GN3006-PowerPoint

Use Psycho-Educational Tools
42 TIPS AND TOOLS FOR THE
DEPRESSION AND ANXIETY
TREATMENT TOOLBOX
JUDITH A. BELMONT, M.S.
from Second and Third Wave
Approaches CBT,
DBT, ACT, MBCT &
Positive Psychology
Mindfulness focus plus CBT
TIP #1
Make learning experiential
As Confucius said:
"Tell me, and I will forget. Show me, and I may remember. Involve
In
nvol me, and I will understand."
Get clients involved in their help!
• Use Psycho-Educational
• Ensure a strong therapeutic and collaborative alliance.
• Start each session with a mood check
• Clarify goals and agenda
• Use experiential activities and visualizations
• Use Metaphors to unlock insight
• Use self-help assignments between sessions
• Get in the habit of asking for feedback
• Use Role Play - representing people or thoughts
• Help client create daily rituals
•  The Therapeutic Relationship
Transcends any Techniques
Carl Rogers - Unconditional positive regard
Linehan - Non - judgmental therapist
Hayes - Utmost importance of positive regard
Even Ellis emphasized the importance of the client feeling
“liked”
COMPASSION
POSITIVITY
HO
TIP #2
Help Your Clients Learn To
Think Flexibly with Simple
Demonstrations
Teach flexibility - Don’t just talk about it! Exercises
PE
EM
H
T
E
LIK
TIP #3
HELP SOMEONE CRY
Be
flexible
Small
change can be a big deal! Don’t
miss opportunities with
inflexible
thinking!
Would you
rather have a
million dollars or a penny
which doubles every day for a month? HELP SOMEONE CRY
The
T
he T
Therapeutic
herapeutic R
Relationship
elationship
Transcends
any
Techniques
Transcend
ds a
ny T
echnique
es
What’s the biggest room in the world? Carl Rogers
rrss - Unconditional
Unc
ncon
nco
ndi
nd
d ti
di
ttio
iio
on
nal
na
all positive
possi
po
sit
itive
it
i regard
regard
Lineha
ha
h
an - No
N
o
on
n - judgmental
judg
ju
dgm
d
gm
g
men
eent
n
ntta
all the
ttherapist
th
herapist
he
Linehan
Non
Utmost
importance
off p
positive
regard
Hayes - U
tm
tm
mo
ost
st imp
im
mportancee o
mp
po
ossi
osi
o
siti
tive regard
Even
Eve
veen Ellis emphasized
emph
has
asi
a
sizze
si
zed
ed
ed th
tthe
he iimportance
mp
mp
mpo
po
orrta
ta
tance
tan
nccee of
nc
of the
the client feeling
feeeli
ling
“liked”
“
“li
liiked
ked”
ke
O N
SIIO
SSI
COMPASS
ITY
IVIT
SITIV
POSI
PO
Opportunity is NOWHERE
Perception is Everything
Learn the lesson of the Cookie Thief!
Activity: We all perceive differently! Examples
TIP #4
Learn the lesson of the Cookie Thief!
The Power of Metaphors
Toolkits
Distress Tolerance
Kit (DBT)
The Recovery Toolkit
The Drug Free Toolkit
The Stress Toolkit
The Life Skills Toolkit
TIP #5
Demonstrations and
visualizations TIP #6
Importance of Homework and
Self-Help Assignments
Practice, Practice Practice!
CBT Bootcamp
Psycho-Education
Introducing your client to CBT concepts
TIP #7
Analogy:
Therapy as a New Language
New Terms
New Acronyms
Learning the Psychological ABCS
Examples of new ABCS: ACT, DBT and CBT TIP #8
Teaching your clients the
Psychological ABCS
A B C
TIP #9
D
E
Common Mental Mistakes
D!
o BA
ss
He i
Life should be fair!
They
have
like to
me!
Between session tracking and practice
-
cornerstone of all
types of treatment
Includes rating of believability or
emotional intensity
That’s
TERRIBLE!
I can’t
stand it!
TIP #10
Rating the Strength
of Your Belief
1
2
3
Mood logs, Diary cards,
Skill building sheets
4
5
6
Low Belief
7
8
9
10
Strong Belief
TIP #11
Identifying Self - Defeating
Beliefs Inventory Sheets, Lists, Cognitive
Distortions lists, Journal Logs,
Handouts and Worksheets
TIP #12
Example - Triple Column
Technique
Automatic Thought
Cognitive Distortion
Rational Response
TIP #13
TIC TOCS - David Burns
Task Interfering Cognitions
Task Oriented cognitions
TIP #14
Types of Cognitive
Distortions
1. Over-Catastrophizing
2. Fortune Telling
CBT Techniques
3. Black and White Thinking
4. Personalization
5. Jumping to Conclusions
6. Labeling
7. Magnification
8. Minimization
9. You “should” on yourself and others
10. Making Comparisons
TIP #15
11. Mental Filter
Digging Deeper to Core Beliefs
Vertical Arrow
w
Technique
TIP #16
CBT Example Coping Card #1
CBT Techniques
Coping Card Varieties
TIP #17
Automatic thought:
If my boyfriend leaves me, I’ll never have
anyone else.
Response:
I won’t have anyone at first. But there are a
lot of things I can do to meet someone new
and I’m learning a lot of things in therapy
to help me have a better relationship next
time. Just because I feel like I am
unlovable doesn’t mean it’s true.
Used with permission of J. Beck, from
Cognitive Therapy for Challenging
Problems (2005).
CBT Example Cognitive Reframing
Turning Anger into Goals
Eliminate the ANTS
TIP #18
CBT Group Activity Irrational & Rational Songs
Other Role Play Variations
Feared Fantasy (CBT)
Externalization of Voices (CBT)
Take turns playing the roles
of client’s negative thoughts
an
a
n the role of your
and
p
positive
thoughts.
(Empty chair technique)
TIP #19
CBT Techniques to Treat Anxiety Cost/Benefit Analysis
TIP #21
TIP #20
Depression Screening
Inventories/Mood Logs
Burns Depression Checklist
Beck Depression Inventory
TIP #22
ACT - Third Wave Treatment
Biblio-Therapy and Depression
Introducing ACT
Acceptance Commitment
Therapy
Founder: Stephen Hayes
y
TIP #23
ACT - Third Wave Treatment
ACT - Third Wave Treatment
ACT Techniques
Use of Metaphors
ACT Techniques
Cognitive Defusion
TIP #24
White room
Conveyor Belt
Monsters on the Bus
Beach Ball
TIP #25
More Role Play Variations
Passengers on the Bus (ACT)
Acceptance Paradox (CBT)
Mind Monsters - which one you feed
Take turns playing the roles of client’s negative thoughts and the role
of your positive thoughts.
TIP #26
More Metaphors
TIP #27
DBT ACT and MBCT
Dialectical Thinking
Mindfulness and Metaphors
TIP #28
Have client make up their own
What are common ones?
Opposing Needs, Wants,
Expectations
We are always making
W
compromises
(even if you’re not aware of them).
TIP #29
Oxymorons
DBT
Understanding
The Four Modules
Jumbo Shrimp
Awfully good
Pretty Ugly
Bittersweet
Can y
you and your clients think of more? Acceptance Based Techniques
Core Mindfulness
Distress Tolerance
Change Based Strategies
Interpersonal Effectiveness
Emotional Regulation
TIP #30
TIP #31
Example of DBT Acronyms
DBT Techniques to Treat Depression Acronyms Galore
MEDDS
When you practice ONE MIND, you are focusing on: O: One thing at a time
N: Being in the here and Now
E: Attend to the Environment
M: Be attentive to the Moment
I: Increase your five senses
N: Take a Non-judgmental stance
D: Describe what you experience without interpretation
MEDDS
Mastery - Exercise - Diet Mastery - Exercise - Diet Drugs (prescription) -
TIP #32
Drugs (prescription) Sleep - Spirituality
Sleep - Spirituality
DBT is full of acronyms
y
One Mind
• 
• 
• 
• 
One thing in the moment
moment
Now
Environment
Moment
Common Acronyms
ATM: Automated Teller Machine
ADD: Attention Deficit Disorder
AIDS: Acquired Immune Deficiency Syndrome
EPCOT: Experimental Prototype Community of Tomorrow
FEMA: Federal Emergency Management Agency
24/7: All the time, 24 hours a day, 7 days a week
AA: Alcoholics Anonymous
ASAP: As Soon as Possible
FYI: For Your Information
B.C.: Before Christ
A.D.: Anno Domini, year of the Lord
• 
• 
Increase Non judgmental
Describe
Dear Man
• 
• 
• 
• 
• 
• 
• 
Describe
Express
Assert
Reinforce
Mindful
Appear confident
Negotiate
Diary and Tracking
Logs using Acronyms
• 
• 
• 
• 
Know the DBT Modules
Radical Acceptance and Mindfulness
Emotional Regulation Strategies
Distress Tolerance
Interpersonal Effectiveness
TIP #33
Psycho-Education for Stress: Important to include: Communication Basics
Teach Assertive Skills
TIP #34
It’s not just what you say!
So much of communication is non-verbal
Assertive
Non-Assertive
Aggressive
Role Play Behavioral rehearsal
Use role play to teach effective
interpersonal communication
I never
neeve said he stole the money!
TIP #35
21
Conflict Resolution Exercise:
Strive to have no
winners and losers strive for relationships
that are
Use Communication Skills
Handouts and Worksheets for skill building to
practice, practice, practice!
WIN- WIN
TIP #36
TIP
“I” message into “You” messages worksheets
Rhetorical Questions worksheet
#37 Communication Log
Communication Skills
Group Activities: Listening
vs
Hearing
Relationship Building
What is the difference? W
Egg
Gem inside of me
TIP #38
TIP #39
Psychosocial Education:
Myth Busting
Activity: STRESS IS…………. Or Who stresses you out activity? TIP #40
Great Group Activities
Manage your stress - don’t carry it!
Clarifying Values
16%
4%
31%
12%
6%
6
6%
Work/Career
Health
Family
Recreation
Spiritual
Friends
Personal/Educational
Social
7%
18%
How I slice my life
4%
16%
31%
12%
6%
6%
TIP #41
TIP #42
7%
18%
Work/Career
Health
Family
Recreation
Spiritual
Friends
Personal/Educational
Social
How I would like to slice my life
Clarifying Values
Can you think of TIP #43
from your own therapeutic toolbox? Contact Information:
Judith Belmont, MS
[email protected]
www.belmontwellness.com
Tips and Tools for the Therapeutic Toolbox series
and The Therapist’s Ultimate Solution Book