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Succeeding with Difficult Clients: Applications of Cognitive Appraisal Therapy PDF

351 Pages·2001·1.11 MB·English
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Succeeding with Difficult Clients Applications of Cognitive Appraisal Therapy This Page Intentionally Left Blank Succeeding with Difficult Clients Applications of Cognitive Appraisal Therapy Richard Wessler Sheenah Hankin Jonathan Stern Academic Press San Diego London Boston New York Sydney Tokyo Toronto This book is printed on acid-free paper. Copyright ©2001 by Academic Press All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. Requests for permission to make copies of any part of the work should be mailed to the following address: Permissions Department, Harcourt, Inc., 6277 Sea Harbor Drive, Orlando, Florida 32887-6777. Explicit permission from Academic Press is not required to reproduce a maximum of two figures or tables from an Academic Press chapter in another scientific or research publication provided that the material has not been credited to another source and that full credit to the Academic Press chapter is given. Academic Press A Harcourt Science and Technology Company 525 B Street, Suite 1900, San Diego, California 92101-4495, USA http://www.academicpress.com Academic Press Harcourt Place, 32 Jamestown Road, London NW1 7BY, UK http://www.academicpress.com Library of Congress Catalog Card Number: 0-12-744470-X International Standard Book Number: 2001088744 PRINTED IN THE UNITED STATES OF AMERICA 01 02 03 04 05 06 SB 9 8 7 6 5 4 3 2 1 To our children, our students, and all of our clients. This Page Intentionally Left Blank CONTENTS I PART Cognitive Appraisal Theory 1 What Makes Difficult Clients Difficult 3 2 Motivation and Attachment 21 3 Basic CAT Concepts: Personotypic Affect, Justifying Cognitions, and Security-seeking Behaviors 33 4 Patterns of Personality 63 5 The Difficult Client Revisited 77 II PART Cognitive Appraisal Therapy 6 The CAT Assessment 93 7 Interventions Based on the CAT Model 127 vii viii Contents 8 Affect-based Interventions 163 9 Additional Interventions Involving Cognition, Behavior, Adjunctive Medication, and Therapeutic Impasses 183 10 The Process of CAT (Case Studies) 199 III PART Applications of CAT 11 CAT with Personality-disordered Clients 227 12 Working with Borderline Personality-disordered Clients 257 13 Couples Therapy 279 14 CAT Group Therapy 293 15 Working with “Difficult” Parents 305 References 323 Author Index 335 Subject Index 339 ACKNOWLEDGMENTS First, we would like to acknowledge the presence in our professional and personal lives of some wonderful colleagues and collaborators: Jesse Rosenthal, Mildred Borrás, Vincent Minetti, and Windy Dryden. We would like to thank our editor, George Zimmar, for his good natured intelligence and encourage- ment in helping to bring this book to fruition and our spirited secretary, Mau- reen Coveney, for putting up with us during the writing of this book. We also would like to tip our hats to colleagues whose theoretical and clin- ical writings have been invaluable influences on our therapy and catalysts to our thinking: Theodore Millon, John Bowlby, Mary Ainsworth, Mary Main and her colleagues, Robert Plutchik, Jeremy Safran, Drew Westen, Donald Nathanson, and Stanley Greenspan. Finally, Jonathan would like to thank his wife, Sandra Waugh, for tirelessly transcribing tape recordings of our peer supervision sessions and for sweeping the kids away to give him time to write. ix

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I know that I am doing therapy correctly and well, so why aren't some of my clients changing? ''Why do I feel anxious when I think about my next session with that difficult client?'' When psychotherapy stalls, it's time to try new ideas. The authors' experience with difficult clients -- uncooperativ
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