Cognitive Case Conceptualization: A Guidebook for Practitioners

Cognitive Case Conceptualization: A Guidebook for Practitioners

Cognitive Case Conceptualization: A Guidebook for Practitioners

Cognitive Case Conceptualization: A Guidebook for Practitioners

Synopsis

For cognitive therapy to be successful, therapists must identify the key factors that contribute to their clients' problems. Effective cognitive case conceptualization necessarily precedes appropriate targeting and intervention selection. It requires the integration of the results of a comprehensive assessment into a strong conceptual foundation.

Solidly grounded in recent research, and focusing particular attention on important new theoretical developments, this book first offers a comprehensive overview of the contemporary cognitive model of therapy. It then lays out detailed, easy-to-follow procedures for assessing within a cognitive framework, developing effective individualized cognitive case conceptualizations, and implementing state-of-the-art interventions based on them. A step-by-step guide for concisely summarizing and representing the salient features of a client's presentation is included. Extensive case histories bring to life the entire process of cognitive therapy--assessment, conceptualization, and intervention--for several clients with a variety of complex clinical problems: panic disorder with agoraphobia, obsessive-compulsive disorder, and chronic or recurrent major depressive disorder.

Cognitive Case Conceptualization will become an indispensable desk reference for many experienced clinicians as well as trainees.

Excerpt

Contemporary psychotherapy has taken a decidedly scientific turn as we enter the 21st century. The definition of the therapist as simply a good listener whose job it is to help the patient feel better has changed to the definition of the therapist as an active and directive participant-observer whose job it is to help the patient get better. Indeed, long before the advent of managed care, cognitive behavioral therapists were practicing an empirically based model of treatment planning and therapy.

All empirically based models of therapy are the product of an interaction between scientists and practitioners. They are developed and then tested, using standardized protocols. Psychodynamic models (e.g., interpersonal therapy [IPT]) and the cognitive behavioral therapy (CBT) model have several points in common.

They both call for a time-limited approach to therapy. Efficacy research protocols generally involve around 12 to 20 sessions, over a period of no more than 20 weeks. In clinical practice, however, the course of treatment is not limited to 20 weeks. For certain patients the length of therapy may be 6 sessions; for other patients, 50 sessions. The length of the therapy, the frequency of the sessions, and the session length are all negotiable. The problems being worked on, the skills of the patient and of the therapist, the time available for therapy, and the financial resources all have the potential to dictate the parameters of treatment. The goal is not simply to limit the number of sessions, but also to determine their most effective use so that even the patient who can come for unlimited sessions can best be worked with in a framework requiring that the therapy be "administered" in a pre-set modular fashion. The modular approach of working in 5- to 10-session blocks of time and effort keep the therapy, the therapist, and the patient on target.

The treatment protocols associated with empirically based models generally have been seen by some as negative and derided as "cookbooks." In point of fact, adherence to a treatment protocol has a positive impact on both patient and therapist in that it helps to maintain a focus in the therapy.

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