Cover

Contents

PART I. Setting the Scene

ONE Treating Anxiety Disorders: The State of the Art

Cognitive Therapy and Anxiety

A Transdiagnostic View of Underlying Cognitive and Behavioral Processes

Current Models and Protocols

Embracing Complexity While Utilizing Specific Protocols

Conclusion

PART II. Deepening Understanding and Securing Engagement

TWO Assessment: Investigating Appraisals in Depth

Standard Methods of Accessing Appraisals

Targeting Higher Level Appraisals

Input from Memory in the Anxiety Disorders

How Should We Access “Hot Cognitions”?

Conclusion

THREE Case Formulation: Making Sense of Complexity

Principles Guiding Case Formulation

Applying these Principles to Resolve Problems in Formulation

Anxiety Disorders and Formulation Work: Mapping the Territory

Judging the Quality of a Case Formulation

Using Metaphors, Pictures, and Diagrams in Formulation Work

Formulating Interactions between People

Formulating Comorbidity with Different Kinds of Anxiety

Conclusion

FOUR Decentering from Thoughts: Achieving Objectivity

The Metacognitive Perspective

Aspects of Cognitive Therapy That Enhance Metacognitive Awareness

Specific Methods for Enhancing Metacognitive Awareness

Conclusion

PART III. Facilitating Emotional Processing

FIVE Bringing About Lasting Change at the Deepest Level

Emotional Processing

Spontaneous Cognitive Change as a Result of Simply Evoking Hot Material

Using Traditional Cognitive Therapy Techniques to Prompt for Change, by Holding Old Material in Mind While Accumulating More Information

Using the Properties of Imagery to Bring About Cognitive Change

Unpacking and Transforming Metaphorical Images

Conclusion

SIX The Role of Behavioral Experiments

The Role of Behavior in Maintaining Anxiety

Behavioral Interventions in Treatment

Behavioral Experiments and Experiential Learning

Creating Successful Behavioral Experiments: The Practicalities

Alan’s Behavioral Experiments: A Clinical Example

Maximizing the Impact of Behavioral Experiments

Therapist-Guided In-Session Experiments

Conclusion

PART IV. Overcoming Three Major Obstacles to Progress

SEVEN Avoidance of Affect

Transdiagnostic Features of Avoidance of Affect

The Meaning of Affect

Recognizing Avoidance of Affect

Making Sense of Avoidance of Affect: Theories, Causes, and Consequences

Strategies for Dealing with Avoidance of Affect

Pitfalls and Difficulties

Conclusion

EIGHT Low Self-Esteem

A Cognitive Perspective

The Relationship between Anxiety and Low Self-Esteem

A Cognitive Model of Low Self-Esteem

The Role of Rules for Living

How the Bottom Line Is Triggered

How Low Self-Esteem Is Maintained

Treating Comorbid Anxiety and Depression: A Case Example

Applying the Model

Interventions Designed to Enhance Self-Esteem

Questioning the Bottom Line: Undermining the Evidence

Creating a New Bottom Line

Conclusion

NINE Dealing with Uncertainty

Making Sense of Anxiety and Uncertainty

Anticipating and Avoiding Common Pitfalls

Strategies Based on Standard Applications of Cognitive Therapy

Acknowledging That Change Involves Taking Risks

Strategies Derived from the Treatment of GAD

Practical Tips

Strategies for Helping People to Live with Uncertainty

Conclusion

PART V. Ending Treatment Productively

TEN Creating a Therapy “Blueprint”

The Processes Involved in Ending Treatment

A Personal Blueprint for Treating Anxiety Disorders

References

Index