Brain-Based Therapy with Adults: Evidence-Based Treatment for Everyday Practice

339 Pages·2008·2.51 MB·English

by  John B. Arden

Arden
An insightful and practical guide that looks at the role
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neuroscience plays as it relates to the evidence-based
treatment of adult disorders
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ritten in an accessible way, Brain-Based Therapy with Adults: Evidence-Based Treatment rr
for Everyday Practice provides a straightforward, integrated approach that looks at
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what we currently know about the brain and how it impacts and informs treatment BBrraaiinn--BBaasseedd
interventions. Authors Arden and Linford show how this new kind of therapy takes into account ii
both the uniqueness of each client, as well as the requirements of standardized care under nn
evidence-based practice—and offers mental health professionals advice that they can put into
practice immediately. --
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Relying on research in developmental neurobiology, brain imaging, and evidence-based TTHHEERRAAPPYY
psychotherapeutic practices, the authors, experts in both neuroscience and evidence-based aa
practice, cover:
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• Recent neuroscientifi c discoveries and how these can be integrated into evidence-
based interventions to create uniquely effective treatments dd
• Detailed background and evidence-based interventions for many of the most
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common adult disorders, such as OCD, panic disorder, generalized anxiety disorder,
and relationship problems
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• Tips on helping patients re-regulate such neurodynamically important processes as
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sleep and the mind-body relationship
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Incorporating vignettes that illustrate how to include these new treatments into effective
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client care, Brain-Based Therapy with Adults: Evidence-Based Treatment for Everyday Practice
explains the concept of brain-based therapy in a succinct and easy-to-grasp way, enabling pp
therapists to make practical sense of neuroscience and its application within their everyday
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practice.

JOHN B. ARDEN, PHD, is the Director of LLOYD LINFORD, PHD, serves as Chair- Treatment
Training for the Kaiser Permanente Medical man of Psychiatry and Chemical Dependency
Centers for the Northern California Region. Best Practices for Kaiser Permanente’s W
In his capacity, he oversees the internships Northern California healthcare system, is a I for
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and postdoctoral psychology residencies in clinical psychologist at Kaiser Permanente H
twenty-two medical centers. He is the author Oakland Medical Center, and is in private
A Everyday Practice
of nine other books. practice in Oakland, California.
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Also Available: L
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Brain-Based Therapy with Children and Adolescents: Evidence-Based Treatment for Everyday Practice
S
John B. Arden and Lloyd Linford
ISBN: 978-0-470-13890-8 PMS 576C PMS BLUE 072C GLOSSY
FM_1 09/29/2008 2
FM_1 09/29/2008 1
Brain-Based
Therapy with
Adults
FM_1 09/29/2008 2
FM_1 09/29/2008 3
Brain-Based
Therapy with
Adults
Evidence-Based Treatment for
Everyday Practice
By
John B. Arden
Lloyd Linford
John Wiley & Sons, Inc.
FM_1 09/29/2008 4
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LibraryofCongressCataloging-in-PublicationData
Arden,JohnBoghosian.
Brain-basedtherapywithadults:evidence-basedtreatmentforeveryday
practice/byJohnArden,LloydLinford.
p. ; cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-13890-8(pbk.:alk.paper)
1. Neuropsychiatry. 2. Psychotherapy. I. Linford,Lloyd. II. Title.
[DNLM:1. MentalDisorders—therapy. 2. Psychotherapy—methods.
3. Evidence-BasedMedicine—methods. 4. Psychophysiology.WM420A6763b
2009]
RC341.A7362009
616.8—dc22
2008022832
PrintedintheUnitedStatesofAmerica
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Contents
Acknowledgments vii
Preface ix
About This Book xi
1 How We Change 1
2 Neuroscience: The Fantastic Voyage 18
3 Psychotherapy and the Pax Medica 49
4 The Therapeutic Relationship 69
5 Working with Memory and Emotion 95
6 Dysregulations 120
7 Brain-Based Therapy for Anxiety Disorders 139
8 Posttraumatic Stress Disorder 166
9 Obsessive-Compulsive Reactions 184
10 Depression: The Dark amid the Blaze 202
11 Exercise, Sleep, and Mindfulness 233
References 253
Author Index 297
Subject Index 300
v
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Acknowledgments
Thisbookissometimesextravagantinitspraiseofthehumanbrain.Ifyou
need a reminder about the brain’s limitations, we recommend you try
writingabooklikethisone.Itquicklybecomesobviousthatnooneperson
(or even two) can do this on their own. Brain-Based Therapy would not
have come into existence without the support and contributions of many
people.Firstandforemost,weareindebtedtoourwives,VickiArdenand
Pam Valois, for their encouragement, insightful editorial comments, and
good-hearted willingnessto sacrifice countlessevenings and weekendsto
theproject.Fortoolongbothofushavegonetobedandwokenuptalking
aboutBDNFandtheDLPFC.VickiandPamhadthegoodgracetorefrain
from pointing out we had developed OCD or ADHD, or some other
alphabeticalpsychologicaldisorder.
This book came out of our good fortune in meeting and talking with
colleagues in Kaiser’s Northern California Best Practices and Post-
Doctoral Training programs, and with presenters at Kaiser’s Annual
Northern California Psychiatry and Chemical Dependency Conference.
We would like to thank the other members of the Conference planning
group—Stephen Miller, Marion Lim-Yankowitz, Marilyn McPherson,
Debby Mendlowitz, Caryl Polk, and John Peters—who for each of the
last 16 years have brought these experts to talk with our colleagues in
San Francisco. Among many outstanding academics and clinicians who
contributed to this book through the ideas they articulated on the confer-
encepodium,we’dliketosingleoutourfriendsJimGrigsby,whohelped
create the idea for this book and edited the first three chapters of this
volume, and Lou Cozolino, who has set a high standard for integrating
neuroscience and psychotherapy in his own work and writing. Conver-
sations with Dr. Cozolino led to the idea for the BASE, a mnemonic that
condenses our ideas about brain-based treatment into a practical and
teachable form. Michael Lambert, the dean of psychotherapy researchers,
finallygotustoseethatpeopletrumptechniqueinpsychotherapy.
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viii ACKNOWLEDGMENTS
Like a tripod, this book is supported by three legs of approximately
equal importance: neuroscience, attachment studies, and psychotherapy
research into evidenced-based treatment for specific psychological disor-
ders. Regarding the latter, we have received heart-warming and brain-
changing support from the members of Kaiser’s Best Practices Steering
Committee, to whom we express our thanks. In particular we must ac-
knowledge Elke Zuercher-White’s generosity in sharing her scholarship
and insight into the origins of anxiety disorders and evidenced-based
treatment for OCD, panic, and social anxiety disorder. Anna Wong, the
leader of Kaiser’s ADHD Best Practices Workgroup and the coauthor of
its clinical recommendations, changed our minds about ADD in two or
three brilliant conversations about brain-based attentional disorders.
Dr.Zuercher-White’sandDr.Wong’sreadingsandcommentsonchapters
in the book resulted in critical changes and improvements. Margaret
Schadler and Jim Ballenger also provided critical input on various chap-
ters (as did, unwittingly, Joel Meresman, whose work on depression has
influencedusboth).ConversationswithanothermemberoftheBestPrac-
tices Steering Committee, John Peters, have been indispensable in formu-
lating our ideas about outcomes management and the ‘‘common factors’’
thatmakepsychotherapywork.CharlesVellahelpeduswithmattersper-
tainingtoneuroscienceandeditedthechapteronmemory.RexBierlyand
Daniel Dalcorso reviewed the whole manuscript. Tom Cohen’s support
and close reading of the ADHD chapter only deepened a debt that’s been
accruing over 30 years of friendship; likewise Patricia Saar’s support and
commentsaboutthebookhelpedreshapeourorientationtothereader.
Finally, we would like to thank the great team at Wiley, whose profes-
sionalism and commitment to clinically relevant books is exemplary.
Peggy Alexander, Marquita Flemming, Kim Nir, and Katie DeChants at
Wileyhavebeengenerousandhelpfulthroughoutthisproject.
In short, many excellent brains have been involved in the creation of
this book and its companion volume. It’s only fair to restate the obvious:
thesecontributorscan’tbeheldresponsibleforthebook’sshortcomingsor
anyerrorsoffactwehaveinadvertentlycommittedtoprint.Wearesolely
responsibleforthecontents.
—JohnArden,Sebastopol,California
—LloydLinford,Piedmont,California