This is the golden age of cognitive therapy. Its popularity among society and the professional community is growing by leaps and bounds. What is it and what are its limits? What is the fundamental nature of cognitive therapy? It is, to my way of thinking, simple but profound. To understand it, it is useful to think back to the history of behavior therapy, to the basic development made by Joseph Wolpe. In the 1950s, Wolpe astounded the therapeutic world and infuriated his colleagues by finding a simple cure for phobias. The psychoanalytic establishment held that phobias-irrational and intense fear of certain objects, such as cats-were just surface manifesta tions of deeper, underlying disorders. The psychoanalysts said their source was the buried fear in male children of castration by the father in retaliation for the son's lust for his mother. For females, this fear is directed toward the opposite sex parent. The biomedical theorists, on the other hand, claimed that some as yet undiscovered disorder in brain chemistry must be the underlying problem. Both groups insisted that to treat only the patient's fear of cats would do no more good than it would to put rouge over measles. Wolpe, however, reasoned that irrational fear of something isn't just a symptom of a phobia; it is the whole phobia."

Much has been written about the basic incompatibility of the dominant quantitative research model in psychotherapy and the qualitative preferences of the practitioner community providing psychotherapy. Researchers and clinicians are at odds over the most valuable type of knowledge needed: that emerging from quantitative, experimental research versus that from qualitative, case-based practice, respectively. Recently, a number of emerging research methods have attempted to bridge and integrate these two approaches. Case Studies within Psychotherapy Trials is one such effort and significantly furthers the synergy between them. The volume provides a comprehensive illustration of the "cases-within-trials" (CWT) model of research. Quantitative findings from four randomized clinical trials (RCT) are synthesized with qualitative and quantitative findings from systematic case studies of successful and unsuccessful clients representatively drawn from each RCT. The book opens with the history of dialectic and political controversy in psychotherapy research and recent initiatives to bridge the differing perspectives. The RCT and case study projects follow, each commented on by outside experts. In the final chapter the editors compare and contrast the separate projects and draw insightful, impactful conclusions. By bringing together quantitative, natural scientific perspectives on research and qualitative, interpretative understandings and strategies, the chapter authors demonstrate how practitioners can be meaningfully included in future psychotherapy research. This book will be of great interest to psychotherapy researchers and practitioners and those interested in research methods in the behavioral sciences more generally.

The most comprehensive guide to cognitive-behavioral therapy (CBT) with clients in crisis is now in a significantly revised fourth edition with 75% new material. Over 15 years of clinical and research advances are reflected in fully updated chapters on evidence-based brief strategies for helping people cope in highly stressful situations. From leading experts, the book addresses suicide prevention, crises related to mental and physical health problems, child and family crises, and exposure to disasters and mass or community violence. Vivid case material illustrates what the interventions look like in action and how to tailor them to individual clients' needs.

New to This Edition

*Chapter on clinician self-care.

*Chapters on managing the involuntary hospitalization process, working with psychosis in inpatient settings, intervening with clients at risk for mass violence, and more.

*Chapters retained from the prior edition are all updated or rewritten to incorporate current data, clinical strategies, and assessment tools.

*All of the case examples are new.

Table of Contents

Foreword, Robert L. Leahy

I. Introduction

1. Crisis Intervention: An Overview, Frank M. Dattilio, Daniel I. Shapiro, & D. Scott Greenaway

2. Ethical and Legal Issues in Crisis Intervention, Jeffery E. Barnett

II. Psychological Crises

3. Effectively Managing Suicidal Crises, David A. Jobes, Ethan W. Graure, & John Paul Ryan

4. Cognitive-Behavioral Therapy for Anxiety-Related Crises, D. Scott Greenaway

5. Working with Psychosis in Inpatient Settings, Katherine Eisen, Sripriya Chari, & Kate Hardy

6. Suicide Prevention with Borderline Personality Disorder, Daniella C. Cavenagh & Dara G. Friedman-Wheeler

III. Medically Related Crises

7. Dementia-Related Crises, Susmita Halder, Akash Kumar Mahato, & D. Scott Greenaway

8. Crises in Substance Misuse and Dependence, Sharon M. Freeman Clevenger, James W. Sturges, & Misti Storie

9. Crises Related to Acute and Chronic Pain, Hillary L. Ditmars, Jenna Sandler Eilenberg, & John D. Otis

10. Crises in Integrated Health Settings and Life-Threatening Illnesses, Joseph R. Pellizzari, Tyler G. Tulloch, & Randi E. McCabe

IV. Child and Family Crises

11. Child Sexual and Physical Abuse, Justin R. Misurell, Jaclyn M. Zocca, & Lindsay Anderson

12. Couples in Crisis, Norman B. Epstein, Stephen E. Schlesinger, & HaeDong Kim

13. Families in Crisis, Frank M. Dattilio & Allison Schoenly

14. Child and Adolescent Disorders, Stephen Timchack

15. Crises with Older Adults, Allison Schoenly & Robert J. Berchick

V. Environmental and Situational Crises

16. Disaster Trauma, Lata K. McGinn, Lauren Bonavitacola, & William Buerger

17. The Involuntary Hospitalization Process, Daniel I. Shapiro & Stephania L. Hayes

18. Terrorism, Patricia J. Watson, Daphna Canetti, & Stevan E. Hobfoll

19. Major Threats of Violence: Evaluation and Management, John S. Rozel, Patrick McCormick, & Jaqulyn Stilson

20. Intervention for Police Following Deadly Force Encounters, Laurence Miller

VI. Concluding Topics

21. The Self-Care of Mental Health Crisis Professionals, Frank M. Dattilio

22. Afterword, Frank M. Dattilio, Daniel I. Shapiro, & D. Scott Greenaway

Index

This is the golden age of cognitive therapy. Its popularity among society and the professional community is growing by leaps and bounds. What is it and what are its limits? What is the fundamental nature of cognitive therapy? It is, to my way of thinking, simple but profound. To understand it, it is useful to think back to the history of behavior therapy, to the basic development made by Joseph Wolpe. In the 1950s, Wolpe astounded the therapeutic world and infuriated his colleagues by finding a simple cure for phobias. The psychoanalytic establishment held that phobias-irrational and intense fear of certain objects, such as cats-were just surface manifesta tions of deeper, underlying disorders. The psychoanalysts said their source was the buried fear in male children of castration by the father in retaliation for the son's lust for his mother. For females, this fear is directed toward the opposite sex parent. The biomedical theorists, on the other hand, claimed that some as yet undiscovered disorder in brain chemistry must be the underlying problem. Both groups insisted that to treat only the patient's fear of cats would do no more good than it would to put rouge over measles. Wolpe, however, reasoned that irrational fear of something isn't just a symptom of a phobia; it is the whole phobia."

From leading cognitive-behavioral therapy (CBT) experts, this book describes ways to tailor empirically supported relationship factors that can strengthen collaboration, empiricism, and Socratic dialogue and improve outcomes. In an accessible style, it provides practical clinical recommendations accompanied by rich case examples and self-reflection exercises. The book shows how to use a strong case conceptualization to decide when to target relationship issues, what specific strategies to use (for example, expressing empathy or requesting client feedback), and how to navigate the therapist's own emotional responses in session. Special topics include enhancing the therapeutic relationship with couples, families, groups, and children and adolescents. Reproducible worksheets can be downloaded and printed in a convenient 8 1/2" x 11" size.

See also Doing CBT, Second Edition, by David F. Tolin, which lucidly explains the full range of CBT techniques, and Experiencing CBT from the Inside Out, by James Bennett-Levy, Richard Thwaites, Beverly Haarhoff, and Helen Perry, a unique self-practice/self-reflection workbook.

Table of Contents

Foreword, Judith S. Beck

1. Introduction

2. Defining the Therapeutic Relationship in CBT

I. Generic and CBT-Specific Relationship Elements

3. Tailoring Empirically Supported Relationship Elements with Cognitive Case Conceptualization

4. Collaboration and Empiricism

5. Socratic Dialogue and Guided Discovery

II. Application of the Guidance in Therapy

6. Setting Agendas and Establishing Pace and Session Goals

7. Behaviorally Focused Interventions

8. Cognitively Focused Interventions

9. Cognitive and Behavioral Experiments

10. Between-Session (Homework) Interventions

11. Concluding Relationships and Relapse Prevention

III. Therapist Reactions and Therapy Contexts

12. Ethics and Safeguards to the Therapeutic Relationship

13. Identifying and Managing Therapist Reactions

14. Working with Couples, Families, and Groups

15. Working with Children and Adolescents, Mark J. Knepley, Hannah Frank, and Philip C. Kendall

References

Index

From a leading expert in cognitive-behavioral therapy and couple and family therapy, this comprehensive guide combines research and clinical wisdom. The author shows how therapeutic techniques originally designed for individuals have been successfully adapted for couples and families struggling with a wide range of relationship problems and stressful life transitions. Vivid clinical examples illustrate the process of conducting thorough assessments, implementing carefully planned cognitive and behavioral interventions, and overcoming roadblocks. Used as a practitioner resource and text worldwide, the book highlights ways to enhance treatment by drawing on current knowledge about relationship dynamics, attachment, and neurobiology. Cultural diversity issues are woven throughout. See also Dattilio's edited volume, Case Studies in Couple and Family Therapy, which features case presentations from distinguished practitioners plus commentary from Dattilio on how to integrate systemic and cognitive perspectives.

From a leading expert in cognitive-behavioral therapy and couple and family therapy, this comprehensive guide combines research and clinical wisdom. The author shows how therapeutic techniques originally designed for individuals have been successfully adapted for couples and families struggling with a wide range of relationship problems and stressful life transitions. Vivid clinical examples illustrate the process of conducting thorough assessments, implementing carefully planned cognitive and behavioral interventions, and overcoming roadblocks. Read and used by clinicians worldwide, the book highlights ways to enhance treatment by drawing on current knowledge about relationship dynamics, attachment, and neurobiology. Cultural diversity issues are woven throughout. See also Dattilio's edited volume, Case Studies in Couple and Family Therapy, which features case presentations from distinguished practitioners plus commentary from Dattilio on how to integrate systemic and cognitive perspectives.

Why do standard, evidence-based interventions fail to work for certain clients or in certain situations? What tools do cognitive-behavioral theory and therapy offer for managing difficult cases? This cutting-edge volume brings together an array of leading practitioners to address these and other critical questions that are often overlooked in the CBT literature. Each research-based chapter addresses a specific kind of "roadblock," exploring how and why it arises and suggesting effective, practical solutions. Topics include overcoming obstacles in the treatment of specific disorders, new directions in case conceptualization, working with emotional and metacognitive processes, and applications to couple and family therapy.

This volume features case presentations by many of the most distinguis hed practitioners of couple and family therapy, bringing to life the f ull spectrum of contemporary approaches in the field. Selected to illu minate the process and goals of each approach and to allow readers to listen in on highly skilled therapists at work, these exemplary cases serve together as a uniquely practical clinical resource for therapist s and students. Exploring the role that cognitive-behavioral strategie s may play within contemporary systems approaches, editor Frank M. Dat tilio annotates the cases throughout with concise recommendations on h ow cognitive principles might usefully be called upon at specific poin ts. Candid responses from contributors consider the benefits of Dattil io's suggestions and further elucidate each practitioner's decision-ma king process.

This volume features case presentations by many of the most distinguis hed practitioners of couple and family therapy, bringing to life the f ull spectrum of contemporary approaches in the field. Selected to illu minate the process and goals of each approach and to allow readers to listen in on highly skilled therapists at work, these exemplary cases serve together as a uniquely practical clinical resource for therapist s and students. Exploring the role that cognitive-behavioral strategie s may play within contemporary systems approaches, editor Frank M. Dat tilio annotates the cases throughout with concise recommendations on h ow cognitive principles might usefully be called upon at specific poin ts. Candid responses from contributors consider the benefits of Dattil io's suggestions and further elucidate each practitioner's own decisio n-making process.

*Major revision of a key clinical guide and text; 75% new material includes numerous new chapters reflecting 15 years of advances in the field. *State-of-the-science information on specific types of crises, plus new coverage of legal and ethical issues and clinician self-care. *Practical--CBT strategies are brought to life by rich case material. *From highly regarded editors and contributors.

What do you do when you run into a patient in a public place? How do you respond when a patient suddenly hugs you at the end of a session? Do you accept a gift that a patient brings to make up for causing you some inconvenience? Questions like these - which virtually all clinicians face at one time or another - have serious clinical, ethical, and legal implications. This authoritative, practical book uses compelling case vignettes to show how a wide range of boundary questions arise and can be responsibly resolved as part of the process of therapy. Coverage includes role reversal, gifts, self-disclosure, out-of-office encounters, physical contact, and sexual misconduct. Strategies for preventing boundary violations and managing associated legal risks are highlighted.