Science-Based Psychotherapy

The Study
In a study recently published in the journal Headache, preliminary evidence was found to support to use of ACT for chronic headache pain.  The study aimed to examine the efficacy of group-based ACT treatment for reducing the experience of pain, disability, and affective distress due to recurrent episodes of headache pain.  The study sample consisted of outpatient Iranian women.


ACT has been validated through numerous studies to date for chronic pain and has been given the highest grade of evidenced-based backing by APA division 12, ‘strong research support’.  While division 12 includes headache pain within the general category if chronic pain, there has been a gap in the literature to date regarding the...

posted in ACT

Even as a professional psychologist, I feel overwhelmed browsing  the self-help shelves of the average book store. There’s a glut of titles, many written by people with no relevant credentials. I sometimes wonder how people wade through them all!

 

In the past few years I have developed an interest in the effectiveness of self-help books. Even when self-help books are based on well-researched principles, it’s rare for researchers to study the effectiveness of specific books as a standalone treatment. Given this situation, I was pleased to come across the new edition of  Self-Help That Works (2013; 4th ed.). This book rates a...

These posts are a subset of my series on using exposure in Acceptance and Commitment Therapy. These particular posts are lighter on theory and instead focus on specific ACT metaphors and exercises therapists can us to help prepare clients for exposure.


Successful exposure therapy requires that individuals remain in contact with uncomfortable thoughts, feelings, and bodily sensations while confronting a feared experience.  However, the ability to identify and stay present with private experiences varies from person to person. Over my years as a therapist, I have discovered these are skills not everyone possesses. Consequently, I routinely introduce clients to basic exercises...

These posts are a subset of my series on using exposure in Acceptance and Commitment Therapy. These particular posts are lighter on theory and instead focus on specific ACT metaphors and exercises therapists can use to help prepare clients for exposure.


In a previous post, I detailed how to use the fingers traps metaphor to help clients contact how avoidance of private experiences may result in greater suffering. For this post, I’d like to outline another exercise I use frequently with anxiety: Tug-of-War-with-a-Monster....

posted in ACT | exposure | exposure therapy

These posts are a subset of my series on using exposure in Acceptance and Commitment Therapy. These particular posts are lighter on theory and instead focus on specific ACT metaphors and exercises therapists can use to help prepare clients for exposure.


In Acceptance and Commitment Therapy (ACT), we use the term creative hopelessness to refer to the process of helping people experientially contact the costs of their avoidance behaviors. By “hopeless” we don’t mean that the client is hopeless. Instead, this term describes the new possibilities that can open up when we let go patterns of behavior that are not working (i.e., the behavior is hopeless). Developing this awareness can increase client willingness to engage in something as intense as exposure.

 

Below I...

posted in ACT | exposure | exposure therapy

Exposure is arguably the most important component of anxiety-related treatment. Despite decades of study, however, researchers are still developing an understanding of how it works and refining the procedures to improve effectiveness. This is an exciting time for exposure! Newer research is questioning the role of habituation in successful exposure and increasingly emphasizing the importance of developing a willingness to experience fear and anxiety.


For the last few years, I’ve been working to immerse myself in exposure research. This has been a steep learning curve, as I didn’t receive much background in graduate school. At times I’ve felt overwhelmed by the more technical accounts. However, I’ve persevered, and although I still have a lot to learn, I feel my clinical work is better for it.


I’ve written these posts to develop my own understanding of exposure and in the hopes that other therapists would find them helpful, too. I’m extremely interested in...

posted in ACT | exposure | exposure therapy

“We’ll never make it!”

Glum from Gulliver’s Travels by Jonathan Swift

 

It started as early as my first year of college, some 20-odd years ago. I was in an abnormal psychology classroom in Boston, eager to finally get moving on my wished-for career as a psychologist that I had dreamed about for years. A professor I was working with at the time (AKA Dr. Glum) seemed determined to crush my hopes and dreams of becoming a clinical psychologist. “You’ll never make it.” “There’s no future in seeing therapy clients unless you want to work 70 hours a week in a community mental health center.” “And you can forget about getting to do research unless you happen to draw the golden ticket and get an academic job, but those are pretty much going the way of the dinosaur too.” While I might be taking some liberty on Dr. Glum’s actual words, there was a clear message she was trying to impart to us....

Some months back, I wrote a blog post about researchers using the ketamine as a fast acting treatment for depression. Recently I was alerted to another study by the same core researchers from the National Institute of Mental Health (NIMH) using ketamine to treatment depression in people with bipolar disorder (Zarate et al., 2012). The study was a replication of a similar study published a few years ago (Diazgranados  et al., 2010).

 

It’s still just ketamine for depression

In this study, ketamine wasn’t used to treat bipolar disorder...

The past few years has seen an increasing push to demonstrate the legitimacy of long-term psychodynamic and psychoanalytic therapies (e.g., Leichsenring & Rabung, 2008). It seems proponents of psychodynamic therapy are trying to play catch up. There’s an enormous amount of research support for cognitive behavioral approaches; by contrast, controlled research for psychodynamic approaches is sparse.

 

Since long-term psychoanalytic psychotherapy is a mouthful, we’ll follow the cue of those before us and call it LTPP for short.

 

It's unfortunate there’s not a lot of controlled research on LTPP, as I think controlled studies carefully examining the processes and outcomes of psychodynamic therapies could only enhance our understanding of treatment. As a way to bolster support, some psychodynamic researchers have taken what studies exist and...

A few years ago, my clinic director suggested I check out trainings offered through the Trichotillomania Learning Center (TLC), a grassroots hub for information on trichotillomania and skin pulling (or dermatillomania). He knew about my interest in structured treatments for anxiety disorders and thought it might be useful for me to look into training.

 

Although TLC offered a DVD training program, I decided to wait until there was an actual physical workshop. In retrospect, I don’t know why I was so attached to in-person training. Having attended my fair share of workshops and even having co-led some myself, I’m fully aware that 1-2 day workshops are pretty limited in what you actually can learn. Intellectually, I figured the training DVD’s were probably a better...

posted in ACT | Trichotillomania

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