Transdiagnostic Road Map to Case Formulation and Treatment Planning

I. Frank Rochelle

Sujets

• Sociologie, société et politique
• Psychiatry
• Clinical psychology
• Abnormal psychology
• Psychotherapy

Informations

• Publié par: New Harbinger Publications
• Date de parution: 01 juillet 2014
• Nombre de lectures: 0
• EAN13: 9781608828975
• Langue: English

Extrait

“Amid today’s flood of books and cacophony of webinars and podcasts, Frank and Davidson’s sage advice stands out in this unique text on transdiagnostic road maps. This book is well written with clinical acumen and a solid link to the empirical literature on comorbidity. It should be required reading for all students, clinicians, and researchers in the field. I highly recommend it!”
—Frank M. Dattilio, PhD, ABPP , Harvard Medical School, Boston, MA
“Follow this road map and you will likely never need to consult another ‘how to conceptualize my treatment approach’ map again! This volume moves the promise of transdiagnostic practice into the realm of possibility by showing how the latest research on transdiagnostic mechanisms informs individualized, case formulation-driven approaches to treatment planning, implementation, and assessment. Rochelle Frank and Joan Davison have written a very timely, important, and useful book that will be of use to clinicians, researchers, and students of mental health. Anyone who is interested in understanding how the latest research on mechanisms that cut across diagnostic boundaries can inform a practical, evidence-based guide to treatment will benefit from reading this book.”
— Ann Kring, PhD , vice chair and professor of psychology at University of California, Berkeley, and president of the Society for Research in Psychopathology
“This book is the first clinically accessible attempt to use transdiagnostic research to create a powerful new form of functional analysis: one that is specific, testable, replicable, and modifiable. As the DSM-V stumbles, this book presents the exciting possibility that we now have enough transdiagnostic knowledge to create a categorization system that will help practitioners select interventions based on their usefulness in targeting identified processes of change. The details could be mistaken, but this is a bold and creative step forward that deserves the attention of practitioners and researchers alike.”
— Steven C. Hayes, PhD , foundation professor and director of clinical training at University of Nevada and cofounder of acceptance and commitment therapy (ACT)
“How cognitive behavioral therapists need this book! Cognitive behavioral therapy (CBT) is in a transitional phase. There is increasing focus on transdiagnostic processes and process mechanisms such as avoidance, ruminative thinking, and anxiety sensitivity that underpin many of the problems we see clinically. But up until now, no one has really put this together in a coherent ‘how to’ form for clinicians. These authors have done it! The book is rich in illustrative examples and helpful ways to think about CBT interventions. I found myself constantly stimulated, as well as challenged, to make adaptations to my approach as a CBT therapist.”
—James Bennett-Levy, PhD , associate professor at the University of Sydney and coeditor of the Oxford Guide to Behavioural Experiments in Cognitive Therapy and the Oxford Guide to Imagery in Cognitive Therapy
Practical Guidance for Clinical Decision Making
Rochelle I. Frank, PhD and Joan Davidson, PhD
New Harbinger Publications, Inc. -->
Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.

Distributed in Canada by Raincoast Books

Copyright © 2014 by Rochelle I. Frank and Joan Davidson
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com

Cover design by Amy Shoup
Acquired by Catharine Meyers
Edited by Jasmine Star



All Rights Reserved


Library of Congress Cataloging-in-Publication Data on file
ePub ISBN: 9781608828975
To Mary—
Who inspires me beyond words and never stops believing in me.
—RIF

To Raja and Nadya—
Who bring joy and love to my life, and whose encouragement, patience, and passion for life make all things possible.
—JD
Contents
Foreword
Acknowledgments
Part 1: Defining the Problem and Mapping Solutions
1. Why We Need a Transdiagnostic Road Map
2. Vulnerability Mechanisms
3. Response Mechanisms
4. Core Principles of the Transdiagnostic Road Map
Part 2: Developing Transdiagnostic Mechanism Hypotheses
5. Assessment and Data Collection: The Road to Mechanism Hypotheses
6. Developing a Transdiagnostic Mechanism Formulation with the Patient
Part 3: Planning Treatment
7. Developing Treatment Goals
8. Selecting Interventions
Part 4: Navigating the Transdiagnostic Road Map
9. Implementing Treatment
10. Assessing Progress, Changing Course, and Ending Treatment
Appendix: Road Map Worksheets
References
Foreword
This book provides a GPS for the psychotherapist whose goal is to provide treatment that is caring, based in science, and individualized to meet the needs of each patient. The road to this destination can be difficult to locate and follow for many reasons. One is that the empirically supported treatment (EST) protocols developed by the scientific community typically target a single DSM disorder. But most individuals who seek treatment have multiple disorders and problems, many of which are not DSM disorders. To adapt the EST protocols to the needs of the patient with multiple disorders, the typical clinician uses a mix-and-match strategy, pulling interventions from multiple protocols to meet the needs of a particular patient in the moment. When I realized I was doing this, I looked over my shoulder repeatedly, fearing I was doing something illegal and would get in trouble. I worried, If I’m not following all the steps of any particular EST protocol, and if I’m drawing interventions from more than one EST protocol, does this mean I’m not doing evidence-based treatment? I also asked myself, How can I make thoughtful and evidence-based decisions about which interventions to pull from which protocols at any given point in treatment?
Complicating my navigational difficulties was the fact that scientists have developed dozens of EST protocols—more than any clinician can learn. In addition, the advent of new theoretical models means clinicians must make decisions about whether it is acceptable to integrate diverse models, and if so, how. That challenge has become particularly acute with the arrival of mindfulness-, dialectical-, acceptance-, and compassion-focused approaches in the third wave of cognitive behavioral therapies. Clinicians who confront these challenges need help in accessing and using all of the information produced by the scientific and academic communities to make good clinical decisions.
Frank and Davidson provide the guidance that clinicians are seeking. In this book they describe a model that calls for the therapist to develop a conceptualization for each case that, together with progress-monitoring data, guides the therapist’s decision making. The heart of the formulation is one or more psychological mechanisms (such as intolerance of uncertainty, perfectionism, problematic schemas, and experiential avoidance) and hypotheses about how these mechanisms operate and interact to cause the patient’s disorders and problems. The authors describe how to use mechanism hypotheses and progress monitoring data to select interventions and make other clinical decisions to guide therapy as it goes forward.
I am proud to say that this book relies considerably on my own writing about case formulation in cognitive behavior therapy. And I’m happy to say that this book extends and strengthens that model in several ways, including by describing and detailing the evidence base supporting a large number of psychological mechanisms that the reader can use to build case formulations. This part of the book in particular is a huge contribution. I wish I had written it myself!
Readers of this book are clearly in the hands of experienced psychotherapists. These two authors have spent and continue to spend countless hours in their office taking care of patients, and their clinical skills and wisdom shine through on every page. At the same time, they offer a scholarly and scientific approach to clinical work. Scholarship, empiricism, and clinical wisdom are beautifully joined here.
I know these authors well. Joan and I have had a very close professional and personal relationship for more than twenty years, and Shelly has been my close colleague, with an office just down the street, for over five years. Each brings her own perspective and skill set to the book. Both were originally trained in psychodynamic models, both have extensive training and experience in cognitive behavioral therapy and acceptance and commitment therapy, and Shelly also has formal training in dialectical behavior therapy. Both are skilled in working with bipolar and other mood disorders. In addition, Shelly has expertise in treating PTSD and dissociative disorders, and Joan specializes in anxiety disorders, especially OCD. I have complete trust in both clinicians’ skills and judgment, and I rely on them when I need help with one of my own tough cases.
If you are a clinician seeking a route to thoughtful, evidence-based, effective, individualized, and caring interventions for your clients, this book will help you find your way.
—Jacqueline B. Persons, PhD
Director of the Cognitive Behavior Therapy and Science Center
Clinical Professor in the Department of Psychology, University of California at Berkeley
Acknowledgments
Before we acknowledge the many individuals who contributed to this project, we would like to express our heartfelt appreciation and gratitude to our spouses, friends, and colleagues, whose ongoing encouragement and support throughout innumerable hours of conceptualizing, researching, and writing helped transform a dinne