SOWK6190/SOWK6127 Cognitive Behavioural Therapy and Cognitive Behavioural Intervention

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SOWK6190/SOWK6127 Cognitive Behavioural Therapy
and Cognitive Behavioural Intervention

• Week 9 Imagery and Homework
• Dr. Paul Wong, D.Psyc.(Clinical)

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• Imagery

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• Numerous clinical observations suggest that an
  individual visualizing an imagined scene reacts
  as though it were actually occurring
• Induced" images can have a profound effect on
  behavior. The usefulness of guided imagery
  techniques have been shown to be effective in
  helping individuals learn or modify behaviors
  such as
• learning to relax
• changing or controlling their negative emotions
  in response to a particular situation
• eliminating or reducing undesirable behaviors
  (smoking, obesity)
• increasing effective pain management coping with
  difficult situations (a difficult boss)
• learning new and desirable behaviors
  (assertiveness)
• becoming more motivated (doing homework between
  therapy sessions)

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• Guided imagery techniques have been applied to
  and found to be effective or show promise witha
  variety of populations, including individuals
  with
• phobias
• mild to moderate depression
• generalized anxiety disorders
• Post-traumatic stress disorder
• Obsessive-compulsive disorder
• sexual difficulties
• chronic fatigue syndrome
• children's behavioral disorders
• stuttering
• acute and chronic pain (and other physical
  disorders)

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Identifying images

1. Elicit a spontaneous image a patient has had or
2. Induce an image (Could you picture it now?)

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Educating clients about imagery

• Some clients do not report images to therapists
  because
• Their images are too graphic and distressing and
  
• Reluctant to re-experience the distress or fear
  the therapist will view them as disturbed.
• Normalizing and teaching the client about images
  help to reduce her anxiety and make it more
  likely that she/he will be able to identify the
  images.

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Responding to spontaneous images

1. Following images to completion
2. Jumping ahead in time
3. Coping in the image
4. Changing the image
5. Reality-testing the image
6. Repeating the image and
7. Substituting, stopping, and distracting oneself
   from images.

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Inducing imagery as a therapeutic tool

1. Rehearsal of coping techniques
2. Distancing and
3. Reduction of perceived threat.

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• Homework

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Ongoing homework assignments

• Behavioral activation
• Monitoring automatic thought
• Biblotherapy
• Reviewing the past therapy session and preparing
  for the next therapy session.
• If not sure, please check pp.251-253.

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Increasing the likelihood of successful homework

• Tailoring homework to the individual
• Providing a rationale
• Setting homework collaboratively
• Making homework a no-lose proposition
• Starting homework in the session and
• Remembering to do homework