The document outlines an agenda and background for a seminar on cognitive behavioral therapy (CBT) for clinical perfectionism. It discusses definitions of perfectionism, ways perfectionism can be problematic, its impact on treatment for various disorders like depression and eating disorders, and empirical evidence that perfectionism can be treated using CBT approaches. Treatment involves developing a personalized formulation based on maintaining factors identified in cognitive models of perfectionism, and using cognitive and behavioral techniques to address problematic standards, self-criticism, and cognitive biases.
Anger is a normal emotion that varies in intensity from mild irritation to intense fury, but uncontrolled anger can harm health and relationships. While it is a myth that anger must be expressed externally to avoid exploding, managing anger positively requires identifying triggers and sources of anger and developing coping mechanisms like taking deep breaths or removing oneself from the situation. Proper anger management focuses on using anger constructively rather than eliminating it entirely.
The document discusses procrastination and provides tips to overcome it. It begins by defining procrastination as postponing or delaying action needlessly. It then notes that a high percentage of people procrastinate and lists common tasks and projects people procrastinate over like chores, writing, and new projects. Some reasons for procrastinating include fear of failure or being imperfect and being overwhelmed. Procrastination can negatively impact work by making it difficult for others, reducing quality, and causing missed deadlines. However, procrastination may sometimes aid creativity. The document concludes by offering tips for starting tasks like using a timer, brainstorming with a friend, and celebrating successes.
This document discusses cognitive behavioral therapy (CBT), including its definition, history, indications, and various techniques. CBT was developed in the 1950s and aims to change unhelpful cognitive patterns and behaviors. The document outlines several CBT techniques, including cognitive restructuring, guided discovery, exposure therapy, journaling, activity scheduling, behavioral experiments, relaxation, role playing, and successive approximation. It notes both the advantages of learning practical coping strategies through CBT, as well as some potential disadvantages such as the time commitment required.
This document summarizes information about procrastination from a presentation by Dr. Timothy Pychyl, an expert on procrastination. It defines procrastination as voluntarily delaying tasks despite expecting negative outcomes. Everyone procrastinates sometimes, but not everyone is a chronic procrastinator. Common causes of procrastination include perfectionism, fear of failure or success, feeling overwhelmed, and using tasks to regulate mood. The document recommends recognizing procrastination patterns and using goal setting, accountability, and the Pomodoro technique to start tasks in bite-sized chunks to overcome procrastination.
Procrastination is the act of delaying tasks that need to be completed. Around 15-20% of people are chronic procrastinators. While procrastination has a negative connotation, postponing less important tasks can sometimes be beneficial. The roots of procrastination often include perfectionism, fear of failure or criticism, and poor organization. These can lead to a slippery slope of distraction and avoidance of important tasks. Breaking large projects into smaller, manageable pieces and prioritizing the schedule can help reduce procrastination.
The document discusses assertiveness communication. It defines assertiveness as expressing views clearly without being aggressive while allowing others to also voice their opinions. Assertiveness has benefits like increased confidence and ability to meet one's needs. It also discusses rights and responsibilities in assertive communication, including the right to say no and make mistakes. Types of communication styles like passive, aggressive, and manipulative are contrasted with assertive behavior. Tips for developing conversations and expressing oneself assertively are provided. Problems with assertiveness training and maintaining assertive behavior are also outlined.
Dr. Pat Schuler
Creative Insights
5th Annual ECU Gifted Conference
October 5, 2011
www.ecugifted.com
Perfectionism is often considered a characteristic of giftedness, and research indicates there are adaptive and maladaptive forms of perfectionism. When it is healthy, perfectionism can help motivate gifted kids to excel. When it is unhealthy, perfectionism can be costly in terms of some gifted kids' self-image, self-esteem, and achievement. This session will examine how the various aspects of perfectionism are manifested in the classroom, and what strategies educators can use to promote healthy perfectionistic tendencies- for themselves and their students.
Anger is a normal emotion that varies in intensity from mild irritation to intense fury, but uncontrolled anger can harm health and relationships. While it is a myth that anger must be expressed externally to avoid exploding, managing anger positively requires identifying triggers and sources of anger and developing coping mechanisms like taking deep breaths or removing oneself from the situation. Proper anger management focuses on using anger constructively rather than eliminating it entirely.
The document discusses procrastination and provides tips to overcome it. It begins by defining procrastination as postponing or delaying action needlessly. It then notes that a high percentage of people procrastinate and lists common tasks and projects people procrastinate over like chores, writing, and new projects. Some reasons for procrastinating include fear of failure or being imperfect and being overwhelmed. Procrastination can negatively impact work by making it difficult for others, reducing quality, and causing missed deadlines. However, procrastination may sometimes aid creativity. The document concludes by offering tips for starting tasks like using a timer, brainstorming with a friend, and celebrating successes.
This document discusses cognitive behavioral therapy (CBT), including its definition, history, indications, and various techniques. CBT was developed in the 1950s and aims to change unhelpful cognitive patterns and behaviors. The document outlines several CBT techniques, including cognitive restructuring, guided discovery, exposure therapy, journaling, activity scheduling, behavioral experiments, relaxation, role playing, and successive approximation. It notes both the advantages of learning practical coping strategies through CBT, as well as some potential disadvantages such as the time commitment required.
This document summarizes information about procrastination from a presentation by Dr. Timothy Pychyl, an expert on procrastination. It defines procrastination as voluntarily delaying tasks despite expecting negative outcomes. Everyone procrastinates sometimes, but not everyone is a chronic procrastinator. Common causes of procrastination include perfectionism, fear of failure or success, feeling overwhelmed, and using tasks to regulate mood. The document recommends recognizing procrastination patterns and using goal setting, accountability, and the Pomodoro technique to start tasks in bite-sized chunks to overcome procrastination.
Procrastination is the act of delaying tasks that need to be completed. Around 15-20% of people are chronic procrastinators. While procrastination has a negative connotation, postponing less important tasks can sometimes be beneficial. The roots of procrastination often include perfectionism, fear of failure or criticism, and poor organization. These can lead to a slippery slope of distraction and avoidance of important tasks. Breaking large projects into smaller, manageable pieces and prioritizing the schedule can help reduce procrastination.
The document discusses assertiveness communication. It defines assertiveness as expressing views clearly without being aggressive while allowing others to also voice their opinions. Assertiveness has benefits like increased confidence and ability to meet one's needs. It also discusses rights and responsibilities in assertive communication, including the right to say no and make mistakes. Types of communication styles like passive, aggressive, and manipulative are contrasted with assertive behavior. Tips for developing conversations and expressing oneself assertively are provided. Problems with assertiveness training and maintaining assertive behavior are also outlined.
Dr. Pat Schuler
Creative Insights
5th Annual ECU Gifted Conference
October 5, 2011
www.ecugifted.com
Perfectionism is often considered a characteristic of giftedness, and research indicates there are adaptive and maladaptive forms of perfectionism. When it is healthy, perfectionism can help motivate gifted kids to excel. When it is unhealthy, perfectionism can be costly in terms of some gifted kids' self-image, self-esteem, and achievement. This session will examine how the various aspects of perfectionism are manifested in the classroom, and what strategies educators can use to promote healthy perfectionistic tendencies- for themselves and their students.
This is a presentation designed to provide an overview of the characteristics and impact of perfectionism on student development, particularly for the gifted and talented ones. Strategies for countering maladaptive perfectionism are also introduced with examples and tasks.
23 Time Management Techniques of Insanely Busy PeopleDaniel Silvestre
Get more productivity hacks: oneproductivity.com/?ref=slideshare_time_management_techniques
Good time management techniques simplify how you work and help you get things done better and faster. Here are my 23 favorite time management techniques. They are a set of principles, rules, and skills that allow you to put your focus on the things that matter and help you be more productive.
Full article: http://www.dansilvestre.com/time-management-techniques/
Motivation and motivational enhancement therapydeveshwaralladi
This document provides an overview of motivation and motivational enhancement therapy (MET). It defines motivation and discusses theories of motivation including need and drive reduction theory, instinct theory, social urges theory, and goal orientation theory. It also summarizes Maslow's hierarchy of needs and characteristics of self-actualized people. The document then discusses motivational treatment approaches like brief motivational intervention, motivational interviewing, and motivational enhancement therapy. It provides details on the stages and processes of MET, including the EARS principles and three phases of building and strengthening motivation for change.
This document discusses perfectionism and strategies for overcoming perfectionistic tendencies. It begins with a poem about a woman who is never satisfied and always finds faults, even in heaven. It then defines perfectionism as setting unrealistically high standards and being unable to accept anything short of perfection. Several myths about perfectionism are identified and dispelled. The negative effects of perfectionism are outlined, and strategies are provided to help develop a healthy approach to goals and tasks.
This document summarizes a presentation on grief therapy given by Dr. Susan Stuber. It discusses research on normal grief versus complicated grief, assessments of complicated grief, debates around including prolonged grief disorder in the DSM-V, and additions related to grief in the DSM-5. The presentation covers critiques of Kubler-Ross's five stages of grief model, analyses of criteria for complicated or prolonged grief proposed by Prigerson and Shear, and risk and protective factors for complicated grief.
This training session is designed to help you make better use of your valuable time. The session will focus on practical techniques and information that you can start using right away, today, to gain more control over your busy schedule.
We will cover everything from planning, to prioritizing, to delegating, to controlling the people who control your time. We’ll talk about how to deal more efficiently with meetings, phones, paperwork, interruptions, and emergencies without letting them sidetrack you and sabotage your schedule.
This document discusses why people procrastinate and provides strategies to overcome procrastination. It notes that procrastinating may provide short-term stress relief but creates more long-term stress. Common reasons for procrastinating include not feeling the impact of delays, fearing tasks are too big, and perfectionism. The document recommends focusing on end goals and envisioning how completing tasks now will make the future easier to help resist procrastination. On average, Americans waste two hours per work day procrastinating, costing $10,000 per employee annually in lost productivity.
Motivational Interviewing - CHANGE TALKJohn Russell
In the latest Motivational Interviewing (MI) Club we look at what Change Talk really is and how to use it to help people to make changes. See examples of what words people might use when discussing their change - www.miinlondon.org
The document discusses integrating mindfulness practices into social and emotional learning (SEL) curriculum. It describes a collaboration where mindfulness training was provided to educators and mindfulness practices and lessons were piloted with students. Key findings included students being calmer and more focused, and educators feeling more present. Going forward, the organization plans to further integrate mindfulness training into its standard curriculum and do additional research on connections between mindfulness and SEL.
The document discusses the problem of procrastination and poor time management among college students. It provides statistics showing that 31% of students waste 30 minutes to an hour daily due to procrastination, while 78% of college students sometimes struggle with time management and 9% always do. To address this, the document recommends starting tasks in small amounts to build focus and breaking large projects into more manageable pieces to facilitate time tracking and completion.
The document discusses managing cravings and triggers when trying to overcome substance dependence. It defines cravings as the desire to use a substance to experience euphoric effects or avoid withdrawal. Cravings are triggered by people, places, things or feelings associated with past use. While intense initially, cravings lessen over time if use is not continued. Cravings are likened to ocean waves that start small and fade, and urges can be "surfed" by focusing on bodily sensations until they pass within minutes. Distracting oneself and delaying a decision to use are recommended strategies to manage cravings.
The document outlines an assertiveness training program that teaches participants to differentiate between passive, aggressive, and assertive behaviors. It defines assertiveness as expressing one's feelings and rights while respecting others. The training covers techniques like controlling tension, using positive self-talk, and learning to say no. Activities help participants evaluate their own assertiveness and practice communication styles. The goal is to help people reduce conflict in their lives by mastering assertive skills like direct but respectful communication.
Time Management Case Study Busy Business PeopleCPA Australia
This document provides time management strategies for busy business owners and their employees. It discusses principles like touching items only once, replacing meetings with workshops, avoiding multitasking, prioritizing important tasks, engaging fully during work hours, creating future business opportunities, maintaining health, implementing morning and evening rituals, batching email and calls, and not allowing drop-in visits. The strategies are meant to increase productivity without major disruptions by focusing fully on one task at a time and setting boundaries between work and personal time.
The “Course Topics” series from Manage Train Learn and Slide Topics is a collection of over 4000 slides that will help you master a wide range of management and personal development skills. The 202 PowerPoints in this series offer you a complete and in-depth study of each topic. This presentation is on "Assertiveness Training".
Mindfulness - Art of Living in the MomentManoj Shah
Mindfulness is an ancient Buddhist practice of paying attention to the present moment non-judgmentally. It can help reduce stress and improve focus. Mindfulness involves focusing attention on a single anchor, like the breath, sounds, or sensations, and gently returning attention to the anchor when the mind wanders. Regular mindfulness practice can have psychological benefits like reduced stress and anxiety and increased focus, as well as physical benefits like reduced blood pressure and stronger immune function. It is a skill that gets easier with consistent practice.
Assertiveness is about standing up for yourself, but also wabout respecting the opinions and needs of others.
When e communicate assertively, we are clear about our opinions and wishes, but we are also open to others’.
1. How to reverse your bad habits and stick to good ones.
2. The science of how your brain processes habits.
3. The common mistakes most people make (and how to avoid them).
4. How to overcome a lack of motivation and willpower.
5. How to develop a stronger identity and believe in yourself.
6. How to make time for new habits (even when your life gets crazy).
7. How to design your environment to make success easier.
8. How to make big changes in your life without overwhelming yourself.
9. How to get back on track when you get off course with your goals.
10. And most importantly, how to put these ideas into practice in real life.
Cognitive Behavioural Therapy: A Basic Overview (Presentation)meducationdotnet
This document provides an overview of cognitive behavioural therapy (CBT). It begins by outlining the learning objectives, which are to develop knowledge of CBT principles and techniques. The document then defines CBT as being based on the idea that emotions are governed by thoughts. It notes CBT aims to help people develop a more objective view by changing unhelpful beliefs. Conditions for which CBT has been shown to be effective are then listed, including depression, anxiety, eating disorders, and others. Key CBT principles like the A-B-C model of activating events, beliefs, and consequences are explained. Common cognitive distortions or thinking errors are defined and examples provided. The document concludes by describing how CBT is applied to
Reviewing Cognitive Treatment for Eating Disorders: From Standard CBT Efficac...State of Mind
Reviewing Cognitive Treatment for Eating Disorders: From Standard CBT Efficacy to Worry, Rumination and Control Focused Interventions - EACBT 2015 Jerusalem
Non-pharmacological management of dementiaRavi Soni
This document discusses non-pharmacological methods for managing dementia, including behavioral symptoms. It begins by defining behavioral and psychological symptoms of dementia (BPSD) and noting that 90% of dementia patients experience BPSD severe enough to be problematic. Common symptoms include agitation, wandering, depression, and psychosis. The document then discusses several non-pharmacological therapies for managing BPSD, including reminiscence therapy, validation therapy, reality orientation, behavioral therapies, and sensory stimulation techniques like light therapy, acupuncture, and aromatherapy. It provides some evidence for the effectiveness of these approaches, though notes most studies have small sample sizes and more research is still needed.
This is a presentation designed to provide an overview of the characteristics and impact of perfectionism on student development, particularly for the gifted and talented ones. Strategies for countering maladaptive perfectionism are also introduced with examples and tasks.
23 Time Management Techniques of Insanely Busy PeopleDaniel Silvestre
Get more productivity hacks: oneproductivity.com/?ref=slideshare_time_management_techniques
Good time management techniques simplify how you work and help you get things done better and faster. Here are my 23 favorite time management techniques. They are a set of principles, rules, and skills that allow you to put your focus on the things that matter and help you be more productive.
Full article: http://www.dansilvestre.com/time-management-techniques/
Motivation and motivational enhancement therapydeveshwaralladi
This document provides an overview of motivation and motivational enhancement therapy (MET). It defines motivation and discusses theories of motivation including need and drive reduction theory, instinct theory, social urges theory, and goal orientation theory. It also summarizes Maslow's hierarchy of needs and characteristics of self-actualized people. The document then discusses motivational treatment approaches like brief motivational intervention, motivational interviewing, and motivational enhancement therapy. It provides details on the stages and processes of MET, including the EARS principles and three phases of building and strengthening motivation for change.
This document discusses perfectionism and strategies for overcoming perfectionistic tendencies. It begins with a poem about a woman who is never satisfied and always finds faults, even in heaven. It then defines perfectionism as setting unrealistically high standards and being unable to accept anything short of perfection. Several myths about perfectionism are identified and dispelled. The negative effects of perfectionism are outlined, and strategies are provided to help develop a healthy approach to goals and tasks.
This document summarizes a presentation on grief therapy given by Dr. Susan Stuber. It discusses research on normal grief versus complicated grief, assessments of complicated grief, debates around including prolonged grief disorder in the DSM-V, and additions related to grief in the DSM-5. The presentation covers critiques of Kubler-Ross's five stages of grief model, analyses of criteria for complicated or prolonged grief proposed by Prigerson and Shear, and risk and protective factors for complicated grief.
This training session is designed to help you make better use of your valuable time. The session will focus on practical techniques and information that you can start using right away, today, to gain more control over your busy schedule.
We will cover everything from planning, to prioritizing, to delegating, to controlling the people who control your time. We’ll talk about how to deal more efficiently with meetings, phones, paperwork, interruptions, and emergencies without letting them sidetrack you and sabotage your schedule.
This document discusses why people procrastinate and provides strategies to overcome procrastination. It notes that procrastinating may provide short-term stress relief but creates more long-term stress. Common reasons for procrastinating include not feeling the impact of delays, fearing tasks are too big, and perfectionism. The document recommends focusing on end goals and envisioning how completing tasks now will make the future easier to help resist procrastination. On average, Americans waste two hours per work day procrastinating, costing $10,000 per employee annually in lost productivity.
Motivational Interviewing - CHANGE TALKJohn Russell
In the latest Motivational Interviewing (MI) Club we look at what Change Talk really is and how to use it to help people to make changes. See examples of what words people might use when discussing their change - www.miinlondon.org
The document discusses integrating mindfulness practices into social and emotional learning (SEL) curriculum. It describes a collaboration where mindfulness training was provided to educators and mindfulness practices and lessons were piloted with students. Key findings included students being calmer and more focused, and educators feeling more present. Going forward, the organization plans to further integrate mindfulness training into its standard curriculum and do additional research on connections between mindfulness and SEL.
The document discusses the problem of procrastination and poor time management among college students. It provides statistics showing that 31% of students waste 30 minutes to an hour daily due to procrastination, while 78% of college students sometimes struggle with time management and 9% always do. To address this, the document recommends starting tasks in small amounts to build focus and breaking large projects into more manageable pieces to facilitate time tracking and completion.
The document discusses managing cravings and triggers when trying to overcome substance dependence. It defines cravings as the desire to use a substance to experience euphoric effects or avoid withdrawal. Cravings are triggered by people, places, things or feelings associated with past use. While intense initially, cravings lessen over time if use is not continued. Cravings are likened to ocean waves that start small and fade, and urges can be "surfed" by focusing on bodily sensations until they pass within minutes. Distracting oneself and delaying a decision to use are recommended strategies to manage cravings.
The document outlines an assertiveness training program that teaches participants to differentiate between passive, aggressive, and assertive behaviors. It defines assertiveness as expressing one's feelings and rights while respecting others. The training covers techniques like controlling tension, using positive self-talk, and learning to say no. Activities help participants evaluate their own assertiveness and practice communication styles. The goal is to help people reduce conflict in their lives by mastering assertive skills like direct but respectful communication.
Time Management Case Study Busy Business PeopleCPA Australia
This document provides time management strategies for busy business owners and their employees. It discusses principles like touching items only once, replacing meetings with workshops, avoiding multitasking, prioritizing important tasks, engaging fully during work hours, creating future business opportunities, maintaining health, implementing morning and evening rituals, batching email and calls, and not allowing drop-in visits. The strategies are meant to increase productivity without major disruptions by focusing fully on one task at a time and setting boundaries between work and personal time.
The “Course Topics” series from Manage Train Learn and Slide Topics is a collection of over 4000 slides that will help you master a wide range of management and personal development skills. The 202 PowerPoints in this series offer you a complete and in-depth study of each topic. This presentation is on "Assertiveness Training".
Mindfulness - Art of Living in the MomentManoj Shah
Mindfulness is an ancient Buddhist practice of paying attention to the present moment non-judgmentally. It can help reduce stress and improve focus. Mindfulness involves focusing attention on a single anchor, like the breath, sounds, or sensations, and gently returning attention to the anchor when the mind wanders. Regular mindfulness practice can have psychological benefits like reduced stress and anxiety and increased focus, as well as physical benefits like reduced blood pressure and stronger immune function. It is a skill that gets easier with consistent practice.
Assertiveness is about standing up for yourself, but also wabout respecting the opinions and needs of others.
When e communicate assertively, we are clear about our opinions and wishes, but we are also open to others’.
1. How to reverse your bad habits and stick to good ones.
2. The science of how your brain processes habits.
3. The common mistakes most people make (and how to avoid them).
4. How to overcome a lack of motivation and willpower.
5. How to develop a stronger identity and believe in yourself.
6. How to make time for new habits (even when your life gets crazy).
7. How to design your environment to make success easier.
8. How to make big changes in your life without overwhelming yourself.
9. How to get back on track when you get off course with your goals.
10. And most importantly, how to put these ideas into practice in real life.
Cognitive Behavioural Therapy: A Basic Overview (Presentation)meducationdotnet
This document provides an overview of cognitive behavioural therapy (CBT). It begins by outlining the learning objectives, which are to develop knowledge of CBT principles and techniques. The document then defines CBT as being based on the idea that emotions are governed by thoughts. It notes CBT aims to help people develop a more objective view by changing unhelpful beliefs. Conditions for which CBT has been shown to be effective are then listed, including depression, anxiety, eating disorders, and others. Key CBT principles like the A-B-C model of activating events, beliefs, and consequences are explained. Common cognitive distortions or thinking errors are defined and examples provided. The document concludes by describing how CBT is applied to
Reviewing Cognitive Treatment for Eating Disorders: From Standard CBT Efficac...State of Mind
Reviewing Cognitive Treatment for Eating Disorders: From Standard CBT Efficacy to Worry, Rumination and Control Focused Interventions - EACBT 2015 Jerusalem
Non-pharmacological management of dementiaRavi Soni
This document discusses non-pharmacological methods for managing dementia, including behavioral symptoms. It begins by defining behavioral and psychological symptoms of dementia (BPSD) and noting that 90% of dementia patients experience BPSD severe enough to be problematic. Common symptoms include agitation, wandering, depression, and psychosis. The document then discusses several non-pharmacological therapies for managing BPSD, including reminiscence therapy, validation therapy, reality orientation, behavioral therapies, and sensory stimulation techniques like light therapy, acupuncture, and aromatherapy. It provides some evidence for the effectiveness of these approaches, though notes most studies have small sample sizes and more research is still needed.
This document discusses techniques for encouraging behavior change in patients. It explains motivational interviewing and the stages of change model, which are patient-centered approaches that explore and resolve ambivalence about behavior change. The biomedical model of simply telling patients what to do is compared to the psychosocial model of empowering patients as partners in their own care. Specific motivational interviewing techniques discussed include assessing a patient's barriers, priorities, readiness to change, and use of tools like the readiness ruler to evaluate importance and confidence in behavior change. The overall goal is a collaborative approach that helps patients move through stages of change at their own pace.
This document provides guidance on developing patient education programs for chronic conditions. It discusses principles of patient education including definitions, theories like the Health Belief Model and Social Cognitive Theory, and evidence supporting patient education. The document also covers needs assessment, setting objectives and priorities, educational approaches, and program planning. The overall goal is to empower patients through education tailored to their specific needs and beliefs.
This document summarizes a presentation on evidence-based practice and searching for information to answer clinical questions. It introduces frameworks for asking clinical questions using PICO (Patient, Intervention, Comparison, Outcome) and finding the best sources of evidence. It discusses searching databases and filters as well as using mobile devices. The goal is to help clinicians structure questions and find relevant evidence efficiently to support clinical decision making.
This document summarizes the results of a Delphi study on self-management strategies for bipolar disorder. The study involved two rounds of surveys with panels of healthcare providers and community members living with bipolar disorder. In the first round, the panels rated over 400 potential self-management strategies. Strategies related to early warning signs and relationships were highly rated. Maintaining mood balance strategies were rated higher than those for stopping mood progression. There was consensus between the panels but also some differences, such as healthcare providers prioritizing medication-related strategies more. The top strategies from the first round were carried forward to the second round for further rating.
Here are the answers to your questions:
1. FINER criteria of a good research question are: Feasible, Interesting, Novel, Ethical, Relevant.
2. A null hypothesis is a statistical hypothesis that predicts that no relationship exists between two variables.
3. The types of relationships that may exist between two variables are: positive, negative, or no relationship.
4. Read around comes first before read into. Read around gives a broad overview of the topic area, while read into involves an in-depth review.
5. The literature review is often called the "mother of the research" as it helps identify gaps and formulate the research question.
6. If we
This document provides an introduction to health psychology. It defines health psychology as the branch of psychology concerned with individual behaviors and lifestyles affecting physical health. The document outlines how views of health have changed, illustrating the biopsychosocial model and its interaction between biological, psychological, and social factors in health. Finally, it describes the role of health psychologists in areas like health promotion, prevention and treatment of illness, and improving healthcare.
UCSF Osher Center Grand Rounds - 12/17David Becker
This document summarizes a presentation on incorporating mind-body medicine techniques into clinical care for children and adolescents. It describes several techniques, including mindfulness, hypnosis, guided imagery and biofeedback. It reviews evidence that these techniques can help with conditions like irritable bowel syndrome, recurrent abdominal pain, asthma and chronic pain. It also discusses important "common factors" for effective use of these techniques, such as developing rapport, managing expectations, cultural adaptation, clinician effects, and using language strategically to create focused states and facilitate changes.
"Validity, Reliability and Factor Structure of the Mindfulness based Self-Efficacy Scale (MSES)", presented at the National conference of the New Zealand Psychological Society, 21 April 2012: Existing self-report questionnaires have been criticised for several reasons. Presents on a new self-report questionnaire to measure self-efficacy before, during and after mindfulness-based therapy or mindfulness training outside the therapy context. To try the MSES online and obtain instant results (at no cost), follow the link: http://www.mindfulness.net.au/mses
The document discusses the roles and responsibilities of nurses. It outlines four main goals of nursing: promoting health, preventing illness, treating human responses to health or illness, and advocating for patients. Key aspects of the nursing process are also summarized, including assessment, diagnosis, planning, implementation, and evaluation. Assessment involves collecting both subjective and objective data to understand a patient's health status. The nursing process provides an organized framework for delivering patient care.
Introduction to Evidence Based MedicinePaul Albert
The document provides an introduction to evidence-based medicine (EBM). It defines EBM as using the best current evidence from clinical research in medical decision making. EBM requires considering both research evidence and a patient's values and preferences. Reliable evidence comes from systematic reviews and meta-analyses of multiple studies rather than individual studies or expert opinions. Practicing EBM involves forming a clear clinical question, finding the best evidence, critically evaluating it, and applying the results to patient care. While evidence-based studies aim to be rigorous, their results could still mislead due to biases or other limitations if not properly appraised.
The document discusses several theories of behavior change that can be applied to improve health behaviors. It summarizes the Health Belief Model, which focuses on perceptions of susceptibility, severity, benefits and barriers. It also describes the Stages of Change Model and Transtheoretical Model, which view behavior change as a process through stages. Motivational Interviewing is explained as a technique to activate a patient's own motivation for change through collaboration, evocation and autonomy.
The document provides an overview of the Health Belief Model (HBM). It was developed in the 1950s to explain why people do or do not engage in health-promoting behaviors. The HBM posits that individuals will take action to prevent or control illness if they feel susceptible to a condition, believe it could have serious consequences, believe a course of action can reduce susceptibility or seriousness, and feel the benefits outweigh the costs. The model's key components are perceived susceptibility, severity, benefits, and barriers. Cues to action and self-efficacy were later added. The HBM is applied to develop health messages focusing on threat, coping responses, and self-efficacy to influence health behaviors. While useful
The document provides an overview of the Health Belief Model (HBM). It was developed in the 1950s to explain why people do or do not engage in health-promoting behaviors. The HBM posits that individuals will take action to prevent or control illness if they feel susceptible to a condition, believe it could have serious consequences, believe a course of action can reduce susceptibility or seriousness, and feel the benefits outweigh the costs. The model's key components are perceived susceptibility, severity, benefits, and barriers. Cues to action and self-efficacy were later added. The HBM is applied to develop health messages focusing on threat, coping responses, and self-efficacy to influence health behaviors. While useful
RSS 2012 Developing Research Idea and QuestionWesam Abuznadah
This document discusses the research process and how to formulate answerable research questions. It explains that the research process begins with identifying a knowledge gap and transforming it into a clear research question. It also discusses where research questions come from and how to define a good question based on importance, interest, and answerability. The document provides guidance on formulating an answerable PICO (population, intervention, comparator, outcome) question and determining the best feasible study type to answer the question. Common study types discussed include observational studies like cross-sectional, cohort and case-control studies, as well as experimental intervention studies.
The document discusses Nola Pender's Health Promotion Model. It introduces Pender as the nursing theorist who developed the model. The model focuses on health promotion and disease prevention. It views individuals as active participants in their health and considers biological, psychological and social factors. The model has been widely used in nursing research, education and practice to promote healthy behaviors and prevent illness.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
3. Flexible Plan
BEFORE TEA BREAK: Agenda setting, theory, exercise 1
BEFORE LUNCH: Empirical status, assessment, formulation,
treatment overview, exercise 2
AFTER LUNCH: Problematic behaviour, rules and standards,
cognitive biases, exercise 3
LAST BIT:
Dysfunctional beliefs, dysfunctional scheme for self-evaluation, relapse
prevention, exercise 4
Summary and feedback
4. Background: Healthy vs. unhealthy
• Normal vs. neurotic
• Functional vs. dysfunctional
• Healthy vs. unhealthy
5. • “Tyranny of the shoulds” (Horney, 1950)
• “Musterbation” (Ellis, 1961)
• “Those whose standards are high beyond reach or reason,
people who strain compulsively and unremittingly toward
impossible goals and who measure their own worth entirely in
terms of productivity and accomplishment” (Burns, 1980)
• “Setting of excessively high standards for performance
accompanied by overly critical self-evaluation (Frost, Marten,
Lahart & Rosenblate, 1990)
• “Multidimensional” (Hewitt & Flett, 1991)
Definitions
7. 1. Significant clinical problem in its own
right
• Time
• Social isolation
• Performance anxiety
• Narrowing of interests
• Low mood
• Procrastination/avoidance
• Unemployment/drop out of studies
8. 2. Impact on treatment: Depression
National Institute of Mental Health Treatment of
Depression Collaborative Research Program (TDCRP)
– Dysfunctional perfectionism was associated with higher pre-
treatment levels of depression and greater impaired adjustment at
the end of treatment (Blatt, Quinlan, Pilkonis and Shea (1995) and
Shahar et al. (2003))
– Smaller or absent increases in therapeutic alliance compared with
those low in perfectionism (Zuroff, Blatt, Sotsky, Krupnick, Martin,
Sanislow, & Simmens (2000))
• Treatment for Adolescents with Depression Study
(n=439).
– Higher perfectionism scores at baseline had higher depression
during treatment period
– Perfectionism impeded improvement in suicidality
– Treatment outcomes partially mediated by change in
perfectionism
(Jacobs et al., 2009)
9. Impact on treatment: eating disorders
• Sutandar-Pinnock, Woodside, Carter, Olmsted &
Kaplan (2003). Negative impact on treatment
outcome for anorexia nervosa
• Steele, Bergin & Wade (2011). Higher levels of
perfectionism at baseline resulted in less
reduction on the EDE global score when treating
bulimia nervosa using guided self help.
10. Impact on treatment: OCD
• Perfectionism (as part of obsessive compulsive
personality disorder) predicted worse treatment
outcome for exposure and response prevention
for 49 patients with OCD, 17 of whom met OCPD
criteria
Pinto, Liebowitz, Foa & Simpson (2011). Obsessive compulsive personality disorder as a predictor
of exposure and ritual prevention outcome for obsessive compulsive disorder. Behaviour Research
and Therapy, 49, 453-8.
11. BUT
• Mussell et al. (2000). Outcome for bulimia nervosa not predicted by
pre-treatment levels of perfectionism
• Lundh & Ost (2001) and Rosser et al. (2003). Perfectionism not
predict outcome for social phobia
• Perfectionism changes as a result of successful treatment of social
phobia (Ashbaugh et al., 2007) and anxiety in children (Mitchell et al.,
2013).
12. 3. Associations with other forms of
psychopathology
• Hewitt & Flett (2002)
• Egan, Wade & Shafran (2011). Clinical
Psychology Review.
– Depression
– Anxiety
– Chronic Fatigue
– Suicidal ideation
– Eating disorders
14. 4. Risk factor
• Development of anorexia
nervosa and bulimia nervosa
(Fairburn et al. 1999; Bulik et al.,
2003)
• Depression. Hewitt, Flett &
Ediger (1996)
15. Treatment issues
1. If perfectionism is a long term personality
problem, do we need a long term personality-
based treatment????
2. Which aspects of perfectionism
should be treated?
• Personal standards
• Socially oriented
• Other oriented
• Doubts about actions
• Concern over mistakes?
16. Treatment Advances
• Interplay of theory – experiments – treatment
experiments (Salkovskis, 2002; Clark, 2004)
• Biggest treatment advances come from focusing on
reversing putative maintaining mechanisms
– Panic disorder (NICE, 2005)
– Bulimia nervosa (NICE, 2004)
• Don’t try to do too much all in one go!
17. “Clinical Perfectionism”
Shafran, R., Cooper, Z. &
Fairburn,
C. G. (2002). Clinical
Perfectionism:
a cognitive behavioural analysis.
Behaviour Research and
Therapy, 40, 773-791.
18. • Self-imposed nature of standards
• Standards are personally
demanding
• Self-worth dependent upon success
and achievement
• Attention to failures at expense of
successes
• Self-defeating
19. Original analysis
• Construes clinical perfectionism as a dysfunctional
scheme for self-evaluation.
• Core psychopathology as the overdependence of
self-evaluation on the determined pursuit of
personally demanding, self-imposed standards in at
least one highly salient domain despite adverse
consequences
20. Context
• Type of perfectionism seen in clinical practice
• Not:
– Positive healthy striving
– Having high standards for other people
– Believing that others have high standards for
you
• Hypothesised maintaining mechanism for eating
disorders (Fairburn, Cooper & Shafran, 2003)
21. Self-worth overly dependent on striving
and achievement
Set standards
Cognitive biases
Fail to meet standards Temporarily meet standards
Self-criticism Reappraise standards as
insufficiently demanding
Adverse consequences:
Positive consequences:
(Re)
22. Self-worth overly dependent on striving
and achievement
Set standards
Cognitive biases
Fail to meet standards Temporarily meet standards
Emotional
distress,
Counter-
productive
behaviour and
Self-criticism
Reappraise standards as
insufficiently demanding
Adverse consequences:
Positive consequences:
(Re)
Performance related
behaviour/emotion
Avoid/
procrastinate
23. Hypotheses
• Clinical perfectionism is maintained by
– Dysfunctional expressions of core psychopathology
e.g., repeated checking
– Rigid standards expressed as rules
– Cognitive biases
• Biased evaluation of performance
• Discounting success
• Resetting standards
– Negative self-evaluation, self-criticism and fear of
‘failure’
24. Hypotheses
• Clinical perfectionism will impede the successful
treatment of Axis I disorders if the domains overlap
• Eating disorders can sometimes be an expression of
clinical perfectionism in the domain of eating, shape and
weight
25. Treatment implications
1. A personalised formulation in terms of clinical
perfectionism
2. Broadening the patient’s scheme for self-evaluation
3. Using behavioural experiments to test competing
hypotheses
4. Using cognitive-behavioural methods to address
personal standards, self-criticism and cognitive biases
that maintain clinical perfectionism
28. Exercise 1
• In pairs, choose a client for whom:
– Clinical perfectionism has been a problem in its own right
OR
– Clinical perfectionism has appeared to interfere with
treatment progress
• Discuss which aspects of the model might be
relevant for this person
• 5 minutes
• Feedback to larger group
30. Can we treat perfectionism?
• Temperament generally considered to be
stable over lifetime
• 9%-49% of Frost measures heritable
• Infers perfectionism can be manipulated
31. Early investigations
• Ferguson and Rodway (1994): case series study (N =9), identifying
automatic thoughts and restructuring cognitive distortions into positive
coping statements
– reduction of perfectionism using “Self-Anchored Scale”, conclusions
were based solely on “visual analysis” of the data, with no formal
statistical analyses
• DiBartolo, Frost, Dixon and Almodovar (2001): 60 female
undergraduate students received either a brief (8 minutes) cognitive
restructuring intervention or a distraction intervention prior to delivering
a speech in front of a small audience
– Cognitive restructuring was successful in reducing evaluative threat
concerns and associated with lower self-reported anxiety compared
to participants in the distraction condition.
• Shafran, Lee, Payne and Fairburn (2006): experimental manipulations
of personal standards resulted in changes in eating behaviours in non-
clinical individuals
– higher personal standards associated with increased restraint and
regret after eating
• Single-case studies
– Hirsch and Hayward (1998)
– Shafran, Lee, & Fairburn (2004)
32. Year 10 girl allocated to
perfectionism (N=51); media
literacy (N=43); control (classes
as normal; N=44)
– 8 lessons
– Pre-, post- and 3-month follow-
up
– Content based on
“Perfectionism: What’s bad
about being too good?” by
Adderholdt & Goldberg (1999)
– Main effect of group for
reduction of concern over
mistakes favouring the
perfectionism group at 3-month
follow-up
• Wilksch SM, Durbridge M, Wade TD.
(2008). A preliminary controlled
comparison of programs designed to
reduce risk for eating disorders
targeting perfectionism and media
literacy. Journal of the American
Academy of Child and Adolescent
Psychiatry, 47, 939-947.
Recent evaluations
33. • 49 people responded to
newspaper/radio calls as experienced
problems with perfectionism,
randomised to 8-week treatment:
– GSH: face to face sessions (N=8)
– PSH: book
• Significant time x group interactions
favouring GSH for measures of
obsessionality
– Both treatments showed significant main
effect of time for perfectionism variables
with large effect sizes
• Pleva J, Wade TD. (2007). Guided self-help
versus pure self-help for perfectionism: a
randomised controlled trial. Behaviour
Research and Therapy, 45, 849-861.
When Perfect Isn’t Good Enough
35. More recent evaluations
• N = 20 participants; high scorers on the Clinical
Perfectionism Examination and the Clinical Perfectionism
Questionnaire (Fairburn, Cooper, and Shafran)
• CBT treatment vs. a wait-list control condition
• Treatment = 10 sessions of individual CBT over 8 wks
• Treatment gains e maintained at 8- and 16-week follow-up
• Ten participants met criteria for an anxiety disorder or
major depressive episode immediately prior to treatment,
reducing to four participants at 16-week follow up
• Riley, C., Lee, M., Cooper, Z., Fairburn, C.G., & Shafran, R. (2007). A
randomised controlled trial of cognitive-behaviour therapy for clinical
perfectionism: A preliminary study. Behaviour Research and Therapy, 45,
2221-2231
36. More recent evaluations
Three GSH interventions for BN, 8 individual outpatient
sessions (20 to 50 minutes), 6-week period, novice
therapist
– 48 clients, 11 drop-outs (23%)
• CBT for perfectionism - 11.8%
• CBT for BN – 26.7%
• Dismantled mindfulness – 37.5%
– No significant time × treatment interactions or main effects for group
– Significant main effects for time for 8/12 outcome variables
excluding use of laxatives and diuretics, depression, anxiety and
personal standards perfectionism
– Within-group effect sizes ranged from .39 to 5.93.
• Steele AL, Wade TD. (2008). A randomised trial investigating guided self-help to
reduce perfectionism and its impact on bulimia nervosa. Behaviour Research and
Therapy, 46, 1316-1323.
37. Case-series design
• N=21
• Compared psychoeducation and group CBT for
perfectionism
• Group CBT for clinical perfectionism was
beneficial, but that psycho-education alone was
not effective for reducing perfectionism or
negative affect.
Steele, A. L., Waite, S., Egan, S. J., Finnigan, J., Handley, A., & Wade, T. D. (2013). Psycho-education
and group cognitive-behavioural therapy for clinical perfectionism: a case-series evaluation. Behavioural
and cognitive psychotherapy,41(02), 129-143.
38. Low Intensity Treatment
• n=77 participants high in perfectionism
• Randomized to 10 weeks of:
– No treatment
– General Stress Management
– CBT
CBT > General Stress Management or no treatment
Changes in perfectionism significantly correlated with
changes in depression and anxiety
Arpin-Cribbie, Irvin & Ritvo (2012). Psychotherapy Research. Web-based cognitive-behavioral
therapy for perfectionism: a randomized controlled trial., 22, 194-207
43. “Holy self hatred”
¶ Make a supreme effort to root out self-love from your heart and to plant in its
place this holy self-hatred. This is the royal road by which we turn our
backs on mediocrity, and which leads us without fail to the summit of
perfection.
Saint Catherine of Sienna, 1347-1380
44. • Use theory to make explanatory inferences
about maintaining factors that can inform
interventions
• At heart of conceptualisation related to
perfectionism:
– Over-evaluation of striving and achievement usually
in context of low self-worth in other domains
45. A parsimonious approach
• Describe person’s presenting problems with
least number of explanatory variables required
in terms of:
– core beliefs, assumptions, automatic thoughts
– emotional reactions
– behavioural aspects of the problems
– behavioural strengths and deficits
– social factors that influence the problem (past &
present)
– biological factors
46. Process not Diagnosis
• The conceptualisation that arises from the
assessment process (not diagnosis) is
– important for the formulation and justification of
treatment plans and developing some hope and
expectation for change
– explicitly shared with the client, in order to promote a
collaborative relationship
– revised over the course of therapy as new information
arises and the client feels comfortable to share further
information
– vicious cycle, showing how the problem can take on a
life of its own after a triggering event, and
communicates that the cycle can be broken by
making gradual changes to its component parts
47. Formulation
• Based on model but personalised
• Heart is overevaluation of striving and achievement
49. Treatment based on theory
• Developed by Centre for Eating Disorders and Obesity for
use within “transdiagnostic” treatment of eating disorders
(Fairburn, Palmer et al.)
• Expanded after case-series to form a 10 session
treatment
• Goal: stand-alone intervention or adjunct to evidence-
based treatment if clinical perfectionism seen as a barrier
to change
50. Overview of treatment
• Range of procedures available for addressing the over-
evaluation of performance and its various expressions
• The choice of procedures to use and the best order in
which to implement them depends on the particular
problems
• Ongoing reassessment is important
• Simpler interventions first
• Importance of objective examination of thoughts, feelings
and behaviours
51. General Points
• Same as “transdiagnostic” treatment i.e.,
– Focuses on maintaining mechanisms, not aetiology
(unless needed)
– Personalised formulation is developed and evolves
– Strong emphasis on behaviour change
– Parsimony in use of interventions
– Homework setting
– Treatment ends with focus on the future
• Manual describes the principles and methods of
treatment and should be used flexibly
52. Structure across sessions
• 10 sessions over 8 weeks
• First six sessions bi-weekly
• Next 3 sessions weekly
• Fortnight’s gap between sessions 9 & 10
ENGAGEMENT
53. Structure within sessions
(Fairburn, Marcus & Wilson, 1993)
Review homework (5 mins)
Agree agenda (2 mins)
Work way through agenda (35
mins)
Agree homework (3 mins)
Summarise session (5 mins)
54. Structure within sessions
(Fairburn, Marcus & Wilson, 1993)
A note about homework!
• Patients can be over-thorough
• Frequently fear that it will be
“wrong”
• Black and white thinking – if can’t
do perfectly, won’t do at all
55. Exercise 2
• Read the case of ‘Charlene’
• What questions would you like to ask to further
assess her perfectionism and her anxiety?
• What relationship may there be between her
perfectionism and anxiety? How could you
assess this?
• Treatment ideas?
• Feedback to the larger group
• Remaining time until lunch
58. 2. Monitoring & psychoeducation
• Repeated performance checking
– Magnifies the relevant concerns
– Maintains negative self-evaluation in general.
– Can focus attention on the aspects of the tasks
causing most anxiety which serves to maintain (and
possibly increase) preoccupation.
– Decreases confidence in memory
• Avoidance/procrastination
– avoiding tests of performance results
“fearing the worst” and having direct adverse
consequences e.g., not sitting an exam.
59. 2. Monitoring & psychoeducation
• Counterproductive ‘safety behaviour’
– Making lists
– Multi-tasking
– Ensuring that ‘everything is in place’ before the
patient begins a task
– Can maintain other beliefs such as ‘I’m stupid – if I
don’t write everything down, I’m bound to make a
mistake.’
• Nature of anxiety
• Formulation-psychoeducation-monitoring-formulation
i.e., evolving and dynamic
61. Self-criticism
• Consistent pattern from 5 studies of negative
association between self-criticism and goal
progress. The results also showed a positive
association between self-oriented perfectionism
and goal progress when self-criticism was
controlled
Powers, Koestner, Zuroff, Milyavskaya & Gorin (2011). The effects of self-
criticism and self-oriented perfectionism on goal pursuit Personality and
Social Psychology Bulletin, 37, 964-75.
62. Monitoring problematic behaviour
• Real-time
• Anticipate any difficulties
• Emphasise importance
• First thing go through subsequent
session
64. Behavioural experiments
• Range of methods available (Bennett-
Levy et al, 2004)
• ‘Contrast’ experiments particularly
helpful for repeated checking
• Hypothesis-testing & discovery
experiments
• Personally salient
65. Surveys
• “Discovery experiment”
• For Carol, asked other people about their standards for
parenting e.g., how much chocolate/treats they allowed
their children
66. Specific methods
•
• Decreasing pathological checking
• “Surfing” the urge
• “habit reversal” (Azrin and Nunn, 1973)
• Specific understanding of reason for checking
is vital
• Decreasing procrastination and avoidance of
tests of performance
– http://www.youtube.com/watch?v=4P785j15Tzk
• Decreasing ‘safety behaviour’
67. Specific methods
•
• Decreasing pathological checking
• “Surfing” the urge
• “habit reversal” (Azrin and Nunn, 1973)
• Specific understanding of reason for checking
is vital
68. Patient Report
“Why do I check so much? I guess it’s because
so many things can go wrong. And things going
wrong always seem worse to me than to other
people. If something bad happened and I didn’t
check properly, I would feel so awful – even more
awful because for most of the things I check, no
one else would ever bother to check them, so it
would definitely be my fault if something
happened.”
69. Cognitive Model of Compulsive Checking (Rachman, 2002)
Perceived
Responsibility
Perceived
Probability of
Harm
Perceived
Seriousness of
Harm
Anxiety
Engage in
Preventative
Checking
SELF-PERPETUATING
MECHANISM
- Check raises responsibility
- Check impairs meta-memory
- Check increases danger
Behaviour - out of
control
-----
Impaired
meta-memory
MEANS
That
•I am abnormal
•I am deteriorating
•I am a failure etc.
I need to be
especially
careful
X X
70. Targets of treatment
• Multipliers
– Perceived responsibility, probablity and seriousness
harm
• Self-perpetuating mechanism
• Are there relationships between checking,
memory and metamemory?
73. Checking
• Did you eat breakfast this morning?
– What did you have?
• Did you eat breakfast on January 10th 1992?
– What did you have?
• Repetition, salience, each check adds to your set
of experiences, making individual episodes
difficult, if not impossible to recall vividly, with
detail or with confidence
74. The more you do it (i.e., check),
• The less confident you are in your memory
– (Memory accuracy is unaffected)
• Beliefs about memory may be key
• Consistent with this approach are decreases in
confidence in attention, confidence in perception,
etc.
76. 4. RIGIDITY, RULES AND EXTREME
STANDARDS
• Rules vs. guidelines: Relax rules
• Behavioural experiments
– E.g., reducing the amount of time
allocated to an assignment
– Go by ‘80:20’ rule of thumb whereby 80% of outcome
takes 20% of effort, and extra 20% of outcome takes
80% effort
• All-or-nothing thinking
• ‘Acceptance’
• Things one cannot change, one has to learn to accept as
positively as possible. Doing so is a sign of strength and
a process of self-affirmation, not passive resignation to
an unhappy fate (Wilson).
• ‘Pros and cons’ in the context of self-evaluation
78. Exercise 3: YES OR NO
Rule Guideline
Flexibility?
Usually consists of ‘must’ statements
Frequently contains words such as ‘sometimes’ and ‘try’
After breaking the person feels….
79. Exercise 3 ctnd: Tranfsform rule into
guideline
• I must always eat before 7 p.m.
• I should always put my friends’ needs before my
own
• It is essential to always make sure the dishes are
spotless
• I can never be late
80. Exercise 3: Last part
Have a specific person/patient in mind. What rule
do you think it would be helpful to transform into
a guideline and how would you think about doing
it?
82. 5. COGNITIVE BIASES
1.Selective attention
2. Discounting positive aspects of performance
3. Double standards and accompanying self-
criticism
4. Overgeneralisation
5. Dichotomous appraisal of performance/ ‘all
or nothing’ thinking/ ‘black and white thinking’
Standard techniques e.g., positive data log, continua,
cognitive restructuring
83. 5. COGNITIVE BIASES
1.Selective attention -
http://www.youtube.com/watch?v=Ahg6qcgoay4
2. Discounting positive aspects of performance
3. Double standards and accompanying self-
criticism Coach analogy (Hofmann & Otto)
4. Overgeneralisation
5. Dichotomous appraisal of performance/ ‘all
or nothing’ thinking/ ‘black and white thinking’
Standard techniques e.g., positive data log, orthogonal and
ordinary continua, cognitive restructuring
84. 6. Dysfunctional assumptions/beliefs
• The harder I work, the better I’ll do
• I’m stupid so I need to work harder than others
• If I ‘slack’ one time, it will be a slippery slope to
complete failure
• I should always be productive
• I should never ‘waste time’
• I should continually strive to better myself
• I should do things thoroughly
• I should leave as little time as possible for tasks so I
don’t ‘waste time’ (even if I’m late)
• I should never be late
Behavioural experiments
Cognitive restructuring
85. 6. Dysfunctional assumption
“I should have perfect control over my children’s
behaviour otherwise people will judge me
negatively”
87. 7. Problem-solving, relaxation, time-
management
• On as ‘as-needed’ basis
• Problem-solving as described by Fairburn (1995)
– Identify the problem early
– Specify the problem precisely (one problem!)
– Brainstorm all possible solutions
– Evaluate the solutions
– Implement a solution or solutions
– Evaluate the solution chosen
88. 8. Overevaluation of striving &
performance
• A historical review of the origins and
development of the over-evaluation
• Continuing to addressing the cognitive
processes currently maintaining the over-
evaluation and facilitating the patient’s
awareness of the scheme and its expressions
• Directly altering the patient’s self-evaluation
scheme via pie-charts
89. 9. Maintenance and relapse prevention
• Maintenance plan
• Purpose to summarise what has been
done in treatment and prepare for future
• Includes distinguishing between lapse &
relapse
• Anticipating situations that might lead to a
setback
91. Exercise 4
• On your own, list the areas that contribute to your self-
evaluation
• Draw a pie-chart to reflect the relative contribution of
each area to your self-worth
• If you think that you have too many eggs in one basket,
then consider which areas you would like to expand,
and which new areas you might want to add
• Consider one practical thing you can do to begin to
broaden your own domains
• Feedback if you wish
93. Flett, G.L., & Hewitt, P.L. (2002).
Perfectionism: Theory, research, and
treatment. Washington, DC:
American Psychological Association.
Antony, M.M., & Swinson, R.P.
(2009). When perfect isn’t good
enough: Strategies for coping with
perfectionism (2nd ed.). Oakland, CA:
New Harbinger Publications
Overcoming Perfectionism by Roz
Shafran, Sarah Egan, and Tracey
Wade (Paperback - 25 Mar 2010)
Egan, S,J., Wade, T. D., Shafran, R.,
& Antony, M. M. (2014). CBT of
Perfectionism. Guildford Press. .
Further reading