Science-Based Psychotherapy

Last week, University of Nevada - Reno professor Steve Hayes, PhD, came through Portland to conduct an intermediate Acceptance and Commitment Therapy (ACT) workshop. In anticipation of the visit, Dr. Hayes reached out to the Oregon chapter of the Association of Contextual Behavioral Science.

 

Through this outreach, Dr. Hayes agreed to be interviewed for the Oregon chapter. As president-elect of the Oregon chapter, I talked with Dr. Hayes about his thoughts on creating a strong and supportive community.

 

I think this interview will be of interest to anyone within the ACT community, and particularly those who, like Oregon, have created their own chapter or are thinking about creating a chapter. Dr. Hayes also...

posted in ACT

Eric Morris, PhD, a psychologist in Australia, wrote a really interesting blog post about therapist reluctance to use exposure.  As I’ve written about in previous posts, exposure therapy is one of the most effective interventions we have in treating anxiety-related disorders, such as OCD, phobias, and PTSD. Unfortunately, although exposure has been around for several decades, many therapists don’t use it.

 

As Dr. Morris writes:

 

Well, it isn’t just that many therapists use approaches that are not evidence-based. It seems that ...

 

Last Friday, Portland Psychotherapy research assistants Monica Bahan, Megan Cheslock, and Jackie Potter presented a research poster at the annual Western Psychological Association convention, which took place in Portland. Their poster detailed findings from one of our ongoing studies exploring the relationship between shame, guilt, and drinking behavior. The findings were based on the first 88 participants in the study, all volunteers from the Portland area.

 

Congratulations to Monica, Megan, and Jackie on their first presentation!

posted in shame

1. Insomnia can cause depression.

A collection of research suggests that untreated insomnia doubles the chance of developing depression, as a causal factor (4 sources – one, two, three, four)

 

2. Insomnia often does not resolve once the depression is treated or without focused insomnia treatment (...

posted in depression | insomnia

In a special issue of Behavior Therapy on “The Theory-Practice Gap in Cognitive Behavior Therapy,” Jonathan Abramowitz, PhD, authored an interesting paper on the importance of understanding theory when doing exposure therapy. Dr. Abramowitz is a well-respected OCD researcher, and I was attracted to this article as part of my ongoing interest in exposure therapy.

 

The article is lucid, well-written, and I think would be of value to anyone beginning to work with exposure therapy. He offers anecdotes about where therapists go wrong and makes a good argument for why understanding theory enhances exposure therapy. Dr. Abramowitz writes from a strictly cognitive behavior perspective, so this work does not cover...

posted in exposure | exposure therapy | OCD

A practice I’m seeing more often that concerns me is the addition of antipsychotic medications on top of antidepressants when the antidepressants aren’t working. If someone isn’t showing improvement on an antidepressant alone, a prescriber may add an antipsychotic medication—the idea being it will increase the effectiveness of the antidepressant. The research for this is a little questionable, especially as the side effects for antipsychotics can be pretty bad. I’ve felt strongly enough about this issue that I wrote an editorial about it that the Oregonian published in 2012.

 

Antipsychotics and obsessive-compulsive disorder

In previous post, I wrote about a study that found that giving an antipsychotic in people with...

Understanding factors that contribute to outcome are crucial as we continue to refine treatments and revise the theories that underlie them. In a study published in the Journal of Anxiety Disorders, Norton and colleagues (2011) examined the role of activation and habituation in exposure therapy. The rationale for study was based on the emotional processing theory, which I’ve written about previously.

 

By activation, the authors mean how distressed the person becomes during the exposure exercise. Habituation refers to the reduction in distress when someone is confronted with a fear inducing stimuli. I’ve...

This post was featured on our client-centered blog The Art and Science of Living Well, but I thought it would be of interest to therapists as well.

 

The post is about a finding from a meta-analysis by Cuipjers and colleagues that looked at studies comparing medication against psychotherapy in the treatment of anxiety disorders and depression. For obsessive-compulsive disorder, the researchers found a clear advantage of evidence-based psychotherapy for OCD above medication.

 

You can read the post by clicking here, and it includes links to the original article, which you can download for free.

posted in Medications | OCD

Some of us at Portland Psychotherapy have a new article that was just published in the September 2013 issue Journal of Contemporary Psychotherapy. This has been a 2-3 year work in progress, so we're super excited to see it in print. 

 

It came to fruition from my ongoing interest in the use of exposure in Acceptance and Commitment Therapy.

 

Here's the Abstract:

 

Exposure is considered one of the most effective interventions for PTSD. There is a large body of research for the use of imaginal and in vivo exposure in the treatment of PTSD, with prolonged exposure (PE) therapy being the most researched example. Acceptance and commitment therapy (ACT) has sometimes been called an exposure-based treatment...

posted in ACT | exposure | exposure therapy | PTSD

A picture is worth a thousand words, so I thought as part of my continuing sequence on exposure therapy, I thought I’d share some videos I like.

 

I should offer credit to Kelly Koerner and Gareth Holman at Practice Ground, who introduced me to many of these videos through an excellent online exposure training they offered. I’ve done two online trainings through Practice Ground and they were both excellent—I highly recommend checking them out!

 

Snake Phobia

Anxiety disorder guru David Barlow invited Swedish expert Lars-Göran Öst to Boston to demonstrate his one-shot 3-hour simple phobia treatment for a woman who was extremely afraid of snakes. Öst shows a charming mix of compassion and...