Pub Date : 2022-05-07DOI: 10.1177/15346501221099651
McKenzie R. Martin, J. Bolden, Jaima Walton
Anxiety and depression are two of the most common mental health diagnoses in adolescents, with higher prevalence rates for gender-nonconforming youth relative to an age-equivalent population of cisgender youth (Veale et al., 2017). This case study examined the effectiveness of the Unified Protocol-Adolescent (UP-A) for a gender-nonconforming 13-year-old diagnosed with both generalized anxiety and mild depression. Amid the ongoing COVID-19 pandemic, this transdiagnostic implementation provided psychoeducation and targeted emotion identification, present-moment awareness, cognitive restructuring, and problem-solving over 21 sessions. Outcome data demonstrated significant reductions in anxiety and depression symptoms, with a notable qualitative change on three subjective measures of anxiety/depression symptoms, as ratings moved from clinical to nonclinical score ranges. Moreover, outcome data demonstrated the potential efficacy of the UP-A administered via telehealth for nonbinary youth with comorbid anxiety and depression. Clinical and research implications regarding the utility of implementing a flexible, transdiagnostic approach to treating diverse adolescents’ emotional disorders are discussed.
{"title":"A Socially Distanced Case Study: Implementing the Unified Protocol-Adolescent in the Treatment of Comorbid Depression and Anxiety via Telehealth","authors":"McKenzie R. Martin, J. Bolden, Jaima Walton","doi":"10.1177/15346501221099651","DOIUrl":"https://doi.org/10.1177/15346501221099651","url":null,"abstract":"Anxiety and depression are two of the most common mental health diagnoses in adolescents, with higher prevalence rates for gender-nonconforming youth relative to an age-equivalent population of cisgender youth (Veale et al., 2017). This case study examined the effectiveness of the Unified Protocol-Adolescent (UP-A) for a gender-nonconforming 13-year-old diagnosed with both generalized anxiety and mild depression. Amid the ongoing COVID-19 pandemic, this transdiagnostic implementation provided psychoeducation and targeted emotion identification, present-moment awareness, cognitive restructuring, and problem-solving over 21 sessions. Outcome data demonstrated significant reductions in anxiety and depression symptoms, with a notable qualitative change on three subjective measures of anxiety/depression symptoms, as ratings moved from clinical to nonclinical score ranges. Moreover, outcome data demonstrated the potential efficacy of the UP-A administered via telehealth for nonbinary youth with comorbid anxiety and depression. Clinical and research implications regarding the utility of implementing a flexible, transdiagnostic approach to treating diverse adolescents’ emotional disorders are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"516 - 532"},"PeriodicalIF":1.0,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41736081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-05DOI: 10.1177/15346501221098458
A. Putica, M. O'Donnell, K. Felmingham
Functional neurological disorder (FND) symptoms resemble neurological symptoms but are unexplained by disease or injury to the body. Psychological trauma and posttraumatic stress disorder (PTSD) are prevalent among patients with FND. This is a case report of a 64-year-old female who began treatment 2 years after developing PTSD, generalised anxiety disorder, major depressive disorder and agoraphobia following a physical assault. She subsequently developed FND approximately 18 months later. Her FND symptomology was characterised by aphasia and paraplegia. These symptoms usually lasted for a period of hours to days and usually occurred on a weekly basis. She had not previously engaged in psychological therapy due to limited insight into the relationship between her psychological and physiological symptomology. She was treated with Prolonged Exposure for PTSD (PE), and by the last session, she no longer met the diagnostic criteria for either FND or PTSD disorder. PE successfully treated both PTSD and FND. Theoretical understandings of the mechanisms underpinning this improvement are discussed.
{"title":"Prolonged Exposure Therapy in the Treatment of Functional Neurological Disorder and Posttraumatic Stress Disorder","authors":"A. Putica, M. O'Donnell, K. Felmingham","doi":"10.1177/15346501221098458","DOIUrl":"https://doi.org/10.1177/15346501221098458","url":null,"abstract":"Functional neurological disorder (FND) symptoms resemble neurological symptoms but are unexplained by disease or injury to the body. Psychological trauma and posttraumatic stress disorder (PTSD) are prevalent among patients with FND. This is a case report of a 64-year-old female who began treatment 2 years after developing PTSD, generalised anxiety disorder, major depressive disorder and agoraphobia following a physical assault. She subsequently developed FND approximately 18 months later. Her FND symptomology was characterised by aphasia and paraplegia. These symptoms usually lasted for a period of hours to days and usually occurred on a weekly basis. She had not previously engaged in psychological therapy due to limited insight into the relationship between her psychological and physiological symptomology. She was treated with Prolonged Exposure for PTSD (PE), and by the last session, she no longer met the diagnostic criteria for either FND or PTSD disorder. PE successfully treated both PTSD and FND. Theoretical understandings of the mechanisms underpinning this improvement are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"497 - 515"},"PeriodicalIF":1.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44818395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1177/15346501221098071
Chloe T. Cohen, T. Hulsey
The current study examines the psychotherapeutic treatment of an early-20s Caucasian male diagnosed with narcissistic personality disorder. The patient was treated with 56 sessions of psychoanalytic psychotherapy utilizing an object relations approach. Treatment aimed at decreasing the patient’s anger, anxiety, depression, and improving emotion regulation. Another focus of this patient’s treatment was helping him gain insight into the nature of his unconscious predictions and interpretations of others’ behavior in the hope that he may begin to experience relationships with greater emotional connection and less conflict. Treatment outcomes were measured using Reliable Change Index analyses, which indicated a significant reduction in anxiety, depression, anger, and emotion regulation difficulty between the beginning of treatment and the most recent session. The patient also demonstrated increased mentalization abilities and fewer anger outbursts throughout the course of treatment. During the sessions surrounding a therapeutic rupture, the patient’s emotion regulation abilities worsened temporarily; therapy shifted during this time to a more supportive analytic framework. An object relations-focused theoretical background and clinical treatment implications are discussed in relation to this case.
{"title":"Object Relations-Focused Psychoanalytic Psychotherapy in the Treatment of Narcissistic Personality Disorder","authors":"Chloe T. Cohen, T. Hulsey","doi":"10.1177/15346501221098071","DOIUrl":"https://doi.org/10.1177/15346501221098071","url":null,"abstract":"The current study examines the psychotherapeutic treatment of an early-20s Caucasian male diagnosed with narcissistic personality disorder. The patient was treated with 56 sessions of psychoanalytic psychotherapy utilizing an object relations approach. Treatment aimed at decreasing the patient’s anger, anxiety, depression, and improving emotion regulation. Another focus of this patient’s treatment was helping him gain insight into the nature of his unconscious predictions and interpretations of others’ behavior in the hope that he may begin to experience relationships with greater emotional connection and less conflict. Treatment outcomes were measured using Reliable Change Index analyses, which indicated a significant reduction in anxiety, depression, anger, and emotion regulation difficulty between the beginning of treatment and the most recent session. The patient also demonstrated increased mentalization abilities and fewer anger outbursts throughout the course of treatment. During the sessions surrounding a therapeutic rupture, the patient’s emotion regulation abilities worsened temporarily; therapy shifted during this time to a more supportive analytic framework. An object relations-focused theoretical background and clinical treatment implications are discussed in relation to this case.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"474 - 491"},"PeriodicalIF":1.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48615290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-15DOI: 10.1177/15346501221078329
Teresa M. Goff, M. E. Moody, Liliana L. Acosta, Diana Joyce-Beaulieu
The goal of the current case study was to illustrate evidence-based cognitive-behavioral treatment (CBT) for an adolescent female with comorbid major depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, suicidal ideations, and a history of multiple involuntary hospitalizations. Multimodal assessment of the child’s symptoms was conducted, including parent, teacher, and child self-report, academic data, and hospital records to inform case conceptualization. Treatment included a combination of psychoeducation, cognitive restructuring, positive self-talk, relaxation skills, and the support of a school-based personal aide. Significant improvements with inattentive, anxiety, and depressive symptoms were reported, with gains being maintained at 1 year follow-up. In addition to a reduction of reported psychosocial problems, treatment benefits also included a decrease in classroom disruptions, improvement in academic performance, and withdrawal of paraprofessional support at school. This study illustrates the use of school-based CBT strategies coupled with additional focused Tier 4 behavior supports as an efficacious treatment for youth with significant comorbidity.
{"title":"School-Based Cognitive-Behavioral Therapy in an Inclusion Model for an Adolescent with Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Attention Deficit Hyperactivity Disorder: A Case Study","authors":"Teresa M. Goff, M. E. Moody, Liliana L. Acosta, Diana Joyce-Beaulieu","doi":"10.1177/15346501221078329","DOIUrl":"https://doi.org/10.1177/15346501221078329","url":null,"abstract":"The goal of the current case study was to illustrate evidence-based cognitive-behavioral treatment (CBT) for an adolescent female with comorbid major depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, suicidal ideations, and a history of multiple involuntary hospitalizations. Multimodal assessment of the child’s symptoms was conducted, including parent, teacher, and child self-report, academic data, and hospital records to inform case conceptualization. Treatment included a combination of psychoeducation, cognitive restructuring, positive self-talk, relaxation skills, and the support of a school-based personal aide. Significant improvements with inattentive, anxiety, and depressive symptoms were reported, with gains being maintained at 1 year follow-up. In addition to a reduction of reported psychosocial problems, treatment benefits also included a decrease in classroom disruptions, improvement in academic performance, and withdrawal of paraprofessional support at school. This study illustrates the use of school-based CBT strategies coupled with additional focused Tier 4 behavior supports as an efficacious treatment for youth with significant comorbidity.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"457 - 473"},"PeriodicalIF":1.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42033713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-12DOI: 10.1177/15346501221082616
Mariana Branquinho, M. C. Canavarro, A. Fonseca
Postpartum depression is a highly prevalent mental health problem with harmful consequences for women, babies, and mother–infant relationships. Cognitive–behavioral therapy (CBT) is among the most effective treatment options for postpartum depression. However, a large number of postpartum women do not seek professional help, suggesting the need for new treatment delivery formats. The present article describes the application of Be a Mom Coping with Depression, a blended CBT treatment for postpartum depression, for a 31-year-old postpartum woman. The intervention was provided over a period of 13 weeks, integrating seven biweekly sessions with a psychologist and six sessions within an online program, and it is described in detail. A summary of the patient’s progress and the results obtained throughout treatment is reported. At the end of the intervention, a significant decrease in depressive and anxiety symptoms was observed, as well as increased perceived maternal self-efficacy, higher psychological flexibility, and higher self-compassion. This case study provides encouraging data for the preliminary evidence of the acceptability, feasibility, and efficacy of the Be a Mom Coping with Depression intervention in the reduction of depressive symptoms during the postpartum period. Advantages of this treatment format and implications for clinical practice and future research are discussed.
{"title":"A Blended Cognitive–Behavioral Intervention for the Treatment of Postpartum Depression: A Case Study","authors":"Mariana Branquinho, M. C. Canavarro, A. Fonseca","doi":"10.1177/15346501221082616","DOIUrl":"https://doi.org/10.1177/15346501221082616","url":null,"abstract":"Postpartum depression is a highly prevalent mental health problem with harmful consequences for women, babies, and mother–infant relationships. Cognitive–behavioral therapy (CBT) is among the most effective treatment options for postpartum depression. However, a large number of postpartum women do not seek professional help, suggesting the need for new treatment delivery formats. The present article describes the application of Be a Mom Coping with Depression, a blended CBT treatment for postpartum depression, for a 31-year-old postpartum woman. The intervention was provided over a period of 13 weeks, integrating seven biweekly sessions with a psychologist and six sessions within an online program, and it is described in detail. A summary of the patient’s progress and the results obtained throughout treatment is reported. At the end of the intervention, a significant decrease in depressive and anxiety symptoms was observed, as well as increased perceived maternal self-efficacy, higher psychological flexibility, and higher self-compassion. This case study provides encouraging data for the preliminary evidence of the acceptability, feasibility, and efficacy of the Be a Mom Coping with Depression intervention in the reduction of depressive symptoms during the postpartum period. Advantages of this treatment format and implications for clinical practice and future research are discussed.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"438 - 456"},"PeriodicalIF":1.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46076242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.1177/15346501221077703
Gabriela A. Olavarrieta, L. Benuto
Rates of PTSD and depression are as high as or higher among samples of refugees than in the general population. There have been few randomized controlled trials of trauma-focused therapies conducted with refugees. Additionally, there has been little research on the use of interpreters in psychotherapy with refugees, but across the studies included in a meta-analysis, a nonsignificant difference between studies that used an interpreter and those that did not was found. Due to COVID-19, mental health providers have had to adapt to the crisis by utilizing telemental health. Research on telemental health with refugee clients is limited, despite a recognition in the literature that telemental health can address some mental healthcare disparities. We review the case of a 26-year-old Afghani/Iranian bilingual diagnosed with post-traumatic stress disorder (PTSD) who presented with intrusive thoughts, panic attacks, nightmares, and flashbacks. Narrative Exposure Therapy (NET) was used with an interpreter via telehealth because it is effective in reducing symptoms of trauma in refugee populations. Treatment success for this case was reflected in the client’s self-reported reduction in symptoms. From this case study, we can conclude that (a) NET is a short-term, cost-effective means for providing trauma-focused care for refugees/asylum-seekers; (b) NET diminishes trauma symptoms with the use of an interpreter via telehealth; (c) a good relationship between therapist, interpreter, and client aids in the effectiveness of NET; and (d) clinician flexibility in the delivery of telemental health and interventions being utilized with refugee/asylum-seeker populations is imperative.
{"title":"Narrative Exposure Therapy: A Case for Use With Refugees via Telehealth With the use of an Interpreter","authors":"Gabriela A. Olavarrieta, L. Benuto","doi":"10.1177/15346501221077703","DOIUrl":"https://doi.org/10.1177/15346501221077703","url":null,"abstract":"Rates of PTSD and depression are as high as or higher among samples of refugees than in the general population. There have been few randomized controlled trials of trauma-focused therapies conducted with refugees. Additionally, there has been little research on the use of interpreters in psychotherapy with refugees, but across the studies included in a meta-analysis, a nonsignificant difference between studies that used an interpreter and those that did not was found. Due to COVID-19, mental health providers have had to adapt to the crisis by utilizing telemental health. Research on telemental health with refugee clients is limited, despite a recognition in the literature that telemental health can address some mental healthcare disparities. We review the case of a 26-year-old Afghani/Iranian bilingual diagnosed with post-traumatic stress disorder (PTSD) who presented with intrusive thoughts, panic attacks, nightmares, and flashbacks. Narrative Exposure Therapy (NET) was used with an interpreter via telehealth because it is effective in reducing symptoms of trauma in refugee populations. Treatment success for this case was reflected in the client’s self-reported reduction in symptoms. From this case study, we can conclude that (a) NET is a short-term, cost-effective means for providing trauma-focused care for refugees/asylum-seekers; (b) NET diminishes trauma symptoms with the use of an interpreter via telehealth; (c) a good relationship between therapist, interpreter, and client aids in the effectiveness of NET; and (d) clinician flexibility in the delivery of telemental health and interventions being utilized with refugee/asylum-seeker populations is imperative.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"419 - 437"},"PeriodicalIF":1.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48621785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-08DOI: 10.1177/15346501221078979
Chloe A. Salvaris, Samantha Galea, Marie B. H. Yap, Katherine A. Lawrence
Children with anxiety disorders are significantly less likely to recover following cognitive-behavioral therapy (CBT) if they have a parent with clinical anxiety. Despite this, prior research which has adapted CBT treatments to cater for this vulnerable clinical cohort of children is limited. In response to the identified need to optimize treatment outcomes for this particular group of children with anxiety disorders, an enhanced CBT intervention was recently developed, specifically to target anxiety maintenance factors in clinically anxious child–parent dyads. This dual case study presents the implementation of the enhanced intervention with two children with complex clinical presentations. Prior to treatment, both children met criteria for multiple anxiety disorders, as did their mothers. The presented case studies describe session-by-session treatment accounts, with a particular focus on the children’s experiences of individual and joint-observational exposure treatment components. Outcome data is provided for both children and their mothers, based on assessment measures collected at pre- and post-treatment, and during the intervention. At post-treatment, both children demonstrated symptom reduction and improved functioning across all diagnoses, including remission on a secondary diagnosis, although both still met criteria for their primary diagnoses. Additionally, self-reported outcomes on intervention acceptability measures were favorable. Results implied that the enhanced intervention provided a viable alternative treatment approach for children and their parents with co-occurring anxiety disorders. Recommendations are provided for clinicians delivering CBT to clinically anxious child–parent dyads.
{"title":"Enhanced Cognitive-Behavioral Treatment for Anxiety Disorders in Children of Clinically Anxious Parents: Two Case Studies","authors":"Chloe A. Salvaris, Samantha Galea, Marie B. H. Yap, Katherine A. Lawrence","doi":"10.1177/15346501221078979","DOIUrl":"https://doi.org/10.1177/15346501221078979","url":null,"abstract":"Children with anxiety disorders are significantly less likely to recover following cognitive-behavioral therapy (CBT) if they have a parent with clinical anxiety. Despite this, prior research which has adapted CBT treatments to cater for this vulnerable clinical cohort of children is limited. In response to the identified need to optimize treatment outcomes for this particular group of children with anxiety disorders, an enhanced CBT intervention was recently developed, specifically to target anxiety maintenance factors in clinically anxious child–parent dyads. This dual case study presents the implementation of the enhanced intervention with two children with complex clinical presentations. Prior to treatment, both children met criteria for multiple anxiety disorders, as did their mothers. The presented case studies describe session-by-session treatment accounts, with a particular focus on the children’s experiences of individual and joint-observational exposure treatment components. Outcome data is provided for both children and their mothers, based on assessment measures collected at pre- and post-treatment, and during the intervention. At post-treatment, both children demonstrated symptom reduction and improved functioning across all diagnoses, including remission on a secondary diagnosis, although both still met criteria for their primary diagnoses. Additionally, self-reported outcomes on intervention acceptability measures were favorable. Results implied that the enhanced intervention provided a viable alternative treatment approach for children and their parents with co-occurring anxiety disorders. Recommendations are provided for clinicians delivering CBT to clinically anxious child–parent dyads.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"396 - 418"},"PeriodicalIF":1.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45142951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-04DOI: 10.1177/15346501221081122
Lisa DeMarni Cromer, Brooke A F Pangelinan, Tara R. Buck
These case examples depict the adaptation of Exposure, Relaxation, and Rescripting Therapy (ERRT) for use with children. ERRT was developed for trauma-related nightmares in adults. The current study modified ERRT to be developmentally appropriate for children, incorporating child appropriate language, interactive activities, and parent coaching. The modified treatment, called cognitive-behavioral therapy for nightmares in children (CBT-NC), added additional stress-management components to further adapt the treatment for children with anxiety-related nightmares and no trauma history. These case studies describe the course of treatment for two girls whose nightmares had different etiologies—one experiencing trauma-related nightmares and the other experiencing idiopathic anxiety-related nightmares. This was the first application of CBT-NC for idiopathic nightmares. Both children responded positively to treatment, and treatment gains were maintained at 3- and 6-month follow-up. Improvements were seen not only for nightmare frequency and distress, but overall sleep also improved. Findings demonstrate that this adapted nightmare treatment for children is feasible and promising for nightmares in children, regardless of nightmare etiology.
{"title":"Case Study of Cognitive Behavioral Therapy for Nightmares in Children With and Without Trauma History","authors":"Lisa DeMarni Cromer, Brooke A F Pangelinan, Tara R. Buck","doi":"10.1177/15346501221081122","DOIUrl":"https://doi.org/10.1177/15346501221081122","url":null,"abstract":"These case examples depict the adaptation of Exposure, Relaxation, and Rescripting Therapy (ERRT) for use with children. ERRT was developed for trauma-related nightmares in adults. The current study modified ERRT to be developmentally appropriate for children, incorporating child appropriate language, interactive activities, and parent coaching. The modified treatment, called cognitive-behavioral therapy for nightmares in children (CBT-NC), added additional stress-management components to further adapt the treatment for children with anxiety-related nightmares and no trauma history. These case studies describe the course of treatment for two girls whose nightmares had different etiologies—one experiencing trauma-related nightmares and the other experiencing idiopathic anxiety-related nightmares. This was the first application of CBT-NC for idiopathic nightmares. Both children responded positively to treatment, and treatment gains were maintained at 3- and 6-month follow-up. Improvements were seen not only for nightmare frequency and distress, but overall sleep also improved. Findings demonstrate that this adapted nightmare treatment for children is feasible and promising for nightmares in children, regardless of nightmare etiology.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"377 - 395"},"PeriodicalIF":1.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41333737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-25DOI: 10.1177/15346501221082231
H. Seesink, Pieter Klokkenburg, H. Schaap-Jonker, B. Ostafin, R. Wiers
This case study focuses on the treatment of a 44-year-old Dutch man presenting with an anxious God representation and religious struggles according to DSM-5 criteria. Having received prior treatment for a panic disorder and alcohol use disorder, the patient was given a 60-day treatment in which the Jesus Prayer intervention was used to address his religious and spiritual problems. To our knowledge, this is the first case study involving the Jesus Prayer in the treatment of a patient. The intervention had positive effects on the patient’s religious and spiritual problems concerning an anxious God representation, religious struggles, stress levels and surrender to God. The intervention may also play a supporting role in decreasing symptoms of depression and anxiety and in promoting global mental health, as reliable change index analyses revealed symptom reduction between baseline levels and at post-assessment levels for all measured symptoms, with a semi-gradual decrease over the course of treatment. These improvements were continued in a 3-month follow-up assessment, suggesting promise for the Jesus Prayer as an effective treatment method for religious and spiritual problems. Recommendations regarding the importance of assessing the religious life of patients and implementing spiritual interventions are discussed, as well as the relevance of the therapist’s own assumptions when treating a religious or spiritual problem.
{"title":"Without Your Therapist: Contemplative Prayer During Treatment as a Religious Exposure Intervention to Reduce Religious Struggle and Anxious God Representation","authors":"H. Seesink, Pieter Klokkenburg, H. Schaap-Jonker, B. Ostafin, R. Wiers","doi":"10.1177/15346501221082231","DOIUrl":"https://doi.org/10.1177/15346501221082231","url":null,"abstract":"This case study focuses on the treatment of a 44-year-old Dutch man presenting with an anxious God representation and religious struggles according to DSM-5 criteria. Having received prior treatment for a panic disorder and alcohol use disorder, the patient was given a 60-day treatment in which the Jesus Prayer intervention was used to address his religious and spiritual problems. To our knowledge, this is the first case study involving the Jesus Prayer in the treatment of a patient. The intervention had positive effects on the patient’s religious and spiritual problems concerning an anxious God representation, religious struggles, stress levels and surrender to God. The intervention may also play a supporting role in decreasing symptoms of depression and anxiety and in promoting global mental health, as reliable change index analyses revealed symptom reduction between baseline levels and at post-assessment levels for all measured symptoms, with a semi-gradual decrease over the course of treatment. These improvements were continued in a 3-month follow-up assessment, suggesting promise for the Jesus Prayer as an effective treatment method for religious and spiritual problems. Recommendations regarding the importance of assessing the religious life of patients and implementing spiritual interventions are discussed, as well as the relevance of the therapist’s own assumptions when treating a religious or spiritual problem.","PeriodicalId":46059,"journal":{"name":"Clinical Case Studies","volume":"21 1","pages":"339 - 354"},"PeriodicalIF":1.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41752399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-25DOI: 10.1177/15346501221080931
Eric D. Tifft, Max Z. Roberts, Shannon B. Underwood, J. P. Forsyth
Though anger is a common human emotion, the unfettered behavioral expression of anger is often costly, contributing to a range of functional impairments, poor quality of life, and both physical and mental health problems. The current case illustrates how a third-generation cognitive behavioral therapy, Acceptance and Commitment Therapy (ACT), may be effective in reducing suffering linked with problematic anger. The client (“Robert”), a treatment-naïve man of low socioeconomic status, presented to a university training clinic reporting problematic anger outbursts that interfered with his relationships at work and with his girlfriend. The therapist conceptualized Robert’s problematic anger through the ACT psychological flexibility model, wherein Robert’s anger appeared to function as experiential avoidance to distance him from underlying emotional hurt. The therapist used ACT over 27 sessions to reduce Robert’s psychological inflexibility while promoting more psychological flexibility. Early sessions highlighted the unworkability of Robert’s anger, whereas subsequent sessions focused on clarifying values, loosening cognitive fusion, facilitating present moment awareness, and cultivating mindful acceptance in the service of living a meaningful life. The therapist monitored treatment progress using quantitative measures and qualitative reports. Collectively, the client showed notable gains. The case study adds to the growing body of literature supporting ACT for problematic anger.
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