Clinician's Guide to Mind Over Mood (36 page)

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Abuse, physical, 18, 43, 51, 150, 218

Action Plans, 29–33, 52, 72, 120, 154, 156, 203

for coping with phobia, 88

for eating disorders, 114

and hopelessness, 111

for inpatient therapy, 217, 231

for relationship problems, 174

for social anxiety, 104

and substance abuse, 112

Adjustment disorders, 119–120

African Americans, 43–45, 54–56

Aftercare group, 233, 234

Agoraphobia, 28, 89–90

Al-Anon, 17, 18, 19, 112

Alcoholics Anonymous (AA), 112, 178, 260

Anger, 4, 23, 49, 129, 174

and culture, 45–46, 54–56

defensive, 131–132

management of, 117, 130

and withdrawal, 66

Anorexia nervosa, 114–115;
see also
Eating disorders

Anxiety, 4, 13–15, 27, 31–32, 51, 81–105;
see also
Generalized anxiety disorder

and avoidance, 93–94, 95–97

managing, 98–99

and medication, 99–102

mixed, 102–104

perfectionist, 158

response, 99

triggers for, 82, 95

withdrawal, 102

Anxiety Inventory, 62–63, 81, 185, 186, 201, 220, 222, 230;
see also

Worksheet 11.1, 11.2

Asian Americans, 46–48

Assertion skills, 17, 18–19, 153, 154

Automatic thoughts, 5, 12, 39, 52, 117

and anger, 23, 132

and anxiety, 82, 95, 191

and culture, 40, 52

and eating disorders, 114

identification of, 18, 30, 191, 195, 210

associated with suicide, 219

testing, 135

Avoidance behavior, 62, 83–84, 87, 125–127, 138, 201

Avoidant personality disorder, 122, 124, 125, 132, 134

Axis I disorders, 121, 132–137

Axis II disorders;
see
Personality disorders

Beck, Aaron T., 249

Beck Hopelessness Scale, 220, 221, 228, 230

Behavioral change, 4–5, 150–153, 156, 201

in personality disorders, 159–164

in relationship difficulties, 117

Behavioral experiments, 5, 32–33, 128, 131, 135

to develop trust, 129

in group therapy, 202–203, 209

and schema change, 150

to test alternative schemas, 123

Beliefs, 5, 18;
See also
Schemas

about change, 159–164

about drugs, 109–110, 111

in the family system, 28

gender-based, 51–52

and noncompliance, 33, 35

perfectionistic, 82, 103, 115

of therapists, 52, 251–252, 257–258

Borderline personality disorder (BPD), 21, 124, 154, 163, 218

hot zones in, 154–155

and major depression, 135

use of manual in, 134–135

Brief therapy, 17, 19, 164, 165, 179

and case conceptualization, 167, 170–172

crisis-oriented, 20, 21, 167–170, 178

goal setting in, 167–173

Bulimia, 114;
see also
Eating disorder

Case conceptualization, 27–28, 108, 109, 201, 256

in brief therapy, 167

in couples therapy, 117

and culture, 41

Client treatment manual, 2–4, 6, 12

as adjunct to treatment, 20–23

assignments for group therapy, 183–208

in brief therapy, 165–179

case conceptualization in, 252–254

and client compliance, 24–27

decision tree for using, 2, 3

individualizing, 37–56, 59

as inpatient treatment manual, 218–245

introducing client to, 13–16, 124–134, 185, 220

modifications of, 132, 158

nontherapist use of, 258–260

personal use of by therapists, 29, 251, 252

as posttherapy guide, 176–178, 204

responses to, 10, 75, 125–132

simplifying, 38–39

and skills development, 23–24, 107–108

for suicidal patients, 218–234

as template for treatment, 1, 20

treatment protocols in, 250

use of in training workshops, 248–250

worksheets in;
see
Worksheets

Cocaine, 109, 110–111;
see also
Substance abuse

Cognitive therapy (CT), 17, 27, 34, 38, 69–70

with Asian American clients, 46

basic principles of, 12, 13

clinical processes in, 5–12

and depression, 69, 70, 219–220

five areas of assessment in, 4, 32, 237, 253

and religious beliefs, 50

therapist-client relationship in, 6;
see also
Collaborative

therapy relationship

training in, 35, 238, 246–263

treatment protocols, 69, 247, 250

Cognitive Therapy of Depression
(Beck et al.), 69, 71, 80, 261, 262, 265

Cognitive Therapy of Personality Disorders
(Beck), 123, 125, 134, 138, 164, 252, 264–265

Cognitive Therapy of Substance Abuse
(Beck et al.), 109, 120, 265

Cognitive Therapy Skills Checklist, 24, 30, 32, 247

Collaborative therapy relationship, 5, 6–10, 12, 13, 29, 34, 56

and case conceptualization, 253, 256–257

client independence in, 6–7

and culture, 42

in eating disorders, 115

in group therapy, 182

in personality disorder treatment, 156–157

Community groups, 179

Competency Checklist for Cognitive Therapists, 262

Compliance, 24–27, 33–35

interference with, 34, 122

Component skills practice, 252

Continuum methods, 140–144, 148, 162, 255;
see also
Scale, Worksheets 9.7 and 9.8

Coping, 82, 88–90, 91, 133, 154–156, 195

adaptive, 150

antisocial, 138

with criticism, 104, 114

plans, 154–155;
see also
Activity Plans

Coping grid, 155–156, 175

Core Belief Record, 117, 145–148, 149, 200, 206;
see also
Worksheets 9.5 and 9.6

Core beliefs;
see
Schemas

Cotherapy, 44

Couples therapy, 90, 116–119, 174

Critical incident stress debriefing, 92

Culture, 39–53

ethnic/racial, 43–48

and family, 43

and gender, 51–53

refusal to discuss, 53–56

and therapist responsibility, 41–42

Dependency, 1–2, 150

Dependent personality disorder, 122, 134

Depersonalization, 103, 104

Depression, 16, 34, 38–39, 69–80, 123, 154, 173, 174

activities for, 71–72, 179

behavioral exercises for, 78

case examples, 1, 17, 19, 22–23, 166, 168–169

chronic, 73

cognitive focus, 4, 70, 79–80

and concentration, 243–244

medication for, 22, 28, 79, 178, 235

melancholic, 78–79

physiological symptoms of, 78

recurrence of, 73

vs. sadness, 79–80

and self-condemnation, 50

and substance abuse, 110

worksheets for;
see
Worksheets

Depression Inventory (
Mind Over Mood),
62–63, 71, 73, 185, 186, 201, 220, 222, 228, 230;
see also
Worksheet 10.2

Diagnosis, 27, 28, 40, 154, 247

Downward arrow technique, 205, 212

Drug abuse;
see
Substance abuse

Dysthymia, 121, 218;
see also
Depression

Eating disorders, 70, 113–116

Emotions;
see
Moods

Employee assistance programs, 18, 166, 176, 258, 259–260

Eye contact, 40, 43

Family, 43, 45–46, 48, 90

Feedback

from client, 7, 41, 56, 124, 128, 157

to client, 6, 7

in group therapy, 183, 189, 210, 211

Gender roles, 51–52

Generalized anxiety disorder (GAD), 16, 69, 82–83

case examples, 1–2, 103

treatment for, 105

Goals

changing, 66–68, 201

and continuum measurement, 162

general vs- specific, 58–59, 60–61, 62, 64

prioritizing, 63–64, 167–168, 244–245

setting, 58–68, 162, 167–173, 184–185

of therapist supervision, 257

Group therapy, 44, 112, 178, 180–214

aftercare, 233–234, 235, 243, 244

agendas for, 185, 187, 191–209

cohesion in, 181, 186

format for, 181, 185–187

open, 214

pacing of, 213–214

postgroup individual session, 209–210

pregroup individual session, 184–185

rates of progress in, 211

silent member in, 211–213

socialization to, 185, 186–187, 214

termination of, 203–204, 209

Guided discovery, 6, 10–12, 13, 100, 157–158, 248–249, 252

with continuum methods, 140–143

in eating disorders, 115

in group therapy, 182

in substance abuse, 110

Handbook of Psychotherapy for Anorexia Nervosa and Bulimia
(Garner & Garfinkel), 113, 120, 266

Helpful Hints boxes, 32, 247, 249

Hispanic culture, 45–46

Historical Test of Core Beliefs, 48, 148–150, 207;
see also
Worksheet 9.9

Histrionic personality disorder, 158

Homework, 183

increasing client compliance, 24–27

individualized, 211

reviewing, 190, 211, 222

scheduling, 34

Hopelessness, 4, 77–78, 80, 111

and change, 153, 162

and noncompliance, 35

in suicidal patients, 217, 244

Hospitalization, 163, 216–245

advantages of, 217

discharge, 231–234, 243

length of stay, 244–245

nursing role in, 237–238

partial, 233, 234, 243, 244

Hot thoughts, 24, 88

evidence for/against, 158, 194–195, 227, 232, 237

identifying, 30, 32, 174, 194–195, 204–205, 226, 231–232

in panic disorder, 84

“If. . . then” beliefs, 5;
see also
Underlying assumptions

Illiteracy, 35

Imagery, 82, 85–86, 93–95, 140

Inpatient settings;
see
Hospitalization

Insurance plans, 1, 17, 166

Japanese culture, 39–40, 41

Latino culture;
see
Hispanic culture

Learning, 26–27, 48, 70, 124, 158–159

Life event stresses, 119–120

Love is Never Enough
(Beck), 116, 120, 264

Medication therapy, 20, 22, 28, 79, 178, 238, 259

compliance with, 235–237

negative patient cognitions

regarding, 235–237

reliance on, 99–102

Metaphor, use of, 38, 163–164

Middle Eastern cultures, 48

Mind Over Mood; see
Client treatment manual

Moods, 17, 32, 191

in borderline personality disorder, 134, 154

fluctuating, 124, 166

identifying, 109, 156, 188

rating, 192, 201

Narcissistic personality disorder, 132, 133–134

Narcotics Anonymous, 112

Native American culture, 40

Negativity, 4, 74–75, 80, 173

Nurses, 237–238, 259

Obsessive-compulsive disorder (OCD), 28, 82, 90–92

treatment for, 90–91, 105

Obsessive-compulsive personality disorder (OCPD), 132, 133

Outcome studies, 69–70, 83, 91, 132, 234

Overeaters Anonymous, 260

Panic attacks, 85, 103

Panic disorder, 40, 44, 69, 83–88

with agoraphobia, 90

treatment for, 83, 85–88, 105

Paranoid behaviors, 150

Perfectionism, 82, 103, 115, 132, 133, 158–159, 240–241

in therapist self-supervision, 263

Personality disorders, 16–17, 121–164, 216;
see also
various personality disorders

beliefs about change in, 157, 164

objections to treatment manual in, 156

and repetition, 135

schemas-maintaining, 123

and therapeutic relationship, 157

treatment of, 5, 123, 137–164

Phobias, 82, 88–90;
see also
Agoraphobia

social, 88–89, 103

treatment for, 105

Physicians, primary care, 259

Positive data log;
see
Core Belief Record

Posttraumatic stress disorder, 82, 92–93, 105, 172, 176

Psychiatrists, 235–237;
see also
Therapists

Racism, 44–45, 54–55

Rational Recovery, 112, 178, 260

Recreational therapy, 238, 240–243

Relapse prevention, 70, 112, 117, 203, 209, 234

Relationship problems, 116–119, 169, 174

core beliefs in, 117–118

most common feelings in, 117

Religious beliefs, 47, 50–51

Buddhist, 47

fundamentalist Christian, 50–51

Hindu, 47–48

Mormon, 51

Religious counselors, 258, 260

Repetition needs, 135

Response prevention, 91, 105

Responsibility Pies, 91, 112