The greatest challenge is stating the problem in a way that will allow a solution.

Monday, July 15, 2019

Dialectical Behavior Therapy (DBT)




By MargaritaJP - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=20392288


The stages used in dialectical behavior therapy


Cycle of group skill training.



Image result for dbt

Image result for dbt 

Image result for dbt



dbt cheat sheet






Related image



Related image





Monday, July 1, 2019

Testing CBT for Treating Chronic Insomnia





Original Contribution
April 11, 2001


Cognitive Behavioral Therapy for Treatment of Chronic Primary Insomnia 

A Randomized Controlled Trial
Author Affiliations
JAMA. 2001;285(14):1856-1864. doi:10.1001/jama.285.14.1856



Abstract 


Context 

Use of non - pharmacological behavioral therapy has been suggested for treatment of chronic primary insomnia, but well-blinded, placebo-controlled trials demonstrating effective behavioral therapy for sleep-maintenance insomnia are lacking.


Objective 

To test the efficacy of a hybrid cognitive behavioral therapy (CBT) compared with both a first-generation behavioral treatment and a placebo therapy for treating primary sleep-maintenance insomnia.


Design and Setting 

Randomized, double-blind, placebo-controlled clinical trial conducted at a single academic medical center, with recruitment from January 1995 to July 1997.

Patients 

Seventy-five adults (n = 35 women; mean age, 55.3 years) with chronic primary sleep-maintenance insomnia (mean duration of symptoms, 13.6 years).

Interventions 

Patients were randomly assigned to receive CBT (sleep education, stimulus control, and time-in-bed restrictions; n = 25), progressive muscle relaxation training (RT; n = 25), or a quasi-desensitization (placebo) treatment (n = 25). Outpatient treatment lasted 6 weeks, with follow-up conducted at 6 months.


Main Outcome Measures
 

Objective (polysomnography) and subjective (sleep log) measures of total sleep time, middle and terminal wake time after sleep onset (WASO), and sleep efficiency; questionnaire measures of global insomnia symptoms, sleep-related self-efficacy, and mood.

Results 

Cognitive behavioral therapy produced larger improvements across the majority of outcome measures than did RT or placebo treatment. 

For example, sleep logs showed that CBT-treated patients achieved an average 54% reduction in their WASO whereas RT-treated and placebo-treated patients, respectively, achieved only 16% and 12% reductions in this measure. 

Recipients of CBT also showed a greater normalization of sleep and subjective symptoms than did the other groups with an average sleep time of more than 6 hours, middle WASO of 26.6 minutes, and sleep efficiency of 85.1%. In contrast, RT-treated patients continued to report a middle WASO of 43.3 minutes and sleep efficiency of 78.8%.

Conclusions 

Our results suggest that CBT represents a viable intervention for primary sleep-maintenance insomnia. 

This treatment leads to clinically significant sleep improvements within 6 weeks and these improvements appear to endure through 6 months of follow-up. 





Cognitive-behavioral therapy (CBT)



Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts.




Cognitive behavioral therapy is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing unhelpful cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems. Wikipedia








Link:  https://www.psychologytoday.com/ca/basics/cognitive-behavioral-therapy



Action is the antidote to fear

  













How to Think Negative and Still Succeed







The role of pain-related fear and avoidance in chronic pain



FirstAscent Physical Therapy

~ Trying to Stay Afloat with Evidence-Based Physical Therapy Practice
 

The role of pain-related fear and avoidance in chronic pain


09FridayJan 2015



Posted by michaeljmcdermott in Chronic Pain

≈ Comments Offon The role of pain-related fear and avoidance in chronic pain




(Image directly copied from Vlaeyen & Linton, 2012)

Key Points
• Long-term avoidance of pain-related behaviors due to fear of pain may increase sensitization to pain and pain-related stimuli, decrease self-efficacy, increase expectation of pain, and increase pain perception, ultimately perpetuating pain-related disability and functional impairment.
• Increased willingness to experience pain and graded exposure to situations or behaviors perceived to be threatening is effective in reducing pain-related fears and subsequent pain-related avoidance and disability among individuals with chronic pain.

Fear and Avoidance in the Development and Maintenance of Chronic Pain
Traditional biomedical models of pain suggest that an individual’s pain experience should directly match the physical damage incurred and that similar injuries should result in similar pain. However, pain isn’t that simple. Rarely will two individuals with identical physical injuries report the exact same pain. For that matter, two individuals with the same injury will likely demonstrate differences in impairment and suffering. These observed discrepancies between expected and reported pain and disability suggest a more complex relationship; one that has led researchers to examine the role of psychological and behavioral factors in the development and maintenance of chronic pain conditions.

The fear-avoidance model (Vlaeyen & Linton, 2000; 2012) details a potential pathway for the development of pain disability, affective distress, and physical disuse resulting from anxiety- and fear-related avoidance behaviors and provides a platform for understanding the dynamic relationship between psychological factors and chronic pain. The fear-avoidance model suggests that pain-related avoidance behaviors and withdrawal, as well as increased vigilance toward internal bodily sensations and external threats of pain, play an adaptive and functional role in protecting the body. It’s healthy to avoid behaviors that cause pain – at least in the short-term. For example, bending or lifting heavy objects may be avoided in order to limit lower back pain from a previous injury. Although adaptive in promoting recovery in acute phases of pain, prolonged avoidance and hypervigilance behaviors may serve to maintain or even exacerbate pain symptoms in the long term by inadvertently increasing pain disability and affective distress. That is, long-term avoidance of pain-related behaviors is maladaptive and ultimately increases pain and pain-related disability.

Pain-related fear and negative affective states play an integral role in escape and avoidance behaviors, suggesting that the meaning of pain may be just as important as the actual experience of pain. When pain is feared and viewed as dangerous, an individual may act in anticipation of pain, rather than in direct response to pain. Avoiding movements due to pain-related fears may contribute to physical deconditioning, negative affect or affective comorbidities, and preoccupation with physical and somatic symptoms associated with pain. These effects in turn may increase sensitization to pain and pain-related stimuli, decrease self-efficacy, increase expectation of pain, and increase pain perception, ultimately perpetuating pain-related disability and functional impairment.



REPORT THIS AD



The Good News

You don’t need to change a patient’s beliefs or fear of pain to reduce their avoidance of pain-related behaviors. Graded exposure to situations or behaviors perceived to be threatening is effective in reducing pain-related fears and subsequent pain-related avoidance and disability among individuals with trauma-related neck pain (de Jong et al., 2008), upper extremity pain (de Jong et al., 2012), complex regional pain syndrome (de Jong et al., 2005) and chronic low back pain (Vlaeyen et al., 2001; 2002). Exposure-based treatments are some of the most effective and widely-used psychological interventions for anxiety and trauma-related disorders and have gained continuing support in the treatment of chronic pain conditions. By providing education about the role of avoidance behaviors in the maintenance and development of pain and systematically increasing engagement in feared or pain-related behaviors, psychological and physical therapists can effectively reduce pain-related fear and anxiety and enhance effective recovery through confrontation and increased self-efficacy.

References

de Jong, J. R., Vangronsveld, K., Peters, M. L., Goossens, M. E. J. B., Onghena, P., Bulté, I., & Vlaeyen, J. W. S. (2008). Reduction of pain-related fear and disability in post-traumatic neck pain: A replicated single-case experimental study of exposure in vivo. The Journal of Pain, 9, 1123-1134.
de Jong, J. R., Vlaeyen, J. W. S., van Eijsken, M., Loo, C., & Onghena, P. (2012a). Reduction of pain-related fear and increased function and participants in work-related upper extremity pain (WRUEP): Effects of exposure in vivo. Pain, 153, 2109-2118.
de Jong, J. R., Vlaeyen, J. W. S., Onghena, P., Cuypers, C., den Hollander, M., & Ruijgrok, J. (2005). Reduction of pain-related fear in complex regional pain syndrome type I: The application of graded exposure in vivo. Pain, 116, 264-275.
Vlaeyen, J. W. S., de Jong, J. R. Geilen, M., Heuts, P. H., & van Breukelen, G. (2001). Graded exposure in vivo in the treatment of pain-related fear: A replicated single-case experimental design in four patients with chronic low back pain. Behavior Research and Therapy, 39, 151-166.
Vlaeyen, J. W. S., de Jong, J. R. Geilen, M., Heuts, P. H., & van Breukelen, G. (2002). The treatment of fear of movement/(re)injury in chronic low back pain: Further evidence on the effectiveness of exposure in vivo. The Clinical Journal of Pain, 18, 251-261
Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85, 317-332.
Vlaeyen, J. W. S., & Linton, S. J. (2012). Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain, 153, 1144-1147.
Advertisements

REPORT THIS AD
Chronic Pain: Breaking the Cycle

16TuesdaySep 2014



Posted by firstascentpt in Chronic Pain

Leave a comment





Chronic Pain is a difficult issue to deal with and treat. Sometimes people experiencing it do not know they have it. Individuals tend to be consumed by their pain and feel helpless. It is hard to think that you can get back to your life prior to pain when healthcare professionals are having trouble finding the root cause and when any activity causes you pain. Chronic low back pain is shown to be as prevalent at 23% of the population.

It is important to not only treat the physical aspect but also the cognitive aspect for individuals with chronic pain. Leventhal provided a self-regulation model that showed maladaptive illness perceptions can lead to maladaptive behavior; such as activity limitations.

I came across an article that developed and studied the effectiveness of a cognitive treatment of illness perceptions (CTIP). The goal of this treatment method is to challenge and change perceptions of patients dealing with chronic pain by going through a 4 phase process.

Cognitive Treatment of Illness Perceptions (CTIP)

Phase 1: Mapping of Existing Illness Perceptions
Approximately 2 sessions to complete
The use of subjective information that focused on activity limitations as a starting point.
Then elaborating on thoughts about low back pain in relation to their limitation activity.
Example: I need to rest in bed in order to allow the pain to fade away.

Phase 2: Challenge Maladaptive Illness Perceptions
Approximately 2 sessions to complete
Create doubt about the most maladaptive illness perceptions
Example: Questioning the patient’s perception that resting in bed would decrease the pain.

Phase 3: Alternative Illness Perceptions are Formulated
Approximately 1 session to complete
Convert maladaptive perceptions to alternative perceptions that will help to increase physical activity
The physical therapist and patient both agree and conclude on plausible perceptions
Example: Doing light jobs is a suitable replacement for bedrest, as it allows the body to recuperate and it distracts away from the pain.

Phase 4: Alternative Perceptions are Tested and Strengthened by Confirming Their Utility in Daily Practice
On going once alternative perception is created
Example: The continuation of completing light jobs instead of bed rest.

This treatment protocol for perception modification gives recommendations for treatment time frame per phase. It is recommended to use professional clinical judgement when using this for patients with chronic pain.



REPORT THIS AD



(Click the link below for access to the article)

Cognitive Treatment of Illness Perceptions in Patients with Chronic Low Back Pain: A Randomized Controlled Trial

Purpose: To compare the effectiveness of treatment of illness perceptions against a waiting list for patients with chronic low back pain.

Methods: They classified chronic pain as greater than 3 months of lower back pain. They studied 156 subjects with an 18% withdrawl rate from treatment. The subjects were randomized into a chronic low back pain group (experimental) and a waitlist group (control). The researchers had an intention to treat. The subjects were treated one time a week for 1 hour each session over a period of 10-14 weeks. They completed the Cognitive Treatment of Illness Perception protocol for the first 5 weeks and then followed the subjects for the remainder of the treatment sessions. The subjects were also expected to keep a diary on medical costs for their back such as doctor visits, physical therapy, and alternative methods. They researchers measured change using the Patient-Specific Complaints Questionnaire (PSC), the Illness Perception Questionnaire (IPQ-R), and the Quebec Back Pain Disability Scale (QBPDS).

Results: They found significant improvement in reported reductions in back pain symptoms in the PSC questionnaire (1 out of 4 will benefit from this treatment and 49% in the experimental group showed clinically relevant change compared to 26% for the control group). There were significantly different changes found in the IPQ-R for baseline and follow-up measurements between the control and experimental groups for 4 of the subscales: time line cyclical, consequences, personal control, and coherence. There were no significant differences found for QBPDS (for general physical activities) which was expected since the focus was on specific tasks.

Limitations: The researchers only concluded on one limitation which was that they did not measure the long-term effectiveness of the treatment.


RECENT POSTS
Does Posture Affect Neck Pain and Headaches? Maybe or Maybe Not… July 16, 2017
The Effect of Stretching AloneFebruary 19, 2017
Modality’s Place in PT April 18, 2016
Types of Muscle TightnessMarch 6, 2016
Resisted Upright Side Stepping or Resisted Squat Side Stepping. That is the Question. September 21, 2015
RECENT COMMENTS
TheDeadWoodDrifter on Adhesive Capsulitis: It’…
firstascentpt on Neck Pain: Look A Little Furth…
THE DeadWoodDrifter on Neck Pain: Look A Little Furth…
Cure Plantar Fasciit…on Plantar Fasciitis: Some Biomec…
firstascentpt on The Importance of the Hamstrin…

CATEGORIESCategories
ARCHIVES
July 2017
February 2017
April 2016
March 2016
September 2015
July 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
Advertisements

REPORT THIS AD



Blog at WordPress.com.
Privacy & Cookies: This site uses cookies. By continuing to use this website, you agree to their use.
To find out more, including how to control cookies, see here: Cookie Policy  










Sunday, June 30, 2019

Surprising Psychological Facts

    
15 Surprising Psychological Facts 

In today's video, we will explore a number of psychological facts that you never knew! Whether you want to learn about psychology facts, secrets of the mind, or the Dunning-Kruger effect, this video has it all... enjoy :)

Music: "Straight" from Bensound.com

Thanks to the rest of the TopThink team who worked on this video, including Tristan Reed (writing), and Maverick (Animation).





Saturday, June 29, 2019

3 Lessons From What The CEO Wants You To Know By Ram Charan

  

3 Lessons From What The CEO Wants You To Know By Ram Charan


Image result for what the ceo wants you to know by ram charan 

WHAT THE CEO WANTS YOU TO KNOW
How Your Company Really Works
Ram Charan 


The universal laws of business success . . . no matter whether you are selling fruit from a stand or running a Fortune 500 company
Have you ever noticed that the business savvy of the world’s best CEOs seems like a kind of street smarts? They sense where the opportunities are and how to take advantage of them. And their companies make money consistently, year after year.
How different is it to run a big company than to sell fruit from a cart or run a small shop in a village? In essence, not very, according to Ram Charan. From his childhood in India, where he worked in his family’s shoe shop, to his education at Harvard Business School and his daily work advising many of the world’s best CEOs, Ram understands business as few can.
The best CEOs have a knack for bringing the most complex business down to the fundamentals — the same fundamentals of the family shoe shop. They have business acumen — the ability to focus on the basics and make money for the company.
What the CEO Wants You to Know captures these insights and explains in clear, simple language how to do what great CEOs do instinctively and persistently:
  • Understand the basic building blocks of a business and use them to figure out how your company makes money and operates as a total business.
  • Decide what to do, despite the clutter of day-to-day business and the complexity of the real world.
Many people spend more than a hundred thousand dollars on an MBA without learning to pull these pieces of the puzzle together. Many others lack a formal business education and feel shut out from the executive suite.
What the CEO Wants You to Know takes the mystery out of business and shows the secrets of success used by business legends like Jack Welch of GE.  
Ram Charan is a world-renowned business advisor, author and speaker who has spent the past 35 years working with many top companies, CEOs, and boards of our time. In his work with companies including GE, MeadWestvaco, Bank of America, DuPont, Novartis, EMC, 3M, Verizon, Aditya Birla Group, Tata Group, GMR, Max Group, Yildiz Holdings, and Grupo RBS, he is known for cutting through the complexity of running a business in today’s fast changing environment to uncover the core business problem. His real-world solutions, shared with millions through his books and articles in top business publications, have been praised for being practical, relevant and highly actionable — the kind of advice you can use Monday morning.
Ram’s introduction to business 




3 Lessons From What The CEO Wants You To Know By Ram Charan

  

3 Lessons From What The CEO Wants You To Know By Ram Charan


Image result for what the ceo wants you to know by ram charan 

WHAT THE CEO WANTS YOU TO KNOW
How Your Company Really Works
Ram Charan 


The universal laws of business success . . . no matter whether you are selling fruit from a stand or running a Fortune 500 company
Have you ever noticed that the business savvy of the world’s best CEOs seems like a kind of street smarts? They sense where the opportunities are and how to take advantage of them. And their companies make money consistently, year after year.
How different is it to run a big company than to sell fruit from a cart or run a small shop in a village? In essence, not very, according to Ram Charan. From his childhood in India, where he worked in his family’s shoe shop, to his education at Harvard Business School and his daily work advising many of the world’s best CEOs, Ram understands business as few can.
The best CEOs have a knack for bringing the most complex business down to the fundamentals — the same fundamentals of the family shoe shop. They have business acumen — the ability to focus on the basics and make money for the company.
What the CEO Wants You to Know captures these insights and explains in clear, simple language how to do what great CEOs do instinctively and persistently:
  • Understand the basic building blocks of a business and use them to figure out how your company makes money and operates as a total business.
  • Decide what to do, despite the clutter of day-to-day business and the complexity of the real world.
Many people spend more than a hundred thousand dollars on an MBA without learning to pull these pieces of the puzzle together. Many others lack a formal business education and feel shut out from the executive suite.
What the CEO Wants You to Know takes the mystery out of business and shows the secrets of success used by business legends like Jack Welch of GE.  
Ram Charan is a world-renowned business advisor, author and speaker who has spent the past 35 years working with many top companies, CEOs, and boards of our time. In his work with companies including GE, MeadWestvaco, Bank of America, DuPont, Novartis, EMC, 3M, Verizon, Aditya Birla Group, Tata Group, GMR, Max Group, Yildiz Holdings, and Grupo RBS, he is known for cutting through the complexity of running a business in today’s fast changing environment to uncover the core business problem. His real-world solutions, shared with millions through his books and articles in top business publications, have been praised for being practical, relevant and highly actionable — the kind of advice you can use Monday morning.
Ram’s introduction to business 




3 Lessons From What The CEO Wants You To Know By Ram Charan

  

3 Lessons From What The CEO Wants You To Know By Ram Charan


Image result for what the ceo wants you to know by ram charan 

WHAT THE CEO WANTS YOU TO KNOW
How Your Company Really Works
Ram Charan 


The universal laws of business success . . . no matter whether you are selling fruit from a stand or running a Fortune 500 company
Have you ever noticed that the business savvy of the world’s best CEOs seems like a kind of street smarts? They sense where the opportunities are and how to take advantage of them. And their companies make money consistently, year after year.
How different is it to run a big company than to sell fruit from a cart or run a small shop in a village? In essence, not very, according to Ram Charan. From his childhood in India, where he worked in his family’s shoe shop, to his education at Harvard Business School and his daily work advising many of the world’s best CEOs, Ram understands business as few can.
The best CEOs have a knack for bringing the most complex business down to the fundamentals — the same fundamentals of the family shoe shop. They have business acumen — the ability to focus on the basics and make money for the company.
What the CEO Wants You to Know captures these insights and explains in clear, simple language how to do what great CEOs do instinctively and persistently:
  • Understand the basic building blocks of a business and use them to figure out how your company makes money and operates as a total business.
  • Decide what to do, despite the clutter of day-to-day business and the complexity of the real world.
Many people spend more than a hundred thousand dollars on an MBA without learning to pull these pieces of the puzzle together. Many others lack a formal business education and feel shut out from the executive suite.
What the CEO Wants You to Know takes the mystery out of business and shows the secrets of success used by business legends like Jack Welch of GE.  
Ram Charan is a world-renowned business advisor, author and speaker who has spent the past 35 years working with many top companies, CEOs, and boards of our time. In his work with companies including GE, MeadWestvaco, Bank of America, DuPont, Novartis, EMC, 3M, Verizon, Aditya Birla Group, Tata Group, GMR, Max Group, Yildiz Holdings, and Grupo RBS, he is known for cutting through the complexity of running a business in today’s fast changing environment to uncover the core business problem. His real-world solutions, shared with millions through his books and articles in top business publications, have been praised for being practical, relevant and highly actionable — the kind of advice you can use Monday morning.
Ram’s introduction to business 




Wednesday, June 19, 2019

Sir Dave Brailsford - CORE Principle and Marginal Gains

  

 Brailsford discussing core principles and marginal gains.


Sir Dave Brailsford discusses two key theories which contributed to his success with Team GB Cycling. Both of which can be applied to any organisation or industry.







Outliers: The Story of Success 

Malcolm Gladwell explains that reaching the 10,000-Hour Rule, which he considers the key to success in any field, is simply a matter of practicing a specific task that can be accomplished with 20 hours of work a week for 10 years.



Link: https://en.wikipedia.org/wiki/Outliers_(book)






"KAIZEN™ means improvement. 



Kaizen is the Sino-Japanese word for "improvement". In business, kaizen refers to activities that continuously improve all functions and involve all employees from the CEO to the assembly line workers.Wikipedia  

Masaaki Imai sat down to pen the groundbreaking book ‘Kaizen: The Key to Japan’s Competitive Success’ (McGraw Hill).   

"KAIZEN™ means improvement. Moreover, it means continuing improvement in personal life, home life, social life, and working life. When applied to the workplace KAIZEN™ means continuing improvement involving everyone – managers and workers alike."