perfectionism and - Obsessive-Compulsive Foundation

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6/24/13 Behavioral Experiment: Consider Discarding • Rate ini8al distress • Predict dura8on of distress • Do the experiment (not acquire, discard) • List thoughts • Evaluate thoughts • Re-‐rate distress • Discuss outcome of experiment Behavioral Test of Hoarding Predic8ons (top of lost board game box) • Predic8on 1: “If I throw this away, it will feel like death.” • Predic8on 2: “If I throw it away, I will feel this way (like death) forever.” Outcome of Predic8ons Conclusions and New Hypotheses • One minute ayer discarding – SUDS ra8ng at 100, but “It does not feel like death.” • 24-‐hours ayer discarding – SUDS ra8ng at 10. “It doesn’t bother me much at all.” • Conclusion -‐ Neither predic8on came true. • New Hypotheses – The thought of throwing things away is worse than the doing of it. – If I throw something away that I am deathly afraid of discarding, it will not feel as bad as I think, and the bad feeling won’t last as long as I think. -147- 15
6/24/13 Downward Arrow and Behavioral Experiment Other Cogni8ve Strategies • Understanding the numbers • Taking another perspec8ve • Evalua8ng advantages and disadvantages • Dis8nguishing need from want Cogni8ve Restructuring Probability ◦ What’s the likelihood that something bad would actually happen What would that be ◦ What is the evidence Severity ◦ How bad would it be Ability to Cope ◦ How well will you be able to manage Distress ◦ How upset would you feel ◦ How long would that last ◦ Can you tolerate that feeling % Reduction 0% -5% -10% -15% -20% -25% -30% -35% Controlled Trial: Saving Inventory-‐Revised Partial ETA 2 = .223 12 26 Session CBT Wait list Partial ETA2 = .475 29% reduction SATURDAY Steketee et al., 2010, Depress&Anx, 27, 476-‐484 -148- 16
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IMAGINE THAT!: A SCRIPTING WORK- SH
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Themes and Variations - Theoretical
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Themes and Variations - Theoretical
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6/14/13 • Subjects (N = 20) with
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The Social Experiment 6/14/13 The
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6/14/13 How Do We Treat Social
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6/14/13 Exposure therapy is: A
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6/14/13 Detailed Inves5ga5on of
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6/14/13 Why Imaginal Exposure
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6/14/13! Common obsessions, continu
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6/14/13! 1# This circuit is called
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6/14/13! -33- 6!
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6/14/13! People with OCD experience
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6/14/13! 1a. Behavior Therapy! •
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ERP Exposed OCD Cycle Obsessions Re
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OCD Definition: OCD Cycle COMPULSIO
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Somatic Obsessions Miscellaneous Ob
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Exposure and Response Prevention -
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Strategic Model of Cognitive Treatm
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Segment 3 Every step of the way, ch
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You also have to tolerate anxiety
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Segment 9 Segment 10 Habituation re
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Get rapport (and get it again) Get
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6/14/13 Example #2: “Dave”
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6/14/13 Talking about Accommoda@o
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6/14/13 Making Decisions about A
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6/14/13 Dealing with Arguments
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Ask an Attorney - What Are My Right
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What is a major life activity Basic
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What is Reasonable Accommodation Mo
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Family and M edical L A eave ct IOC
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THE SPENCER LAW FIRM 2727 Camino de
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Importantly, the ADA requires cover
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Some possible reasonable accommodat
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THE SPENCER LAW FIRM 2727 Camino de
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insurance, sick leave, education be
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Protection and Advocacy The Protect
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Can’t - vs. -Won’t • If you s
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Rewards Fear Stimulus CBT Model of
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My Child-Brother-Sister Has OCD But
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I’m Afraid I’m Really Gonna Do
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Roger is a 52 year old widowed dent
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Fear of loss of impulse control: B:
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Page 106 and 107: 6/14/13 Defining the Problem- Raci
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Page 110 and 111: Manipulating Language to Improve Pa
Page 112 and 113: 6/24/13 SHIFT LANGUAGE TO PROMOTE H
Page 114 and 115: 6/24/13 LABEL ANXIETY AND OCD Agai
Page 116 and 117: The BDD Challenge 6/14/13 The BDD C
Page 118 and 119: 6/14/13 WHICH BODY PARTS ASSOCIATED
Page 120 and 121: 6/14/13 WHAT DOESN’T APPEAR TO WO
Page 122 and 123: 6/14/13 COGNITIVE THERAPY CONT. IDE
Page 124 and 125: 6/14/13 ERP HIERARCHY #1 BDD ISSUE:
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Page 128 and 129: 6/14/13 FAMILY ACCOMMODATION & MAIN
Page 130 and 131: 6/14/13 HMO HMO = Health Maintenan
Page 132 and 133: 6/14/13 RECOGNIZE THE SIGNS OF OCD
Page 134 and 135: 6/14/13 COLLABORATING WITH SCHOOLS
Page 136 and 137: Conceptualizing and Treating Hoardi
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Page 140 and 141: 6/24/13 Family Burden • Growin
Page 142 and 143: 6/24/13 Biological vulnerability
Page 144 and 145: 6/24/13 • Depression • Self-
Page 146 and 147: 6/24/13 Mo8va8on and Ambivalence
Page 148 and 149: 6/24/13 Skills Training: Objec8ve
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Page 154 and 155: Perfecting Perfectionism Perfecting
Page 156 and 157: Types of Perfectionism Being th
Page 158 and 159: Healthy Perfectionism In general
Page 160 and 161: The cost of perfectionism • T
Page 162 and 163: Let’s Focus on Two Problemati
Page 164 and 165: • Are we there yet • The r
Page 166 and 167: Addressing Relapse in CBT for OCD 6
Page 168 and 169: 6/14/13 Lisa’s Exposure Hierar
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Page 172 and 173: 6/14/13 Frame ERP to Mismatch
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Page 196 and 197: 6/14/13 Jenny Jenny • Referred
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6/14/13 Bill • His intrusive
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6/14/13 Response Prevenaon • D
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6/14/13 Study Comparing Individual
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6/14/13 Exclusionary Criteria Struc
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6/14/13 Contact Information The OCD
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6/14/13 Acceptance vs. Change Chan
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6/14/13 Positive Reacting Styles P
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6/14/13 What is P-N-P What is P-N-
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People and Places - Emotional Conta
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6/14/13 CASE EXAMPLE • 67 year
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6/14/13 THE ROLE OF BETRAYAL
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6/14/13 THE ROLE OF ACCEPTANCE
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Challenging Kids Challenged Adults
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Regulatory Disorders Challenging Ki
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Tips for Non-OCD Anxiety Disorders
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Sleep Problems Tips for Sleep Probl
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EXECUTIVE FUNCTION “He is such a
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Write It or Regret It! CL UE Tips f
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Slow Processing Speed (Sluggish Cog
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Tips for Handwriting • Reduce cop
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Curiosity vs Judgment! © Sheryl K.
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Prepare the child for the path….
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How Can the Whole Family Fight OCD
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Task Description & Reminder of spec
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Using Scaffolding Steps in Unplanne
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6/14/13 Examples of Behavioral
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Assessment and Treatment of Postpar
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Cognitive-Behavioral Strategies in
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6/14/13 iCompulsions (OCD) or Cyber
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6/14/13 Similarities Between HC and
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6/14/13 C = Increased Fear and Doub
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6/14/13 Sample Exposures For Health
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6/14/13 The Effect of Attention (Ta
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6/14/13 Health-Related OCD Case Exa
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6/14/13 Treatment • Stop all comp
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So You Expect Them to Leave Home So
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Daniel G. Pruitt, Jr., PCC, SCAC In
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NEEDED TRANSITION SKILLS: • Time
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Memory Functioning CL UE Short-Term
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Taking Medications Exercise! •Und
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Washer and Dryer TRANSITION SKILLS:
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TRANSITION SKILLS: Ready ! Money Ma
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TRANSITION SKILLS: • Tell them wh
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TRANSITION SKILLS: This Isn’t It!
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Tigers, Too Tigers, Too: Supplement
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WHEN REASSURANCE IS HARMFUL By Paul
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APOSTOLIC CHRISTIAN Counseling and
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