Table of Contents
Innovations and Advances in Cognitive Behaviour Therapy by Danielle Einstein
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About the Innovations and Advances in Cognitive Behaviour Therapy by Danielle Einstein
This book has been written for clinicians wishing to update their awareness and skills based on clinical research being conducted predominantly in Australia and New Zealand. It explores innovations and cutting edge developments in the way cognitive–behaviour therapy (CBT) is applied across the full spectrum of psychopathology.
Emphasis is placed on flexible modes of delivery and new directions in treatment modality. Chapters discussing new treatments focus on the practical implementation of the new treatment. Data-driven investigations are included when they reveal advances in treatment or where research provides exciting information for clinical practice. The authors have provided a clear description of new treatment procedures. The book has combined a theoretical basis with practical applicability for the experienced clinician.
Innovations and Advances in Cognitive–Behaviour Therapy are divided into three parts. The first part examines innovative treatments for specific presentations.
Chapter 1 presents a cognitive–behavioural treatment package for music performance anxiety (MPA). The treatment developed by Tarrant and Leatham incorporates a range of strategies in which clients (i) acquire an understanding of the nature of MPA and its relationship with anxiety, (ii) develop insight through the examination of their personal performance history, (iii) examine the role of personality contributions to MPA, (iv) explore the role of technical and non-technical preparation prior to performance, (v) learn to discriminate alternate options of focus for their attention during the performance. The chapter is practical and detailed and the authors describe an evaluation of the treatment. They have included a copy of their measure ‘the Music Performance Anxiety Scale’ as an Appendix.
Chapter 2 is a practitioner guide for the treatment of Magical Ideation (MI). This treatment was developed for use with individuals suffering from obsessive-compulsive disorder (OCD) with high levels of magical ideation. It is the first published description of the treatment package and the majority of materials (patient handouts and target articles) are provided. A review of the research program supporting the importance of addressing MI in the treatment of OCD is provided and pilot data support the implementation of the package within this population.
Chapter 3 provides a rationale for the use of mindfulness as a treatment for bipolar disorder. It is a more theoretical chapter. Ball, Corry, and Mitchell describe rationales, precautions, and techniques that, from their experience, are important in the application of mindfulness to clients with bipolar disorder.
Huxter’s chapter (chapter 4) examines the Buddhist origins of mindfulness treatments. Given the explosion in evidence suggesting the use of mindfulness for the treatment of recurrent depression, this perspective is valuable and enlightening. Huxter alerts clinicians of the need to be informed of the origins of mindfulness and provides an accessible description of its Buddhist roots.
Chapter 5 presents a new treatment of trauma-related nightmares for children. Encel and Dohnt have adapted imagery rehearsal therapy (IRT) for this population. They provide an introduction to IRT, a description of how to implement this therapy within the paediatric population, and information on where to find further resources for clinicians wishing to learn more about IRT with adults. As standard treatment of childhood trauma does not try to address nightmares, this chapter may be the first of its kind. It is extremely practical and detailed.
Woodcock, Milic and Johnson then describe the treatment of selective mutism in chapter 6. This comprehensive chapter reviews the literature, explains the theoretical basis of selective mutism, and compares their program to alternative treatments. The authors have provided a detailed description of how to apply their intervention. They report data they have collected and provide case examples useful to any therapist wishing to commence treatment. Reading about computer treatments is often less than exciting.
However, the chapter written by Cunningham, Donovan, and March is captivating. Their chapter thoroughly examines the issues arising in the development and delivery of computer- and Internet-based CBT for anxiety disorders in young people. They describe the issues that arose in developing two treatment programs (‘The Cool Teens Program’, developed at Macquarie University, and ‘The BRAVE program’, developed at The University of Queensland). They compare the ways that these two independent and eminent groups of clinical academics chose to handle each issue.
Chapter 8 is a useful starting point for any clinician wishing to expand their practice into work with an older population. Deborah Koder combines a review of the literature with her own clinical experience to impart practical advice on the implementation of CBT. She provides examples of how to adjust CBT for this population. Her reference list will be a useful resource for those wishing to further their knowledge in this area.
Merritt, Pervan, and Sheady have written a practitioner guide for the implementation of acceptance and commitment therapy (ACT) for individuals suffering from chronic pain. These clinicians describe exercises and metaphors they have found useful from their work at Prince Alfred Hospital in Sydney with this notoriously difficult group to treat.
Their description of the treatment explains miniature steps by which to break down behaviour therapy and introduce it in a palatable way to this population. Once again, information on where to find out more about ACT is provided throughout the chapter. Shearsby, Walker, and Steel have written a chapter about the cognitive–behavioural treatment of psychosis that is both philosophical and helpful.
It attempts to remove the myths behind what clinicians aim for in their treatment of psychosis. Their chapter is written from the perspective of a group that has conducted a randomized controlled trial (RCT) of two treatments for psychosis: cognitive therapy and coping strategy enhancement (the ‘Voices and Beliefs Project’). They provide three case studies from which they draw lessons to assist clinicians wishing to work in this area.
The second part of the book presents results from treatment comparisons. Once again, the authors have provided a detailed description of the treatments and explanations of how these treatments represent advances in existing treatments.
Chapter 11 describes a trial conducted at the Black Dog Institute in which emotive techniques have been added to cognitive therapy in the treatment of the bipolar disorder. In chapter 12, Maree Abbott provides an in-depth description of her new package for the treatment of generalized anxiety disorder and presents initial results. In chapter 13, a new treatment focuses on the engagement of eating disorders patients within an inpatient setting. It is not hard to envisage how aspects of motivational enhancement treatment could be attempted with a range of populations where there is the reluctance to initiate change. Chapter 14 presents an RCT of cognitive processing therapy for assault victims with acute stress disorder. Chapter 15 presents the results of an RCT of MoodGYM (a computerized treatment for depression).
The final section focuses on clinical research being conducted throughout Australia. Prominent researchers were asked to describe their research where the questions under investigation have implications for understanding aetiology or treatment. For example, Hill and Touyz discuss their research into schema underlying eating disorders; Moulds and Kandris review their research examining the role of avoidance in depression; Parker reviews his research on modeling the depressive disorders; and Bryant, Sutherland, and Guthrie present studies on the role of autobiographical memory in posttraumatic stress disorder (PTSD).
In chapter 20, Ellis and Nixon examine the role of cognitive and social factors in the development of trauma responses within children. In chapter 21, Haarhoff examines the role of therapist schema in training and attitudes of intern cognitive therapists. From a clinician’s perspective understanding and considering the therapist, schema seems to be a worthwhile goal within one’s professional development. In the final chapter, Theiler and Bates investigate the significance of early childhood memories. They discuss the potential use of these within assessment and treatment.
Innovations and Advances in Cognitive–Behaviour Therapy is based on a select group of submissions to the national conference of the Australian Association for Cognitive Behaviour Therapy, held in Sydney (October 2006). All submissions were reviewed and chapters were invited from research groups where it was clear that innovative clinical research had been, or was in the process of being, conducted.
The authors were asked to write chapters with an emphasis on the ‘how-to’ of the procedures being evaluated for each disorder. Of course, as scientist-practitioners, the authors have provided concise reports of their data or, when the research was still in its infancy (e.g., case studies), have discussed how their research relates to the current literature.
What has resulted is, in my view, a wonderful resource for clinicians wishing to know more about treatment in a range of areas. If a certain area arouses particular interest, the authors have provided a comprehensive review, treatment outlines (including experienced clinical suggestions), and references to allow readers to obtain further information.
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