FALL
Application of Cognitive Behavior Therapy for Anxiety Disorders and
Depression.
COURSE DESCRIPTION (Prerequisite: Psychology 229):
Approximately 25% of the general population suffers from an anxiety
disorder at some point in their life. 20% suffer from depression. This twosemester course will focus on the clinical application of specific treatment
strategies that have been shown to be effective in controlled research
studies to address these prevalent emotional disorders. Students will learn
how to: (1) conduct a thorough assessment utilizing a structured clinical
interview and battery of questionnaires, (2) implement specific cognitive
behavioral treatment strategies targeting the diagnosed symptoms and
problems, (3) evaluate the effectiveness of treatment as it progresses
utilizing relevant patient self-report questionnaires. By the end of the twosemester course, students will have a thorough exposure to information
regarding the psychopathology, assessment, and treatment of anxiety and
depression.
Students will evaluate and treat one case in the clinic (as part of the CBT
Program for Anxiety and Depression) following a general introduction to
cognitive behavioral assessment and treatment during the first few weeks
of the course. A second case will be added during December (please note
that the timing of case assignment depends upon availability). Class time
will include a combination of lectures, role-plays, case presentations, and
discussion of relevant literature. The primary focus of each class will
involve group supervision of ongoing cases by the instructor.
Grading:
50% of grade will be based upon write up of case, including assessment,
treatment planning, and response to treatment in a case report format (cf:
Kazdin, A.E. (1998)). One paper, no more than 20 pages APA style, due
at the last class each semester. The remaining 50% of grade will be
based upon class attendance and participation.
Required Texts:
Barlow, D.H. (2002). Anxiety and Its Disorders.
Gotlib, I.H & Hammen, C.L. (2002). Handbook of Depression.
Sanderson, W.C. & Bruce, T.J. (2007). Symptom Focused Treatment:
Evidence Based Treatment Strategies for Anxiety and Depression.
Young, J & Klosko, J. (2003). Schema Focused Therapy.
Recommended Texts:
Leahy, R.L. (2003). Cognitive Therapy Techniques.
SCHEDULE
Week 1.
Assessment of anxiety disorders and mood disorders:
structured interview & questionnaires
à DiNardo, PA & Barlow, DH (2002). Anxiety Disorders Interview Schedule
for DSM-IV. (Copies will be provided).
Week 2. Classification of Anxiety and Depression: differential diagnosis,
comorbidity
àBarlow: Ch 9
àGotlib & Hammen: Ch 1 & 3
Week 3. Treatment Planning: matching empirically supported
psychological interventions to symptoms
àSanderson & Bruce: Ch 1-2, 10-15
Week 4. Using single case designs to evaluate the effectiveness of
treatment
àKazdin, A.E. (1998). Drawing valid inferences from case studies. In AE
Kazdin (Ed), Methodological Issues and Strategies in Clinical Research.
Washington, DC: APA.
Weeks 6,7. Major treatment strategies for anxiety disorders: lowering
arousal, exposure, cognitive therapy Sanderson & Bruce: Ch 5-9
Weeks 8,9 Major treatment strategies for depression: behavioral activation,
cognitive therapy Sanderson & Bruce: Ch 16,17
Week 10. Psychopharmacological treatment of anxiety and mood
disorders Antianxiety and Antidepressant medication chapters will be
provided from AE Schatzberg: Manual of Clinical Psychopharmacology
(3rd Ed).
Weeks 11-15. Case Conferences (during each class, 2 students will
present their cases in detail, including assessments forms and data on
response to treatment. Focus of discussion will be treatment planning,
modification, and dealing with difficult issues).Readings for Weeks 11-15:
Working with Schema and Beliefs – From Young & Klosko
11: Ch 1,2: Schema Therapy: Conceptual Model & Schema Assessment
and Education
12: Ch 3,4: Experiential Strategies & Cognitive Strategies
13: Ch 5,6: Behavioral Pattern-Breaking & The Therapy Relationship
14: Ch 7: Detailed Schema Treatment Strategies
15: Ch 8: Schema Modes
COURSE OBJECTIVES: Intervention Skills
1) Students will interpret and explain the principles and techniques of
applied behavior analysis and cognitive-behavioral therapy, in both oral
and written form.
2) Students will demonstrate competence in the use of interventions based
on applied behavior analysis and cognitive behavior therapy.
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SPRING
Application of Cognitive Behavior Therapy for Anxiety Disorders and
Depression.
COURSE DESCRIPTION (Prerequisite: Psychology 315):
This course is a continuation of Psychology 315.
Required Texts:
same as 315 (see above)
Grading:
50% of grade will be based upon write up of case, including assessment,
treatment planning, and response to treatment in a case report format (cf:
Kazdin, A.E. (1998)). One paper, no more than 20 pages APA style, due
at the last class each semester. The remaining 50% of grade will be
based upon class attendance and participation.
Schedule:
Week 1. Fear, Anxiety, and Theories of Emotion
à Barlow: 2
Week 3. The Nature of Anxious Apprehension and Panic
à Barlow: 3,4
Week 4. The Origins of Panic and Apprehension
à Barlow: 7,8
Week 5. Panic Disorder & Agoraphobia
à Barlow: 10
Week 6. Post-traumatic Stress Disorder
à Barlow: 12
Week 7. Social Phobia
à Barlow: 13
Week 8: Generalized Anxiety Disorder
à Barlow: 14
Week 9: Obsessive Compulsive Disorder
à Barlow: 15
Week 10: Depression: Early Adverse Experiences, Current Interpersonal
Relationships, Stress
à Gotlib & Hammen: 10, 12, 13
Weeks 11-15. Case Conferences (during each class, 2 students will
present their cases in detail, including assessments forms and data on
response to treatment. Focus of discussion will be treatment planning,
modification, and dealing with difficult issues).Readings for Weeks 11-15
from Gotlib & Hammen
Wk 11: Cognitive Vulnerability in Depression: Ch 11
Wk 12: Biological Aspects of Depression: Ch 8
Wk 13: Regulation of Emotion in Depression: Ch 9
Wk 14: Gender Differences in Depression: Ch 21
Wk 15: Interpersonal Psychotherapy for Depression
COURSE OBJECTIVES Intervention Skills
1) Students will interpret and explain the principles and techniques of
applied behavior analysis and cognitive-behavioral therapy, in both oral
and written form.
2) Students will demonstrate competence in the use of interventions based
on applied behavior analysis and cognitive behavior therapy.
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MISCELLANEOUS INFORMATION:
SUPERVISION OF CASES
I will conduct all supervision in a group format. You will have
approximately 20 minutes for supervision of your ongoing case(s).
Therefore, it is important to be as efficient as possible. Rather than just
summarizing what went on each week in session, I think presenting in the
following SOAP format is best. For example:
Subjective: pt reports feeling more anxious this week, had two panic
attacks
Objective: Beck Anxiety Inventory score increased from 17 to 26, other
measures remained the same
Assessment: Patient had an interpersonal conflict with spouse and is not
compliant with relaxation strategies perhaps leading to an increase in
anxiety.
Plan: a. cognitive restructuring to address noncompliance with relaxation
procedure
b. assertiveness training for interpersonal conflict
c. cognitive restructuring of anxiety provoking situations related to
panic attacks
d. assess depression level
e. introduce breathing retraining
This is a brief example, but thinking in this format and using this structure
will facilitate supervision, which should be problem-oriented, focused on
where to go next with the pt, as well as problems that arise in using the
various strategies.
CASE CONFERENCE PRESENTATIONS
Everyone will have a chance to present their case in detail during their
assigned case conference (sometime during the last five weeks of each
semester). The presentation is informal. The only requirement is to
distribute summaries of your patient's self-report questionnaire scores preand during treatment (use a table or figure to do so). Limit your
presentation to approximately 10-15 minutes covering the info below, so
that approximately 30 minutes is left for group discussion of the case.
Please cover the following during your 10-15 minute presentation:
1. DSM Diagnosis and other assessment results (e.g., self-report
questionnaires)
2. Specific symptoms/problems addressed in treatment (e.g., panic
attacks, assertiveness, schemas)
3. Interventions employed to address problems/symptoms.
4. What went well? What did not?
This info will facilitate group discussion regarding the assessment and
treatment of the case.
INSTRUCTIONS FOR PAPER
20 pages maximum. The paper should include the following:
1. Introduction (discuss treatment outcome literature for the
problem/diagnoses you are treating -- no more than 4 pages).
2. Assessment section describing your evaluation of the case, including
results of the SCID and any self-report questionnaires used. Differential
diagnosis and decisions about principal diagnosis can be discussed as
well.
3. A table summarizing your session by session treatment.
4. A discussion of the application of specific treatment strategies and the
patient's response to treatment employed, including a discussion of
difficulties if any (this section should be the bulk of the paper).
5. A figure or table depicting the self-report questionnaire scores over time.
6. Discussion of future directions with the case (no more than 2 pgs).
The Kazdin (1998) article, listed on the syllabus, is a good overview for
writing up a case study.