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Psychology.lakeheadu.caDepartment of Psychology
Psychology 5311 – Cognitive-Behaviour Therapy
2004-05 Winter Course Outline
Instructor: Ron Davis, Ph.D.
Office: SN 1042, 343-8646, [email protected]: Tuesdays, 1:00-4:00pm, Evans HouseOffice hours: by appointment Course Description:
This course provides an overview of the science and practice of cognitive-behaviour
therapy (CBT). Theoretical underpinnings, putative mechanisms of change, and
therapeutic efficacy will be studied with reference to Major Depressive Disorder and the
Anxiety Disorders. Participants will also become familiar with specific CBT therapeutic
interventions and practice issues.
• Beck, J.S. (1995). Cognitive therapy: Basics and beyond. New York: The Guilford
• Leahy, R.L., & Holland, S.J. (2000). Treatment plans and interventions for depression and anxiety disorders. New York: The Guilford Press. This is a requiredtext.
• Forty-five additional journal articles are indicated below. These articles entail scientific studies or research reviews that bear upon our understanding of the topicunder consideration. Four articles marked with ** are available in library holdings.
All others available from the instructor.
• Mock CBT first interview according to Beck (1995), to be videotaped Friday
February 4, debriefed Tuesday February 8 with the course instructor, and contributing25% towards final grade. Participants will be given a psychological report on themock client 24 hours prior to the interview. This mock client will meet diagnosticcriteria for Major Depressive Disorder.
• Mock CBT first interview according to Leahy and Holland (2000), to be videotaped on Wednesday March 23, debriefed Tuesday March 29 with the course instructor, andcontributing 25% towards final grade. Participants will be given a psychologicalreport on the mock client 24 hours prior to the interview. This client will meetdiagnostic criteria for one of the following Anxiety Disorders: Panic Disorder withAgoraphobia, Generalized Anxiety Disorder, Social Phobia, Posttraumatic StressDisorder, or Obsessive-Compulsive Disorder.
• Final examination, 1-5pm April 5, contributing 50% towards final grade.
Each meeting is divided into two parts. The first part involves a critical understanding of
what the current science tells us (or not) about key elements of CBT. This part will be
achieved through active class discussion of assigned readings. All participants are to readall articles and corresponding emails from assigned discussants (see below) before classand come to class prepared to discuss the material. A participant will be assigned prior toclass to act as discussant for each reading. The discussant will pose to the class aquestion that is relevant to the reading (e.g., theoretical, research, translation into clinicalpractice), the class will then discuss the question, and the discussant will conclude withtheir own perspective regarding the question. The time limit of 10 minutes for thediscussant will be strictly adhered to. Discussants will email their question to the courseinstructor and all participants not later than 3pm on the Monday before the class. Failureto do so will result in a 1-point reduction on the final grade. The email must includediscussant’s name, meeting number and date, complete reference for the reading to bediscussed, the question, and a brief rationale (2-4 lines) as to why they believe thequestion to be relevant. Do not include your own perspective (i.e., answer) to thequestion. The latter you will reveal during the class discussion.
The second part of each class is devoted to CBT skill acquisition to be achieved throughactive role-play by all participants.
Meeting 1: January 4
Topics: (1) course overview; (2) historical background; (3) principles of CBT.
McGinn, L. K., & Sanderson, W. C. (2001). What allows cognitive behavioral therapy to be brief: Overview, efficacy, and crucial factors facilitating brief treatment.
Clinical Psychology: Science & Practice, 8(1), 23-37.
Meeting 2: January 11
Topics: (1) principles of CBT continued; (2) client-therapist factors; (3) cognitive-
behavioural case conceptualization.
Readings: Beck (1995) chapters 1-2.
Padesky, C. A. (1997). Collaborative case conceptualization. Newport Beach, CA: Center for Cognitive Therapy. [In-class videotape] Feeley, M., DeRubeis, R. J., & Gelfand, L. A. (1999). The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal ofConsulting & Clinical Psychology, 67(4), 578-582.
Klein, D.N. (2003). Therapeutic alliance in depression treatment: Controlling for prior change and patient characteristics. Journal of Consulting and Clinical Psychology,71(6), 997-1006.
Meyer, B., Pilkonis, P. A., Krupnick, J. L., Egan, M. K., Simmens, S. J., & Sotsky, S. M. (2002). Treatment expectancies, patient alliance, and outcome: Furtheranalyses from the national institute of mental health treatment of depression collaborativeresearch program. Journal of Consulting and Clinical Psychology, 70(4), 1051-1055.
Trepka, C., Rees, A., Shapiro, D.A., Hardy, G.E., & Barkham, M. (2004).
Therapist competence and outcome in cognitive therapy for depression. CognitiveTherapy & Research, 28(2), 143-157.
Meeting 3: January 18
Topics: (1) case formulation cont’d; (2) the structure of therapy.
Readings: Beck (1995) chapters 3-5, 16.
Davis, R. (2001, unpublished). Structuring of the first CBT session. [In-class Bieling, P. J., & Kuyken, W. (2003). Is Cognitive Case Formulation Science or Science Fiction? Clinical Psychology: Science & Practice, 10(1), 52-69.
Kuyken, W., Fothergill, C. D., Musa, M., & Chadwick, P. (in press). The reliability and quality of cognitive case formulation. Behaviour Research and Therapy.
Meeting 4: January 25
Topics: (1) behavioural techniques; (2) homework and compliance ; (2) cognitive
techniques: Socratic dialogue
Readings: Beck (1995) chapters 6-8, 12-14; Leahy & Holland (2000) appendix A in
book and on CD-ROM.
Padesky, C. A. (1996). Guided discovery using Socratic dialogue. Newport Beach, CA: Center for Cognitive Therapy. [In-class videotape] Burns, D. D., & Spangler, D. L. (2000). Does psychotherapy homework lead to improvements in depression in cognitive-behavioral therapy or does improvement lead toincreased homework compliance? Journal of Consulting & Clinical Psychology, 68(1),46-56.
Detweiler, J. B., & Whisman, M. A. (1999). The role of homework assignments in cognitive therapy for depression: Potential methods for enhancing adherence. ClinicalPsychology: Science & Practice, 6(3), 267-282.
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science &Practice. Special Issue, 8(3), 255-270.
Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science &Practice, 7(2), 189-202.
Schmidt, N. B., & Woolaway-Bickel, K. (2000). The effects of treatment compliance on outcome in cognitive-behavioral therapy for panic disorder: Qualityversus quantity. Journal of Consulting & Clinical Psychology, 68(1), 13-18.
Meeting 5: February 1
Topics: (1) CBT for depression; (2) Cognitive techniques: thought records, intermediate
and core beliefs.
Readings: J. Beck (1995) chapters 9-11.
Padesky, C. A. (1996). Testing automatic thoughts with thought records. Newport Beach, CA: Center for Cognitive Therapy.[In-class videotape] DeRubeis, R. J., & Gelfand, L. A. (2000). "Medications versus cognitive behavior therapy for severely depressed outpatients: Mega-analysis of four randomizedcomparisons": Reply. American Journal of Psychiatry, 157(6), 1025-1026.
DeRubeis, R. J., Gelfand, L. A., Tang, T. Z., & Simons, A. D. (1999).
Medications versus cognitive behavior therapy for severely depressed outpatients: Mega- analysis of four randomized comparisons. American Journal of Psychiatry, 156(7), 1007-1013.
Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I.-M. (1998). A meta- analysis of the effects of cognitive therapy in depressed patients. Journal of AffectiveDisorders, 49(1), 59-72.
Kuyken, W., Kurzer, N., DeRubeis, R. J., Beck, A. T., & Brown, G. K. (2001).
Response to cognitive therapy in depression: The role of maladaptive beliefs andpersonality disorders. Journal of Consulting & Clinical Psychology. Special Issue, 69(3),560-566.
Merrill, K. A., Tolbert, V. E., & Wade, W. A. (2003). Effectiveness of Cognitive Therapy for Depression in a Community Mental Health Center: A Benchmarking Study.
Journal of Consulting and Clinical Psychology, 71(2), 404-409.
Tang, T. Z., & DeRubeis, R. J. (1999). Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of Consulting & ClinicalPsychology, 67(6), 894-904.
Teasdale, J. D., Scott, J., Moore, R. G., Hayhurst, H., Pope, M., & Paykel, E. S.
(2001). How does cognitive therapy prevent relapse in residual depression? Evidencefrom a controlled trial. Journal of Consulting & Clinical Psychology. Special Issue, 69(3),347-357.
Meeting 6: February 8
Topic: Debriefing of 1st mock interview. To be videotaped Friday February 4.
Meeting 7: February 22
Topic: CBT for Panic Disorder and Agoraphobia
Readings: Leahy & Holland (2000) chapter 1 and 3.
**Addis, M. E., Hatgis, C., Krasnow, A. D., Jacob, K., Bourne, L., & Mansfield, A. (2004). Effectiveness of Cognitive-Behavioral Treatment for Panic Disorder VersusTreatment as Usual in a Managed Care Setting. Journal of Consulting and ClinicalPsychology, 72(4), 625-635.
Clark, D. M., Salkovskis, P. M., Hackmann, A., Wells, A., Ludgate, J., & Gelder, M. (1999). Brief cognitive therapy for panic disorder: A randomized controlled trial.
Journal of Consulting & Clinical Psychology, 67(4), 583-589.
Ost, L.-G., Thulin, U., & Ramnero, J. (2004). Cognitive behavior therapy vs exposure in vivo in the treatment of panic disorder with agrophobia. Behaviour Researchand Therapy, 42(10), 1105-1127.
Otto, M. W., Pollack, M. H., & Maki, K. M. (2000). Empirically supported treatments for panic disorder: Costs, benefits, and stepped care. Journal of Consulting andClinical Psychology, 68(4), 556-563.
**Smits, J. A. J., Powers, M. B., Cho, Y., & Telch, M. J. (2004). Mechanism of Change in Cognitive-Behavioral Treatment of Panic Disorder: Evidence for the Fear ofFear Mediational Hypothesis. Journal of Consulting and Clinical Psychology, 72(4), 646-652.
Stuart, G. L., Treat, T. A., & Wade, W. A. (2000). Effectiveness of an empirically based treatment for panic disorder delivered in a service clinic setting: 1-year follow- up.
Journal of Consulting and Clinical Psychology, 68(3), 506-512.
Meeting 8: March 1
Topic: CBT for Generalized Anxiety Disorder
Readings: Leahy & Holland (2000) chapter 4.
Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder andthe role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70(2),288-298.
**Borkovec, T. D., & Ruscio, A. M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry. Special Issue, 62(Suppl11), 37-42.
Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-basedapproaches with existing cognitive-behavioral models. Clinical Psychology-Science andPractice, 9(1), 54-68.
Stober, J., & Borkovec, T. D. (2002). Reduced concreteness of worry in generalized anxiety disorder: Findings from a therapy study. Cognitive Therapy andResearch, 26(1), 89-96.
Wells, A. (1999). A metacognitive model and therapy for generalized anxiety disorder. Clinical Psychology & Psychotherapy, 6(2), 86-95.
Meeting 9: March 8
Topic: CBT for Social Phobia
Readings: Leahy & Holland (2000) chapter 5.
Clark, D. M., & McManus, F. (2002). Information processing in social phobia.
Biological Psychiatry, 51(1), 92-100.
Clark, D.M., et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: A randomized placebo-controlled trial. Journal of Consulting and ClinicalPsychology, 71(6), 1058-1067.
Furmark, T., Tillfors, M., Marteinsdottir, I., Fischer, H., Pissiota, A., Langstrom, B., & Fredrikson, M. (2002). Common changes in cerebral blood flow in patients withsocial phobia treated with citalopram or cognitive-behavioral therapy. Archives ofGeneral Psychiatry, 59(5), 425-433.
**Hofmann, S. G. (2004). Cognitive mediation of treatment change in social phobia. Journal of Consulting and Clinical Psychology, 72(3), 392-399.
Rodebaugh, T. L., Holaway, R. M., & Heimberg, R. G. (2004). The treatment of social anxiety disorder. Clinical Psychology Review, 24(7), 883-908.
Meeting 10: March 15
Topic: CBT for Posttraumatic Stress Disorder
Readings: Leahy & Holland (2000) chapter 6.
Becker, C. B., Zayfert, C., & Anderson, E. (in press, 2005). A survey of psychologists' attitudes towards and utilization of exposure therapy for PTSD. BehaviourResearch and Therapy.
Blanchard, E. B., Hickling, E. J., Devineni, T., Veazey, C. H., Galovski, T. E., Mundy, E., Malta, L. S., & Buckley, T. C. (2003). A controlled evaluation of cognitive behaviorial therapy for posttraumatic stress in motor vehicle accident survivors.
Behaviour Research and Therapy, 41(1), 79-96.
Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment forPTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70(5),1067-1074.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345. Foa, E. B., Zoellner, L. A., Feeny, N. C., Hembree, E. A., & Alvarez-Conrad, J.
(2002). Does Imaginal Exposure Exacerbate PTSD Symptoms? Journal of Consultingand Clinical Psychology, 70(4), 1022-1028.
Taylor, S., Thordarson, D. S., Maxfield, L., Fedoroff, I. C., Lovell, K., & Ogrodniczuk, J. (2003). Comparative efficacy, speed, and adverse effects of three PTSDTreatments: Exposure therapy, EMDR, and relaxation training. Journal of Consulting andClinical Psychology, 71(2), 330-338.
Meeting 11: March 22
Topic: CBT for Obsessive Compulsive Disorder
Readings: Leahy & Holland (2000) chapter 8.
Abramowitz, J.S., et al. (2003). Symptom presentation and outcome in cognitive- behavioural therapy for obsessive-compulsive disorder. Journal of Consulting andClinical Psychology, 71(6), 1049-1057.
Franklin, M. E., Abramowitz, J. S., Bux, D. A., Zoellner, L. A., & Feeny, N. C.
(2002). Cognitive-behavioral therapy with and without medication in the treatment ofobsessive-compulsive disorder. Professional Psychology-Research and Practice, 33(2),162-168.
McLean, P. D., Whittal, M. L., Thordarson, D. S., Taylor, S., Soechting, I., Koch, W. J., Paterson, R., & Anderson, K. W. (2001). Cognitive versus behavior therapy in thegroup treatment of Obsessive-Compulsive disorder. Journal of Consulting & ClinicalPsychology. Special Issue, 69(2), 205-214.
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37, S29-S52.
Warren, R., & Thomas, J. C. (2001). Cognitive-behavior therapy of obsessive- compulsive disorder in private practice: An effectiveness study. Journal of AnxietyDisorders. Special Issue, 15(4), 277-285.
Meeting 12: March 29
Topic: Debriefing of 2nd mock interview. To be videotaped Wednesday March 23.
Final Examination: April 5, 1-5pm, Evans House
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