Is EMDR a Power Therapy

Rosen et al. (1998) describe EMDR as a 'power therapy' (Figley, 1997), and group it together with therapies such as thought field therapy (Callahan, 1995), trauma incident reduction (Gerbode, 1989), and emotional freedom techniques (Craig, 1997). Rosen et al. say 'These Power Therapies appeal to popular healthcare models with an emphasis on tapping energy points.' Poole, De Jongh & Spector (1999), however, respond that the theoretical foundations of these procedures linked together have no...

David A Winter

University of Hertfordshire and Barnet, Enfield and Haringey Mental Health NHS Trust, UK The two broad approaches to psychotherapy that will be described in this chapter essentially arose in the middle of the twentieth century out of dissatisfaction with the reductionist, deterministic, and mechanistic assumptions evident in traditional psychodynamic and behavioural approaches and the need to develop a 'third force' (Bugental, 1964) in psychology. In contrast to such assumptions, constructivist...

Social Anxiety In Children And Adolescents

Social anxiety is often evident early in life and may be diagnosed in children as young as eight years old (Beidel & Turner, 1998). Furthermore, when the social fears of children continue to be expressed through late adolescence they are more likely to be associated with a poor prognosis for recovery (Davidson et al., 1993 Mannuzza et al., 1995). The clinical presentation of social anxiety in children is similar to that of adults, with comparable somatic symptoms and feared situations....

Family Interventions

As mentioned earlier in the chapter, several ineffectual family theories of schizophrenia were postulated, but led to very little in terms of actual therapy. The hegemony of psychological therapies arising out of the private therapist's couch was poorly adapted for the everyday reality of families of individuals with schizophrenia. The goals of family approaches to schizophrenia are to reduce relapse, improve functioning and contain the burden on the family. The earliest evidence in this area...

Problemsolving Therapy Rationale

Problem-solving therapy is a time-limited, structured intervention, which helps patients use their own skills and resources to cope with specific current problems and which is in keeping with cognitive- behavioural approaches. The connection between psychological symptoms and impaired capacity to resolve psychosocial problems is a basic assumption of this approach and the primary aim is to develop more effective problem-solving skills leading to symptom improvement. Problem solving capacity is...

Psychodynamic Psychotherapy Rationale

Psychodynamic psychotherapy, like CBT, is more accurately understood as a range of approaches with a common origin, namely psychoanalytic psychotherapy, with specific prominence given to object relations theory. The specific focus of attention varies between models but each explores internal conflicts, the early developmental origins of conscious and unconscious defences - particularly those developed to protect against loss, hostility or powerlessness - and their current depressive...

Studies Of Psychological Treatments In Bipolar Disorders

There is a large literature of individual case studies on the use of a variety of psychological therapies in BP. The benefits to individuals with BP described in these papers led to a number of open studies and case series. Between 1960 and 1998 there were 32 published papers describing the combined use of psychological and pharmacological treatments in BP. However, the majority were small-scale studies, with an average sample size of about 25. The combined sample size for all studies was just...

Interpersonal Psychotherapy Rationale

Interpersonal therapy provides a pragmatic, time-limited and interpersonally focused approach to the treatment of major depression. It is modest in its use of psychotherapy jargon and promotes attention to the relationship-based issues that are central to the experience of many depressed patients. The treatment does not become entangled in questions of causation, acknowledging the capacity for depression to both precipitate and reflect interpersonal change, difficulty and loss. Instead it...

The Theoretical Basis Of Emdr

Shapiro (1993, 1995, 2001) calls the model that guides the use of EMDR the adaptive information processing (AIP) model. She emphasises that it is just that - a model - and may be modified in the light of further experimental and clinical findings. The model uses the terminology of neuro-physiological information processing introduced by Bower (1981) and Lang (1979). The model begins by suggesting that there appears to be an innate and adaptive neurologically based information processing system...

Humanistic Therapies Theoretical Basis

As with constructivist therapies, humanistic therapies encompass a range of different approaches. However, as Elliott (2001, p. 38) indicates, they 'share a set of values, including grounding in immediate, lived human experiences fostering of agency and self-determination prizing of differences within and between people relationships based on authentic presence and pursuit of wholeness and growth throughout the life cycle.' The first major humanistic therapies to be developed were Carl Rogers'...

Approaches To Therapy

In Discrete approaches anger is identified as the clear focus of the therapy and it is broadly separated from other clinical issues or problems in intervention. This is so even when it is adjunctive to a wider programme of therapy. Discrete approaches are sub-classified as Discrete Directed if the nature and scope of intervention is guided by assessment, or as Discrete Autonomous if assessment is minimal and the intervention is delivered on an inflexible and stand alone basis. The latter...

Hypertension

Some individuals are more susceptible to exaggerated cardiovascular changes, including blood pressure (BP) changes, in response to physical or psychological stress. The so-called 'reactivity hypothesis' suggests that such susceptibility contributes to cardiovascular pathology over time. Consistent findings in the literature on hypertension include greater cardiovascular responses to stress in hypertensive patients than normal controls and reports that the children of hypertensive parents...

Treatment With

Interpersonal therapists use a few simple principles to explain the patient's situation and illness. These are simple enough for dysphoric patients with poor concentration to grasp them. First, they define depression as a medical illness, a treatable condition that is not the patient's fault. This definition displaces the burdensome guilt of the depressed patient from the patient to her illness, making the symptoms ego-dystonic and discrete. It also provides hope for a response to treatment....

Introduction

Obsessive compulsive disorder (OCD) involves the presence of obsessions or compulsions or both. Obsessions are defined as intrusive thoughts or images (for example, thoughts about harming others or becoming contaminated) and compulsions are defined as repetitive behaviours that are overt (for example, hand-washing), or mental acts which are covert (for example, silent counting). The obsessions cause distress and the compulsions are carried out to try to reduce the distress, or prevent a feared...

Intensity Setting And Costeffectiveness Of Treatment

With the advent of brief interventions, treatment for alcohol problems has become more variable in length (duration) and intensity (amount of therapist contact). There is little doubt that, for heavy drinkers not seeking treatment and identified by screening in generalist settings, brief interventions of one or two sessions are all that is necessary in most cases for those in the treatment-seeking population with more serious problems the optimal intensity of treatment is unknown. Project MATCH...

Cognitive Behavioural Therapy Rationale

Cognitive behavioural therapy for depression, rather than referring to a single system of therapy, now more accurately describes a range of practices derived from the original work by Aaron Beck (Beck et al. 1979), focusing on the thinking patterns and associated emotional, behavioural and physiological systems operating within the depressed individual. Problematic schema, acquired in and reflecting the course of development are retained into later life and can be triggered by thematically...

References

Personality disorder as a pathogenic factor in bereavement. Journal of Nervous and Mental Disease, 172, 45-47. Allumbaugh, L. & Hoyt, W. (1999). Effectiveness of grief therapy A meta-analysis. Journal of Counseling Psychology, 46, 370-380. Barrett, C.J. (1978). Effectiveness of widows' support groups in facilitating change. Journal of Consulting and Clinical Psychology, 46, 20-31. Bass, D.M., Bowman, K. & Noelke, L.S. (1991). The influence of care-giving and support...

Section I From Dichotomy To Chiasmus Introduction

The aim of this chapter is to provide a context within which to place much of the current research work focusing on the psychological therapies and to do so in a way that is useful for researchers and practitioners alike. The preceding chapters in this volume as well as other major texts - for example, the fifth edition of Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (Lambert, 2004) and the second edition of What Works for Whom A Critical Review of Psychotherapy Research...

Sensory Therapies

Sensory therapies with people with severe and profound intellectual disabilities in popularity have increased since the mid-1990s. There are two main reasons for the increase. First, these individuals have relatively little language and sensory therapies do not require speech. Second, advocates of sensory therapy have noted that people with developmental disabilities are at greater risk for sensory and proprioceptive disorders and handicaps than the general population. There are a variety of...

How Valid is the Theoretical Basis for EMDR

Rosen et al. (1998) criticise the theoretical basis of EMDR as unsubstantiated. Poole, De Jongh & Spector (1999) address this criticism by pointing out that Shapiro's 'accelerated information processing model' is just that - a model - which may evolve in the light of new findings over time. They argue that this is no different from Wolpe's early theory of reciprocal inhibition to explain the effects of behaviour therapy being superseded by other more cogent models in the light of new...

Acute Treatment of Major Depression

The first acute study of IPT was a four-cell, 16-week randomized trial comparing IPT, amitriptyline (AMI), combined IPT and AMI, and a non-scheduled control treatment for 81 outpatients with major depression (DiMascio etal., 1979 Weissman etal., 1979). Amitripty-line more rapidly alleviated symptoms, but at treatment completion there was no significant difference between IPT and AMI in symptom reduction. Each reduced symptoms more efficaciously than the control condition, and combined AMI-IPT...

Review Of Anger Treatment Outcomes

The challenge in making sense of the array of relevant outcome studies has been made much easier due to the increasing number of pertinent meta-analyses that are now published (for example, Beck & Fernandez, 1998 Del Vecchio & O'Leary, 2004 DiGiuseppe & Tafrate, 2003 Edmonson & Conger, 1996 Tafrate, 1995). Perhaps it is no surprise that such work has reviewed the field from a predominantly CBT standpoint with outcome research focussing particularly on group therapy interventions for...

Skin

Skin, our largest sensory organ, plays a vital role in how we interface and communicate with the external world. It is integral to our body image and self-esteem, acting both as a protective barrier and a container. Given that foetal ectoderm gives rise to both the central nervous system (CNS) and the skin and that both systems share several hormones, neurotransmitters and receptors, it is not surprising that they are closely interlinked. However, despite longheld beliefs by doctors and...

Cognitive Behaviour Therapy

Although the school of behaviour therapy evolved empirical treatments for the management of schizophrenia, it chiefly focused on social skills and behavioural disturbances (Meichen-baum, 1969). Moreover the behavioural work was dominated by operant reward systems through external reinforcers, both positive and negative. This was an acceptable option in the 1970s. In the postmodern era this began to be seen as mechanistic with no reference to the patient's own attitudes and inner experiences. As...

Ineffective Treatment Modalities

We shall consider first treatment modalities that have been shown by research to be ineffective (as shown by a negative CES in the Mesa Grande) and those for which there is little or no evidence either for or against effectiveness (a CES close to zero in the Mesa Grande). The intention is not to list all treatment modalities fitting this description but to focus on a few prominent examples of modalities that continue to be widely implemented despite the absence of good evidence to support them....

The Dialectical Underpinnings Of

One defines dialectics in terms of the method of argumentation by which two opposing views are synthesized and the truths of each position are verified to the point that neither has to completely give up its position. The second definition of dialectics is the philosophy that two polarities (the thesis and the antithesis) are merged into a synthesis. Dialectics pervades DBT. Dialectics is seen in the biosocial theory of the development and maintenance of BPD....

The Cognitive Model

At the heart of cognitive therapy lies a deceptively simple idea. Perceptions of ourselves, the world and the future shape our emotions and behaviours. What and how people think profoundly affects their emotional well being. As Shakespeare's Hamlet put it' is nothing either good or bad, but thinking makes it so . . . ' From this principle comes the idea that if we evaluate and modify any dysfunctional thinking, we can profoundly affect our emotional Handbook of Evidence-based Psychotherapies A...

Dysthymic Disorder IPTD

Interpersonal therapy was modified for dysthymic disorder, a disorder whose chronicity does not fit the standard IPT model. This adaptation also may provide a better fit for dysthymic patients without acute life events who previously would have been put in the interpersonal deficits category of acute IPT. IPT-D encourages patients to reconceptualize what they have considered lifelong character flaws as ego-dystonic, chronic mood-dependent symptoms as chronic but treatable 'state' rather than...

Spider Phobia

Studies of recall and perceptual bias in spider phobia have been contradictory (Cameron, 1997). Disgust and fear evoked by spiders are largely independent of one another (Smits, Telch & Randall, 2002 Thorpe & Salkovskis, 1995) even though both decline with brief exposure (Smits, Telch & Randall, 2002 Thorpe & Salkovskis, 1997). Disgust as well as fear is, therefore, probably worthy of attention. Many people with spider phobia are also afraid, in the presence of spiders, of being...

Theoretical Formulations

Current psychological formulations of GAD emphasise excessive worry as the core feature of the disorder and are concerned with understanding the nature of worry and the conditions under which it persists. A comprehensive overview of theory, treatment and research on worry can be found in Davey amp Wells 2006 . In this section we summarise the work of the most prominent theorists in the field. Borkovec and his colleagues have conducted extensive and influential research on the nature of worry...

Cognitive Therapy for Different Populations and in Different Settings

Given the common features of cognitive therapy and these widely differing areas of application, it is not surprising that cognitive therapy has evolved in several different formats to ensure it is acceptable and effective to a range of groups of people children, adolescents, adults, older adults and people with learning disabilities , in different therapy formats self-help, individual, couples, families, groups, organisations and across different levels of service delivery primary, secondary...

Is EMDR More or Less Effective and Efficient Than ExposureCBT

Until 1998 critics of EMDR suggested that claims for its effectiveness were based on comparisons with non-effective therapies, rather than CBT exposure therapies being demonstrated as effective. There was some truth to this criticism in that the only genuine comparison with CBT exposure therapy up until 1998 was in the Vaughan et al. 1994 study, in which EMDR was compared with image habituation training an exposure variant with some minor advantages for EMDR especially in reducing intrusions....

Improving Motivation

The second function of comprehensive DBT is to improve motivation, which is generally targeted in the individual psychotherapy in standard DBT. Each DBT patient is assigned a primary therapist who coordinates all aspects of the treatment - skills training, pharmo-cotherapy if available and case management. In outpatient DBT the primary therapist is also the individual psychotherapist and meets with the client weekly for one hour. The individual psychotherapist is charged with all of the crisis...

Flying Phobia

Although fear of flying is very common, affecting up to 40 of airline passengers, so that many airlines offer treatment programmes Van Gerwen, Lucas amp Diekstra, 2000 , there are few studies of the experience of flying phobia. These include lists of preoccupations associated with the fear for example fear of the aircraft crashing and of losing control of one's reactions Van Gerwen et al., 1997 Wilhelm amp Roth, 1997 . It is not difficult, therefore, to imagine catastrophic predictions that...

The Effectiveness Of Interventions

Reviews of the effectiveness of bereavement intervention do not indicate a strong evidence base for much current clinical practice. The methodological flaws described at the start of the chapter have resulted in few studies that meet the criteria set by reviewers. Schneiderman et al. 1994 found only four articles out of 53 published that satisfied their criteria. These four studies had conflicting results and the authors concluded there was little sound evidence for or against bereavement...

Kathryn L Bleiberg and John C Markowitz

Weill Medical College of Cornell University, USA Interpersonal psychotherapy IPT is a time-limited 12-16 sessions , diagnosis-targeted, empirically tested treatment. Relative to most psychotherapies, it has been carefully studied but, until recently, used primarily in research settings and not widely used in clinical practice. The success of IPT in the treatment of outpatients with major depression has led to its testing for an expanded range of diagnostic indications. Furthermore, it has grown...

The Structure of Cognitive Therapy Behavioural Techniques Cognitive Techniques and Homework

Cognitive therapy is made up of a range of therapeutic approaches Figure 2.3 . The first class of therapeutic approaches focus on the client's behaviour. The rationale is that for some people behaviour monitoring, behavioural activation and behavioural change can lead to substantive gains. For example, people with more severe depression often become withdrawn and inactive, which can feed into and exacerbate depression. They withdraw and then label themselves as 'ineffectual', fuelling the...

Methodological Issues

Many studies have been published since the mid-1970s on the effectiveness of bereavement intervention but there are major methodological flaws with most of them Allumbaugh amp Hoyt, 1999 Dowdney, 2000 Kato amp Mann, 1999 . Stroebe, Stroebe amp Schut 2003 argue it is unethical to carry out poorly designed bereavement research given the sensitivity of the subject. The following aspects have been criticised frequently in study design. Recruiting and maintaining subjects in large studies is...

Training And Supervision In Cognitive Therapy

Our experience of observing skilled cognitive therapists suggests the metaphor of a swan. Above the water, it seems that the swan is composed and at one with its surroundings. However, the strength of the river's current and the nearby weirs suggest that the swan is continually taking stock of its environment and working hard beneath the water's surface. Similarly, skilled cognitive therapists are constantly formulating and reformulating clients' problems, maintaining a good working therapeutic...

Conduct Problems

The effectiveness of psychological interventions for four distinct but related categories of conduct problems will be considered in this section. These are oppositional behavioural difficulties attentional and overactivity problems Handbook of Evidence-based Psychotherapies A Guide for research and practice. Edited by C. Freeman amp M. Power. Copyright 2007 John Wiley amp Sons, Ltd. pervasive conduct problems in adolescence Oppositional Behavioural Difficulties Preadolescent children who...

Cognitive Therapy Focusses on Cognition and Behaviour

Cognitive Conceptualization Diagram

The cognitive model of emotional disorders is central to every aspect of cognitive therapy the formulation, intervention planning and change processes. Thus, the therapist seeks to understand the client's presenting problems in terms of maladaptive beliefs and behaviours and develops an intervention plan that will effect changes in the presenting problems through changes in beliefs and behaviours. When successes and difficulties are encountered in the therapeutic process these are formulated in...

Anorexia Nervosa

Historical and geographical studies suggest that anorexia nervosa has occurred wherever there are humans. The first formal medical account is in Richard Morton's Phthisiologia 1689 . Anorexia nervosa responds to the same precipitants as bulimia but depends on a physiological capacity to tolerate extreme starvation, which may be genetic. The core psy-chopathology of anorexia nervosa is overwhelming concern about body shape and weight. Phobia of fatness increases as weight decreases. The...

Prevalence Of Latelife Depression And Anxiety

The Epidemiological Catchment Area Study ECA Regier et al., 1988 was a major study investigating rates of depression and anxiety in the community carried out across five sites in the US. The ECA prevalence rates of major depressive disorder amongst older adults were lower than for younger adults for review see Powers et al., 2002 . In the UK, Lindesay, Brigs amp Murphy 1989 reported prevalence rates of 4.3 for severe depression and 13.5 for mild moderate depression in a community dwelling urban...

Cognitive Therapies

Adapted versions of the cognitive therapies are being used increasingly with people with ID. It had been considered by earlier writers that methods for cognitive therapy would have to be adapted considerably in order to be understood clearly by individuals with mild ID Kroese, 1997 . However, more recent research suggests that with minor adaptations, simplification and so on, assessment and treatment are extremely similar to those seen in mainstream therapy. Dagnan amp Sandhu 1999 used an...

Subsyndromally Depressed Hospitalized Elderly Patients

Recognizing that subthreshold symptoms for major depression impeded recovery of hospitalized elderly patients, Mossey et al. 1996 conducted a trial using a modification of IPT called interpersonal counselling IPC Klerman et al., 1987 . Seventy-six hospitalized patients over age 60 with subsyndromal depression were randomly assigned to either 10 sessions of IPC or usual care UC . A euthymic, untreated control group was also followed. Three-month assessment showed non-significantly greater...

Depressed Adolescents IPTA

Mufson, Moreau amp Weissman 1993 modified IPT to address developmental issues of adolescence. In adapting IPT to this population, they added a fifth problem area and potential focus the single parent family. This interpersonal situation appeared frequently in their adolescent treatment population and actually reflected multiple wider social problems in an economically deprived, high crime and drug-filled neighbourhood. Other adaptations included family and school contacts. The researchers...

The Emdr Procedure

Shapiro 1999 describes the eight phases of EMDR treatment. The first of these phases is 'client history and treatment planning'. The history taking is undertaken with the same degree of thoroughness that any good mental health clinician would employ when considering a client for psychotherapy. Particular emphasis will be placed on the nature of the client's psycho-pathology and the client's suitability for EMDR. Contraindications such as suicidal ideation, organic problems that could interfere...

Cognitive Therapy In Practice

A typical cognitive therapy session involves checking how the client has been doing, reviewing the previous session, setting an agenda, working through the agenda items, setting homework, reviewing summarising the session and eliciting feedback. It begins with the therapist and client negotiating an agenda or list of topics that they agree to work on in that session. This involves ensuring the agenda is manageable, prioritising the items and linking them to the therapy goals. The therapist will...

Cognitive Therapy is Based on a Cognitive Formulation of the Presenting Problems

Cognitive therapy distils cognitive theories of emotional disorders to the understanding of particular cases through the case formulation method. A skilled cognitive therapist aims to understand presenting problems in terms of cognitive theory while maintaining the 'essence' of the presenting problems for a particular individual. To the scientist-practitioner cognitive therapist, individualised case formulation is the heart of good practice Tarrier amp Calam, 2002 . The process of clinical...