CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit

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Nigel Sage (Guildford and Waverley Primary Care Trust, UK) Michelle Sowden (Frimley Park Hospital)

CBT for Chronic Illness and Palliative Care

A Workbook and Toolkit

Nigel Sage (Guildford and Waverley Primary Care Trust, UK), Michelle Sowden (Frimley Park Hospital), Elizabeth Chorlton (Frimley Park Hospital) , Andrea Edeleanu (Surrey and Borders Partnership NHS Trust)

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English

Wiley-Interscience
08 April 2008

Medicine; Psychotherapy

There is a growing awareness of the need to address the psychological distress associated with physical ill health; however, current resources are limited and difficult to access. The best way to tackle the issue is by enhancing the skills of those professionals who have routine contact with them. CBT provides the evidence-based skills that most readily meet these requirements in a time and cost efficient manner. Based on materials prepared for a Cancer Network sponsored training programme and modified to address the needs of a larger client population of people experiencing psychological distress due to physical ill-health, this innovative workbook offers a basic introduction and guide to enable healthcare professionals to build an understanding of the relevance and application of CBT methods in everyday clinical practice.

By: Nigel Sage (Guildford and Waverley Primary Care Trust UK), Michelle Sowden (Frimley Park Hospital), Elizabeth Chorlton (Frimley Park Hospital), Andrea Edeleanu (Surrey and Borders Partnership NHS Trust)
Imprint: Wiley-Interscience
Country of Publication: United States
Dimensions: Height: 249mm, Width: 176mm, Spine: 16mm
Weight: 680g
ISBN: 9780470517079
ISBN 10: 0470517077
Pages: 400
Publication Date: 08 April 2008
Audience: Professional and scholarly , Undergraduate
Format: Paperback
Publisher's Status: Active

About the Authors xi Acknowledgements xiii Introduction xv Part I: The Workbook: The Cognitive Behavioural Approach Chapter 1: What is the Cognitive Behavioural Approach? 3 Chapter 2: The Relevance of a Cognitive Behavioural Approach for People with a Life-changing Illness 10 Chapter 3: Does Cognitive Behaviour Therapy Work? The Evidence Base 18 Chapter 4: Communication Skills in Health Care 47 Chapter 5: Cognitive Behavioural Communication Style 58 Chapter 6: Guided Discovery: Using the Socratic Method 66 Chapter 7: Assessment 78 Chapter 8: Formulation 87 Chapter 9: Deciding on a Course of Action: Part 1 97 Chapter 10: Goal Setting and the Step-by-Step Process 102 Chapter 11: The Practicalities of Setting Goals 113 Chapter 12: Bringing About Change 125 Chapter 13: Methods of Behaviour Change 132 Chapter 14: Methods of Cognitive Change 143 Chapter 15: Challenging Unhelpful Thoughts 158 Chapter 16: Managing Emotions and Unpleasant Physical Sensations 167 Chapter 17: Decision on a Course of Action: Part 2 176 Chapter 18: Applying a Cognitive Behavioural Approach to Clinical Practice 182 Part II: The Issues: Some Psychological Problems How to Use This Part of the Book 191 Glossary of Everyday Terms 191 Adjustment Difficulties 193 Altered Body Image 195 Anger 198 Avoidance 201 Denial 203 Fatigue 206 Fear of the Future 208 Inactivity 210 Indecisiveness 212 Intrusive/Distressing Thoughts 214 Lack of Motivation 216 Loss of Pleasure or Ability to Enjoy Things 218 Low Mood 220 Low Self-Esteem 222 Negative Outlook 224 Pain 226 Panic Attacks 229 Special Note: Safety Behaviours 231 Physical Tension 232 Poor Concentration 234 Problem Solving Difficulties 236 Setbacks 238 Sleep Difficulties 240 Unassertiveness 242 Worrying 244 Part III: The Toolkit: CBT Methods in Practice Section 1: Techniques Activity Monitoring 249 Assertiveness Skills 250 Assessing Psychological Distress 251 Attention Strategies 252 Basic Counselling Skills 254 Behavioural Change Methods: A Summary 255 Behavioural Experiments 256 Behavioural Rehearsal 257 Believable Alternative Thoughts 258 Breathing Control 259 Challenging Unhelpful Thoughts 260 Cognitive Change Methods: A Summary 261 Denial: Strategies for Encouraging Acceptance 263 Denial: Strategies for Engaging the Patient 264 Denial: Strategies for Reducing Distressing Thoughts 265 Denial: Suggestions for Questions to Ask 266 Effective Communication Skills 267 Emotional Expression 268 Expressive Writing 269 Graded Activities 270 Listening Skills 271 Mental Distraction 272 Mindfulness 273 Pacing 274 Problem Solving 275 Psycho-education 276 Purposeful Planning 278 Relaxation Exercises 280 Respectfulness Skills 282 Socratic Questioning 284 Stimulus Control 285 Weighing the Pros and Cons 286 Section 2: Information Sheets Antidotes to Bad Days 287 The Assertiveness Model 288 Assertiveness Rights 289 Assertiveness Techniques 290 Bad Old Habits: Avoiding Relapsing Into Them 292 Change: Bringing It About 293 Change: The Desire for It 294 Change: The Transition Curve 295 Coping with Setbacks 1: Physical Health Setbacks 296 Coping with Setbacks 2: Mental Attitude Setbacks 297 Denial: Advantages and Disadvantages 298 Experiential Learning Cycle 299 Goal Setting and the Step-by-Step Approach 300 Goal Setting: Examples 302 Goal Setting Questions 303 Mental Traps: Examining the Evidence 307 Mental Traps: Examples of How to Get Out of Them 308 Mindfulness Attitudes 310 Mindfulness Exercises 311 Pacing 312 Pacing Examples 314 The Reactions of Other People 315 Reflective Practice Diary Guidance 317 Relaxation: Mental Exercise 318 Relaxation: Muscle Exercise 319 Relaxed Breathing Exercise 320 The Serenity Prayer 321 Sharing and Mixing with Other People 322 SMART Guidelines 323 Socratic Questioning: Examples 324 Stress: The Effect it Has 325 The Stress Response 326 A Vicious Cycle Model of Anxious Avoidance 327 A Vicious Cycle Model of Anxious Preoccupation 328 A Vicious Cycle Model of Hopelessness-Helplessness 329 Section 3: Record Forms Event-Emotion-Thought Analysis Form 332 Example of Event-Emotion-Thought Analysis Form 333 Believable Alternatives 335 Thought Record 336 Pacing Record Form 337 Denial: Assessing its Costs and Benefits 338 Denial: Example of Pros and Cons Assessment 339 Action Plan for Denial 340 Goal Planning: Step-By-Step Action Plan 342 Your Ideas for Goals 342 Reflective Practice Diary 351 References 357 Index 363

Nigel Sage is Consultant Clinical Psychologist in cancer and Palliative Care at The Beacon community Specialist Centre for Cancer and Palliative Care in Guildford, Surrey. He is an Accredited Cognitive Behaviour therapist and also works in primary care mental health in Hampshire. Michelle Sowden is Consultant Clinical Psychologist at Frimley Park Hospital where she has provided and developed a service to patients with physical health problems across the Clinical Directorates. She has a special interest in the application of cognitive behavioural and systemic therapies to the management of chronic medical conditions. Elizabeth Chorlton is a Chartered Clinical Psychologist at Frimley Park Hospital, in the Department of Psychological Medicine, with patients who are experiencing psychological difficulties as a result of physical health problems. In addition to her clinical psychology training, she has an MSc in the field of health psychology. Andrea Edeleanu is Director of Specialist Therapies and Service User Involvement for Surrey and Borders Partnership NHS Trust. She works clinically in Community Health Psychology and provides consultancy and clinical supervision to colleagues in health, mental health and community services. She is a consultant Clinical Psychologist, Chartered Health Psychologist and an Accredited Cognitive Behaviour therapist.

Reviews for CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit

It is very thorough, with clear explanations of the approach, uses, and techniques to assist patients or families in changing behavior so that they may better manage their illnesses and meet their life goals. (Doody's , August 2009)