最新Cognitive-behavioral treatment of social phobia教学讲义PPT课件.ppt

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1、Cognitive-behavioraltreatmentofsocialphobiaBasicSocialPhobicBeliefsTheywillbehaveinanunacceptableway(andtheyhavestrictrulestojudgebehavior)anditwillleadtorejection,lossofworth/status,orfailuretoachieveimportantgoalsTypicalSocialPhobicThoughtsWhatIsaysoundsstupidI’mboringIwillmadeafool

2、ofmyselfTheydon’tlikemeThewillseeI’manxiousIwon’thaveanythingtosayI’llblush/shake/losecontrolTreatmentoutcomeHeimbergetal.(1990)65%“clinicallysignificantchangeMattickandPeters(1988)-38%“highend-statefunction”DegreeofcognitivechangeismodestHeimbergetal(1990)FNEatPre-24.7andatpost20.7Tr

3、eatmentoutcome(2)OxfordRCTwithN=60PreFNEPostFNECT(16wks)2514Prozac+SE2521Placebo+SE2522OxfordModelforMaintenanceofSocialPhobiaSocialSituationActivatesassumptionsPerceivedsocialdangerProcessingofselfasasocialobjectSafetybehavioursSomaticandcognitivesymptomsEvidencethatmaintainssociala

4、nxietyDistortedmentalimageEmotionalreasoning(feelanxioussothereforemustlookanxious)“feltsense”-sittingcloseandfeelingasifveryfaraway-ofteninvolvessomefeelingofexclusionWhatmaintainssocialanxietyAttentionshift-todetailedselfobservationandmonitoring(sensations,images,feltsense)Safetybe

5、haviours-intendedtopreventfearedconsequencesBUTtheypreventdisconfirmationandcancausefearedsymptoms,canmakethepersonappearwithdrawnandfocusothersattentiontoselfMaintenancecontinuedAvoidance-preventsdisconfirmationAnticipatoryandpost-eventprocessing-focusesonfeelingsandconstructedimages

6、ofselfafterthefactandselectiveretrievalsofpastfailuresStagesofCognitiveTherapy1.Deriveidiosyncraticmodel2.Safetybehaviourmanipulation3.Videoandaudiofeedback4.Shiftattentiontoobservationofothers5.Behavioralexperimentinsocialsetting6.Dealingwithanticipatoryanxietyandselfimage7.Construct

7、ingaveridicalsocialself-image8.DealingwithremainingassumptionsDerivingthemodelReviewseveralrecentepisodesofsocialanxietyorcreateananalogueinsessionIdentifythemainautomaticthoughtsDivideanxietyresponseintosafetybehavioursandothersymptomUsefulquestionsforderivingthemodelForidentifyingn

8、egati