Pre-Conference and Conference Abstracts 

Pre Conference Workshop

Title: CBT in Adjustment to Chronic Illness

Presenter: Professor Louise Sharpe, Sydney University

Date: 19 November 2018

 

Adjustment is, invariably defined in the literature as some aspect of psychological function. However, in reality, adjustment is a process that begins at the point of diagnosis, continues throughout the course of the illness and responds to changes in illness status. Recent research confirms that many of the factors known to be associated with the development of psychological disorders in the absence of physical illness are also relevant to the development of psychological problems in those with ill health. The prevalence of psychological disorders is also generally found to be considerably higher amongst those with a variety of health problems. Nonetheless, a considerable number of patients who experience even the most devastating of illnesses seem able to adjust to illness without experiencing clinically significant psychological problems. The process(es) by which these people are able to adjust and, in many cases, find positive meaning in their experiences, is important to understand in order that we might be able to better facilitate adjustment amongst those who fail to negotiate this process without intervention.

This workshop will describe a model of adjustment to illness. From that theoretical position, ways of adapting cognitive-behavioural approaches (CBT) to various stages of the adjustment process will be discussed and demonstrated. This workshop will outline the similarities and differences in using CBT with people in poor health, using examples from a range of illnesses. In addition, other strategies that help patients negotiate the process of adjustment will be considered, including: helping patients change their beliefs that were adaptive prior to ill health but may no longer be; helping patients to disengage their illness-schema from their self-schema; encouraging the search for positive meaning in adversity and encouraging response shift. This workshop will suit people with experience in cognitive-behavioural therapy who wish to improve skills in working with patients where psychological problems arise in the context of real and distressing situations, such as being chronically unwell.

 

Workshop Summary: Learning Outcomes

• Understand Prof Sharpe’s model of adjustment to illness
• Learn how to adapt CBT to various stages of the adjustment process
• Understand the similarities and differences in using CBT with people in poor health, using examples from a range of illnesses, especially anxiety and depression
• Discover key strategies that help negotiate the process of adjustment, using schemas, beliefs and acceptance processes

 

ANZACBT 2018 National Conference

Half-Day Workshop

Title: How to use behavioural activation to overcome symptoms of depression

Presenter: Dr Beverly Haarhoff, Massey University Auckland

 

Behavioural Activation is an empirically supported therapy that is effective in the alleviation of depressive, and in some instances, anxiety symptoms. This practical workshop introduces the core principles of Behavioural Activation as a short-term structured intervention.

Participants will learn to:

• Conduct an individualised functional analysis of the experience of depression.
• Identify the role of avoidance as a maintaining factor
• Identify the client’s valued directions to enhance motivation
• Plan a behavioural activation intervention
• This workshop is suitable for all practitioners working in primary mental health.

 

Keynote Address

Title: Novel Interventions in Pain

Presenter: Professor Louise Sharpe, Sydney University

Chronic pain is one of the most prevalent medical conditions affecting 1 in 5 Australians. Indeed low back pain has the highest burden of all diseases for years lived with disability. Despite this, medical interventions (such as pain medication and surgery) are typically of limited value. In contrast, there are many randomized controlled trials that attest to the efficacy of cognitive behavioural therapy (CBT) for people with chronic pain. Meta-analyses have confirmed the efficacy of CBT, however, the effect sizes for CBT for pain are considerably smaller than those observed for depression or anxiety. While this is partly due to the heterogeneity of pain conditions, few experts would suggest that our current treatments (although effective) are optimal. In this keynote address, evidence for the efficacy of novel approaches to the management of pain conditions will be explored. These include novel interventions that are based on (1) theories of the development of chronic pain, such as attention bias modification; (2) interventions targeting factors that predict the outcome of intervention, such as motivational interviewing; and (3) novel approaches, such as the “third wave” therapies.

  

Workshop

Title: Is there a Place for Self-Disclosure in CBT?

Presenter: Mr Tobias Schulze

 

Therapist self-disclosure has been viewed with much suspicion in the larger psychotherapeutic traditions for many decades. CBT stances in this matter have implicitly followed this long-held view of cautionary tales and at times have taken even a position of complete taboo on the matter. Yet with the arrival of the “third wave” in CBT new therapeutic frontiers have been inhabited among these also strategies of self-disclosure. Schema Therapy has incorporated a relational stance of “limited reparenting” and Cognitive Behavioural Analysis System of Psychotherapy (CBASP) introduces “disciplined personal involvement” as major technique. Similar processes and reflections have spawned the psychodynamic traditioned with the arrival of relational psychoanalysis and two-person-psychology this old dictum of strict abstinence has come under scrutiny.  Intention of the workshop is to explore some general emerging themes among these various therapeutic approaches and establish some guidelines for a transdiagnostic process-based use of self-disclosure in CBT.

Outline:

• Use of Self-disclosure in Schema Therapy and CBASP
• Emotional processing and change in therapeutic relationship
• Guidelines for use of self-disclosure in process-oriented CBT

Learning Outcomes:

• Overcoming stereotypes around self-disclosure
• Familiarizing with strategies of self-disclosure
• Building confidence around when, how and with whom to use such a technique

 

Short Presentation.

Title: Core Beliefs as an obstacle in the treatment of a client diagnosed with Generalised Anxiety Disorder

Presenter: Ms Emma Burland

The client’s core beliefs of “I’m not capable”, “I’m not good enough” and attendant compensatory behaviours of storytelling (to show knowledge and insight), over-preparing, seeking feedback, controlling emotional responses were clearly articulated in the first three sessions of therapy. These core beliefs and compensatory behaviours became a barrier to the client understanding key concepts such as the definition of worry and the role of uncertainty, central to the evidence-based treatment protocol. Conceptualising the client’s idiosyncratic core beliefs and resultant compensatory behaviours was a crucial step in removing the therapy interfering cognitions and behaviours. Therapeutic strategies such as taking it slowly, empathy, validation and gentle guided discovery empowered the client to challenge his old ways of being and become motivated to engage with, and use these concepts to address his generalised anxiety disorder.

Towards the end of the therapy the client was able to identify and challenge his old ways of thinking from “I am not capable” e.g. “I only came to therapy because I thought I would be helping you as a student, not because I thought it would help me” to new beliefs of “I am capable” and “I can cope”.

Overall, the client made huge positive changes throughout therapy, being able to identify the core beliefs and the compensatory behaviours that maintained these was essential in helping the client understand key aspects of the Laval protocol and therapy.