Cognitive-Behavioral Therapy for PTSD A Case Formulation Approach

by Zayfert, Claudia; Becker, Carolyn Black

• ISBN13: 9781606230312
• ISBN10: 160623031X
• Edition: 1st
• Format: Paperback
• Copyright: 2008-10-15
• Publisher: The Guilford Press

Summary

This book has been replaced by Cognitive-Behavioral Therapy for PTSD, Second Edition, ISBN 978-1-4625-4117-1.

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. 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. Dr. Zayfert's primary interests have been the treatment of PTSD with comorbid conditions. Her current research is focused on treatment of posttraumatic insomnia. Dr. Zayfert has published extensively and has presented at national and international conferences to promote the use of empirically supported treatments for anxiety disorders in clinical practice. She routinely provides training and consultation regarding cognitive-behavioral treatments for complicated PTSD.

 

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