Integrated CBT for Difficult to Work with Clients

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Dr Jeff Riggenbach is one of the most sought after tutors in North America in the area of CBT and personality disorders. Over the past 15 years he has developed and overseen CBT-based treatment programmes on Mood Disorder, Anxiety Disorder, Borderline Personality Disorder at two different psychiatric hospitals. Dr Riggenbach trained at the Beck Institute of Cognitive Therapy and Research in Philadelphia, is a Diplomat of the Academy of Cognitive Therapy, and has presented in all 50 United States, Mexico, and Canada on topics related to CBT, DBT and Personality Dysfunction. He is also an author of two best-selling books, The Cognitive Behaviour Therapy (CBT) Toolbox: A Workbook for Clients and Clinicians (2012) and Borderline Personality Disorder Toolbox: A Practical Evidence-Based Guide to Regulating Intense Emotions (2016), This Masterclass for SDS Seminars is Jeff's first appearance as a tutor in the UK.

Course outline:

Introduction to Integrated Evidence-Based Model

• Traditional Cognitive Model
  • Levels of Cognition
  • The Relationship between thoughts and feelings
  • Cognitive Diagraming
• New Trends in CBT
  • Neurobiological Findings
  • Emotional Schema Work
  • Imagery in the Restructuring Process
  • Integration of “Third Wave” & other Techniques from Alternative Modalities
  • Schematic and “Structural” Level Interventions
• Effective Socialization to the Model
  • Practical Conversations to Elicit Client Buy-In
  • Instillation of Hope
  • Decrease Treatment Dropout

Cognitive Conceptualisation

• Case Formulation
• Conceptualisation Drives Treatment, Planning & Documentation
• Case Study

Treatment Concepts

• The Therapeutic Relationship
  • Myths about the therapeutic alliance
  • Harnessing the relationship for experiential learning and positive treatment outcome
  • The Thinking of the therapist
• Types of Interventions and Indications for Each
  • Behavioural Interventions
  • Mindfulness and Distraction
  • Advanced Cognitive Distortions Work and Other Restructuring Techniques
  • Behavioural Pattern-Breaking for helping clients get “unstuck” from Life-Long Patterns

Cognitive Model of Addiction

• Enhancing Motivation in “Resistant” Clients
• Increased Awareness of Triggers
• Identifying Function of Usage and Modifying Addiction Related Beliefs
• Managing Urges and Developing Self - Control

Application to Clinical Practice

• Structure of a CBT Session
• Session Acuity Protocol
• Processing Homework
• Summary of Learning and Cognitive Fortification
• Booster Sessions

Common Factors in Successful Treatment of Personality Related Issues

• Increased Use of Therapeutic Relationship
• Importance of Validation
• The Thinking of The Therapist
• Intentional Structure and Process
• Longer Term Belief level Work vs Management

Personality Disorder Diagnosis

• Distinguishing Characteristics
• Corresponding Assessment Strategies

Histrionic PD: Characteristics and Symptom Management

• Alternative Ways of “Getting Noticed”
• Broadening Self-Worth

Antisocial PD: Characteristics and Symptom Management

• Psychopathy
• Modifying Criminal Thinking

Narcissistic PD: Characteristics and Symptom Management

• Types of Narcissists
• Empathic Confrontation and Mode Work

Paranoid PD: Characteristics and Symptom Management

• Building Trust
• Considering Alternative Explanations

The BPD Diagnosis

• Differential Diagnosis with PTSD and Bipolar Disorder
• 8 Motives for Non-Suicidal Self-Injury & Ramifications for Effective Intervention
• Importance of Talking about and De-stigmatizing the Diagnosis
• Having the Conversation in Everyday Language to Reduce Defensiveness

Traditional CBT and Short-Term Strategies

• Anger Management
• Continuums and Dichotomous Thinking
• Belief Based Validation for Disarming Clients before they Explode
• Relationship Management

In-Depth and Long-Term Treatment

• Integrated Strategies Case Study
• Schema Mode Work and Modification Strategies

Relapse Prevention and Ending Treatment Well

• Warning Signs for Relapse
• The Road to Recovery and Episode Management

Q&A and Dismissal

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