Alex Clarke, Andrew R. Thompson, Elizabeth Jenkinson, Nichola Rumsey, Robert Newell

CBT for Appearance Anxiety (eBook, ePUB)

Psychosocial Interventions for Anxiety due to Visible Difference

• Format: ePub

Produktbeschreibung

This clinical manual provides a CBT-based psychosocial intervention for use with individuals distressed about their appearance due to a disfigurement from birth, accident or illness, or those coping with another visible difference. * Contains a wealth of case material with specific relevance to physical health conditions that affect appearance, practical advice on assessment, and session-by-session guidance for addressing common issues * Written by leading academics and clinicians working in the management of disfigurement and rational appearance anxiety * Uses a flexible stepped-care model that allows for use by experienced CBT practitioners as well those wishing to deliver a more basic psychological intervention * Identifies the psychological factors involved in appearance anxiety while also addressing the practical concerns of living with a visible difference, such as managing the reactions of others

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Produktdetails

• Verlag: John Wiley & Sons
• Seitenzahl: 320
• Erscheinungstermin: 28. Oktober 2013
• Englisch
• ISBN-13: 9781118523414
• Artikelnr.: 39936741

Autorenporträt

Alex Clarke is a clinical and health psychologist specializing in disfigurement and altered appearance. Andrew R. Thompson is Reader in Clinical Psychology at the University of Sheffield NHS Clinical Psychology Doctoral Training Programme. Elizabeth Jenkinson is a registered Practitioner Health Psychologist, Chartered Psychologist and Senior Lecturer in Health Psychology at the University of the West of England. Nichola Rumsey is Vocational Training Charitable TrustProfessor of Appearance Research at University of the West of England and is Co-Director of the Centre for Appearance Research. Rob Newell is Emeritus Professor of Nursing Research at the University of Bradford.

Inhaltsangabe

Foreword xv Preface xvi 1 Background, Clinical Problems, Common
Presentation and Treatment Considerations 1 Physical and Treatment-Related
Factors 3 Socio-Cultural Factors 3 Psychological Factors and Processes 3
Body Image Disturbance 3 Clinical Problems and Presentation 4 Common
Features in Referral 8 Visibility of Condition 8 Shame 9 The Meaning of
Visible Difference 9 The Experience of Loss 9 Physiological Responses 10
Culture 10 Gender 11 Age 11 Expectations of Treatment 11 Association of
Physical Change with Psychological Outcome 12 Fix It Solutions 12 Treatment
Considerations 13 2 A Stepped-Care Approach to Psychosocial Intervention 15
The PLISSIT Model 16 Level 1: Permission 16 Level 2: Limited Information 18
Level 3: Specific Suggestions 18 Level 4: Intensive Treatment 19 3 Models
and Frameworks: Expanding the Conceptual Approach to Managing
Appearance-Related Distress 21 Explanation for Choice of Therapeutic
Approach 22 Behavioural Approaches: Fear Avoidance and Social Skills
Training 22 Building an Evidence Base 25 Cognitive Approaches: Comparison
of Appearance Anxiety and Social Phobia 26 Use of Safety Behaviours 28
Anticipatory and Post-Event Processing 29 The Role of Assumptions and
Schema in Appearance Anxiety 32 Summary 33 Deriving a Cognitive Behavioural
Treatment Model: Identifying Factors and Processes Contributing to
Successful Adjustment to Disfiguring Conditions 34 Working Framework of
Adjustment to Disfiguring Conditions 34 The ARC Framework of Adjustment to
Disfiguring Conditions 34 Predisposing Factors 35 Intervening Cognitive
Processing 36 Socio-Cognitive Processing 37 Outcomes 41 The ARC Research
Programme Findings 43 The Studies 43 Summary of Findings 43 Key Messages
from the Research Programme 45 Implication of These Findings for Design of
Interventions 45 Summary 47 4 Clinical Assessment 48 Eliciting the Problem
49 Summarizing 51 Motivation and Self-Efficacy 52 Readiness for Change 53
Measurement Tools 55 Generic Measures of Psychological Constructs (as used
in the ARC Study) 55 Measures of Psychological Constructs Specifically
Related to Appearance 57 Measures of Body Image 58 Measures of
Psychological Constructs Specifically Related to a Condition Type 58 Body
Dysmorphic Disorder (BDD) 59 Core Clinical Dataset 59 Regular Subjective
Measures of Frequency for Events, Thoughts and Feelings 60 Goal Setting 61
The SMART Acronym 61 Challenges in Treatment for Appearance-Related
Problems 62 Introducing a Biopsychosocial Model 62 Treatment 'buy-in' 63 5
Social Skills and Coping Strategies 64 Staring, Questions, Comments and
Loss of Anonymity 66 Making the Most of Appearance 66 Developing a Positive
Approach to Visible Difference 67 Posture, Smiling and Eye Contact 67
Developing Verbal Skills 68 Learning to Have a Conversation 68 Answering
Questions About Appearance 68 Managing Staring 70 Putting it into Practice
71 Taking the Initiative in Social Encounters 72 Managing Anger and
Developing Assertiveness 73 Anger 73 Managing Intimacy 75 Disclosing a
Disfiguring Condition to a Partner 75 Summary 77 6 Cognitive Behavioural
Therapy 78 Techniques in Cognitive Behavioural Therapy 79 Socratic Dialogue
79 Eliciting Negative Automatic Thoughts 82 Unhelpful Beliefs Record Form
84 Negative Automatic Thinking Styles Associated with Anxiety 84 Triple
Column Technique 87 Pie Charts 87 Manipulating Safety Behaviours 88 Anxiety
management techniques 88 Target, Tools, Troubleshoot, Test 89 Cost-Benefit
Analyses 90 Some Techniques for Dealing with Appearance-Related
Self-Criticism and Shame 93 Functional Analysis of Self-Criticism 94
Identifying the power of self-criticism 94 Summary 97 7 Planning Treatment
and Sessional Guides 98 Introduction 102 Working at Level 1 102 Working at
Level 2 104 Working at Level 3 105 Session 1 106 Structure Outline 106
Working at Level 3 Using FaceIT (www.faceitonline.org.uk) 108 Working at
Level 4 using CBT 108 Planning Treatment and Sessional Guides 108 Clinical
Examples 112 Example 7.4 112 Session 1 112 Session 2 116 Review Data 116
Set Agenda 116 Restatement of Formulation 117 Elicit Patient Understanding
118 Session 3 118 Review of Homework and Reformulation 118 Set Agenda 119
Introduction to Answering Questions About Her Face 119 Role of Self-Focused
Attention Discussed 119 TTTT 119 Homework 119 Session 4 119 Review of
Homework and Reformulation 119 Set Agenda 120 Reattribution of Beliefs 120
Design Behavioural Experiments 121 Homework 121 Session 5 121 Review of
Homework 121 Set Agenda 121 Strategies for Attentional Training 122
Development of Personal Coping Approaches 122 Homework 122 Session 6 122
Review of Homework 122 Measure Noticeability and Worry 122 Reattribution of
Beliefs 122 Feedback from Behavioural Experiments 122 Development of
Personal Coping Approaches 123 Homework 123 Session 7 123 Review of
Homework 123 Set Agenda 123 Schema-Focused Reattribution 123 Preparation
for Ending 123 Homework 123 Session 8 124 Review of Homework 124
Schema-Focused Reattribution 124 Planning for Ending 124 Homework 124
Session 9 124 Homework 124 Agenda 124 Outcome 125 Example 7.5 126 Session 1
126 Summary 129 Session 2 130 Review Data 130 Introduction to Social
Comparison Processes 130 Restatement of Formulation 130 Elicit Patient
Understanding 131 Introduction to Compassionate Thinking 132 Homework 132
Session 3 132 Review of Homework and Reformulation 132 Set Agenda 132 TTTT
132 Introduction to NATs 132 Section 4 133 Review of Homework and
Reformulation 134 Set Agenda 134 Reattribution of Beliefs 136 Design
Behavioural Experiments 136 Session 5 137 Review of Homework and
Reformulation 137 Set Agenda 137 Session 6 137 Review of Homework and
Reformulation 137 Set Agenda and Review Progress 138 Measure Noticeability
and Worry 138 Reattribution of Beliefs 138 Feedback from Behavioural
Experiments (Disclosure) 138 Homework 138 Sessions 7, 8 and 9 138 Review of
Homework and Development of Final Reformulation (See Figure 7.13) 138 Set
Agenda 139 Focus on Schema-Focused Reattribution 139 Session 10 140 Outcome
140 Example 7.6 140 Session 1 140 Summary 144 Session 2 144 Review Data 144
Noticeability and Worry Graph 145 Set Agenda 145 Introduction to Social
Comparison Processes 146 Self-Efficacy 146 Safety Behaviours 146
Restatement of Formulation 146 Homework 147 Session 3 147 Review of
Homework and Reformulation 147 Set Agenda 147 TTTT 147 Anxiety Management
148 Introduction to NATs 148 Homework 148 Session 4 148 Review of Homework
and Reformulation 148 Set Agenda 148 Design Behavioural Experiments 149
Homework 149 Session 5 149 Review of Homework 149 Set Agenda 149 Homework
149 Session 6 150 Review of Homework 150 Set Agenda 150 Measure
Noticeability and Worry 150 Design of Behavioural Experiments 151 TTTT:
Role Play Her Response If Her Breasts Are Mentioned 151 Homework 151
Session 7 151 Review of Homework 151 Set Agenda 151 Focus on Reattribution
151 Preparation for Ending 152 Homework 152 Sessions 8, 9 and 10 152
Session 11 152 Homework 154 Agenda 154 Outcome 154 Example 7.7 154 Session
1 154 Summary 157 Session 2 157 Review Data 157 Plan Homework 158
Therapeutic Buddy 158 Homework 158 Session 3 158 Review of Homework and
Reformulation 158 Homework 159 Session 4 160 Review of Homework and
Reformulation 160 Set Agenda 160 Set Homework 160 Session 5 160 Review of
Homework 160 Set Agenda 160 Homework 161 Session 6 161 Review of Homework
and Reformulation 161 Set Agenda 161 Completion of Rating Scales and
Outcomes 161 Sessions 7 and 8 161 Set Agenda 161 Session 9 162 Completion
of Rating Scales and Outcomes 162 Summary and Feedback 162 Outcome 162
Long-Term Outcome and Maintenance of Change 162 Complete Maintenance 162
Partial Maintenance 163 Slip-Back and Sub-maintenance 163 Slip-Back and
Failure 163 Social Support and Therapeutic Partners 164 Summary 164
Additional Resources 165 8 The Emerging Adult: Facilitating Transition from
Child to Adult Service 166 Introduction 167 Introducing the Problem of
Transition 167 Transition from the Young Person's Perspective 168
Transition from the Parents' Perspective 168 Transition from the Health
Professionals' Perspective 168 Guidance for Improving Transitional Care 169
Issues Pertinent to Caring for Young People with Appearance Concerns 170
The Salience of Appearance to Young People 170 Reluctance to Seek or Accept
Support 171 Factors that Can Promote Adjustment to a Visible Difference
among Young People 171 Romantic Issues 173 Transition as an Opportunity for
Those with a Visible Difference 174 Concluding Remarks 175 9 Psychological
Assessment for Cosmetic Surgery 176 Introduction 177 Is Cosmetic Surgery
Effective? 177 Access to Surgery in the NHS 178 Psychological Screening by
the Surgeon 179 NICE Guidelines 179 Onward Referral 179 What Does the
Surgeon Want from a Psychological Assessment? 180 What Does the Patient
Want from a Psychological Assessment? 181 A Framework for Psychological
Assessment 181 Case Examples 183 Common Problems in Referral 189 Liaising
with the GP 189 Health Professionals' Knowledge of Cosmetic Procedures 189
Summary 190 Additional Resources 190 10 Models of Service Delivery 191
Lay-Led Support 192 Specialist Services 192 Outlook 192 Embedded Services
192 Royal Free Hospital, London 192 Access to Psychology Services 192
Access to Mental Health Services 193 Mapping Service Models onto Stepped
Care 193 Appendix 194 Resources 272 References 280 Index 293

Rezensionen

"This book is perhaps most useful for those working with individuals where appearance anxiety is the result of an observable visible disfigurements as this is clearly the main focus of the book." (Behavioral and Cognitive Psychotherapy, 1 May 2014)