This book provides the foundations and training that social workers need to master cognitive behavior therapy (CBT). CBT is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that CBT and practice represents a strongly supported approach to social work education and practice. The book covers the most common disorders encountered when working with adults, children, families, and couples including: anxiety disorders, depression, personality disorder, sexual and physical abuse, substance misuse, grief and bereavement, and eating disorders. Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating CBT’s effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients.
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Over the years, cognitive behavior therapy (CBT) has been applied to a variety of client populations in a range of treatment settings and to the range of clinical problems. This chapter provides a general overview of the cognitive behavior history, model, and techniques and their application to clinical social work practice. It begins with a brief history and description, provides a basic conceptual framework for the approach, highlights the empirical base of the model, and then discusses the use of cognitive, behavior, and emotive/affective interventions. Cognitive behavior therapy is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice.
The treatment of the suicidal individual is perhaps the most weighty and difficult of any of the problems confronted by the clinical social worker. Some frequent comorbid pathology with suicidal behavior includes alcoholism, panic attacks, drug abuse, chronic schizophrenia, conduct disorder in children and adolescents, impulse control deficits, schizophrenia, and problem-solving deficits. Suicidal harmful behavior appears in all ages and characterizes clients in a large spectrum of life. There are four types of suicidal behavior namely rational suicider, psychotic suicider, hopeless suicider and impulsive or histrionic suicider. This chapter presents some primarily cognitive techniques for challenging suicidal automatic thoughts. Recent reports suggest that individuals suffering from alcohol or substance abuse are at an increased risk both for attempting, and for successfully completing, a suicidal act. The therapist must develop an armamentarium of cognitive techniques, and the skills to use these effectively in ways that are appropriate for each individual client.
When the perpetrator is the client’s own body, the Illness and Somatic Disorders Protocol can be used. It is important to note that this protocol addresses both psychological and physical factors related to somatic complaints. For many, addressing the psychological dimensions will cause partial or complete remission of the physical symptoms. When primarily organic processes are involved, the psychological issues may be exacerbating the physical conditions. While physical symptoms may not remit, the clinical emphasis is on improving the person’s quality of life. Eye Movement Desensitization and Reprocessing (EMDR) has also been used in the hospital to assist clients who are suffering from intractable pain to let go of the guilt they feel about wanting to die and be released from the pain. There are many ways to bolster the immune system in order to facilitate the healing process, however, death may be inevitable for some clients.
Protocol for excessive grief is to be used when there is a high level of suffering, self-denigration, and lack of remediation over time concerning the loss of a loved one. Eye Movement Desensitization and Reprocessing (EMDR) does not eliminate healthy appropriate emotions, including grief. The protocol is similar to the Standard EMDR Protocol for trauma. The goal of this work is to have clinicians’ client accept the loss and think back on aspects of life with the loved one with a wide range of feelings, including an appreciation for the positive experiences they shared. Francine Shapiro often brings up the issue: How long does one have to grieve? She asks us to not place our limitations on our clients as this would be antithetical to the notion of the ecological validity of the client’s self-healing process.
This author is interested in the idea of consolidating information in an accessible form throughout her career. The Eye Movement Desensitization and Reprocessing (EMDR) Summary Sheet was the result of a need on her part to have access to all of the relevant information concerning client information and EMDR interventions at a glance. This EMDR Summary Sheet is a way to consolidate important client information quickly and succinctly. It contains details such as the name of the patient, diagnosis, paper and pencil test results, goals, presenting problem, touchstone event, and experiences of childhood, adolescence, adulthood, and any anticipatory anxiety. Major themes/cognitive interweaves and present resources are also noted.
This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. The idea of the safe place has been a staple in practices of Clinical Hypnosis practitioners. The first known use of the Safe Place with EMDR was when Dr. Neal Daniels, an EMDR practitioner working at the Veterans Administration Hospital in Philadelphia, adopted this resource to assist the veterans with whom he worked to ground themselves and contain their affect before doing trauma work. Dr. Francine Shapiro saw the merit of this intervention and by 1995 included a formalized version into the first EMDR text.
This chapter presents a summary of the Single Traumatic Event Protocol. For single traumatic events, the Standard Eye Movement Desensitization and Reprocessing (EMDR) Protocol should be applied to the certain targets, including the past, present, and future templates. The chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for EMDR practice. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. Encourage clients to imagine themselves coping effectively in the face of specific challenges, triggers, or snafus. Therapists can make some suggestions of things in order to help inoculate them with future problems. It is helpful to use imaginal rehearsing type of future template after clients have received needed education concerning social skills and customs, assertiveness, and any other newly learned skills.
This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice. It discusses phobia protocol script notes. The fear is generated by the sight of the object and is independent of further participation. When targeting a process phobia, the clinician must address all the pertinent aspects of the experience, including the decision-making and anticipatory anxiety. Although the procedures for the simple phobia may eliminate the client’s self-perceived fear, they may not overcome the evolutionary biases challenged by a Behavioral Avoidance Test (BAT). Although the Simple Phobia Protocol may be sufficient in many instances, some phobia researchers believe that the division is not useful and that the Process Phobia Protocol should be used exclusively. Eye movement desensitization and reprocessing EMDR, simple phobia protocol, process phobia protocol, decision-making, anticipatory anxiety, self-perceived fear, and behavioral avoidance test BAT.
Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations
Scripting is a way to inform and remind the Eye Movement Desensitization and Reprocessing (EMDR) practitioner of the component parts, sequence, and language used to create an effective outcome. As EMDR is a fairly complicated process, this book provides step-by-step scripts that will enable beginning practitioners to enhance their expertise more quickly. The book is separated into nine parts. The Client History part represents the first of the eight phases of EMDR treatment. The ability to gather, formulate, and then use the material in the intake part of treatment is crucial to an optimal outcome in any therapist’s work. Part II includes an important element of the Preparation Phase that addresses ways to introduce and explain EMDR, trauma, and the adaptive information processing (AIP) model. The importance of teaching clients how to create personal resources is the topic of Part III. Here, an essential element of the Preparation/Second Phase of EMDR work is addressed to ensure clients’ abilities to contain their affect and remain stable as they move through the EMDR process. Part IV shows how to work with clients concerning the targeting of their presenting problems when the usual ways do not work such as usage of drawings to concretize clients’ conceptualization of their issues and usage of an alternative initial targeting method. Part V includes protocols that have been scripted based on the material that appears in Francine Shapiro’s EMDR textbook. Parts VI and VII address EMDR and early intervention procedures for man-made and natural catastrophes for individuals and groups. Performance enhancement and clinician’s self-care are dealt with in the final two parts of the book.