In-congress workshop “CBT for Complex Conditions”
When therapists hit a roadblock in treatment, they need to specify the problem: What is the client doing or not doing in session or between sessions that is a problem? Or what is the client saying or not saying in session or between sessions that is a problem? Next, therapists need to conceptualize the problem. Is it related to a factor external to the therapy session itself (such as a difficulty with medication)? Is it related to a mistake they themselves have made in treating the client (such as probing too deeply, resulting in the client’s feeling unsafe)? Is it related to a practical problem (such as an inadequate “dose” of therapy)? Is it related to clients’ dysfunctional beliefs and coping strategies? And/or is it related to the therapist’s dysfunctional beliefs and coping strategies?
Dr. Judith Beck will focus on adapting treatment for clients with personality disorders, clients who, for example, depend too much on the therapist, avoid revealing important information, control the therapy session, insist on being granted special favors, try to entertain the therapist, become angry in session, engage in self-harm, fail to complete Action Plans (homework), and so on. She’ll discuss how to plan treatment for these clients and what to do when they display therapy-interfering behavior.
Dr. Allen Miller will then discuss the particular challenges in working with clients who present with substance use, pain and PTSD. Clients who experience physical withdrawal, medical conditions that produce pain, and traumatic events that pose imminent danger often wonder how therapy can help. They tend to hold beliefs such as “I can’t stand what is happening to me” and “Only a medical provider can help.” Their thinking is characterized by catastrophic beliefs and negative appraisals. Dr. Miller will describe and demonstrate how to conceptualize these issues and offer specific strategies for working effectively with these clients.
In this workshop, Drs. Beck and Miller will discuss participants’ challenging cases, specify problems, and conceptualize why they arose. They will then discuss strategies to get treatment back on track. They will demonstrate various techniques through roleplays.