Exposure Therapy for Anxiety: Principles and Practice - Softcover

Abramowitz, Jonathan S.; Deacon, Brett J.; Whiteside, Stephen P. H.

 
9781462539529: Exposure Therapy for Anxiety: Principles and Practice
Softcover
ISBN 10: 1462539521 ISBN 13: 9781462539529
Verlag: Guilford Press, 2019

Inhaltsangabe

Now revised and expanded to include cutting-edge acceptance-based techniques and a new focus on inhibitory learning, this is the leading guide to therapeutic exposure, a crucial element of evidence-based psychological treatments for anxiety. The book helps the clinician gain skills and confidence for implementing exposure successfully and tailoring interventions to each client's needs, regardless of diagnosis. The theoretical and empirical bases of exposure are reviewed and specialized assessment and treatment planning techniques are described. User-friendly features include illustrative case examples, sample treatment plans, ideas for exercises targeting specific types of fears, and reproducible handouts and forms that can be downloaded and printed in a convenient 8½" x 11" size.
 
New to This Edition
*Chapter on acceptance and commitment therapy (ACT) techniques.
*Reflects a shift in the field toward inhibitory learning--helping clients learn to tolerate anxiety and uncertainty to maximize long-term outcomes.
*Chapter on uses of technology, such as computer-based therapy and virtual reality tools.
*Conceptual, empirical, and clinical advances woven throughout.

See also the related client recommendation, The Anxiety and Worry Workbook, Second Edition, by David A. Clark and Aaron T. Beck.

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Über die Autorinnen und Autoren

Jonathan S. Abramowitz, PhD, ABPP, is Professor of Psychology and Neuroscience, Research Professor of Psychiatry, and Director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. Dr. Abramowitz conducts research on anxiety disorders and has published over 250 articles, book chapters, and books. He serves as Editor of the Journal of Obsessive–Compulsive and Related Disorders and is on the editorial boards of several other scientific journals. He is past president of the Association for Behavioral and Cognitive Therapies and serves on the scientific and clinical advisory board of the International OCD Foundation. Dr. Abramowitz is a recipient of the Outstanding Contributions to Research Award from the Mayo Clinic Department of Psychiatry and Psychology and the David Shakow Early Career Award for Distinguished Scientific Contributions to Clinical Psychology from Division 12 of the American Psychological Association. His books include Getting Over OCD, Second Edition, and The Stress Less Workbook (for general readers) and Exposure Therapy for Anxiety, Second Edition (for mental health professionals).
 
Brett J. Deacon, PhD, is a clinical psychologist in private practice in Wollongong, Australia, and Conjoint Associate Professor at the University of New South Wales. He has published approximately 100 research articles and book chapters, served as Editor of The Behavior Therapist and Associate Editor of the Journal of Cognitive Psychotherapy, and is an editorial board member of numerous scientific journals. Dr. Deacon’s research examines the dissemination, optimal delivery, and acceptability of exposure therapy for anxiety. He is the recipient of numerous teaching, research, and student mentorship awards from the University of Wyoming, as well as the Golden Anniversary Alumni Award from Northern Illinois University College of Liberal Arts and Sciences. Dr. Deacon presents workshops around the world on exposure therapy.  
 
Stephen P. H. Whiteside, PhD, ABPP, is Professor of Psychology and Director of the Pediatric Anxiety Disorders Program at the Mayo Clinic in Rochester, Minnesota. His research focuses on improving access to evidence-based care for pediatric anxiety disorders and obsessive–compulsive disorder through the development of effective and efficient treatments facilitated by technology. Dr. Whiteside serves on the editorial board of the Journal of Anxiety Disorders and on the Education and Training Committee of the Minnesota Psychological Association. He has published over 60 scientific articles and is the codeveloper of the Mayo Clinic Anxiety Coach, a smartphone app that aids in the delivery of exposure.

Jonathan S. Abramowitz, PhD, ABPP, is Professor of Psychology and Neuroscience, Research Professor of Psychiatry, and Director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. Dr. Abramowitz conducts research on anxiety disorders and has published over 250 articles, book chapters, and books. He serves as Editor of the Journal of Obsessive–Compulsive and Related Disorders and is on the editorial boards of several other scientific journals. He is past president of the Association for Behavioral and Cognitive Therapies and serves on the scientific and clinical advisory board of the International OCD Foundation. Dr. Abramowitz is a recipient of the Outstanding Contributions to Research Award from the Mayo Clinic Department of Psychiatry and Psychology and the David Shakow Early Career Award for Distinguished Scientific Contributions to Clinical Psychology from Division 12 of the American Psychological Association. His books include Getting Over OCD, Second Edition, and The Stress Less Workbook (for general readers) and Exposure Therapy for Anxiety, Second Edition (for mental health professionals).
 
Brett J. Deacon, PhD, is a clinical psychologist in private practice in Wollongong, Australia, and Conjoint Associate Professor at the University of New South Wales. He has published approximately 100 research articles and book chapters, served as Editor of The Behavior Therapist and Associate Editor of the Journal of Cognitive Psychotherapy, and is an editorial board member of numerous scientific journals. Dr. Deacon’s research examines the dissemination, optimal delivery, and acceptability of exposure therapy for anxiety. He is the recipient of numerous teaching, research, and student mentorship awards from the University of Wyoming, as well as the Golden Anniversary Alumni Award from Northern Illinois University College of Liberal Arts and Sciences. Dr. Deacon presents workshops around the world on exposure therapy. 
 
Stephen P. H. Whiteside, PhD, ABPP, is Professor of Psychology and Director of the Pediatric Anxiety Disorders Program at the Mayo Clinic in Rochester, Minnesota. His research focuses on improving access to evidence-based care for pediatric anxiety disorders and obsessive–compulsive disorder through the development of effective and efficient treatments facilitated by technology. Dr. Whiteside serves on the editorial board of the Journal of Anxiety Disorders and on the Education and Training Committee of the Minnesota Psychological Association. He has published over 60 scientific articles and is the codeveloper of the Mayo Clinic Anxiety Coach, a smartphone app that aids in the delivery of exposure.

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Exposure Therapy for Anxiety

Principles and Practice

By Jonathan S. Abramowitz, Brett J. Deacon, Stephen P.H. Whiteside

The Guilford Press

Copyright © 2019 The Guilford Press
All rights reserved.
ISBN: 978-1-4625-3952-9

Contents

I. The Fundamentals of Exposure Therapy, 1, 
1. Overview and History of Exposure Therapy for Anxiety, 3, 
2. How Well Does Exposure Therapy Work?, 19, 
3. The Nature and Treatment of Clinical Anxiety, 32, 
4. Treatment Planning I: Functional Assessment, 53, 
5. Treatment Planning II: Treatment Engagement and Exposure List Development, 79, 
6. Implementing Exposure Therapy, 106, 
II. Implementing Exposure Therapy for Specific Types of Fears, 133, 
7. Animal-Related Fears, 135, 
8. Environmental Fears, 151, 
9. Social Situations, 165, 
10. Unwanted Intrusive Thoughts, 183, 
11. Bodily Cues and Health Concerns, 215, 
12. Contamination, 237, 
13. Trauma-Focused Fear, 257, 
14. Blood-, Injection-, and Injury-Related Stimuli, 275, 
15. Incompleteness, Asymmetry, and "Not-Just-Right" Feelings, 289, 
III. Special Considerations in the Use of Exposure Techniques, 303, 
16. Exposure Therapy with Complex Cases, 305, 
17. Exposure Therapy with Children, 320, 
18. Involving Significant Others in Treatment, 337, 
19. Combining Exposure Therapy with Medication, 353, 
20. Maintaining Improvement after Treatment, 365, 
21. Using Technology to Implement Exposure Therapy, 375, 
22. Using Acceptance and Commitment Therapy with Exposure, 384, 
23. A Risk-Benefit Analysis of Exposure Therapy, 400, 
References, 415, 
Index, 443,


CHAPTER 1

Overview and History of Exposure Therapy for Anxiety


The range of human fears is immeasurable. Whereas some people break out in a cold sweat at the thought of riding in an elevator or driving over a bridge, others fear animals (large or small, alive or dead), loss of control, speaking in front of others, or experiencing the sensations of physiological arousal. Still others are afraid of eternal damnation, "immoral" words and "unlucky" numbers, unwanted thoughts about sex or violence, or using public restrooms. There are even those who become immobilized at the sight of a clown, a cemetery, or their own navel.

In order to help people overcome such distressing and disabling anxiety, mental health professionals face the daunting task of selecting an effective treatment strategy from a dizzying array of available options. Some of these strategies are vigorously promoted as "cures" for a wide range of psychological (and medical) problems. Some are touted as short-term or "brief," whereas others ostensibly work over a longer period. Some are designed for individual therapy and others for group settings. Although proponents of most of these interventions claim that they are effective, convincing scientific evidence to support these claims is lacking in the majority of cases.

With so many possibilities, it is inevitable that many interventions that seem plausible are in the end ineffective or even harmful. Indeed, the treatment of anxiety has a long and colorful history dating back well past the fifth century B.C. Dimopoulos, Robinson, and Fountas (2008) recount instructive examples of "treatment" for panic attacks by "trephination," as described by contemporaries of Hippocrates. Essentially, "physicians" of the day — who had little knowledge of human anatomy — bored holes into the sufferer's skull, presumably to coax out from the brain the demons that were thought to cause "insanity." Although we may snicker at this practice now, variations of this approach have endured and are still in use in some parts of the world today. Practitioners used trephination because it "worked," by which we mean that it was occasionally followed by the cessation of panic attacks. However, one can achieve this same spontaneous remission of symptoms in about a third of panic sufferers without any intervention at all (Swobota, Amering, Windhaber, & Katschnig, 2001) — which has the added benefit of saving patients a hole in their head! Given the complexity and subtly of clinical fear and anxiety, it is no surprise that so many different treatments have been tried, and that so many have persisted despite a lack of evidence supporting their effectiveness.

This somewhat unruly state of the field demands not only that treatments prove their muster in carefully conducted research trials, but also that we gain knowledge about the process by which they produce their outcomes. Accomplishing this task requires demarcating potentially useful and valid principles of therapeutic change. Several candidates common to most, if not all, psychological treatments for clinical fear and anxiety include the therapeutic relationship, the milieu in which the patient is treated, and the patient's (and therapist's) expectations of improvement (Frank, 1989). Yet another common principle of change — that with which we concern ourselves in this book — derives from the observation that alterations in thoughts, feelings, and behavior appear to occur following a strong emotional response to material presented within the context of therapy. Psychoanalytically oriented therapists, for example, confront patients with information about so-called unconscious conflicts and unacceptable wishes through free association and the interpretation of dreams (Freud, 1949/1989). Likewise, Gestalt therapists use imagery, role enactment, and group interactions to coax the patient into confronting information that has been avoided (Perls, 1969). In this volume, we focus on a cognitive-behavioral oriented approach — namely, exposure therapy — that involves a more direct and systematic sort of encounter with feared stimuli.

Exposure therapy refers to the process of helping a patient approach and engage with anxiety-provoking stimuli that objectively pose no more than everyday risk without the use of anxiety-reduction "coping" skills. Anxiety-evoking stimuli can be alive (e.g., snakes, clowns), inanimate (e.g., balloons, toilets), situational (e.g., funeral homes, bridges), cognitive (e.g., ideas of committing heinous acts, memories of a traumatic event), or physiological (e.g., racing heart, dizziness). Engagement with the objectively safe (or "low-risk") fear-eliciting stimulus typically precipitates a response ranging from mild apprehension to intense panic, the basis for which is the patient's exaggerated expectation of danger. It is thought that learning of one form or another takes place when a person repeatedly confronts a feared stimulus (e.g., a dog) in the absence of the expected feared consequence (e.g., the dog does not bite). Although debate continues regarding what exactly happens in the mind and brain during therapeutic exposure, a new behavioral repertoire seems to be cultivated and strengthened each time an individual effectively handles a previously feared situation without relying on safety cues or strategies for reducing the anxiety. Before we discuss the implementation of exposure therapy, however, let us explore the concept of anxiety and the history of exposure therapy.


ANXIETY: NORMAL AND ABNORMAL

Although a complete definition of anxiety is outside the scope of the present volume (entire books have been written on the subject; e.g., Barlow, 2002), anxiety is, broadly speaking, an organism's response to the perception of threat. This implies that actual threat need not be present in order to experience...

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Verlag
Guilford Press
Erscheinungsdatum
2019
Sprache
Englisch
ISBN 10 
1462539521
ISBN 13 
9781462539529
Einband
Taschenbuch
Auflage
2
Anzahl der Seiten
459
Kontakt zum Hersteller
Nicht verfügbar
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