The Widening Scope of Cognitive Behavioral Therapy
Robert M. Goisman, MD,
Matcheri S. Keshavan, MD
July 31 – August 4, 2017 • Monday – Friday
The influence of cognitive-behavioral therapy (CBT) is widening. From its beginnings as a treatment for specific phobias, CBT is now indicated as primary or adjunctive treatment for a wide range of mood, anxiety, and psychotic disorders. Simultaneously, cognitive impairments are increasingly being viewed as core disturbances in several neuropsychiatric disorders and are benefited by a cognitive approach such as cognitive remediation. Topics in this course will include a brief review of the development of behavioral and cognitive treatments; anxiety disorders, including panic, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder; mood disorders; principles underlying the development of cognitive remediation for schizophrenia, mood disorders, ADHD, mild cognitive impairments, and autism; social skills training and cognitive restructuring for psychotic disorders; and the relationship of CBT to psychodynamic psychotherapy. We will review efficacy data and therapeutic mechanisms for cognitive remediation approaches and discuss cognitive therapy approaches for bipolar disorder and for the treatment of delusions, hallucinations, and negative symptoms of schizophrenia. We will in part utilize a case presentation format, in which a case illustrating the subject matter of that morning will be presented and then discussed using the principles just developed. Live role-playing exercises will also be used to illustrate the application of social skills training principles and methods for induction of the relaxation response. Participants will be invited to present their own cases for consultation.
Upon completion of this seminar, participants will be able to:
- Utilize specific techniques for anxiety reduction in patients with anxiety disorders;
- Evaluate specific CBT interventions used in panic disorder, obsessive-compulsive disorder, phobias, and PTSD;
- Apply cognitive and behavioral therapy methods in the treatment of patients with unipolar depression and with bipolar disorder;
- Review principles and approaches to cognitive restructuring as they apply to the serious and persistently mentally ill, and what we know about the efficacy of these interventions;
- Determine areas of convergence as well as divergence in the relationship between CBT and psychodynamic psychotherapy;
- Gain a basic understanding of cognitive deficits and impaired neuroplasticity in schizophrenia;
- Learn principles of cognitive remediation as applied to schizophrenia and related disorders;
- Apply approaches to cognitive remediation in schizophrenia and evidence for their efficacy;
- Describe the Cognitive Triad of depression and its relationship to treatment;
- Discuss the Relaxation Response and its use in the treatment of anxiety disorders;
- Describe similarities and differences in the cognitive-behavioral treatment of unipolar depression and bipolar disorder;
- Discuss how psychotic disorders are on a continuum with neurotic disorders.
- Learning Theory and Anxiety Disorders I: brief overview of cognitive and behavioral theory; Case I; the relaxation response and mindfulness meditation; the principle of exposure; making anxiety hierarchies.
- Anxiety Disorders II: Applications to phobias and obsessive-compulsive disorder; cognitive-behavioral treatment of panic attacks; drug and non-drug treatments; safety behaviors; Anxiety Disorders III: Case II; approaches to post-traumatic stress disorder; exposure treatments in PTSD; stress inoculation.
- Mood Disorders I: Case III; the cognitive triad; schemas and automatic thoughts; behavioral approaches and other homework tasks; Mood Disorders II: Daily Record of Dysfunctional Thoughts; collaborative empiricism and hypothesis-testing; other cognitive strategies; indications and limitations; applications to bipolar disorder.
- Cognitive Remediation I: Principles; Cognitive Remediation II: Techniques and evidence for efficacy.
- Psychotic Disorders: social skills training and cognitive restructuring in psychotic disorders; new approaches to negative symptoms; CBT and Psychodynamic Psychotherapy; the "Common Factors" movement; convergence and divergence with psychodynamic psychotherapy; the “Y-Model”; comparative outcome studies.