Chapter
5 Panic disorder and agoraphobia
Cognitive restructuring and combined CBT packages
Combining drug and nondrug treatments
6 Panic disorder and agoraphobia
Management of comorbid disorders
Three-week intensive group program structure
Nine-week less intensive group program structure
Problems with slow breathing
Problems with graded exposure
Problems with cognitive restructuring
7 Panic disorder and agoraphobia
1 The nature of anxiety,panic,and agoraphobia
1.1 How do panic disorder and agoraphobia develop?
1.1.3 Hyperventilation or overbreathing
1.1.4 Personality characteristics
1.3 The development of situational fears
1.5 Rationale of the program
1.6 Hindrances to recovery
1.7 The nature of anxiety: a true alarm
1.8 Anxiety: a false alarm
1.9 Why do I have false alarms?
1.10 The effect of personality
1.13 Types of overbreathing
1.14 Common myths about anxiety symptoms
2 Control of hyperventilation
2.1 Recognizing hyperventilation
2.2 Slow-breathing technique
2.3 Daily record of breathing rate
3.1 The importance of relaxation training
3.3.1 Progressive muscle relaxation
3.3.2 Isometric relaxation
3.3.3 Further isometric exercises
3.3.4 Difficulties with relaxation
4.2 Planning your program
4.3 Implementing your program
4.5 Facing fears in imagination
4.6 Achieving your own personal goals
5.1 Step 1: Identifying anxiety-provoking thoughts
5.1.1 Anxiety-provoking thoughts in panic disorder
5.1.2 Misinterpreting physical sensations
5.1.3 Situational fears and unhelpful thinking
5.1.5 More tips on detecting unhelpful thoughts
5.2 Step 2: Challenging anxiety-provoking thoughts
5.3 Step 3: Generating alternative thoughts
6 Producing the panic sensations
6.1 Panic sensations exercises
6.2 Constructing a stepladder of panic sensation exercises
6.3 Practicing the panic sensation exercises
6.4 Scheduling the panic sensation exercises during the program
Panic sensations exercise
7 Producing panic sensations in your daily life
8 More about thinking straight
9 Keeping your progress going
9.1 Coping with setbacks or difficulties in making progress
9.1.1 Managing anxiety and hyperventilation
9.1.2 Planning of goals and steps
9.2 Emotional problems during setbacks
9.3 Expect lapse occasionally
Classification, subtypes and relationship to avoidant personality disorder
History of presenting complaint
Mental state at presentation
History of presenting complaint
Personal history and premorbid personality
Relationship of social phobia to ‘‘shyness’’ and social anxiety
Axis II: Personality disorder
Psychological treatments for social phobia
Cognitive-behavioral treatment of social phobia
Treatment effect sizes and dropout rates
Avoidant personality disorder
Frequency of negative cognitions
Pharmacological treatments
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Treatment effect sizes and dropout rates
Comparison trials: pharmacological versus psychological treatment for social phobia
Comorbid anxiety disorders
Comorbid personality disorder
Special considerations applying to group treatment
The first few group sessions
Education: what is social phobia (Sections 1.1–1.5) and the nature of anxiety (Section 2)
Anxiety-management strategies (Section 3)
Cognitive therapy for social phobia (Section 4)
Problems with cognitive restructuring
Problems with graded exposure
General progress to be expected
Problem solving: failure to progress
1.1 How does social phobia differ from shyness and normal social anxiety?
1.2 What is avoidant personality disorder?
1.3 How common is social phobia?
1.4 What causes social phobia?
1.4.1 The effect of personality
1.5 Treatment of social phobia
1.5.1 The aims of this program
2.1 What is a panic attack?
2.1.1 The role of hyperventilation
2.1.2 Recognizing hyperventilation
2.2 What other factors contribute to anxiety?
2.3 The relationship of anxiety to performance
3 Anxiety-management strategies
3.1 Slow-breathing technique
3.1.1 Daily record of breathing rate
3.1.2 Problems with breathing control: troubleshooting
Relaxation training – progressive muscular relaxation
4 Cognitive therapy for social phobia
4.1 Cognitive therapy: the importance of the way you think
4.2 Specific anxieties in social phobia
4.3 The ABCs of realistic thinking
4.4 Cognitive restructuring:changing the way you think
4.4.1 Step 1: Identify your thoughts
4.4.2 Step 2: Challenge your thoughts
4.5 Common problems challenging negative thoughts: troubleshooting
5.1 Why is exposure necessary?
5.2 Principles of graded exposure
A moderate level of anxiety
5.3 Planning your program
Step 1: Identify your problem situations and choose your goals to create your exposure hierarchy
Step 3: Breaking down your goals into steps
5.4 Getting the most from your exposure program
‘‘Discounting’’ or minimizing
5.5 Imaginal desensitization
5.6 Exercises in planning activities
5.7 Implementing your program
6.1 What is assertiveness?
6.2 What is faulty assertion?
6.3 Choosing how to respond in any situation
6.4 Structured problem solving
6.4.1 Sending the message effectively
Protection 1: Broken record
Protection 2: Selective ignoring
Protection 3: Disarming anger
Protection 4: Sorting issues
Protection 5: Dealing with guilt
Protection 7: ‘‘I ’ll let you know’’
6.7.1 Be prepared to negotiate
7 Coping with setbacks and difficulties
7.1.1 Learn to be your own best friend
8.1 Recommended paperbacks
Early conditioning and preparedness theories
Difficulties with conditioning theories of phobias
Recent theories of phobias
Dangers of behavioral treatments
Combining drug and psychological treatments
Enhancing motivation for treatment
Enhancing treatment comprehension and compliance
Problems with graded exposure
Handling patient complaints and difficulties in treatment implementation
1 The nature of anxiety and phobias
1.1 Rationale of the program
1.2 Anxiety: the life-saving alarm
1.3 Anxiety: false alarms
1.4 Why do I have false alarms?
1.5 The effect of history and learning
1.6 Role of hyperventilation
1.7 Types of overbreathing
1.8 Common myths about anxiety symptoms
2 Control of hyperventilation
2.1 Recognizing hyperventilation
2.2 Slow-breathing technique
2.3 Daily record of breathing rate
3.1 The importance of relaxation training
3.3.1 Progressive muscle relaxation
3.3.2 Isometric relaxation
3.3.3 Further isometric exercises
3.3.4 Difficulties with relaxation
4.1.1 Planning your program
4.1.2 Implementing your program
4.1.3 Practicing the steps
4.1.4 Coping with difficulties
4.2 Facing fears in imagination
4.3 Exercises in planning activities
5.1 The importance of the way you think
5.2 Misinterpretation and mislabeling
Step 1: Identifying anxiety-provoking thoughts
Step 2: Challenging anxiety-provoking thoughts
Step 3: Generating alternative thoughts
5.3 Putting it all together
6 Blood and injury phobia
6.2 Fainting control skills
7 Keeping your progress going
7.1 Coping with setbacks or difficulties in making progress
7.1.1 Managing anxiety and hyperventilation
7.1.2 Planning of goals and steps
7.2 Emotional problems during setbacks
7.3 Expect a lapse occasionally
16 Obsessive–compulsive disorder
History of presenting problem
Previous psychiatric history
Personal and social history
Phenomenology and classification
Etiological and theoretical models of OCD
17 Obsessive–compulsive disorder
Factors affecting outcome with behavioral treatment
18 Obsessive–compulsive disorder
Program design and implementation
19 Obsessive–compulsive disorder
1 The nature of obsessive–compulsive disorder
1.1 Symptoms of obsessive–compulsive disorder
2 The causes and treatment of obsessive–compulsive disorder
2.1 The biochemical theory
2.3 Learning theory This model suggests
2.5 Psychoanalytical theory
2.6 The treatment of obsessive–compulsive disorder
3 Exposure and response prevention
3.2 Basic rules for success
5.1 Recommended paperbacks
20 Generalized anxiety disorder
Previous psychiatric history
Personal and social history
Differential diagnosis and assessment
Construct validity of the diagnosis
Features of worry in nonclinical populations
Worry in generalized anxiety disorder
Etiological and theoretical models of generalized anxiety disorder
21 Generalized anxiety disorder
Pharmacological treatments
Combining psychological and pharmacological treatents
22 Generalized anxiety disorder
Structured problem solving
Solving difficulties in treatment
23 Generalized anxiety disorder
1 What is generalized anxiety disorder?
1.1 Generalized anxiety disorder and everyday worry
1.2.1 Antidepressant medication
1.2.2 Sedatives, tranquilizers, and sleeping pills
2 The nature of anxiety and worry
2.1 The nature of anxiety
2.1.2 Anxiety and performance
2.1.4 Why do the symptoms of tension and anxiety begin?
The effect of personality
The effect of life events and stressors
The effect of your view of the world
2.2.2 Behaviors that can maintain worry and anxiety
2.2.3 Keeping a record of your anxiety or worry
3.1 What is relaxation training?
3.2 Importance of relaxation training
3.3 Components of relaxation training
3.3.1 Recognizing tension
3.3.2 Relax your body in a general,total sense:achieving the relaxation response
3.3.3 Let tension go in specific muscles:isometric relaxation
3.4 Important points about learning to relax quickly
3.5 Difficulties with relaxation
4.1 Identifying anxiety-provoking thoughts
4.2 Challenging anxiety-provoking thinking
4.2.1 What is the evidence for what I thought?
4.2.2 What alternatives are there to what I thought?
4.2.3 What is the effect of thinking the way I do?
4.2.4 What thinking errors am I making?
4.3 Generating alternative thinking
4.4 Assumptions and core beliefs
5.4 Letting go of worries
6 Structured problem solving
6.1 Setting up a problem-solving session
6.3 Step 1: Defining problems and goals
6.4 Step 2: Generating solutions through brainstorming
6.5 Step 3: Evaluating the solutions
6.6 Step 4: Choosing the optimal solution
6.9 When things don’t go as planned
6.10 Problem-solving practice
Structured problem solving
7 Dealing with behaviors that maintain anxiety or worry
8 Keeping your practice going
8.1 Dealing with setbacks
8.2 Expect to lapse occasionally
24 Posttraumatic stress disorder
Diagnostic criteria and clinical presentation
History of presenting complaint
Other diagnoses of traumatic stress
Etiology and vulnerability factors
The assessment of posttraumatic stress disorder
Structured clinical interviews
Malingering and symptom exaggeration
25 Posttraumatic stress disorder
Psychological treatments:description
Psychological treatments: empirical review
Other treatment approaches
Prevention and early intervention
Secondary prevention and the treatment of acute stress disorder
26 Posttraumatic stress disorder
Chronicity and comorbidity
Stabilization and engagement
Exposure: background issues
Exposure: potential problems
Relapse prevention and maintenance
The duration and timing of treatment
Acute traumatic stress reactions: a five-session…intervention
27 Posttraumatic stress disorder
1 The nature of traumatic stress and posttraumatic stress disorder
1.1 What is a traumatic event?
1.2 What is posttraumatic stress disorder?
1.3 Common symptoms of posttraumatic stress disorder
Impact on relationships and work
1.5 Why do traumatic stress reactions develop?
1.6 The process of treatment and recovery
2 Stabilization of a crisis and engagement in treatment
3 Education and information
4 Managing anxiety and distress
Hints for family and friends
Hints for sleeping better
4.2 Overview of anxiety management
4.3 Subjective units of distress (SUDs)
4.4 Managing the physical symptoms
4.5 Managing problems with thoughts
5 Exposure therapy: confronting feared situations
5.1 Planning your program
5.2 Implementing your program
6 Exposure therapy: confronting the memories
6.1 What is imaginal exposure?
6.2 Therapist-assisted imaginal exposure
6.3 Self-directed imaginal exposure
6.4 Exposure:can I cope with it?
7 Cognitive restructuring
7.1 The process of cognitive restructuring
The Treatment of Anxiety Disorders
：Clinician Guides and Patient Manuals
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