Saving Talk Therapy by Enrico Gnaulati

Author:Enrico Gnaulati [Gnaulati, Enrico]
Language: eng
Format: epub
ISBN: 9780807093412
Publisher: Beacon Press
Published: 2017-11-06T05:00:00+00:00

Clients are urged to identify and keep a log of stuck points, or distorted automatic thoughts. In the vignette above, the client would be coached to see this as an example of survivor guilt and to categorize it as a distorted sense of power stuck point.

There is a strong psychoeducational component to the therapy. Early in the series of twelve modules, the client is taught about PTSD, the psychological and physiological effects of flight-or-fight reactions, and the various emotions people with PTSD experience. They are versed on standard CBT distortion mechanisms like all-or-nothing thinking, mind reading, jumping to conclusions, and emotional reasoning. This knowledge primes them to more confidently self-analyze for, and categorize, thinking mistakes in therapy and in their impact statement.

In an impact statement, the client, on his or her own time, writes a narrative of a selected traumatic event and later reads it to the therapist. The act of writing and reading aloud a detailed description of the traumatic event undoes the tendency to push out of one’s mind the traumatic event and its effects. Throughout the treatment, the impact statement is continuously revised to incorporate less exaggerated self-recrimination.

Homework is assigned throughout in the form of worksheets. For example, on the Challenging Beliefs Worksheet, there are columns for clients to fill in to help them analyze automatic thoughts (e.g., “This can’t be happening to me,” “My life is over,” “If only I had loaded my rifle better, I would have shot the person who shot my buddy George”) for evidence of distortion (e.g., personalizing, emotional reasoning, jumping to conclusions). The Alternative Thought column allows for a more balanced, positive version of the original thought (“I’m nowhere near all to blame for what happened,” “I can recover from this terrible event if I try,” “You can’t always predict when things will go wrong”). Usually, at intervals during CPT treatment, time is set aside to administer a symptom checklist, like the Clinician-Administered PTSD Scale (CAPS). If the CAPS is chosen, the therapist fills it out in direct consultation with the client over the hour or so it takes to complete it.

Beginning in 2006, Resick spearheaded a national VA initiative to disseminate CPT to locations across the United States. Through evidenced-based practice coordinators assigned to various VA medical facilities and clinics, CPT was promoted as a “first-line psychotherapy for PTSD.”32 By 2010, more than four thousand VA mental health staff had attended a CPT workshop. Today, at VA facilities as far apart as the Alaska VA Healthcare System and the Togus VA Medical Center in Maine, CPT training is a staple on the vast majority of postings for psychology, social work, and counseling internship positions and psychiatric residency slots.

Despite the bold initiative and ample resources allocated to implement CPT usage among mental health professionals throughout the VA system, attitudes toward this type of therapy are ambivalent at best. The latest figures by behavioral health providers from the US Department of Defense reveal that more than half of the 60 percent of

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.