Master Clinical Seminar 1
Master Clinical Seminar 1
Cognitive Behavior Therapy for Jealousy
Basic level of familiarity with the material
Robert L. Leahy, Ph.D., American Institute for Cognitive Therapy
Jealousy is a “social emotion” that is accompanied by anger, anxiety, sadness, and resentment and, in some cases, can lead to destructive behavior, including homicide or suicide. Jealousy is often a central element in the “power and control wheel,” where the jealous partner seeks to control the thoughts, behaviors and relationships of the other in attempts to maintain a valued relationship while, ironically, pushing the partner away. Jealousy will be discussed in terms of evolutionary theory (parental investment model), universal patterns of defense against threat to attachment, core beliefs about self, maladaptive coping (reassurance-seeking, testing, withdrawing, punishing, interrogating, restraining), intolerance of uncertainty, and thought-action fusion. Participants will learn how to develop a case conceptualization, normalize this intense emotion, link jealousy to values, examine how jealous behavior interferes with a valued relationship, distinguish between productive and unproductive worry, use detached mindfulness to accept intrusive thoughts while not acting on them, evaluate how personal schemas are related to jealousy, and enhance independence and self-care. Finally, we will examine how loss may be decatastrophized, safety behaviors relinquished, acceptance embraced, and personal roles elaborated for multiple meanings in life.
You Will Learn:
1. How to develop a case conceptualization for jealousy.
2. How to modify the agitated angry worry and attempts to control that underlie jealousy.
3. Reverse jealousy while enhancing acceptance, self-care, and purpose-driven living.
Recommended Readings:
Leahy, R. L., & Tirch, D. (2008). Cognitive behavioral therapy for jealousy. International Journal of Cognitive Therapy, 1, 18-32.
Leahy, R.L., Tirch, D., & Napolitano, L. (2011). Emotion regulation in psychotherapy: A practitioner’s guide. New York: Guilford Press.
Leahy, R.L. (in preparation). Emotional schema therapy: A therapist’s manual. New York: Guilford Press.
Master Clinical Seminar 2
When Anxiety Traps Emerging Adults and Their Parents: Developmentally Informed CBT for the “Failure to Launch”
Moderate level of familiarity with the material
Anne Marie Albano, Ph.D., ABPP, Columbia University Center for Anxiety and Related Disorders
Anxiety disorders onset by adolescence, co-occur with mood and substance use disorders, and result in serious distress, disability, and impairment in functioning, specifically in the ability to become independent and move forward into college or the workforce. It is well established that anxiety also leads to extended dependence on family, with early and continued parental overprotection noted for its role in the maintenance of these disorders. CBT and medication are effective treatments for anxiety disorders in adolescents and children; however, long-term remission through the transition to adulthood is not maintained for nearly half of effectively treated youth (Ginsburg et al., 2014). Given the chronicity of anxiety and its extended, deleterious impact on adult functioning, we established a treatment program to address parental overinvolvement and youth overdependency. The Launching Emerging Adults Program (LEAP) integrates the core components of effective cognitive behavioral treatments for anxiety disorders in adolescents and adults with specific components designed to address patient-caretaker dependency, role transitions, and attainment of behaviors necessary for independent adult functioning. LEAP is an integrated, developmentally informed treatment aimed at both syndrome relief and maximizing functional outcomes and is based on our experiences in treating transition-aged adolescents and young adults in our anxiety clinics and informed by critical reviews of the developmental psychology of emerging adulthood (e.g., Arnett, 2004). In this Master Clinician presentation, Dr. Albano presents specific guidelines for engaging parents and adolescents together to address key overprotection traps while increasing the adolescent’s exposure to anxiety-provoking situations. The first hour will focus specifically, with clinical case examples, on negotiating a developmental hierarchy and plan for parental “letting go” while addressing core beliefs and fears of the parents and their emerging adult child. The second hour will provide guidance in setting up higher-level exposures to facilitate anxiety management while increasing engagement in adult-transition and role behavior.
You Will Learn:
1. To recognize the tasks of development necessary for adolescents to transition to adulthood.
2. Strategies for addressing parental overinvolvement and adolescent dependency including family communication and problem solving.
3. To develop exposures that maximize the use of context and address developmental stage issues to increase ecological validity and reduce or develop tolerance of anxiety.
Recommended Readings:
Arnett, J. J. (2004). Emerging adulthood: The winding road from late teens through the twenties. New York: Guilford Press.
Ginsburg, G.S., Becker, E.M., Keeton, C.P., Sakolsky, D., Piacentini, J., Albano, A.M., . . . Kendall, P.C. (2014). Naturalistic follow-up of youths treated for pediatric anxiety disorders. JAMA Psychiatry, 71(3), 310-318.
Hambrick, J.P., Comer, J.S., & Albano, A.M. (2011). Cognitive behavioral model of anxiety disorders: Theory, practice and current issues. In H.B. Simpson, F. Schneier, Y. Neria, & R. Louis-Fernandez (Eds.), Understanding anxiety: Clinical and research perspectives from the Columbia University Department of Psychiatry. New York: Cambridge University Press.
Master Clinical Seminar 3
Acceptance and Change in Couple Therapy: Integrative Behavioral Couple Therapy
Moderate level of familiarity with the material
Andrew Christensen, Ph.D., UCLA
In an effort to improve the outcome of couples therapy, Andrew Christensen of UCLA and the late Neil Jacobson of the University of Washington developed Integrative Behavioral Couples Therapy (IBCT), which integrates strategies for promoting acceptance in couples with the traditional behavioral strategies for promoting change in couples. “Acceptance work” focuses on turning problems into vehicles for promoting intimacy and increasing couples’ tolerance for what they see as each other’s negative behavior. As couples let go of the struggle to change one another, change often occurs in response to natural contingencies. Several clinical trials have demonstrated the efficacy of IBCT. The most recent study showed that IBCT led to significantly greater improvement in couple satisfaction than traditional behavioral couple therapy for 2 years posttreatment (Christensen, Atkins, Baucom, & Yi, 2010). IBCT has recently been adopted by the Veteran’s Administration as one of their empirically supported treatments; extensive efforts to train VA therapists in IBCT are under way.
This seminar will outline the theoretical foundation of IBCT and provide an overview of the assessment methods, clinical formulation, feedback session, and treatment strategies of IBCT. Treatment strategies will be illustrated with video clips from treatment sessions of couples in one of the outcome studies or in Christensen’s own work with couples.
You Will Learn:
1. The theoretical and empirical basis for IBCT.
2. The assessment methods, clinical formulation, and feedback techniques in IBCT.
3. The treatment strategies of IBCT.
Recommended Readings:
Christensen, A., Atkins, D. C., Baucom, B., & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78, 225-235.
Christensen, A., Doss, B. D., & Jacobson, N. S. (2014). Reconcilable differences (2nd ed.) New York: Guilford Press.
Jacobson, N. S., & Christensen, A. (1996). Acceptance and change in couple therapy: A therapist’s guide to transforming relationships. New York: Norton.
Master Clinical Seminar 4
Cognitive Therapy for Social Anxiety Disorder
Moderate to Advanced level of familiarity with the material
David M. Clark, Ph.D., University of Oxford
Social anxiety disorder is common and remarkably persistent in the absence of treatment. It frequently leads to occupational and educational underachievement. Interpersonal relationships are impaired. Dissatisfaction with the way that life is progressing often triggers depressive episodes.
Clark and Wells (1995) proposed a cognitive model that aims to explain why social anxiety disorder is so persistent. A distinctive form of cognitive therapy that targets the maintenance processes classified in the model was developed. Randomized controlled trials in the U.K., Germany, and Sweden have demonstrated that the new treatment is highly effective. Comparisons with other active treatments have established that cognitive therapy is superior to two forms of group CBT, exposure therapy, interpersonal psychotherapy, psychodynamic psychotherapy, SSRIs, medication-focussed treatment as usual, and placebo medication. Such a comprehensive demonstration of differential effectiveness is extremely rare in psychotherapy.
This Master Clinician Seminar explains the Clark and Wells model and illustrates the key treatment procedures that have been developed from the model. These include: the self-focused attention and safety behaviors experiential exercise, video-feedback, externally focused attention training, behavioral experiments, and procedures (discrimination training and memory rescripting) for addressing early experiences that influence patient’s current behavior in social situations. The treatment procedures are illustrated with case material and videos clips from therapy sessions. Guidance on the use of the most appropriate measures for identifying therapy targets and monitoring progress is also provided. Finally, the seminar explains why some procedures that are common in other CBT programs (e.g., thought records, positive self-talk in a phobic situation, exposure hierarchies) are not used in Clark and Wells’ cognitive therapy program.
You Will Learn:
1. To identify key processes in maintaining social anxiety disorder.
2. The main procedures in cognitive therapy for social anxiety disorder.
3. How to track change in the maintenance processes during therapy.
Recommended Readings:
Clark, D.M. (2001). A cognitive perspective on social phobia. In R. Crozier & L.E. Alden (Eds.), International Handbook of Social Anxiety. Chichester: Wiley.
Clark, D.M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M.J.V., Waddington, L., Grey, N., & Wild, J. (2006). Cognitive therapy and exposure plus applied relaxation in social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74, 568-578.
Clark, D.M., & Wells, A. (1995). A cognitive model of social phobia. In R.G. Heimberg, M. Liebowitz, D. Hope, & F. Scheier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp 69-93). New York: Guilford Press.
Stangier, U., Schramm, E., Heidenreich, T., Berger, M., & Clark, D. M. (2011). Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: A randomized controlled trial. Archives of General Psychiatry, 68, 692-700. doi: 10.1001/archgenpsychiatry.2011.67
Master Clinical Seminar 5
Perspective Taking and Compassion in Modern CBT
Basic level of familiarity with the material
Steven C. Hayes. Ph.D., University of Nevada
Psychotherapy is built on powerful therapeutic relationships, but in order to build such relationships we need to know their elements. The present seminar explores the theory and practice of perspective-taking and its link to compassion as a central core of therapeutic work in modern CBT. Drawing especially on relational frame theory, ACT, and evolutionary perspectives, this seminar will demonstrate the use of perspective taking to construct powerful, compassionate therapeutic alliances.
You Will Learn:
1. To recognize and use the three cognitive relations that underlie perspective taking.
2. How to increase the social basis of perspective-taking and compassion in therapy.
3. How to link perspective-taking and compassion to common therapeutic goals in modern CBT.
Master Clinical Seminar 6
Comprehensive Cognitive Behavior Therapy for Obsessive-Compulsive Disorder to Maximize Gains
Basic level of familiarity with the material
Lata K. McGinn, Ph.D., Yeshiva University, Albert Einstein College of Medicine
This presentation will offer clinicians the knowledge and skills to effectively treat OCD using a comprehensive CBT approach to maximize gains. Clinicians will learn how to functionally target, assess, and monitor the different symptoms that become the focus of treatment and how the different strategies, including psychoeducation, cognitive restructuring, exposure, and response prevention, are implemented. Emphasis will be placed on (a) how cognitive strategies can be used to maximize gains and increase client willingness to engage in exposure; (b) how to systematically create both overall and operational exposure hierarchies; (c) how and when to use only imaginal exposure or only in vivo exposure, or both, based on differing symptom presentations, and (d) how to design and implement response prevention to block rituals, as well as how to use specific strategies to help patients comply with response prevention. A case vignette will be used to illustrate techniques in a hands-on-fashion. Slides will be presented and handouts (outlines, assessment and treatment forms, readings for clients and professionals) will be provided so that clinicians may apply what they learn in the seminar. Clinicians are encouraged to ask questions and bring in treatment cases to ensure maximal learning.
You Will Learn:
1. How to functionally target, assess, and monitor the different symptoms that become the focus of treatment.
2. How different treatment strategies can be used to maximize gains and increase client willingness to engage in exposure.
3. How and when to use only imaginal exposure or only in-vivo exposure, or both, based on differing presentations.
Recommended Readings:
Leahy, R.L., Holland, S., & McGinn, L.K. (2011). Treatment plans and interventions for anxiety and depressive disorders (2nd ed.). New York: Guilford Press.
McGinn, L.K., & Sanderson, W.C. (1999). Treatment of obsessive compulsive disorder. New York: Jason Aronson.
Master Clinical Seminar 7
Integrating CBT Strategies Into Ongoing Clinical Practice
Basic level of familiarity with the material
Michael W. Otto, Ph.D., Boston University
This seminar is designed for clinicians who are new to CBT and are seeking to integrate CBT strategies into their clinical practice. For this seminar, emphasis is placed on the principles of change that underlie cognitive-behavioral interventions. Rather than relying on a prescribed session-by-session format, the focus of this presentation is on elements of CBT that can be used by clinicians from a variety of training perspectives (e.g., interpersonal, psychopharmacologic, dynamic, supportive, etc.) in whatever session time they have to devote to these interventions. The seminar is balanced between discussion of the philosophy behind interventions and the variety of techniques that can be used to realize these principles of change, with review of useful metaphors for communicating therapeutic principles. The result is an especially user-friendly seminar for clinicians seeking to enhance their CBT skills, with a focus on the anxiety and mood disorders that are most common in clinical practice.
You Will Learn:
1. The core elements of cognitive-behavioral treatment for mood and anxiety disorders.
2. Several strategies for promoting emotional acceptance.
3. Metaphors for promoting self-observation and cognitive restructuring.
Recommended Readings:
Otto, M. W. (2000). Stories and metaphors in cognitive-behavior therapy. Cognitive and Behavioral Practice, 7, 166-172.
Otto, M. W., Simon, N. M., Olatunji, B. O., Sung, S. C., & Pollack, M. H. (2011). 10-Minute CBT: Integrating cognitive-behavioral strategies into your practice. New York: Oxford University Press.
Otto, M. W., Tolin, D. F., Nations, K. R., Utschig, A. C., Rothbaum, B. O., Hofmann, S. G., & Smits, J. A. J. (2012). Five sessions and counting: Considering ultra-brief treatment for panic disorder. Depression and Anxiety, 29, 465-470.