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Anxiety disorders and phobias: A cognitive perspective.

Interrater relability of cognitive-behavioral case formulations

New York: Basic Books. Cognitive therapy of personality disorders. New York: Guilford Press. Cognitive therapy of depression. Beck, J. Cognitive therapy: Basics and beyond. Beckham, E. Development of instrumentation for process research in cognitive therapy of depression.


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Caston, J. The reliability of the diagnosis of the patient's unconscious plan. Weiss, H. Collins, W. Extending the plan formulation method to an object relations perspective: Reliability, stability, and adaptability. Psychological Assessment , 3, 75— CrossRef Google Scholar. Crits-Christoph, P. The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy. Journal of Consulting and Clinical Psychology, 56 , — Clinicians can agree in assessing relationship patterns in psychotherapy.

Archives of General Psychiatry, 45 , — PubMed Google Scholar. Curtis, J. The plan formulation method. Psychotherapy Research. Developing reliable psychodynamic case formulations: An illustration of the plan diagnosis method. Psychotherapy, 25 , — Fretter, P. The immediate effects of transference interpretations on patients' progress in brief, psychodynamic psychotherapy Doctoral dissertation, University of San Francisco, Glantz, S.

Primer of applied regression and analysis of variance. New York: McGraw-Hill. Hay, W. The reliability of problem identification in the behavioral interview. Behavioral Assessment, 1 , — Hayes, S. The treatment utility of assessment: A functional approach to evaluating assessment quality. American Psychologist, 42 , — Horowitz, L. Psychodynamic formulation, consensual response method, and interpersonal problems.

Journal of Consulting and Clinical Psychology, 57 , — Horowitz, M. Personality styles and brief psychotherapy. Leventhal, H. A perceptual motor theory of emotion. Ekman Eds. Hillsdale, NJ: Erlbaum. Luborsky, L.

Principles of psychoanalytic psychotherapy: A manual for supportive-expressive SE treatment. Muran, J. The development of an idiographic measure of self-schemas: An illustration of the construction and use of self-scenarios.

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Psychotherapy, 29 , — Self-scenarios as a repeated measure outcome measurement of self-schemas in short-term cognitive therapy. Behavior Therapy, 25 , — Padesky, C. Clinical tip: Presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6 , 1. From this idiographic vantage point, the method itself provides a way to answer the effectiveness question because it calls for the therapist and patient to collect data to evaluate the effec- tiveness of the therapy for each case. However, the question of whether CBT guided by a case formulation has been shown to be effective can also be posed from a more general, nomothetic point of view.

The evidence on this question is sparse.

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Cognitive Therapy in Practice: A Case Formulation Approach

A handful of randomized trials comparing out- comes of case formulation-driven and standardized CBT shows that formulation-driven treatment produces outcomes that are not different from and sometimes a bit better than standardized treatment Jacobson et al. Although the Schulte et al. Schulte et al. Furthermore, no statistical tests were conducted to directly compare the patients in the standardized condition with those in each of the other conditions.

An uncontrolled trial showed that patients with bulimia nervosa who received individualized treatment guided by a func- tional analysis had better outcomes than patients who received standardized treatment on some measures abstinence from bulimic episodes, eating concerns, and body shape dissatisfaction but not others self-esteem, perceived social support from friends, and depression Ghaderi, Another relevant literature is the literature on the treatment utility of idiographic assessment, as the main role of the idiographic case formulation is to aid in the treat- ment process.

Nelson-Gray and Haynes, Leisen, and Blaine reported that functional analysis one of the methods of case formulation described in of this book; see Chapter 3 had good treatment utility in the treatment of individuals with severe behavioral problems, such as self-injurious behavior.


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The treatment utility of functional analysis and other idiographic assessment methods for the types of outpatient cases described in this book has unfortunately rarely been studied. The case formulation approach to treatment requires frequent monitoring of the process and outcome of the therapy. Surprisingly, the effects of monitoring on outcome have rarely been studied. One exception is the work of Michael Lambert and his col- leagues, who have conducted several studies showing that patients treated by thera- pists who received feedback through monitoring data had better outcomes than patients treated by therapists who did not receive feedback.

The studies reviewed here converge to provide support for the assertion that reli- ance on a cognitive-behavioral case formulation can contribute to treatment outcome. However, few studies have examined this question directly. Central to case formulation-driven CBT is a solid understanding of the theories of cognition, learning, and emotion that underpin the currently available empirically supported cognitive-behavioral protocols. These theories are described in the next three chapters, beginning with cognitive theories and therapies.

The Case Formulation Approach to Cognitive-Behavior Therapy - Jacqueline B. Persons - Google книги

T WO Cognitive Theories and Their Clinical Implications This chapter describes cognitive theories that underpin evidence-based protocols for treating mood, anxiety, and related disorders and spells out clinical implications of those theories. I focus in detail on the cognitive theory developed by Aaron T. Beck because it underpins a large number of ESTs. The chap- ter also provides brief accounts of other cognitive theories and therapies. Beck, proposes that we all have deep cognitive struc- tures called schemas that enable us to process incoming information and interpret our experiences in a meaningful way A.

Beck et al. Symptoms of psychopathology emotions, cognitions, and behaviors result when pathological schemas are activated by stressful events see Figure 2. Beck ; A. Brown et al. From Persons, Davidson, and Tompkins Copyright by the American Psychological Association.


  1. CBT Case Conceptualization / Case Formulation / Cognitive-Behavioral Models.
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  4. Cognitive Therapy in Practice: A Case Formulation Approach;
  5. Reprinted by per- mission. Flowing directly from his theory, Beck developed a therapy that treats psychopa- thology by intervening to change the automatic thoughts, behaviors, and schemas that cause unpleasant emotions and to change the relationships among them. Some inter- ventions also target the events and situations that trigger schemas to cause symptoms. Because automatic thoughts, behaviors, and emotion are reciprocally causal, changes in automatic thoughts or behaviors are expected to lead to changes in emotion.

    Changes in schemas are expected to reduce the number, likelihood, and intensity of future episodes of illness. Instead, I provide a brief overview of the literature and I highlight some important and illustrative studies. However, most tests of the theory provide only cor- relational data e. Relatively few studies have been conducted to test the causal hypotheses of the theory largely because these studies are so difficult to conduct.

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    Emerging evidence shows that for depression and some anxiety disorders, cognitive therapy provides better protection from relapse than pharmacotherapy A. Butler et al. For several disorders, cognitive therapy has best outcomes when it is paired with pharmacotherapy e. Disappointingly little is known about the mechanisms of action of cognitive therapy Garratt et al.

    These findings provide impressive support for the notion that cognitive therapy produces a cognitive change that protects patients from relapse. However, this last finding provides only weak support for the theory because, as Hollon, DeRubeis, and Evans pointed out, the demonstration that cognitive change covaries with symptom change is not sufficient to prove that cognitive change causes symptom change.

    The Case Formulation Approach to Cognitive Behavior Therapy Guides to Individualized Evidence Based