Pre-Conference Workshop Abstract

Title: CBT for Depression: Not so Easy After All
Presenter: David A. Clark, PhD
Date: November 23, 2017

Cognitive therapy (CT) began as a treatment for depression. Over the years numerous CT studies have reported clinical effectiveness of 60% or greater (DeRubeis et al., 2005), lower relapse rates, improved prefrontal cortical functioning, and clinical efficacy in real-world clinical settings (DeRubeis, Siegle & Hollon, 2008; Gyani, Shafran, Laynard & D.M. Clark , 2013).  However recent evidence suggests that effect sizes for psychological treatments of depression are overestimated by 25% due to publication bias (Drissen et al., 2015).  Clearly, there is considerable room for improvement in the delivery of CT for depression. This workshop focuses on specific clinical features of depression that complicate treatment of the disorder.  Topics addressed include depressive rumination, unwanted intrusive thoughts including traumatic intrusions, avoidance and procrastination, perfectionism, reassurance seeking and dependency, and heightened suicidality.  Emphasis is placed on cognitive and behavioral intervention strategies that address each of these issues and improve treatment effectiveness.  Throughout the workshop case illustration, role play demonstrations, problem-oriented case consultation, and participant exercises are employed to enhance the cognitive therapy skills of attendees. 

Workshop participants will learn:

a)    alternative interventions for a type of spontaneous thought that is unresponsive to standard cognitive restructuring of depression

b)    to identify and treat depressive rumination

c)     to utilize specific cognitive strategies for hopelessness and heightened suicide risk

d)    to take a strategic approach to procrastination and avoidance

e)    about the cognitive formulation and treatment of perfectionism

f)     how to deal with dependency and reassurance seeking in the therapeutic relationship

 

Post-Conference Workshop Abstract

Title: Modified CBT for Persistent Anxiety and Obsessions
Presenter: David A. Clark, PhD, University of New Brunswick, CANADA
Date: November 25, 2017

Approximately two-thirds of individuals with an anxiety disorder achieve clinically significant symptom improvement with standard cognitive behavior therapy (CBT) but only 25% - 40% achieve symptom-free status. Thus a significant number of anxious clients (25%-33%) achieve only limited treatment response. This one-day workshop addresses the problem of failed or, at best, minimal response to CBT in the anxiety disorders as well as OCD. It begins with an analysis of treatment failure, the nature of treatment-resistant anxiety, and the limitations of standard CBT. The remainder of the workshop focuses on innovations in theory, assessment, case conceptualization, cognitive restructuring, and behavioral experiments that target specific features of treatment resistant anxiety and obsessional rumination.  This is an intermediate level workshop intended for mental health professionals with at least a basic understanding of CBT and clinical experience in the treatment of anxiety and OCD. 

Workshop participants will learn to

a)    address poor treatment response in order to prevent discontinuation,

b)    incorporate resistance issues into case formulation and goal setting,

c)     tailor psychoeducation to increase “buy-in” of reluctant clients,

d)    modify cognitive and behavioral strategies that target emotional reasoning, distress intolerance, and homework noncompliance,

e)    treat excessive mental control effort, and

f)     target excessive fear of losing control.