A Practical Approach to Cognitive Behaviour Therapy for Adolescents PDF
Preview A Practical Approach to Cognitive Behaviour Therapy for Adolescents
Manju Mehta · Rajesh Sagar Editors A Practical Approach to Cognitive Behaviour Therapy for Adolescents A Practical Approach to Cognitive Behaviour Therapy for Adolescents Manju Mehta · Rajesh Sagar Editors A Practical Approach to Cognitive Behaviour Therapy for Adolescents 1 3 Editors Manju Mehta Rajesh Sagar Department of Psychiatry Department of Psychiatry All India Institute of Medical Sciences All India Institute of Medical Sciences New Delhi New Delhi India India ISBN 978-81-322-2240-8 ISBN 978-81-322-2241-5 (eBook) DOI 10.1007/978-81-322-2241-5 Library of Congress Control Number: 2014957632 Springer New Delhi Heidelberg New York Dordrecht London © Springer India 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer (India) Pvt. Ltd. is part of Springer Science+Business Media (www.springer.com) Preface Adolescence (11–19 years age) has been recognized as a period of turmoil. This is a transitional stage characterized by rapid biological, psychological and inter- personal changes. The adolescent has dreams but many times fails in methods to achieve them. In the present scenario, many adolescents have to face high com- petition, unrealistic expectations and multiple distractions. It is not surprising that different types of psychological problems are manifested during adolescence. Although, there is evidence that only 3–12 % of the adolescent population need help for various mental disorders, 25 % need help for adjustment problems and almost 40 % need help in developing life-skills and competencies to learn to deal with their problems effectively. Psychosocial support through Cognitive Behavioural Therapy (CBT) helps to bring changes in patterns of thinking, feel- ing and behaviour in an individual. CBT is a collaborative approach that teaches adolescents and their parents new ways of thinking (cognitive) and acting (behav- ioural) which are more balanced, less negative and lead to improvements in psy- chological well-being. CBT empowers adolescents to solve problems and cope with their own diffi- culties while supporting parents with strategies to help their children achieve suc- cess. CBT also helps to improve psychosocial competence and builds resilience. Psychological empowerment is an adolescent’s cognitive state characterized by a sense of perceived control, competence and goal internalisation. This is a proactive approach to life, which helps in adaptation, capacity building, provides a sense of well-being and prevents development of mental disorders. There are different approaches to deliver CBT, namely individual CBT; group CBT; TF—Trauma Focused CBT; and self-help approach which includes Computerized CBT, Internet-based CBT and manual-based CBT; and Tele-CBT. Computer-assisted/Internet-based therapies have great potential to make psycho- logical assessment and treatment more cost-effective than other approaches. These forms of therapies are feasible and efficacious and can reduce the stigma of visit- ing mental health professionals. This book comprises 19 chapters and is divided into three parts. The first part provides an overview of problems faced by adolescents and the psychological v vi Preface techniques that can be used to help them deal with mental health problems. Chapter 1 describes the prevalence and magnitude of mental health conditions among adolescents in India. Chapter 2 provides an introduction to Cognitive Behavior Therapy, its basic principles and applications in various mental health disorders. Chapter 3 enumerates the significance of community-based interven- tions for Indian adolescents. The second and third part of the book (Building Skills and Interventions) has been developed out of intense research carried out on clinical populations. Each of the chapters describes modules in detail, including assessment of the adolescent and practical steps to be followed to bring change in the behaviour. Modules on building skills can be used in the school set-up by school counsellors and other mental health professionals working with adolescents. Chapter 4 imparts study skills that may help adolescents cope with academic difficulties. Different strat- egies are given to develop effective studying styles and to make studying more rewarding. Chapter 5 deals with relationship issues often precipitating emotional problems in adolescents. The chapter describes skills that may aid in interpersonal problem solving. Chapter 6, Anger Management, addresses the prevalent problem of anger and aggression in adolescents and imparts techniques for management of the same. Chapter 7 deals with Sleep Disorders in adolescents and elaborates on techniques for sleep management as well as sleep hygiene. Stress is a common problem among adolescents and is widely seen as a precipitating factor for many mental health issues, therefore, Chap. 8 focuses on imparting skills for effective stress management. Chapter 9 deals with management of pain-related issues in various disorders such as psychosomatic pain, fibromyalgia, etc. The next few chapters (Interventions) focus on mental health disorders. The interventions described can be practiced, after training in clinical skills by pro- fessionally trained clinical psychologists. The practice of CBT requires exten- sive supervised training. It is imperative that only trained professionals practise CBT with utmost efficiency. Chapter 10, the management of Anxiety disorders, lays the foundation for CBT techniques. As anxiety is an underlying condition in many psychiatric and psychophysiological disorders, the techniques described have a wider application. Chapter 11 on Depression in adolescents, is very rel- evant to current mental health needs. Depression is manifested in adolescents in a different way compared to adults. Currently this disorder is becoming very com- mon due to psychosocial stressors, which need specialized intervention. Obsessive Compulsive Disorder covered under Chap. 12 also provides self-help methods. Somatoform Disorder in adolescents are often seen in Indian and Asian cultures, but there is a scarcity of standardized psychological intervention and Chap. 13 aims at bridging this gap. Chapter 14 elaborates on a transdiagnostic approach to the management of headaches in adolescents, employing more recent modules to the practice of CBT in management of comorbid conditions. Chapter 15 focuses on management of Attention Deficit Hyperactivity Disorder in adolescents. ADHD is no longer limited to childhood, the adolescent period aggravates some other problems, which are being addressed in this chapter. Chapters 16–18 are based on more recent lifestyle-based issues faced by adolescents, namely Substance Abuse, Preface vii Internet Addiction and Obesity. These chapters enumerate intervention modules to address these concerns. The final Chap. 19, Effectiveness of Cognitive Behaviour Therapy in Adolescents, focuses on the efficacy studies and applicability of cognitive behav- iour therapy in various mental disorders. All the modules are presented as practical steps in session format and guides the practitioner through the various techniques. This book aims at disseminating CBT techniques which are culturally adapted and are likely to empower adoles- cents with skills to make their life more meaningful, happier and worthy. Manju Mehta Rajesh Sagar Acknowledgments We express our sincere thanks to all the contributors for consolidating research work into a book. We are thankful to all the members of the doctoral committee from Psychiatry and Biostatistics Department of All India Institute of Medical Sciences, New Delhi, for giving critical feedback during the development of treat- ment modules. We wish to acknowledge help provided by Prof. Girishwar Mishra, Vice Chancellor, Wardha University; Ex Prof. of Psychology, Delhi University and Chairman of ICSSR, New Delhi for peer review of the chapters. Our heartfelt thanks to patients of Psychiatry OPD, All India Institute of Medical Sciences, New Delhi, on whom the modules were administered and refined. We extend our thanks to Dr. Paulomi Sudhir for her unconditional support and valuable suggestions at every step of development of this book. Our special thanks to Ms. Sneh Kapoor, Ms. Paakhi Srivastava and Ms. Pragya Sharma for help in organizing and editing the material. Thank you all Manju Mehta Rajesh Sagar ix Contents Part I Introduction 1 Magnitude of Mental Health Problems in Adolescence ............ 3 Usha Naik 2 Cognitive Behaviour Therapy with Adolescents .................. 21 Paulomi Matam Sudhir 3 Community-Based Mental Health Interventions in Adolescents .... 43 M. Manjula Part II Building Skills 4 Study Skills ............................................... 57 Garima Srivastava Malhotra and Manju Mehta 5 Interpersonal Skills ......................................... 91 Deepika Gupta, Manju Mehta and Rajesh Sagar 6 Anger Management ......................................... 109 Vidhi M. Pilania, Manju Mehta and Rajesh Sagar 7 Management of Sleep Problems ............................... 131 Angela Ann Joseph, Manju Mehta and Garima Shukla 8 Stress Management ......................................... 149 Manju Mehta and Vandita Sharma 9 Pain Management .......................................... 179 Anubha Dhal, Manju Mehta and Rajesh Sagar xi xii Contents Part III Interventions 10 Anxiety Management ....................................... 193 Swati Kedia Gupta and Manju Mehta 11 Depression ................................................ 215 Paakhi Srivastava, Manju Mehta, Atul Ambekar and Rajesh Sagar 12 Obsessive-Compulsive Disorder ............................... 245 Sneh Kapoor, Manju Mehta and Rajesh Sagar 13 Somatoform Disorders ...................................... 263 Suparna Kailash, Manju Mehta and Rajesh Sagar 14 Headache—A Transdiagnostic Approach ....................... 285 Pragya Sharma, Manju Mehta and Rajesh Sagar 15 Attention-Deficit/Hyperactivity Disorder ....................... 311 Monica Mongia, Manju Mehta and Rajesh Sagar 16 Treatment of Substance-Abusing Adolescents ................... 331 Renu Sharma, Manju Mehta and Anju Dhawan 17 Intervention for Internet Use: Current Understanding and Perspective ............................................ 363 Manoj Kumar Sharma and P. Thamil Selvan 18 Obesity ................................................... 375 Tanu Gupta, Vandana Jain and A.C. Ammini 19 Effectiveness of Cognitive Behavioural Therapy in Adolescents .... 395 Rajesh Sagar, Manju Mehta and Anamika Sahu Appendix ..................................................... 415
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