Science-Based Psychotherapy

“Dealing with others is dealing with ourselves, dealing with others.”

--Norman Fischer

 

Creating intense and curative therapeutic relationships is a fundamental skill for meaningful therapy. Strong relationships like this can engage people in ways that challenge and can perhaps even frighten them.  This means that therapy can involve exposure to avoided thoughts, emotions and sensations for the client AND the therapist.

 

"Exposure therapy typically elicits a temporary increase in patients' negative affect in order to facilitate new learning. This may in turn increase therapist discomfort as therapists interact with the patient and are confronted with their own uncomfortable subjective experiences.” (Scherr, Herbert and Foreman, 2015).

 

The authors of this study found that therapists with high levels of avoidance tended to avoid doing exposure therapy....

A new study conducted by Portland Psychotherapy's Melissa Platt, along with colleague Jennifer Freyd, finds that perpetrator closeness matters when considering the effects of trauma. In this study, 124 female survivors of trauma were recruited to participate. Participants completed a set of questionnaires related to trauma, shame, dissociation, and fear. Next, they were randomly assigned to either see a set of images depicting threatening events of an interpersonal nature such as depictions of sexual harassment and interpersonal violence, or a set of images depicting threatening events of a non-interpersonal nature such as depictions of car accidents and natural disasters. After viewing the images, participants again completed self-reports of fear, shame, and dissociation.

Our hypotheses were guided by betrayal trauma...

posted in PTSD | trauma

Do you practice CBT for Insomnia? 

Would you like to be involved in a community effort to create a needed resource?

 

In the field of behavioral sleep medicine (BSM), the sleep diary is an essential and ubiquitous tool. While there has been progress in creating a standard sleep diary form, there has not yet been any advances in providing practitioners with a common and easy to use interface for this standard.

 

This has left providers stuck with the task of calculating sleep data in inefficient  ways such as by pen and paper or ‘re-inventing the wheel’ by creating their own  means of calculating and tracking the data via MS excel or MS access. Large  amounts of time and creativity are lost as people’s efforts to tackle this problem are not shared with the community.  

 

To address this problem Dr....

posted in insomnia

In my ongoing series of posts about exposure therapy, I’ve written several times about the work of UCLA professor Michelle Craske, PhD. Dr. Craske has been on the cutting edge of exposure research, and her work has undermined the traditional notion posited in in the emotional processing theory that habituation to a feared stimulus is important in exposure work.

 

The Society for a Science of Clinical Psychology has posted an interview that Dr. Jacqueline Persons conducted with Dr. Craske on “Maximizing Exposure Therapy for Anxiety Disorders.” This...

In case you didn't know already, starting October 1st 2015, insurance companies will start using the ICD-10 system for diagnostic codes, rather than the ICD-9/DSM codes. For any Date of Service (not date of claim submission) Sept. 30th or before, clinicians will still need to use the DSM codes. But any claims submitted for dates of service Oct. 1st or later will be rejected if they are not ICD codes. If you are a clinician billing insurance, you need to make this change or else you will be soon running into a lot of problems with rejecte claims.

 

What’s the difference between the DSM and the ICD system? Do I still need both of them?

DSM is a diagnostic determination guide. It can be a resource in providing information needed to make an accurate diagnosis, but it is a ICD 10 diagnosis (not a DSM diagnosis) that we are to now assign...

posted in dsm | insurance

In 2005, the clinic directors (Jenna LeJeune, Ph.D. & Jason Luoma, Ph.D.) at Portland Psychotherapy helped found a peer-consultation group to provide a place for local therapists to learn and practice Acceptance and Commitment Therapy (ACT) and to build supportive community of like-minded practitioners.

 

The ACT peer consultation group underwent a number of iterations in the years that followed. It took several years for the group to find its feet, and there was process and evolution in creating a workable structure and set of roles to help guide the meetings.

 

Recently, several of us got together and wrote a paper describing the process of creating an ACT peer consultation group and the...

posted in ACT

I’ve been working with trichotillomania (i.e., hair pulling) for several years now and am always happy to see this understudied problem receive more press.

 

I recently came across a useful informational page on trichotillomania on the Psychiatry Advisor website. The page provides concise, up-to-date info on “trich,” including behavioral and pharmacological treatment, and diagnostic considerations. It is a great reference for anyone new to trichotillomania.

 

You can check it out here.

APA has a new set of guidelines for psychologists working with transgender and gender nonconforming people (TGNC). In an appendix to those guidelines, APA included a very useful index defining many of the terms used within the TGNC community. Terminology of this sort is rapidly evolving and it can be difficult to stay abreast of it all. The index APA included in its guidelines is a helpful resource as psychologists strive towards treating others in a respectful and culturally competent way. For example, the term “transgender” has rapidly become part of American lexicon, especially since Caitlyn Jenner told her story in Vanity Fair magazine earlier this summer. However, although I’m familiar with the term, I’ve...

There is great news coming out of APA this week. (Finally, some good news coming out of APA!) The APA Council of Representatives has finally approved a set of guidelines for psychologists working with transgender and gender nonconforming people (TGNC).  You can read the entire 55 page document here and it is certainly on my “to read” list as well. However, given how important this is and given the fact that my “to read” list is dauntingly long at this point, I wanted to make sure I was familiar with at least the main guidelines until I can have time to read the entire document. And so, I created this cheat sheet of the 16 guidelines outlined in the document.  So if your “to read” list is like mine, here is a summary of the APA guidelines on working with TGNC people.

 

APA Guidelines for...

Prolonged exposure (PE) is an evidence-based cognitive behavioral treatment that uses imaginal and in vivo exposure in the treatment of PTSD. Imaginal exposure involves the client recounting a core traumatic event in great detail repeatedly in session, and then listening to an audio recording of the exposure daily between sessions. In additional to imaginal work, clients engage in in vivo (Latin for “in life”) exposure to trauma-related triggers. Exposure is done until the client habituates to the trauma-related similar, and/or until PTSD symptoms are largely resolved, according to the PE model.

 

For those unfamiliar with exposure therapy, you can read more about...