PSY330 w3d1

Choose a specific disorder from the following list.

Agoraphobia Anorexia or Bulimia Generalized Anxiety Disorder Depression Panic Disorder Obsessive-Compulsive Disorder Post Traumatic Stress Disorder Specific Phobias (public speaking, heights, animals, etc.) Substance Abuse

For your initial post you will take on the role of a cognitive behavioral therapist. Create a fictional client experiencing your chosen disorder. Apply cognitive and behavioral theories to the client’s issue to develop a cognitive behavioral experiment you might use with this client. Describe in detail the specific experiment you would create with your client to address the chosen disorder. Your experiment should include both cognitive and behavioral aspects. Use the first six of the seven steps for designing coginitive behavioral experiments outlined on page 33 of the Combs, Tiegreen, and Nelson article to organize your hypothetical experiment. Your initial post should be a minimum of 350 words.    




Steps in Designing Behavioral Experiments for Delusions and Paranoia

1.     Establish rapport and readiness to engage in experiments  – Usually after the verbal challenge phase of treatment, rapport will be sufficient to initiate the subject of using behavioral experiments. We commonly ask if the client is ready to put his or her belief to the test, or we suggest that there are other ways to examine his or her beliefs if he or she is interested. Professionals should assess the client’s level of fear, anxiety, potential for aggression, and previous compliance with assigned activities when deciding if the time is right for behavioral experiments.

2.     Involve the client in designing the experiment  -Behavioral experiments work better if the client has a role and collaborates in deciding how to test his or her belief. The clinician needs to attend to two issues at this stage. First, the purpose of the experiment is not to prove that the belief is true, but to examine the evidence. Second, the client may come up with a flawed, incomplete, or irrelevant experiment, and the clinician is encouraged to help shape or revise the experiment if necessary. Generally, we do not tell clients what to do, but we make suggestions on how to make it better. By allowing the client to participate in this process they take a sense of ownership, which makes the data gathered in the experiment harder to discount. Describing the conduction of experiments as similar to doing detective work puts the client in the correct frame of mind in terms of gathering evidence.

3.     Test specific predictions  – Predictions as to what will happen are made in advance. Generally two predictions are all that are needed: one prediction if the client’s belief is true and an alternative prediction (provided by client or therapist). Since delusions are often pervasive and wide-ranging, it is necessary to focus on specific parts instead of the delusion as a whole.

4.     Discuss problems  – After the plan is derived and predictions are made, the client and therapist need to discuss any potential problems that may interfere with the experiment. In particular, an assessment of social skills and/or practice/role-playing in the session may be needed. The expression of negative emotion, hostility, or anger to others during the experiment may actually lead to increased paranoia (reciprocal interaction; Haynes, 1986). For persons with paranoia, professionals should realize that a significant amount of behavioral avoidance may be present, and this is why observational experiments are used first to lessen the threat and avoidance.

5.     Refine plan  – Based on potential problems, the plan is refined or altered as needed. Both the client and therapist should feel comfortable with the proposed experiment. At this stage, we find that setting a date when the experiment is to be completed is important in ensuring that the plan is actually carried out.

6.     Conduct, observe, and evaluate evidence  – The client (and any other person involved) should be instructed to take careful notes about the event and to fully attend to the interaction. This may be difficult, but as a practice exercise we have clients look at a magazine picture and report as many details as they can. We emphasize that clients should approach the experiment the same way. Following the experiment, we employ the thought record, which allows the client to document the antecedents, beliefs, and consequences. We discourage the use of verbal reports since they are incomplete and less detailed and subject to cognitive biases. The experiment is then reviewed in the therapy session in terms of the predictions. When confronted with contradictory evidence, the client may gradually modify his or her belief.