Cognitive-Behavioral Treatment of Social Phobia

Social phobia can be a chronic disorder, capable of restricting a client's social and occupational functioning. Cognitive-behavioral therapy can help many clients learn to overcome their social inhibitions, and make lasting changes in their interpersonal style. Cognitive-behavioral therapy for social phobia includes four general components for helping clients learn to manage their social anxiety. First, therapy begins with the establishment of a sound therapeutic alliance, a focus on assessment, diagnostic interviewing, and education regarding anxiety symptoms and their treatment. Second, the therapist helps clients to develop competence in social skills, relaxation training, and cognitive restructuring. Third, therapy uses exposure to social situations in order to help clients confront their fears and refine their coping skills. Fourth, relapse prevention strategies are used to help clients learn to tolerate feelings of discomfort and confront challenging social interactions. This treatment framework can be adapted to the specific needs of different clients.     

The Annual Survey of Psychoanalysis,Volume III Edited by John Frosch and Nathaniel Ross,Sidney Tarachow,Jacob A. Arlow

The effects of brief group psychotherapy in relapse prevention were tested. The groups focused on the clients' capacity to formulate their own treatment goals, including controlled drinking, programmed relapse, and total abstinence. Twelve months after completion of the eight-week outpatient group treatment, thirty-five clients were followed up. There appeared to be no harmful effects as a result of the treatment. Nobody in the follow-up group had a deteriorated drinking pattern as compared to pretreatment data. The follow-up results were significantly better than before treatment and also than in a comparison group of alcohol dependent patients. It seemed as if those patients who could benefit from the treatment had a shorter duration of abuse and had a later onset of uncontrolled drinking compared to those who continued with a negative drinking pattern and the dropouts. The clients assigned the positive treatment effects to course leaders' encouragement of personal decision making, increased awareness of risk situations, and improved coping skills. The group situation in itself seemed to be of special importance for this result. The degree of structure implemented by course leaders allowed a free and respectful opennes to develop between group members.     

The Association of Negative Urgency with Psychological Distress: Moderating Role of Proactive Coping Strategies

Abstract

Negative urgency, which is the tendency to act impulsively under the influence of negative emotions, is a risk factor for various psychological disorders including anxiety and depression. In contrast, proactive coping is a future oriented coping strategy that aims to prepare the self for future stressors by reappraising the stressors as challenges or keep oneself prepared for impending losses. Although the effect of proactive coping and preventive coping strategies on reducing depression and anxiety has been consistently documented, the association of their interaction with risk factors received little attention. In the current study, the moderator roles of two dimensions of Proactive Coping strategies in the association of negative urgency with anxiety and depression, is examined. Data were collected from 404 individuals (255 women) aged 18 to 59 (M?=?31.29, SD = 11.70) through scales assessing negative urgency, proactive coping, anxiety and depression from a community sample. The results revealed that the interaction of proactive coping with negative urgency to be significantly associated with individual differences in depression scores, indicating that appraising the threats as challenges may have potential for buffering the effects of negative urgency on depression. However, a similar pattern was not observed for anxiety or preventive coping.     

Coaching Clients to Manage Depression

The author presents a system of behavioral techniques that permits clients to manage their own depression. By coaching clients through the sequence of self-management procedures identified by Kahn (1976) and using the strategies offered by Lewinsohn (1975), counselors have an effective set of techniques to lead clients to successful coping with depression. The sequence of self-observation, self-mediation, and self-reinforcement activities is based on Lewinsohn's (1975) work and is effective with moderately depressed clients. This comprehensive treatment program requires a minimum amount of counselor intervention for a maximum amount of client gain.     

Cognitive-Behavioral Treatment of Depression, Part IX: Confronting Predisposing Factors

Cognitive-behavioral therapy can help many depressed clients learn more effective ways of coping with problems in their lives. However, for many clients with chronic or recurrent depression, it can be helpful to examine the biological, psychological, and social/cultural factors that may predispose a person toward depressive episodes. In order to address possible biological predispositions, it is important to assess for a positive family history of depression, evaluate family members' response to previous treatments, and refer for medications when needed. In order to address possible psychological predispositions, it is useful to evaluate long-standing personality styles, identify negative events from childhood, examine the client's relationship with his or her parents, evaluate the history of abuse, and identify early loss experiences. Cultural factors may play an influential role in the etiology of depression, and can be useful to incorporate into a broad treatment plan. However, cultural factors are difficult to modify through individual psychotherapy. Hence, they are unlikely to play a central role in cognitive-behavioral therapy for depression. Overall, therapists working with depressed clients should be prepared to confront a broad range of biological, psychological, and environmental factors that can create or perpetuate a client's risk for depression.     

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

Abstract

The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.     

Cognitive-Behavioral Treatment of Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) can be treated effectively with cognitive-behavioral therapy. When working with clients who have GAD, therapy can focus on four central areas that help to promote therapeutic change. The initial focus of therapy is on developing a sound therapeutic alliance and educating the client about anxiety symptoms. Skills training focuses on relaxation training and cognitive changes that can help clients confront their worries in a constructive manner. Then, exposure to internal and external aspects of the anxiety can help clients test and refine their coping skills. Finally, because of the chronic nature of GAD, relapse prevention strategies can be used to help maintain treatment gains over time. These strategies allow a broad but flexible treatment plan that can be adapted to the unique needs of each individual client.     

Contextualising Risk and Building Resilience: Returnees Versus Local Entrepreneurs in China

Risk is a pivotal concept in entrepreneurship research, as entrepreneurs constantly face uncertainty, ambiguity, setbacks, and stressful situations. Attitudes toward risk vary contingent upon individual risk preferences and cultural influences. Building resilience is critical for entrepreneurs to overcome obstacles, deal with risk, and grow their ventures. By juxtaposing effectuation theory and resilience literature, we compare the perceptions of risk held by Chinese returnees and local entrepreneurs and their coping strategies in building resilience. Our research reveals two types of coping approaches, namely effectual coping and causal coping. This study contributes to the comparative international entrepreneurship literature by contextualising the notion of risk held by entrepreneurs influenced by Eastern and Western cultures. Our study further contributes to the nascent literature on resilience in organisations by specifying the entrepreneurial occupational context and exploring the influence of cultures on resilience, and by identifying distinctive resilience-building coping strategies based upon cultural influences and interpretations of risk. Furthermore, we suggest that resilience can constitute one micro-foundation of effectuation theory in the context of entrepreneurship dealing with risk.     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Lay Theories Concerning Causes and Treatment of Depression

This study compared perceptions of the causes of, therapies for, and means of coping with, depression between two groups of currently nondepressed adults: one with a history of major depression and one with no history of depression. Currently nondepressed participants were selected so that effects of past experience of depression could be distinguished from those of current mood. Recovered depressed participants (RD) (n = 25) and Never depressed participants (ND) (n = 25) recruited via newspaper advertisements completed self-report measures of (a) the perceived utility of either professional or self-help coping strategies for managing their own experiences of depression; (b) likely effectiveness of several major therapies for depression; and (c) perceived accuracy of several etiological theories of depression. RD participants rated depression as being less amenable to everyday self-help methods of coping and more in need of professional intervention. However, RD and ND subgroups did not differ significantly in their perceptions of the plausibility of etiological theories of depression in general, nor in their ratings of the likely helpfulness of major therapies.     

Cognitive-Behavioral Treatment of Obsessive-Compulsive Disorder

Cognitive-behavioral therapy can be effective for many clients who have obsessive-compulsive disorder. Despite its effectiveness, many treatment guidelines fail to describe cognitive-behavioral therapy procedures in adequate detail. The present paper will review the literature on cognitive-behavioral therapy for OCD in an attempt to provide concise, meaningful guidelines for the psychological treatment of this disorder. Cognitive-behavioral therapy includes four general components: initial preparation for therapy, development of applied coping skills, exposure with ritual prevention, and relapse prevention. The four general treatment components are described, and clinical examples are provided.     

Coping mediates between social support,neuroticism, and depression after earthquake and examination stress among adolescents

Abstract

The objective of this study was to investigate the mediating role of coping strategies in the relationships between neuroticism, social support, and depression in two groups of adolescents: earthquake group and examination group. Adolescents facing earthquake stress (earthquake group, N=219) completed measures of neuroticism, perceived social support, coping strategies, and self-rating depression. Similarly, adolescents facing examination stress (examination group, N=241) completed the same measures. Results indicated that the earthquake group reported more use of secondary control engagement coping, whereas the examination group reported more use of primary control engagement coping. In addition, neuroticism was more strongly associated with coping in earthquake group and coping strategies explained significantly larger part of the relationship between neuroticism and depression. In contrary, perceived social support was more strongly associated with coping in examination group, and coping strategies explained significantly larger part of the relationship between perceived social support and depression.     

Coping strategies and depression in Puerto Rican adolescents: an exploratory study

The use of inadequate coping strategies in stressful situations results in the development of depression in adolescents. This study identified coping strategies used by Puerto Rican adolescents and evaluated the relationship between coping and depression. Fifty-one adolescents participated in the study. Results indicated that the most frequently used coping strategy was developing positive perceptions about life situations. Significant differences were observed according to the severity of depressive symptoms. Investing in family relationships and developing positive perceptions about life situations seemed to reduce depression. Furthermore, the strategies of investing in family relationships and relieving tension through diversion were the variables with more predictive value for depression. The importance of exploring coping responses within the cultural context of the adolescent is discussed.     

Integrating Expressiveness and Instrumentality in Real-Life Settings: A New Perspective on the Benefits of Androgyny

Personality trait research has failed to substantiate a link between androgyny and well-being. Using an alternate, social context approach, the present study investigated (a) positive and negative aspects of situations in which expectations for androgynous behavior were salient (dual expectation situations), and (b) associations between gender role coping strategies and well-being in these situations. Interviews were conducted with 124 female and 70 male undergraduates, most of whom were African American (14%) or White American (81%). Participants reported significantly more negative aspects of the process of coping with dual expectation situations and more positive aspects of the outcomes of the situations. Androgynous coping strategies were associated with greater positive well-being and lesser negative well-being than were instrumental or indeterminate strategies. Well-being scores of expressive strategists were not significantly different from those of androgynous strategists.     

Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients

The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.