicidality is discussed and broader issues of theoretical integration addressed.     

Individual Multimodal Therapy for Weight Loss: A Case Example

Individual multimodal therapy provides a comprehensive approach to the treatment of overeating. The multimodal treatment plan helps to target social and emotional issues related to eating disorders as well as the eating behaviors themselves. The authors present a case study highlighting a treatment model based on a multimodal conceptualization.     

Cognitive Behavior Therapy with Children:

No abstract available for this article.     

The Acceptability of Computer-Aided Cognitive Behavioural Therapy: A Pragmatic Study

The clinical and cost-effectiveness of a computer-aided cognitive behavioural therapy (CCBT) programme, Beating the Blues, is indicated by a number of studies, but relatively little is known about its acceptability for patients with depression, anxiety, or both. This study investigated the acceptability of Beating the Blues offered on eight scheduled clinic visits with brief face-to-face support. Pre and posttreatment measures explored the relationship among programme acceptability, treatment continuation, and outcomes for people accessing the programme in routine care. Two hundred and nineteen patients with depression, anxiety, or both were offered Beating the Blues in 11 primary and secondary care practices. One hundred and ninety-one (87%) completed the pretreatment measures and 84 (38%) completed a treatment feedback questionnaire. Analysis of treatment acceptability for CCBT indicated a positive patient experience with the programme. Pretreatment expectancies predicted CCBT treatment completion but not outcomes. No differences were found between men and women on pretreatment measures. Posttreatment, women reported more favourable responses to the therapy, finding the programme more helpful and more satisfactory, than did men. No relationship between treatment acceptability and age was found. Study limitations, including research methods and attrition rates, and implications for future research are discussed. It is concluded that the Beating the Blues CCBT programme is an acceptable treatment for common mental health problems in routine care.     

Loving: A developmental challenge of middle age

The capacity to love fully is one of the central developmental challenges of middle age. Loving is predicated upon the dynamic synthesis of trusting, autonomous, and creative relationships during childhood and adolescence. With the emergence of a productive orientation during middle age, it becomes increasingly clear that it is important to work for that which we love. It is impossible to encapsulate the essence of loving, but it can be partially delineated in terms of care, responsibility, respect, and knowledge. As a loving relationship develops, sexuality may emerge as another phase of mutuality. However, many loving relationships have no sexual overtones. In summary, loving is an end experience, for it engenders the joy that comes from being fully alive.     

Cognitive Therapy and Theories of Knowing: A Social Constructionist View

It is argued that current theory and practice of cognitive therapy are encapsulated by a set of epistemic values that assign causative primacy for psychological problems to the cognitive processes of the individual knower. Social contructionism represents an alternative to this state of affairs by underscoring the inextricable connection between the personal and the social, challenging the merit of decontextualized accounts of psychological problems, and identifying empowerment and social change as viable therapeutic options.     

A Systemic Approach to Couple Therapy

This article presents a model of couple therapy based on the reciprocal double bind. Two cases are presented to illustrate the model, and different modes of intervention are described. This paper stresses that therapy has more to do with the intersection of the maps of the world of members of a system than it has with a search for some individual or systemic truth.