Auto DraftWhat does CBT work for?

CBT works to change our thoughts and behaviors, which in turn help to change our moods. Although it began with Depression, literally  100’s of clinical trials have shown VERY strong evidence for CBT as a highly effective treatment for the below-listed issues.

Summary

CBT works to change our thoughts and behaviors, which in turn help to change our moods. Although it began with Depression, literally  100’s of clinical trials have shown VERY strong evidence for CBT as a highly effective treatment for the below-listed issues.

Overview of CBT

Using CBT to change your brain-8CBT is based on Dr. Aaron Beck’s theory that our automatic thoughts about situations largely influence how we react – emotionally,  physically, and behaviorally. Sometimes those automatic thoughts are not exactly true, but we act as if they are. In CBT, people learn to be mindful in the moment and identify what’s true and what’s not. Usually, this results in significantly decreased distress.

Often when we behave in self-defeating patterns, automatic thoughts are fueled by automatic beliefs (about ourselves, others, & the world) that aren’t exactly true either. In CBT, when people modify their underlying beliefs (to be more accurate), they’re even able to change lifelong disturbing characteristic ways of behaving.

The goal is to teach people to learn how to identify, evaluate, and modify these patterns themselves. That’s why CBT can be relatively brief, compared to traditional therapies. People can learn to be their own best therapist.

CBT works for … 

Adults

  • Anger
  • Anxiety
  • Agoraphobia and Panic Disorder with Agoraphobia
  • Dental Phobia
  • Generalized Anxiety Disorder
  • Geriatric Anxiety
  • Obsessive-Compulsive Disorder
  • Panic Disorder
  • Posttraumatic Stress Disorder (PTSD)
  • Social Anxiety / Social Phobia
  • Withdrawal from Anti-Anxiety Medications
  • Attention Deficit Disorder
  • Atypical sexual practices/sex offenders
  • Bipolar Disorder (in combination with medication)
  • Body Dysmorphic Disorder
  • Borderline Personality Disorder
  • Caregiver distress
  • Depression
  • Geriatric Depression
  • Relapse Prevention
  • Dissociative Disorders
  • Eating Disorders
  • Anorexia
  • Binge-eating Disorder
  • Bulimia
  • Gambling (in combination with medication)
  • Habit disorders
  • Marital discord
  • Schizophrenia (in combination with medication)
  • Seasonal Affective Disorder
  • Somatization Disorder
  • Substance Abuse
  • Alcohol abuse
  • Cocaine abuse (CBT relapse prevention is effective)
  • Opiate dependence
  • Smoking cessation (Group CBT is effective, as well as CBT that has multiple treatment components in combination with relapse prevention)
  • Suicide attempts

Medically-related Issues

  • Asthma with Coexisting Panic Disorder (in combination with asthma education)
  • Cancer pain
  • Chronic back pain
  • Chronic fatigue syndrome
  • Chronic pain (CBT, in combination with physical therapy, is effective for chronic pain in many medical conditions)
  • Colitis
  • Erectile dysfunction (CBT is effective for reducing sexual anxiety and improving communication)
  • Fatigue and functional impairments among cancer survivors
  • Fibromyalgia
  • Geriatric sleep disorders
  • Gulf War Syndrome
  • Hypertension (CBT is effective as an adjunctive treatment)
  • Hypochondriasis, or the unsubstantiated belief that one has a serious medical condition
  • Infertility (anovulation)
  • Insomnia
  • Irritable-bowel syndrome
  • Migraine headaches
  • Non-cardiac chest pain
  • Obesity (CBT is effective in combination with hypnosis)
  • Pain with no known cause (Idiopathic pain)
  • Physical complaints not explained by a medical condition (Somatoform disorders)
  • Pre-menstrual syndrome
  • Rheumatic disease pain (CBT that has multiple treatment components is effective)
  • Sickle cell disease pain (CBT that has multiple treatment components is effective)
  • Sleep disorders
  • Somatization Disorder
  • Temporomandibular Disorder pain
  • Tinnitus
  • Vulvodynia

Children & Adolescents

  • Anxiety disorders
  • Avoidant disorder
  • Chronic pain
  • Conduct disorder (oppositional defiant disorder)
  • Depression (among adolescents and depressive symptoms among children)
  • Distress due to medical procedures (mainly for cancer)
  • Obsessive-compulsive disorder
  • Overanxious disorder
  • Phobias
  • Physical complaints not explained by a medical condition (Somatoform disorders)
  • Posttraumatic stress disorder
  • Recurrent abdominal pain
  • Separation anxiety

Other issues

  • Aging
  • Family therapy
  • Grief and loss
  • Group therapy
  • Low self-esteem
  • Psychiatric Inpatients
  • Relationship difficulties
  • Separation and Divorce
  • Stress
  • Work problems & procrastination

 

* Quoted from The Beck Institute  (http://www.beckinstitute.org/cognitive-therapy-can-treat/)

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Fibromyalgia (FM)Fibromyalgia (FM)

Understand the state-of-the-art treatment for Fibromyalgia (FM). Below you will find excellent videos as well as a link to the best self-help tool for CBT for Fibromyalgia.

Summary

Understand the state-of-the-art treatment for Fibromyalgia (FM). Below you will find excellent videos as well as a link to the best self-help tool for CBT for Fibromyalgia.

Understanding Fibromyalgia (FM)

Dan Clauw, MD is the Director of the Chronic Pain and Fatigue Research Center at the University of Michigan as well as Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry. As a leader in Fibromyalgia research, he explains the current understanding and best practices for treating Fibromyalgia and related conditions.

Dr. Clauw’s multidisciplinary team has extensively studied the use of CBT and exercise in context to Fibromyalgia and discusses his findings (in plain language).

Cannabinoids & Opioids for FM

 

Depression, FM, & Centralized Pain

Depression is common among chronic pain and Fibromyalgia. However, it’s also important to pay attention to what Dr. Clauw calls the 800 pound gorilla in chronic pain – centralized pain – which he believes will be a primary focus of the future of pain research and treatment.

Computer-based (free) CBT for FM

Dr. Clauw’s research team, including pain psychologist David Williams, PhD, developed an online self-paced version of CBT for Fibromyalgia. If you would like to try a do-it-yourself approach to CBT, this is a wonderful first step.  Go to FibroGuide.  I was part of the clinical research team (when it was based at Georgetown University) that tested an earlier, face-to-face version of CBT modules for FM.

Understanding Pain 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Find CBT-trained Therapists

If self-help is not enough, contact me at drcary@mac.com or look for CBT providers in the CBT Directory for providers near you. Also, many providers will conduct CBT using teleconferencing.

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Fibromyalgia & IBSFibromyalgia & IBS

Irritable Bowel Syndrome is very commonly experienced by those with FM – due to their super sensitivity to pain. Here you will hear from experts on IBS as well as learn about self help method to take back lost parts of your life.

Summary

Irritable Bowel Syndrome is very commonly experienced by those with FM – due to their super sensitivity to pain. Here you will hear from experts on IBS as well as learn about self help method to take back lost parts of your life.

What is IBS?

IBS is a problem with the gut not working well. That’s why it’s called a functional disorder. There’s no tissue damage. So, having tests aren’t used to diagnose it. It’s like having a software (rather than a hardware) problem on a computer.

Irritable Bowel Syndrome 1Symptoms can include: chronic pain, gas, and bloating, diarrhea or constipation, … or both. People have a super sensitive stomach. It causes a great deal of stress … as well as being caused by stress (among other things).

For more details, I recommend listening to one of the best medical experts who also has a PhD in the new field of ‘Gut-Brain’ Gastroenterology. Dr. Geoff Hebbard answers questions in this Podcast: IBS and Functional Digestive Disorders related to:  differences between several GI diseases, belching, bloating, farting, gurgling, if constipation can be toxic, and much more.

How can CBT help?

Besides the physical distress of IBS, there’s the day-to-day stress of an unpredictable flare-up, the fear of not being close enough to a bathroom, or the embarrassment of an urgent exit. People can suffer an extraordinary loss in their quality of life, due to limiting or altogether avoiding enjoyable food, activities, and relationships.

Cognitive Behavior Therapy (CBT) for IBS is scientifically proven to help you take back the parts of your life that are lost. It’s a specific type of stress management, including 3 parts:

  1. Education about IBS and how stress relates to the intestinal tract
  2. Skill development for managing thoughts, feelings, and behavior patterns that can improve ‘function’
  3. Gradual re-entry back into more desirable patterns – to take back your life.

CBT using self-help works

Fortunately, for those who prefer self-help to going to a therapist, there’s an unusual book that’s actually been tested and proven to help people with IBS. I recommend Dr. Hunt’s book, Reclaim Your Life From IBS. I believe this user says it best … as did 26 other people!

Irritable Bowel Syndrome 25 stars Very useful book, easy to understand and implement in life

June 13, 2016

Verified Purchaser
I have read a few other books to improve my IBS symptoms. Books containing new diet plans and meditation techniques are all very useful. But the insight into the real problem I gained after reading this book is extremely helpful to me.
This book clearly explains how mental condition is related to the gut problems. I was always aware of this connection but the idea was not this clear to me. Living in a professional world full of deadlines and job duties, puts lots of pressure on human body and intestinal problems such as IBS are just one way the body is alarming about the mental issues. This book focuses on this aspect and tries to provide simple but strong techniques to block the route from outside stress to the body and intestine.
The book is very easy to read, no technicality,,,so my recommendation as a person with IBS symptoms is give it a read,,I am sure you will find it very useful!
26 people found this helpful

What does CBT look like?

For those who prefer trying CBT with a therapist, Dr. Hunt has also demonstrated (with a person playing someone with IBS) a segment of a typical therapy session. This clip gives you an excellent idea of what to expect. Pay attention to how frankly they collaborate and discuss the patient’s thoughts, feelings, and behaviors as well as what the next step will be for the patient to try before her next visit.

Find a CBT therapist

Not all CBT therapists are trained to work with people with IBS. Be sure to ask therapists if this is one of their specialties. I recommend 3 different sources to search:

  1. The CBT Hub Directory (Glance at the Map to see if there are any in your area)
  2. The Association for Behavioral and Cognitive Therapies Directory
  3. The Academy of Cognitive Therapy Directory

Participate in a study?

If you are an IBS patient, Dr. Hunt at the University of Pennsylvania is currently enrolling people in her study. It’s goal: Test which works better …  Reclaim Your Life From IBS versus The Complete Low FODMAP Diet. Contact the study coordinator at ibsselfhelp@gmail.com for more information.

Hypnotherapy

Since the 1980’s, Dr. Peter Whorwell BSc MB BS MD PhD FRCP, Professor of Medicine & Gastroenterology at the University of Manchester has become known for studies showing that hypnotherapy for IBS is another highly effective psychological treatment. More recently, his study published in 2018 showed that group hypnotherapy was no less effective than individual hypnotherapy – a step in reducing the cost!

Listen to Dr. Jim Kantidakis’ Podcast with Dr. Whorwell about hypnotherapy.

Find certified hypnosis professionals near you using the The Society of Psychological Hypnosis website. They list the professional organizations which will have directories.

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Auto Draft 1Chronic Back Pain

Pain, in the U.S., is the most common complaint in healthcare and an enormous public health challenge. One in 3 adults have it. It causes the most disability. It costs us up to $635 billion/year. By far, pain is untreated or under-treated.

Summary

Pain, in the U.S., is the most common complaint in healthcare and an enormous public health challenge. One in 3 adults have it. It causes the most disability. It costs us up to $635 billion/year. By far, pain is untreated or under-treated.

The National Problem of Pain

Dr. Mackey is Chief of Stanford’s Division of Pain Medicine, Director of the Systems Neuroscience and Pain Laboratory (SNAPL) and Redlich Professor of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and (by courtesy) Neurology.

In this video, Dr. Mackey kicks off the 2016 Back Pain Day by discussing pain as a chronic disease itself and a how we can address it clinically and as a public health problem. He broadly describes what’s involved in pain management – a team sport. Then, the other 8 Pain Medicine faculty members describe their roles on the pain team in their videos.

Sean Mackey, M.D., Ph.D

Dr. Mackey explains, in terms patients can understand, the state-of-the-art understanding about how pain actually works.

Beth Darnall, PhD

Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine, Dr. Darnall is a pain psychologist and scientist. Her research investigates how to best treat and prevent chronic pain. She is a principal investigator for $14M in federal research awards.

Dr. Darnall explains the importance of using CBT to manage ‘catastrophizing’ – a common reaction to chronic pain.

Heather Poupore-King, PhD

Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine, Dr. King’s interest is in providing interdisciplinary care and specializes in comprehensive functional rehabilitation for chronic pain patients, using Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (a form of CBT), and Biofeedback.

Dr. King explains how care team members work together – with you at the center – to manage chronic pain best.

Fiona Barwick, PhD

Clinical Assistant Professor in Psychiatry & Behavioral Sciences – Stanford Center for Sleep Sciences and Medicine, Dr. Barwick specializes in the assessment and treatment of insomnia, sleep apnea, circadian rhythm sleep-wake disorders, and parasomnias from a Health Psychology perspective.

Dr. Barwick explains the role of CBT and augmented therapies for addressing problems with sleep and chronic pain.

Ming-Chih Kao, MD, PhD

Clinic Chief at Stanford Pain Management and Clinical Assistant Professor, Orthopaedic Surgery, Dr. Kao’s mission is to offer all of his patients comprehensive interdisciplinary diagnosis and treatment, leveraging the full extent of what is known in state-of-the-art Pain Medicine.

Dr. Kao discusses the variety of meds used and their role in pain management.

Michael S. Leong, MD

Clinical Associate Professor of Anesthesiology and Pain Medicine and Neurosurgery (by courtesy), Dr. Leong’s clinical foci are in radiculopathy; spinal, abdominal, and cancer pain; postherpetic neuralgia; and workers compensation cases.

Dr. Leong explains the role of the use of spinal cord stimulation and how it works to reduce chronic pain.

Jordan Newmark, MD

Dr. Newmark is the pain division’s Associate Division Chief of Education, and Pain Medicine Associate Fellowship Director. His clincal interests are in chronic and perioperative pain management, headache and orofacial pain management, and interdisciplinary / procedural treatment.

Dr. Newmark teaches us about the safe use of opioids for chronic pain.

Corinne Cooley, DPT

Ms. Cooley, a member of the Pain Physical Therapy staff, explains the role of physical movement in managing chronic pain – “Movement as Medicine”

J. Drew Sturgeon, PhD

A Postdoctoral Research Fellow, Dr. Sturgeon explains the importance of managing social relationships and shows their impact on the brain and on chronic pain.

Questions and Answers (Video 1 and 2)

The entire panel participates.

The Future: ‘Personalized’ Pain Management

This video, not part of the 2016 Pain Day, outlines how the Stanford team is developing an extraordinary diagnostic and treatment tool that will inform clinicians (throughout the world) how to better ‘personalize’ pain treatment for their patients. Perhaps your physician could participate with this project, CHOIR, in the future.

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Understanding Pain 3Understanding Pain

If you are one of 100 million Americans with chronic pain, you’re likely under-treated and have not been taught by health providers how to improve your quality of life.

Summary

If you are one of 100 million Americans with chronic pain, you’re likely under-treated and have not been taught by health providers how to improve your quality of life.

Science of Pain

 

At a minimum, the below videos suggest the importance of getting treated by a Pain Medicine specialist who works alongside a Behavioral Pain specialist as part of a care team.  Learning a little about the science of pain may profoundly change how you view your pain condition and what to do about it.

A Roundtable of Pain Specialists

For a good overview on the state of the science of pain, watch the Charlie Rose Brain Series episode on Chronic Pain.

What is Pain?

Dan Bruns, a Pain Psychologist, explains pain in a very understandable way.

 

Catastrophizing + Pain

 

Where’s the Edge of Pain?

Low Back Pain

An Anatomy Professor’s Take on Pain

University of California Professor Basbaum presents a quick course for the public. As he’d say, don’t get bogged down trying to learn details. Just get the gist of how your brain processes the ‘experience of pain.’

An Internist-Pediatrician’s Take on Pain

Dr. Schubiner briefly explains his view of the steps to take to begin to ‘unlearn’ a learned pain brain pathway. It’s important to realize that his belief, that pain can be completely unlearned is as yet a hypothesis – not proven.

Behavioral Treatment of Pain

Living with persistent pain, regardless of what the cause, necessitates some lifestyle management skills. The University of Michigan Chronic Pain and Fatigue Research Center has developed and tested an online self-help series of modules that may help you learn these skills.

Although you may not have Fibromyalgia, these same skills are the basis for the cognitive-behavioral therapy that Health Psychologists use in providing behavioral pain management for chronic pain in general. Check out these skill modules.

 

Virtual Reality (VR) for Pain Management

Another behavioral tool, VR, can help alleviate pain. Watch this short video that see how ‘Snow World’ – a VR Game – helps with pain associated with burns.

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Headaches and BiofeedbackHeadaches and Biofeedback

Daily stress is an unavoidable part of daily life. It’s how you manage the stress that’s most important.

Summary

Daily stress is an unavoidable part of daily life. It’s how you manage the stress that’s most important.

Overview

Then during the nineties, when I was on the Clinical Faculty in Behavioral Medicine at Georgetown University, outpatients with all kinds of pain – head, back, stomach – came into the Biofeedback Lab I directed. I always thought how ironic it was. They rushed through traffic, hassled with parking, and stressed about being late – just to come in to relax.

Thankfully now, Biofeedback is entirely portable. In the quiet of your favorite place, you can teach yourself how to relax tension away and take control of your nervous system  – to access the relaxation response. So, you might want to look into something like the Stress Eraser (I don’t have any stock in their company). It’s a proven tool.

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