[Katharina_Manassis]_Cognitive_Behavioral_Therapy

demystification of, 79–80 depression-focused, 71 disadvantages of, 71–72

on externalizing problems, 71, 93 for Fear-Masters program, 199 for group CBT, 74, 138

imagery use with, 76–77 language skills for, 4 learning style and, xviii

modifications to, 70, 73, 76–79 modularized, 82–84

for needle phobias, 186 parenting work in, 120, 127 for school-based CBT, 139 selection of, 73–74

on termination of CBT, 172 therapeutic alliance and, 72, 79–80 therapeutic flexibility in use of, 70 time to complete, 57

worksheet, 85–86

for young children, 93 March, J.

OCD in Children and Adolescents, 71, 118

MASC; See Multidimensional Anxiety Scale for Children

Mastery, 244

Mediator of change, 10, 76, 244 Medical conditions

allergic reactions, 105, 111, 243 asthma, 105

Fear-Masters program and, 195 goals of therapy with, 112–113 from OCD, 184

parent–child interaction and, 105, 111–113

seizures, 111, 188–189

strategies for, 105, 111–113, 188– 189

thyroid problems, 21, 108 Medication

ADHD and, 36, 40, 45, 104, 106, 187 anxiety and, 36, 45

behavioral interventions and, 182 benefits of, 44–45

depression and, 36, 45 disadvantages of, 44, 45 ideal CBT candidates and, 24t

impairment level and, 18–19 in Jerry’s case, 50

for OCD, 35–36, 171 organizational mandate and,

10 perfectionism and, 158 research studies and, 4 rules for use of, 43t

school attendance and, 19 screening questions on, 21

for selective mutism, 18–19, 36, 105

serotonin-specific; See Serotoninspecific medication

stimulants; See Stimulants for “stuck” cases, 158 studies on, 2, 10, 35–36 time frame for, 45–46

Meditation, 197–198, 226–237, 240–242 Memory

testing of, 26

verbal working; See Verbal working memory

Mike’s case, 25

Mindfulness meditation, 197, 232–234 Moderator, 244

Modular CBT, 11, 82–84 Modules, 244 Monitoring, 16, 20

Mood disorder, 37, 107–108, 244

Mood Management (Langelier), 71 Motivation

A.B.C. rule for, 96, 163 cognitive level and, 6 in group CBT, 145

impairment level and, 18 parent input on, 128

in problem prioritization, 38 research studies and, 4–5 strategies to improve, 96–97,

165–167 MTA study, 36 Mulle, K.

OCD in Children and Adolescents, 71, 118

Multidimensional Anxiety Scale for Children (MASC), 19, 183

“Munchausen-by-proxy,” 50

Murdock, Maureen

Spinning Inward, 234 Mutism, selective

behavioral interventions for, 69, 105, 110

definition of, 245

developmental delays and, 104–105 group CBT and, 143

medication for, 18–19, 36, 105 parenting book on, 118 self-consciousness and, 110 social anxiety and, 104–105, 110 strategies for, 110–111

studies on, 69

therapeutic engagement and, 18–19

N

Nancy’s case, 169, 191–192 Negativity

challenging, 109, 207–208 contagious, 148, 244 depression and, 78 externalization and, 93 feelings engendered by, xvi overgeneralization and, 78, 166 parental, 46, 127, 129

stigma of therapy and, 91 Nelson, W.M.

Keeping Your Cool, 71 Nicholas’ case, 179, 192–193 Nightmares, 240–241

Nonverbal learning disabilities (NVLD), 5–6, 187, 195

Nutrition, 46; See also Eating NVLD; See Nonverbal learning disabilities

O

Obsessive compulsive disorder (OCD) booster sessions and, 171

in children vs. adults, 89 expectations of treatment for, 6 family-focused protocols for, 117 goals of therapy for, 6, 93

group CBT and, 137 in Jeff’s case, 118–119

in Jerry’s case, 50, 184 medication for, 35–36, 171

OCD in Children and Adolescents, 71, 118

POTS Study, 35–36 screening for, 17, 19 sleep and, 119

therapy group for, 27–28 Obsessive thinking, 20 Obstacles, therapeutic

in case studies, 158–159 identification of, 3, 160–167,

162t

studies on, 157–158 worksheet, 168

OCD; See Obsessive compulsive disorder (OCD)

OCD in Children and Adolescents (March

& Mulle), 71, 118 Operationalizing the problem,

17, 22 Oppositional behavior

in community setting, 8 concurrent therapies and, 104 fear and, 208

ground rules and, 107 modular approach and, 82 reasoning with, 129 session structure and, 91 situational factors, 20 therapeutic alliance and, 77 in Vicky’s case, 29

Oppositional defiant disorder, 19, 244

Oppositionality, 8, 77, 82 Organizational factors, 3t, 8–10

P

Pain, 105, 197, 208, 232 Panic attacks

cognitive performance during, 196

parental, 125

screening questions on, 17 strategies for, 22–23, 127, 196 symptoms of, 208

Parenting books, 18, 118, 124

Parenting groups benefits of, 145

brainstorming by, 131, 145 ground rules for, 145

problem solving in, 76, 126, 131 session content, 186

strategies for, 145–146, 190–191 termination of CBT and, 172

Parents

with ADHD, 120, 121

behavioral principles for, 128–132, 206–207

cognition level and, 6 consistency of, 46, 126, 132, 209 coping support from, 122t, 124–

125, 128–130, 207 coping with behavior of, 127

custody arrangements of, 4, 24t, 50, 122–123, 184

divorce of, 122–123, 122t education of, 5

in exposure exercises, 9, 198

in Fear-Masters program, 199–211 frustration of, 124–125

in group CBT, 28

homework for, 124, 126–127, 199 of ideal CBT candidates, 23–24, 24t involvement of, 35, 90–91, 117–

132, 122t limit setting by, 29

manual modifications for, 78 marital therapy for, 120 organizational skills of, 5, 24t, 121 planning ahead by, 211

positive reinforcement of, 199 progress recognition by, 122t, 123–124 psychopathology of

addressing, 120 concurrent work with, 6 coping skills and, 124–126

for ideal CBT candidates, 24t organizational skills and, 121 parent groups and, 145, 186 progress and, 122t, 123–124 support of strategies and, 183

questionnaires for, 18 reports from, 16, 18, 21 resources for, 132

role of, 57–58, 176 same sex, 121

school-based CBT and, 150 separation of, 122–123, 122t support of strategies by, 76,

181–182, 199, 205 Paroxetine, 245

P.A.S.T.E. problem-solving approach, 130–131, 210, 244

Paul’s case, 107–109, 115, 188

Pavlov’s dog experiment, 196 Peers, child

activities with, 108 bullying by; See Bullying in group CBT, 28 impact of, 22

teasing by; See Teasing Penn Resiliency Program (PRP),

140 Perfectionism

brainstorming and, 96 choice and, 20

Fear-Masters modules for, 220, 222–223

impact of, 206 medication and, 158 positive feedback and, 96

progress recognition and, 55 Performance anxiety, 21 Personality disorders, 120 Phobia, 69, 186

Physical examinations, 21, 108 Play therapy, 44

Points, 84, 174, 209, 241–242 Positive-thinking strategies, 74 Posttraumatic stress disorder (PTSD)

behavioral interventions for, 69

biological vulnerability to, 62 in Carrie’s case, 37–39 imaginal exposure in, 105,

244

parental trauma and, 39, 105 serotonin-specific medication and,

36

studies on, 36, 69 POTS Study, 35–36

Praise

effective, 124

in Fear-Masters program, 199, 209 ineffectual, 122t

rapport building and, 91 rules for use of, 96–97 selective mutism and, 110

Probabilistic thinking, 47, 83, 195, 245

Problems

alternative solutions to, 131 in community setting, 8 listing of, 37

“one at a time” rule, 42, 76, 131, 145

P.A.S.T.E. approach to, 130–131, 210, 244

prioritizing of, 2, 38, 41, 48 in research setting, 2, 4

PRP; See Penn Resiliency Program Pseudo-CBT, 74

Psychodynamic therapy combined with CBT, 44 conclusion of, 171

for depression, 69 group CBT and, 9 intensity of, 69

parent–child interaction and, 130, 165

studies on, 69

transference identification, 165, 166

Psychoeducational assessment, 39, 106, 187, 188

PTSD; See Posttraumatic stress disorder Puberty, 22

Q

Questionnaires

during assessment, 18, 19–20 CDI, 19

goal setting and, 56 Koala Fear, 93 MASC, 19, 183

for parents, 18 RCMAS, 19

for research studies, 4–5

SASC, 183

SCARED, 19

Spence Anxiety Inventory, 19

Y-BOCS, 19

R

Ralph’s case, 18, 21 Rapee, R.

Cool Kids, 71

RCMAS; See Revised Children’s Manifest Anxiety Scale

Reading skills assessment of, 20

for Fear-Masters program, 198

group CBT, suitability for, 28

strategy modification for low, 94

of withdrawn children, 110 Reasoning, 6, 22, 83, 202 Relaxation strategies

in Carmen’s case, 27 choice of, 27

diaphragmatic breathing, 29, 47, 94, 176

family involvement with, 128

in Fear-Masters program, 227–230 for group CBT, 144

imagery use in, 27 practicing of, 176 situations for, 74

for young children, 94 Research coordinators, 9–10 Resiliency, 11, 83, 245

Revised Children’s Manifest Anxiety Scale (RCMAS), 19

Rigidity, 21 Rituals

assessment of, 17 culture and, 121 graduation, 174 in Jeff’s case, 118 in Jerry’s case, 50

in Madison’s case, 119 in OCD, 6

Roger’s case, 40–42, 45

Role-playing manual on, 77

in online video games, 66, 185

during sessions

as characters in games, 110 in Fear-Masters program, 208 giving a friend advice, 110 using new skills, 77, 183

S

SASC; See Social Anxiety Scale for Children

SCARED; See Screen for Child AnxietyRelated Emotional Disorders

Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), 16

School

academic problems in, 22, 187–188 aggressive behavior at, 9, 113 attendance at; See Attendance, school behavioral observations in, 16 bullying in; See Bullying

homework, 23, 46, 62 involvement in therapy, 23, 76, 90 medical conditions and, 113 suspension from, 9, 41

symptoms at, 23 time frame for, 127 transfer to new, 22

School-based CBT acceptability of, 10 for adolescents, 140 benefits of, 148–149

effectiveness of, 10, 140 FRIENDS program, 139–140, 148 implementation of, 139

in intervention triangle, 139f location for, 150, 189–190 manuals for, 139

selection criteria for, 149 strategies for, 149–151 studies on, 139–140, 149 Screen for Child Anxiety-Related

Emotional Disorders (SCARED), 19

Screening, diagnostic APA on, 17

for comorbid disorders, 19

in group supervision program, 2 organizational structure and, 8 paper and pencil; See Questionnaires in research setting, 4, 7

verbal; See Interviews, diagnostic Screening, drug, 108

Secure attachment, 203 Seizures, 111, 188–189 Self-consciousness

in adolescents, 22

praise and, 96–97, 110, 124 strategies for, 104, 110

Self-esteem

in Carrie’s case, 37 coping skills and, 44 cultural identity and, 81 definition of, 62, 245 groups focused on, 37, 39 in Jenny’s case, 61–62

in Paul’s case, 107

Self-harm behavior; See also Suicide Self-observation, 197

Sensory sensitivities, 21 Separation anxiety

behavioral intervention for, 26, 27, 92–93, 162–163

coping exercise for, 77 Fear-Masters modules for, 221–222 progress in therapy for, 58 regression, 192

sleep and, 58, 106 in Tony’s case, 27

Sequential therapies, 44, 245 Serotonin-specific medication, 36, 50,

105, 245 Sertraline, 36, 245 Sessions

attendance at; See Attendance, session

booster; See Booster sessions bridges between, 75 concurrent adult and child, 43 in Fear-Masters program, 200,

210

ground rules for, 91–92, 107

homework; See Homework, CBT for modular CBT, 83–84 number of, 56–57, 77–79 scheduling of, 63

seating arrangements during, 79, 91

setting of, 2, 9 structure of, 74–76, 162

taping of, 7, 8, 123, 158, 200 time frame for, 173, 175

Short-term dynamic therapy, xvi Shyness; See also Social anxiety

Fear-Masters modules for, 220–221 group CBT and, 28

positive feedback on overcoming, 207

rapport building and, 77 in Tom’s case, 182–184

Sleep

disengagement and, 79 inability to, 25, 208 irregularities in, 21 OCD and, 119

regulation of, 21, 46, 208 screening questions on, 18, 182 separation anxiety and, 58, 106

S.N.A.P. (Child Development Institute), 71

Social anxiety

behavioral inhibition and, 16 culture and, 81

group CBT and, 6–7, 28, 138, 143, 184

precursors of, 16 SASC, 183

school-based CBT for, 140 screening for, 19

selective mutism and, 104–105, 110

situational factors, 23 skills to reduce, 77

in Tom’s case, 182–184 Social Anxiety Scale for Children

(SASC), 183 Social skills training, 183 Socratic questions

for adolescents, 166 confidence and, 95–96, 110

definition of, 245

in Fear-Masters program, 199–200 Speech, 36, 110

Spence Anxiety Inventory, 19

Spinning Inward (Murdock), 234 Sports, 127–128

Spousal abuse, 29 Stallard, P.

Think Good–Feel Good, 71

Starbright (Garth), 234 Stark, K.D.

“ACTION” Workbook, 71, 139 Taking Action, 71, 83, 139

Stimulants

ADHD and, 36, 40, 104, 106 administration of, prior to CBT, 40 anxiety disorders and, 104 definition of, 245

dosage adjustments, 41 studies on, 36

in Wendy’s case, 106

Stop and Think (Kendall), 71 Suicide

attempted, 29

child’s thoughts of, 148, 188 family history of, 107 parental thoughts of, 125 research studies and, 4 threat of, 182

Support groups, child

for low self-esteem, 37, 39

for separated/divorced parents, 176 Support groups, parent; See Parenting

groups

Supportive therapy, 25, 38–39, 175, 184 Support staff, 9

T

TADS Study, 36

Taking Action (Stark & Kendall), 71, 83,

139

Tantrums, 21, 96, 106, 172

Teaching Problem Solving (Kendall &

Bartel), 138

Teasing

coping with, 39, 50

depression and, 100

262

about meditation, 234 social anxiety and, 37 supportive therapy for, 184

talking with school officials about, 39

witnessing of, by adults, 187 Telephone

cellular, 96

for initial contact, 108

parental contact through, 25, 127 progress reports by, 175

refusal to answer/use, 23, 55, 183

use in therapy, 9, 175 Television, 113 Temperament, 21 Tension, symptoms of, 208 Termination of CBT

concurrent therapies and, 44, 60

definition of, 245 expectations of, 60, 173 graduation rituals, 174 manuals on, 172 prematurely, 39, 58 preparation for, 172–174 relapse prevention, 176

reliance on therapist and, 56–57, 60, 174–175

strategies for, 172–175, 192–193 studies on booster sessions,

171–172 therapeutic alliance and, 54 worksheet, 178

Tertiary care, 139f Test-taking anxiety, 16 Therapeutic alliance

with adolescents, 53–54 challenges to, 53

culture of client/therapist and, 165

definition of, 245 establishment of, 77, 91

for group CBT, 144–145, 147–148 manuals and, 72, 79–80 oppositional behavior and, 77 problems with, 164–165

studies on, 53–54

Index

termination of CBT and, 54 with young children, 53

Therapeutic drift, 73, 164 Therapeutic flexibility, 70, 165, 245 Therapists

age of, 145 characteristics of, 95

community practitioners, xv consultation by; See Consultation of

colleagues

cultural sensitivity of, 2, 81–82, 120–121

factors affecting, 3t, 7–8 frustration with, 125

getting started worksheet, 12 ground rules of; See Ground rules group supervision program for, 2–3 in research setting, 7

role of, 57–58 rotation of, 57, 173 self-disclosure by, 91

technique use by, 2, 7, 80 visits by, 9, 95, 108

Think Good–Feel Good (Stallard), 71 Thyroid problems, 21, 108 Time-outs, 124, 209

Timing worksheet, 48–49 Tom’s case, xiii–xiv, 182–184 Tony’s case, 27 Transference, 165, 166, 245 “Treasure Map, The,” 238

Treating Depressed Children (Charma), 71 Treatment

advice to a friend, 110 athletic metaphor for, 57–58 checklists for, 7, 8, 73, 74–76

conclusion of; See Termination of CBT

concurrent; See Concurrent therapies concurrent parent work in, 6, 43, 80,

120, 142 continuity in, 75, 162

cotherapist role in, 28, 94, 142, 147

effectiveness/efficacy of, 1, 244

expectations of; See Expectations of treatment

goals of; See Goals good cop/bad cop, 94 leading the witness, 110

level of functioning and, 39, 92, 92f

manualized, 70–82 math metaphor for, 58 modularized, 82–84 one size fits all, 82

in research setting, 7 resistance to, 66, 107–109,

165–167

sequencing therapies in, 43t, 44 Socratic questioning; See Socratic

questions strategies for, 93–97

talking in the third person, 110 team approach to, 9, 94 termination of; See Termination of

CBT time for, 56–57

Treatment fidelity, 73, 74–76, 245 Trust/rapport; See also Therapeutic

alliance

in initial sessions, 72, 74, 77, 83

parental attendance and, 123 worksheet, 98

U

Universality, 28, 143, 245

V

Validation of experience, 95 Verbal learning disabilities (LD), 5,

196

Verbal working memory ADD and, 196

ADHD and, 5, 104, 107 definition of, 5, 83, 245 learning disabilities and, 5–6,

196 modules and, 83 testing of, 26

Vicious cycles, 245

Vicky’s case, 29, 94, 181–182

W

“Wave, The,” 228–229 Web sites, 113

Weight, concerns about, 37 Wendy’s case, 106–107, 115, 187–188

Withdrawn children anxious, 109–111 depressed, 107–109 group CBT and, 6, 143 medication for, 19, 45

mute; See Mutism, selective Paul’s case, 107–109 positive reinforcement of, 96,

104 situational factors, 23

treatment strategies for, 104–111 Worksheets

assessment, 30–31 challenging child, 114 challenging families, 133–134 expectations, 64–65

getting started, 12 group CBT, 152–153 manuals, 85–86 termination of CBT, 178

therapeutic obstacles, 168 timing, 48–49

working with children, 98–99 Writing skills

for exercises, 77, 94

for Fear-Masters program, 198 group CBT, suitability for, 28 for homework, 75, 94

in Jenny’s case, 61

Y

Yale Brown Obsessive Compulsive Scale (Y-BOCS), 19

Yerkes-Dodson curve, 196, 199, 245 Young children

assessment of, 16, 18, 20 concurrent parent work and, 120 environment and, 18

goals of therapy for, 55 manuals for, 93

parent in sessions with, 43, 123, 127, 198

precursors of disorders in, 16 rating of feelings, 93 relaxation strategies for, 94

reports from, 16, 20 strategies for, 93–94 symptom endorsement by,

5

therapeutic alliance with, 53