COMMON LANGUAGE FOR PSYCHOTHERAPY PROCEDURES The first 80
Isaac Marks, Editor Lucio Sibilia & Stefania Borgo, Co-Editors
www.commonlanguagepsychotherapy.org
First edition, 2010 Copyright (C) 2010 Centro per la Ricerca in Psicoterapia (CRP). Piazza O. Marucchi n.5 - 00162 Rome (Italy) Email:
[email protected] http://www.crpitalia.eu Permission is granted to copy and distribute this document under the terms of the GNU Free Documentation License, Version 1.3 or any later version published by the Free Software Foundation, with no Front-Cover Texts and no Back-Cover Texts. Invariant Sections are: "Sponsoring organisations", "Acknowledgements", "Task Force members", "Authors of accepted entries", and "Introduction". A copy of the licence is included in the section entitled "GNU Free Documentation License" at: http://www.gnu.org/copyleft/fdl.html
Printed by: Books on Demand GmbH, 22848 Norderstedt, Germany ISBN: 978-88-86290-02-9
Contents Sponsoring organisations ..............................................................................6 Task Force members......................................................................................8 Authors of accepted entries............................................................................9 Introduction...................................................................................................17 Procedures: Acceptance, promoting of.............................................................................19 Anger management......................................................................................21 Applied relaxation.........................................................................................24 Assertiveness (assertive, assertion) training................................................27 Attention training ..........................................................................................29 Becoming the other.......................................................................................31 Behavioral activation.....................................................................................34 Cognitive defusion........................................................................................37 Cognitive restructuring..................................................................................39 Community reinforcement approach ............................................................41 Compassion-focused therapy.......................................................................43 Computer-aided vicarious exposure ............................................................46 Coping cat treatment.....................................................................................48 Countertransference, use of.........................................................................51 Danger ideation reduction therapy ...............................................................53 Decisional balance........................................................................................55 Dialectical behaviour therapy .......................................................................57 Dream interpretation.....................................................................................60 Empathy dots, use of....................................................................................63 Evoked response arousal plus sensitization.................................................65 Experiment....................................................................................................67 Exposure, interoceptive (to internal cues).....................................................69 Exposure, live (in-vivo, live desensitization).................................................71 Expressed empathy......................................................................................73 Expressive writing therapy............................................................................75 Family focused grief therapy.........................................................................77 Family work for schizophrenia......................................................................80 Fixed-role therapy.........................................................................................83
Free association............................................................................................85 Guided mourning..........................................................................................87 Habit reversal................................................................................................89 Harm reduction ............................................................................................92 Imagery rehearsal therapy of nightmares.....................................................94 Imagery rescripting therapy..........................................................................96 Imago relationship therapy............................................................................99 Inflated responsibility, reducing..................................................................102 Internalized-other interviewing....................................................................104 Internet-based therapy................................................................................107 Interpersonal psychotherapy ......................................................................109 Interpreting defenses against unpleasant feelings.....................................112 Life-review (reminiscence) therapy.............................................................114 Linking current, past and transference relationships .................................116 Mentalizing, promotion of............................................................................118 Metacognitive therapy ................................................................................121 Metaphor, use of.........................................................................................123 Method of levels .........................................................................................125 Mindfulness training....................................................................................128 Morita therapy.............................................................................................131 Motivational enhancement therapy ............................................................134 Motivational interviewing ............................................................................136 Narrative exposure......................................................................................138 Nidotherapy.................................................................................................140 Problem-solving therapy ............................................................................141 Prolonged exposure counterconditioning...................................................143 Prolonged-grief therapy..............................................................................145 Promoting resilience in young children.......................................................148 Puppet play preparing children for surgery.................................................151 Reciprocal role procedures, describing & changing...................................154 Repairing rupture........................................................................................157 Repertory grid technique.............................................................................159 Ritual (response) prevention.......................................................................161 Schema focussed emotive behavior therapy .............................................163 Self as context............................................................................................166 Self-control skills training ...........................................................................168 Self-praise training......................................................................................171
Sibling fighting-reduction training................................................................173 Skills-directed therapy ................................................................................175 Socratic questioning....................................................................................177 Solution-focused questioning / brief therapy...............................................179 Speech restructuring...................................................................................181 Stimulus control of worry.............................................................................183 Task concentration training ........................................................................185 Time-boundary setting and interpreting......................................................188 Time-in management..................................................................................190 Token economy..........................................................................................193 Transference interpretation.........................................................................195 Triple P – positive parenting program.........................................................199 Two-chair technique....................................................................................202 Validation of feelings...................................................................................205 Values exploration and construction...........................................................207 Well-being therapy .....................................................................................209
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Sponsoring organisations Association for Behavioral and Cognitive Therapies www.abct.org European Association for Behavioural and Cognitive Therapies eabct.glimworm.com American Psychoanalytic Association www.apsa.org Asian Psychological Association www.cdu.edu.au/apsya Australian Psychological Society www.psychology.org.au British Association for Counselling & Psychotherapy www.bacp.co.uk Centro per la Ricerca in Psicoterapia www.crpitalia.eu Royal College of Psychiatrists www.rcpsych.ac.uk Sociedad Mexicana de Psicología www.sociedadmexicanadepsicologia.org Society for Psychotherapy Research www.psychotherapyresearch.org Society for the Exploration of Psychotherapy Integration sepiweb.org World Psychiatric Association www.wpanet.org
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Acknowledgements This volume has been made possible thanks to the collaborative work of the clp Task Force members and of the 95 authors of the 80 entries listed below.
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CLP 80 COGNITIVE RESTRUCTURING Isaac MARKS, 43 Dulwich Common, London SE217EU, UK; ph+44 208 2994130; Lucio SIBILIA, Dipartimento di Scienze Cliniche, Università Sapienza di Roma & Centro per la Ricerca in Psicoterapia, Roma, Italy; ph +39 06 86320838; Stefania BORGO, Università Sapienza di Roma & Centro per la Ricerca in Psicoterapia, Roma, Italy; ph +39 06 86320838. Definition: Methods that encourage clients to identify dysfunctional sets of thoughts and beliefs relating to their problem, and to challenge the validity of those in order to produce and use more adaptive alternatives. Elements: Helps clients to identify and challenge maladaptive thoughts (e.g. absolute / all-or-none / dichotomous / black-and white / catastrophising / over-generalising thinking) and beliefs concerning the problem through interviews and daily thought diaries. May include: - Socratic questioning to weigh evidence for/against each thought and belief - Downward arrow (what if?) technique and probabilistic reasoning to challenge maladaptive thoughts and beliefs - Behavioural experiments to challenge maladaptive beliefs - Distancing/giving perspective to generate alternative adaptive thoughts and beliefs. Related procedures: Rational emotional therapy, self-instructional training, problem-solving. Application: Usually taught individually rather than in groups. 1st use? Concept first used by Alexander JM (1928). References: 1. Alexander JM (1928). Thought control in everyday life. Funk & Wagnalls, New York. 2. Beck AT (1967). Depression: Causes and treatment. University of Pennsylvania Press, Philadelphia. 3. Ellis A (1969). A cognitive approach to behaviour therapy. Internat. J.Psychother, 8, 896-900. 4. Lovell K (1999). Exposure and cognitive restructuring alone and combined for PTSD. PhD dissertation, University of London. Case illustration: (Lovell 1999) A man of 26 with PTSD for 2 years after being assaulted, injured and scarred was asked to keep daily diaries of thoughts to record negative
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CLP 80 thoughts and beliefs. They related to fear of being re-assaulted. When asked, he rated his belief in the probability of being re-assaulted as 80% (monitoring). This belief was challenged by probabilistic reasoning - he was asked to calculate how often he'd been out with friends in the years before the assault and to estimate the probability of a future assault. The self-rated difference between his initially perceived (80%) and the probable (now rated as 10%) risk led him to identify his thinking error of over-estimation of danger. He reframed his belief as the alternative `My chances of being attacked are no more than other people’s’, and rated his reframed belief in it as 90%. Soon after this he began to go out with friends and then alone. He also identified shaming thoughts and beliefs (diary keeping) e.g. `I’m a coward as I cried after the attack; men don’t cry’. He rated their validity as 85%. When challenged to provide evidence for and against such thoughts, he recalled that his father had been upset after the assault and had cried when visiting him in hospital, but his father was not a coward. He also recalled that he and his friends had wept at a funeral, which was appropriate and not a sign of cowardice. He then reframed his thought to: `Crying is appropriate in stressful situations’. He recorded a negative overgeneralising thought: `People with scars are thought to be criminals, so others seeing my scar will think I’m a criminal’. He rated this thought as 85% valid. He was asked to list the hair colour, height etc of criminals and to compare these features with his own. Mismatch of the two lists led him to rerate his belief that others would consider him a criminal as 40%. For homework he listened to the audiotape of the session and was required to think of people he knew with scars and how much he believed them to be criminals, and to spot his thinking error. At the next session, he said he realised he knew many scarred people but did not think them as criminals. He generated an alternative response: `Acting suspiciously and having a past criminal record suggest criminality, not a scar’. He rated his belief in this reframed thought as 100%. He labelled his thinking error as mind-reading (false attribution). The PTSD had reduced markedly after 10 sessions and even more so 1 year later.
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