Cognitive-Behavioral Therapy for PTSD A Case Formulation Approach

by Zayfert, Claudia; Becker, Carolyn Black

• ISBN13: 9781593853693
• ISBN10: 1593853696
• Edition: 1st
• Format: Hardcover
• Copyright: 2006-11-27
• Publisher: The Guilford Press

Summary

Presenting clear-cut strategies for working with traumatized patients who have multiple co-occurring disorders and life problems, this highly practical manual puts an array of proven cognitive-behavioral strategies at the clinician's fingertips. The authors illustrate the "whats," "whys," and "how-tos" of exposure, cognitive restructuring, and other effective techniques for treating posttraumatic stress disorder (PTSD), and show how to organize interventions within a systematic yet flexible case formulation. Throughout, detailed clinical material shows exactly what the process of therapy looks like and offers guidance for overcoming treatment hurdles. More than 20 reproducible clinical tools are included. 

See also the related self-help guide, When Someone You Love Suffers from Posttraumatic Stress, an ideal recommendation for clients and their family members.

Author Biography

Claudia Zayfert, PhD, a clinical psychologist and an Associate Professor of Psychiatry at Dartmouth Medical School, has been involved in treatment, research, and training related to PTSD for over 15 years. She completed her doctoral degree at West Virginia University and was a Research Associate at the National Center for PTSD. Currently, she is Director of the Anxiety Disorders Service and the Posttraumatic Stress Disorder Treatment Program in the Department of Psychiatry at Dartmouth Hitchcock Medical Center. Her primary interests include promoting the use of empirically supported treatments for anxiety disorders in clinical practice and understanding barriers to their implementation. Dr. Zayfert has published extensively and presented at national and international conferences, and provides training and consultation regarding cognitive-behavioral treatments.
           
Carolyn Black Becker, PhD, is an Associate Professor of Psychology at Trinity University, San Antonio. Trained at Rutgers University, Dr. Becker is a practicing clinical psychologist who specializes in the treatment of PTSD, anxiety disorders, and eating disorders. She has over 14 years of experience with cognitive-behavioral treatments for a variety of anxiety disorders, including PTSD. The primary focus of her teaching, research, and clinical work is the implementation of scientifically supported prevention and treatment interventions in clinical settings. In addition to numerous publications on these topics, Dr. Becker regularly presents at national and international conferences and provides training and consultation to clinicians.

Table of Contents

Cognitive-Behavioral Therapy for PTSD: Overview and Empirical Foundation	1	(8)
What Is CBT?	2	(1)
What Is CBT for PTSD?	3	(1)
Summary of Research on CBT for PTSD	4	(4)
Conclusion	8	(1)
Cognitive-Behavioral Conceptualization of PTSD	9	(12)
Rationale for Learning to ``Think'' Cognitive-Behaviorally	9	(1)
Conceptualization of PTSD	10	(9)
Exposure and Cognitive Restructuring	19	(1)
Conclusion	20	(1)
Assessment, Case Conceptualization, and Treatment Planning	21	(23)
Assessment of PTSD	22	(3)
Using Nomothetic Models to Develop Evidence-Based Idiographic Formulations	25	(5)
Case Formulation: Sophie	30	(3)
Case Formulation: Morgan	33	(5)
Using the Case Formulation to Decide on the Focus of Treatment: Where to Start?	38	(2)
Sequential versus Simultaneous Treatment	40	(1)
Session Planning: Developing an Initial Template	41	(1)
Building the Formulation with Your Patient and Informed Consent	41	(2)
Conclusion	43	(1)
Embarking on Treatment: Clearing the Path for Success	44	(15)
Becoming a Team: The Therapeutic Relationship	44	(2)
Addressing Your Own Issues	46	(4)
``I Feel Confident: Which Techniques Should I Use?''	50	(6)
Managing Practical Concerns and Systemic Barriers	56	(2)
Conclusion	58	(1)
Psychoeducation	59	(19)
Rationale and Background	59	(1)
Orientation to CBT	60	(4)
Teaching Common Reactions to Traumatic Experiences	64	(7)
Conclusion	71	(7)
Introducing Exposure Therapy	78	(41)
Making Sense of the Exposure Process	78	(4)
Implementing Exposure	82	(14)
Troubleshooting In Vivo Exposure	96	(9)
Conclusion	105	(14)
Imaginal Exposure	119	(38)
Preparing for Imaginal Exposure: The Rationale	120	(3)
Preparing for Imaginal Exposure: Constructing a Hierarchy and Selecting the First Memory	123	(4)
Conducting Imaginal Exposure: The Basic Steps	127	(5)
Strategies to Titrate Anxiety during Imaginal Exposure and Facilitate Engagement and Habituation	132	(6)
Troubleshooting	138	(10)
Unusual Reactions	148	(1)
Conclusion	149	(8)
Cognitive Restructuring	157	(45)
Why Should I Use Cognitive Restructuring?	158	(1)
What Is Cognitive Restructuring?	159	(18)
Common PTSD Thoughts	177	(5)
Cognitive Restructuring for PTSD: Possible Problems	182	(7)
Conclusion	189	(13)
Supplemental Tools	202	(21)
Dialectical Behavior Therapy	203	(2)
Activity Scheduling	205	(1)
Assertive Communication Skills	206	(1)
Problem-Solving Skills	206	(1)
Exposure for Comorbid Anxiety Disorders	207	(2)
Decision Analysis	209	(1)
Treatment for Insomnia	210	(1)
Treatment for Eating Disorders	211	(2)
Substance Abuse and Dependence	213	(1)
Conclusion	213	(10)
Putting It Together	223	(16)
Common Stumbling Blocks	223	(7)
Treating Patients with Multiple Problems: Deciding When to Transition from PTSD Treatment	230	(3)
Planning for Termination	233	(5)
Conclusion	238	(1)
References	239	(8)
Index	247