Clinical Practice of Cognative Therapy With Children and Adolescents PDF
Preview Clinical Practice of Cognative Therapy With Children and Adolescents
Clinical Practice of Cognitive Therapy with Children and Adolescents v The Nuts and Bolts ROBERT D. FRIEDBERG JESSICA M. MCCLURE THE GUILFORD PRESS New York London 2002 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved Except as noted, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 2 1 LIMITED PHOTOCOPY LICENSE These materials are intended for use only by qualified mental health professionals. The Publisher grants to individual purchasers of this book nonassignable permission to reproduce all figures for which photocopying permission is specifically provided in the figure’s caption. This license is limited to you, the individual purchaser, for use with your own clients and patients. It does not extend to additional clinicians or practice settings, nor does purchase by an institution constitute a site license. This license does not grant the right to reproduce these materials for resale, redistribution, or any other purposes (includingbutnotlimitedtobooks,pamphlets,articles,video-oraudiotapes, and handouts or slides for lectures or workshops). Permission to reproduce these materials for these and any other purposes must be obtained in writing from the Permissions Department of Guilford Publications. Library of Congress Cataloging-in-Publication Data Friedberg, Robert D., 1955– Clinical practice of cognitive therapy with children and adolescents: the nuts and bolts / Robert D. Friedberg, Jessica M. McClure. p. ; cm. Includes bibliographical references and index. ISBN 1-57230-723-4 (hardcover : alk. paper) 1. Cognitive therapy for children. 2. Cognitive therapy for teenagers. I. McClure, Jessica M. II. Title. [DNLM: 1. Cognitive Therapy—methods. WM 425.5.C6 F899c 2002] RJ505.C63 F75 2002 618.92′89142—dc21 2001054319 AAbboouutttthheeAAuutthhoorrss About the Authors Robert D. Friedberg, PhD, is a clinical psychologist on the faculty of the WrightStateUniversitySchoolofProfessionalPsychology.HeisanAsso- ciate Professor and directs the Predoctoral Internship Program and the Preventing Anxiety and Depression in Youth Program (PANDY). Dr. Friedbergistheauthorofthreeotherbooksonchildrenandadolescents: SwitchingChannels(withCarolynMasonandRaymondFidaleo),Thera- peutic Exercises for Children (with Barbara Friedberg and Rebecca Friedberg), and A Professional Guide to Therapeutic Exercises for Children(withLoriCrosby).Hehasauthorednumerousarticlesinschol- arly journals and delivered presentations on cognitive therapy with children and adolescents to professional audiences. Dr. Friedberg is a Founding Fellow in the Academy of Cognitive Therapy. JessicaM.McClure,PsyD,worksasaclinicalpsychologistspecializingin the assessment and treatment of children and adolescents for the Child- ren’s Hospital Medical Center in Cincinnati, Ohio. She is an adjunct faculty member at the Wright State University School of Professional Psychology,wheresheteachesseveralchild-focusedcourses.Dr.McClure has coauthored presentations and articles on the treatment of children and adolescents and currently serves children and adolescents experienc- ing depression, anxiety, behavior problems, and developmental delays. v This page intentionally left blank AAcckknnoowwlleeddggmmeennttss Acknowledgments Thank you to my wife, Barbara, and daughter, Rebecca, whose love and supportinspiredmethroughoutthisproject.Ivaluethecollaborationand collegiality with my coauthor, Jessica McClure, whose attention to detail is peerless. Kitty Moore, our editor, was an exceptional guide, shepherd- ing us through this project with creative and insightful comments. The many clinical trainees I supervised deserve mention, as our lively discus- sionsledmetorefinemanyideas.Iwanttoacknowledgethemanyyoung clients and families my trainees and I served and thank them for entrust- ingtheircaretous.IamgratefultotheWrightStateUniversitySchoolof ProfessionalPsychologyforgivingmetheopportunitytopursuemyclini- calserviceandresearch.Finally,specialthanksgoestoCarolSmart,who typedandretypedearlierversionsofthemanuscriptwithprofessionalism and good humor. ROBERT D. FRIEDBERG I would like to acknowledge the invaluable support that my family and friends provided me throughout this endeavor. I express my deepest ap- preciation to my husband, Jim McClure, for all of his patience and en- couragement over the countless hours of work. Thanks to my coauthor, Robert Friedberg, for his great sense of humor and collaboration on this project.IamgratefultomycolleagueDenisePrice,whoendurednumer- ous questions and provided endless encouragement throughout the pro- cess.Finally,CarolSmart’sclericalskillsweremuchappreciatedthrough- out the writing of this book. JESSICA M. MCCLURE vii This page intentionally left blank CCoonntteennttss Contents CHAPTER 1. Introduction 1 Who Are We? 1 Why Write a Book on Cognitive Therapy with Children and Adolescents? 2 What Will This Book Teach You? 2 What Is Cognitive Therapy? 3 What Are the Similarities between Cognitive Therapy with Adults and Cognitive Therapy with Children and Adolescents? 7 What Are the Differences between Cognitive Therapy with Adults and Cognitive Therapy with Children and Adolescents? 7 A Word about Our Transcripts and Examples 9 CHAPTER 2. Case Conceptualization 11 Case Conceptualization: Once Is Never Enough 11 Case Conceptualization and Treatment Planning 12 Case Conceptualization and Diagnosis 12 Case Conceptualization: “Dressing Up” the Client Picture 13 Components of the Case Formulation 15 Planning and Thinking Ahead: Provisional Formulation, Treatment Plan, and Expected Obstacles 26 Case Conceptualization Example 27 Conclusion 33 ix x Contents CHAPTER 3. Collaborative Empiricism 34 and Guided Discovery Continuum of Collaboration and Guided Discovery 37 Conclusion 44 CHAPTER 4. Session Structure 45 Mood or Symptom Check-In 47 Homework Review 51 Agenda Setting 54 Session Content 58 Homework Assignment 61 Eliciting Feedback 62 Conclusion 67 CHAPTER 5. Introducing the Treatment Model 68 and Identifying Problems Introducing the Treatment Model to Children 68 Introducing the Treatment Model to Adolescents 74 Identifying Problems with Children and Adolescents 77 Conclusion 81 CHAPTER 6. Identifying and Connecting Feelings 82 and Thoughts Identifying Feelings with Children and Adolescents 82 Identifying Thoughts and Connecting Thoughts to Feelings 91 Using the Content-Specificity Hypothesis to Guide Identifying Thoughts and Feelings 98 Avoiding Confusion between Thoughts and Feelings 100 Helping Children and Adolescents Complete a Daily Thought Record 100 Conclusion 102 CHAPTER 7. Therapeutic Socratic Dialogues 103 Considerations in Constructing a Therapeutic Socratic Dialogue 104 Hints about Constructing a Socratic Dialogue 107 Universal Definitions 110 Metaphorical and Humorous Questions 116 Conclusion 124 Contents xi CHAPTER 8. Commonly Used Cognitive 125 and Behavioral Techniques Dimensions of Cognitive-Behavioral Techniques 125 Skill Acquisition (Psychoeducation) versus Skill Application (Psychotherapy) 126 Basic Behavioral Tools 127 Social Skills Training 129 Basic Self-Instructional Techniques: Changing Thought Content 137 Basic Rational Analysis Techniques: Changing Thought Content and Process 138 Basic Exposure Therapy: Developing Self-Confidence through Performance Attainment 142 Conclusion 145 CHAPTER 9. Creative Applications of 146 Cognitive–Behavioral Therapy Storytelling 146 Play Therapy Applications 150 Games, Storybooks, Workbooks, and Making Masks 155 Thought–Feeling Hoops 158 Priming Exercises 161 Conclusion 166 CHAPTER 10. Homework 167 General Considerations in Assigning Homework 167 Homework Noncompliance 172 Conclusion 179 CHAPTER 11. Working with Depressed Children 180 and Adolescents Symptoms of Depression 180 Cultural and Gender Considerations 185 Assessment of Depression 187 Treatment of Depression: Choosing an Intervention Strategy 189 Suicidality with Depressed Children and Adolescents 190 Behavioral Interventions for Depression 200 Problem Solving 206 Self-Monitoring 207 Self-Instructional Approaches 209 Rational Analysis Techniques 211 Conclusion 217
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