Instructor:

David M. Fresco, Ph.D.

Office:

226 Kent Hall Annex

Office Hours:

TBA; By appointment

Email/Telephone:

fresco@kent.edu / (330) 672-4049

Course Web Page:

http://www.personal.kent.edu/~dfresco/
http://itunes.kent.edu

Assigned Texts:

1.     Barlow, D. H. (Ed.) (2007). (Fourth edition). Clinical handbook of psychological disorders: A step-by-step treatment manual. New York: Guilford. ISBN: 978-1-59385-572-7

2.     O'Donohue, W., Fisher, J. E., & Hayes, S. C. (2003). Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice. Hoboken, NJ: Wiley. ISBN: 0-471-23614

3.     Pryor, K. (1999). Don't shoot the dog. New York: Bantam.

They are available at the bookstore.  

Goals:

• Central features of behavior (BT) cognitive-behavior therapy (CBT) and of evidence-based mode of practice more generally
• Basics of several cognitive-behavioral (CB) theories
• Methods for assessing, conceptualizing, and treating patients using this approach
• Theories, methods, and efficacy evidence for BT & CBT for several disorders, primarily anxiety and affective disorders
• A feel for what it is like to provide and receive BT & CBT
• Introduction and practice in "third wave" behavior therapies such as mindfulness based cognitive therapy (MBCT) and Acceptance and Commitment Therapy (ACT)

Format:

The teaching format is lecture, discussion, and audiotape, videotape, and role-plays demonstrations and exercises.  Class participation is expected.  Participation can come in the form of questions, comments, or class discussion appropriate for a classroom setting. You will also be asked to participate in role-plays, and hopefully share experiences from cases you are seeing outside of this class.
 

Computer/Internet:

Some of the materials that I will provide for you will be text or audio/video files that require you to install free software on your computer. 

1. Many of the readings I assign outside of our text as well as copies of lecture notes are saved as Adobe Acrobat *.pdf files.  The Adobe Acrobat reader is a free program that is pre-installed on most computers, but can be downloaded at the Adobe webpage.
2. One title you may need is QuickTime from Apple Computer.  Please visit the QuickTime website and install this software for Macintosh or Windows.
3. You may also need the RealOne Player, which is also available for Macintosh or Windows.
 

Lecture Notes & Readings:

I do provide handouts for my lectures in hopes that you will not simply spend your time writing what you see on the screen or the board.  Also, there may be some supplemental readings.  You can download them below.
 

Examinations:

There will be one take home exam due around midterm time.  We will settle on a date together. You will have a week to complete it.  I will provide you some history and assessment data on a case.  Your job will be to write up a case formulation and treatment plan for the case.  I expect you to base your treatment recommendations in evidenced based treatments by providing a short review of the empirical literature (nomothetic) but make the treatment plan as idiographic as possible. (5-6 pages plus a one page annotated bibliography of work cited). 

Graded Assignments:

1. I am assigning you to conduct a behavioral experiment on yourself, a consenting adult, or a pet.  The consenting adult can be a current client if you get your supervisor's permission*. Essentially, you will need to gather baseline data on a target behavior, thought, etc., and develop an experiment designed to change the frequency, intensity of that behavior.  You will then write up your results in a 8-10 page paper.  Grades will be assigned based on the thoughtfulness and thoroughness of the experiment and not on whether the intervention actually works.  The paper will be due at the end of the semester.
2. Generate a fear and avoidance hierarchy for an actual or hypothetical client (1-2 pages)
3. Generate a relaxation tape for use with an actual or hypothetical client (15-20 minutes)

*If you use a client, we can contemplate the appropriateness of writing up the case as a single-subject design and submitting it for publication.

Weekly Assignments:

In addition to readings, you will frequently have homework assignments to complete.  Essentially, I am going to ask you to complete the same homework assignments associated with behavioral technologies that we assign to our clients.  For example, I will ask you to self-monitor your behavior, thoughts, feelings, etc.  These homework assignments will not be handed in for a grade, but instead will form the basis of discussion in class.  So, please complete these tasks honestly with the knowledge that I will not see these private events or require you to self-disclose to the class.  You will have control of what you self-disclose and what you chose not to self-disclose.
 

Final Grade:

Your grade for the course will be computed as follows:
Midterm 30%
Behavioral Experiment 30%
Graded Homework 20%
Participation/Role Plays/Weekly Homework* 20%

*Evidence of completing it by way of discussion in class

 SDS:

University policy 3342-3-18 requires that students with disabilities be provided reasonable accommodations to ensure their equal access to course content. If you have a documented disability and require accommodations, please contact the instructor at the beginning of the semester to make arrangements for necessary classroom adjustments. Please note, you must first verify your eligibility for these through Student Disability Services (contact 330-672-3391) or visit www.kent.edu/sds for more information on registration procedures.
 

ASSIGNMENT

Aug-25

Review classical and instrumental conditioning
& Behavioral Assessment

Introductions, Nuts and nolts of the class

Lectures:
Classical & Instrumental Conditioning
Behavioral Assessment

Readings:
Don't Shoot the Dog (Begin reading to familiarize yourself with instrumental conditioning)

Schroeder, C. S. & Gordon, B. N. (1991). Chapter 3. Assessment. Assessment and Treatment of Childhood Problems. (pp. 40-70). New York:  Guilford.

Sept-01

Functional Analysis and Idiographic Approaches

Happy Labor Day, no class Sept 1.

Lecture:
Functional Analysis and Idiographic Approaches

Readings:
Bissett, R. T. &. Hayes, S. C. (1999). The likely success of functional analysis tied to the DSM. Behaviour Research and Therapy, 37, 379-383.

Haynes, S. N., Leisen, M. B., & Blaine, D. D. (1997).  Design of individualized behavioral treatment programs using functional analytic clinical case models.  Psychological Assessment, 9, 334-348.

Lambert, M. J., Hansen, N. B., & Finch, A. E. (2001).  Patient-focused research:  Using patient outcome data to enhance treatment effects.  Journal of Consulting and Clinical Psychology, 69, 159-172.

Nelson-Gray, R.O. & Farmer, R.F. (1999). Behavioral assessment of personality disorders. Behaviour Research and Therapy, 37, 347-368.

Optional Readings:
Farmer, R. F. & Nelson-Gray, R. O. (1999). Functional analysis and response covariation in the assessment of personality disorders: a reply to Staats and to Bissett and Hayes. Behaviour Research and Therapy, 37, 385-394.

Staats, A. W. (1999). Valuable, but not maximal: it's time behavior therapy attend to its behaviorism, Behaviour Research and Therapy, 37, 369-378.

Homework:
Complete your own activity log for the coming week; report back next week on the results. (Not to turn in, just to discuss.)

Sept-08

Discuss:
Activity log homework
Lecture:
Case Conceptualization and Treatment Planning
Readings:
Persons, J. B. (1989). The case formulation model. Cognitive Therapy in Practice:  A Case Formulation Approach. (pp. 1-18). New York:  Norton.

Persons, J. B. & Fresco, D. M. (2008). Adult depression. In J. Hunsley & E. J. Mash (Eds.) A Guide To Assessments That Work. (pp. 96-120). New York:  Oxford University Press.

Persons, J. B. (1989). The Problem List. Cognitive Therapy in Practice:  A Case Formulation Approach. (pp. 19-36). New York:  Norton.

Kazdin, A. E. (1993).  Evaluation in clinical practice:  Clinically sensitive and systematic methods of treatment delivery. Behavior Therapy, 24, 11-45.

Activity: 
On Wednesday, come to class with a case in mind that you are treating. We will use this approach to develop a behavioral case formulation of your case.

Homework:
Develop and carry out a self-monitoring assignment for a minimum of one week using the A-B-C log and report on what you learned from doing it in class. (Not to turn in, just to discuss.)

Sep-15

The Thought Record & Cognitive Restructuring

Discuss:
ABC Homework

Lecture:
The Thought Record & Cognitive Restructuring

Readings:
Persons, J. B., Davidson, J. & Tompkins, M. A. (2001). Chapter 5: Using the thought record. Essential Components of Cognitive Behavior Therapy for Depression. Washington, DC: American Psychological Association.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Chapter 8: Cognitive Techniques. Cognitive Therapy of Depression (pp. 142-166). New York: Guilford.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Chapter 12: Depressogenic Assumptions. Cognitive Therapy of Depression (pp. 244-271). New York: Guilford.

Activity:
On Wednesday, come to class with a case that you are treating in mind (or to roleplay a client). We will work on using a thought record and engaging in cognitive interventions.

Homework: Complete your own DRDT and report back next week. (Not to turn in, just to discuss.)

Sept-22

Emotions: Neglected No More

Discuss:
DRDT Homework

Lecture:
Introduction to emotions in a CBT context

Readings:
Keltner, D. & Gross, J. J. (1999). Functional Accounts of Emotions. Cognition and Emotion, 13, 467-480.

Levenson, R. W. (1999). The Intrapersonal Functions of Emotion. Cognition and Emotion, 13, 481-504.

Keltner, D. & Haidt, J. (1999). Social Functions of Emotions at Four Levels of Analysis. Cognition and Emotion, 13, 505-521.

Samoilov, A., & Goldfried, M. R. (2000). Role of emotion in cognitive-behavior therapy. Clinical Psychology: Science and Practice, 7 373-385.

Mennin, D. S. & Farach, F. (2007). Emotion and Evolving Treatments for Adult Psychopathology. Clinical Psychology: Science and Practice, 14, 329-352.

Greenberg, L. S. (2007). Emotion Coming of Age. Clinical Psychology: Science and Practice, 14,414-421.

Homework:
Use what you learned from last week's homework to modify a behavior by modifying an antecedent, consequence, or behavior itself or ideally more than one of these. (Not to turn in, just to discuss.)

Sept-29

Exposure Methods:  Overview

Discuss:
ABC Behavior Modification Homework

Lecture:
Overview of exposure therapy

Readings:
Barlow, Ch. 1, 2 & 4

Bouton, M. E., Mineka, S., & Barlow, D. H. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108, 4-32.

Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear:  Exposure to corrective information. Psychological Bulletin, 99, 20-35.

Heimberg, R.G. (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry, 51, 101-108.

Optional Readings:
Heimberg, R. G., Liebowitz, M.R., Hope, D.A., Schneier, F.R., Holt, C.S., Welkowitz, L., Juster, H.R., Campeas, R., Bruch, M.A., Cloitre, M., Fallon, B., & Klein, D.F. (1998). Cognitive-behavioral group therapy versus phenelzine in social phobia: 12-week outcome. Archives of General Psychiatry, 55, 1133-1141.

Liebowitz, M.R., Heimberg, R. G., Schneier, F.R., Hope, D.A., Davies, S., Holt, C.S., Goetz, D., Juster, H.R., Lin, S.-L., Bruch, M.A., Marshall, R., & Klein, D.F. (1999). Cognitive-behavioral group therapy versus phenelzine in social phobia: Long-term outcome. Depression and Anxiety, 10, 89-98.

Exposure Methods:  Practice and Role-plays

Discuss:
ABC Behavior Modification Homework

Activity:
Both days, come prepared to role-play as an anxious client and also to role-play as a therapist treating an anxious client. We will work on developing exposure exercises

Readings:

Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G. (1999). An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy 37, 559-574.

Sloan, T. & Telch, M. J. (2002). The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation. Behaviour Research and Therapy 40, 235-251.

Alden, L. E. & Bieling, P. (1998). Interpersonal consequences of the pursuit of safety. Behaviour Research and Therapy, 36, 53-64.

Powers, M. B., Smits, J. A. J., & Telch, M. J. (2004). Disentangling the Effects of Safety-Behavior Utilization and Safety-Behavior Availability During Exposure-Based Treatment: A Placebo-Controlled Trial. Journal of Consulting and Clinical Psychology, 72, 448–454.

Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26, 153–161.

Lovibond, P. F., Davis, N. R., & O'Flaherty, A. S. (2000). Protection from extinction in human fear conditioning. Behaviour Research and Therapy, 38,

Homework: 
Develop Fear and Avoidance Hierarchy for actual or fictional patient. (Turn in next Monday.)

Cognitive Therapy of Depression

Lecture:
Overview of cognitive therapy of depression

Readings:
Barlow, Ch. 6

Persons, J. B. (2008). Cognitive theories and their clinical implications. The Case Formulation Approach to Cognitive-behavior Therapy. New York: Guilford.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford. (Graze the whole book)

Activity:
Wednesday: We will roleplay and discuss aspects of cognitive therapy strategies.

Turn in: Written assignment on Fear and Avoidance Hierarchy for actual or fictional patient.

Homework: Make relaxation tape for actual or fictional patient.

Behavioral Activation Treatment for Depression

Lecture:
Behavioral activation therapy for depression

Readings:
Barlow, Ch. 8.

Ferster, C.B. (1973). A functional analysis of depression. American Psychologist, 28, 857-870.

Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8, 255-270.

Lejuez, C.W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25, 255-286.

Activity: 
Wednesday: We will roleplay and discuss aspects of Behavioral Activation strategies.

Turn in:  Relaxation tape for actual or fictional patient.

Homework: Practice with your relaxation tape daily and report back next week on the results.

Oct-27

Mindfulness Based Cognitive Therapy

Discuss:
Guided relaxation practice

Readings:
Bishop, S. R. et al. (2004). Mindfulness: A Proposed Operational Definition. Clinical Psychology: Science and Practice, 11, 230-242.

Hayes, A. M., & Feldman, G. (2004). Clarifying the Construct of Mindfulness in the Context of Emotion Regulation and the Process of Change in Therapy. Clinical Psychology: Science and Practice, 11, 255-262.

Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1993). Three-year follow-up and clinical implications of Mindfulness Meditation-Based Stress Reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192-200.

Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting & Clinical Psychology, 68, 615-623.

Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Soulsby, J. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology, 109, 150-155.

Nov-03

Mindfulness (Cont'd)

Readings:
Baer, R. A (2003). Mindfulness training as a clinical intervention:  A conceptual and empirical review. Clinical Psychology: Science and Practice.

Dimidjian, S. & Linehan, M. M. (2003). Defining an Agenda for Future Research on the Clinical Application of Mindfulness Practice. Clinical Psychology: Science and Practice.

Kabat-Zinn, J.(2003). Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology: Science and Practice.

Roemer, R. & Orsillo, S. M. (2003). Mindfulness: A promising intervention strategy in need of further study. Clinical Psychology: Science and Practice.

Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (2003). Mindfulness Training and Problem Formulation. Clinical Psychology: Science and Practice

Activity:
Both days, we will practice and discuss mindfulness exercises that can be implemented in practice.
 

Nov-10

Acceptance and Commitment Therapy (ACT)

No Class Wed, Nov 12 DMF@ABCT

Readings:
Blackledge, J. T. & Hayes, S. C. (2001). Emotion Regulation in Acceptance and Commitment Therapy. Journal of Clinical Psychology, 57, 243-255.

Hayes, S. C. (1994). Content, context, and the types of psychological acceptance. In S. C. Hayes, N. S. Jacobsen, V. M. Follette, & M. J. Dougher. Acceptance and Change:  Content and Context in Psychotherapy. (pp. 13-32). Reno:  Context Press.

Hayes, S. C. & Pankey, J. (2003). Psychological acceptance. In W. T. O'Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Empirically supported techniques of cognitive behavior therapy: A step by step guide for clinicians. New York: Wiley.

Luoma, J. & Hayes, S. C. (2003). Cognitive defusion. In W. T. O'Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Empirically supported techniques of cognitive behavior therapy: A step by step guide for clinicians. New York: Wiley.

Blackledge, J. T. (2003). An Introduction to Relational Frame Theory: Basics and Applications. The Behavior Analyst Today, 3, 421-433.

Wilson, K. G. & Murrell, A. R. (in press). Values-Centered Interventions: Setting a Course for Behavioral Treatment. In S. C. Hayes, V. M. Follette, & M. Linehan (Eds.). The new behavior therapies: Expanding the cognitive behavioral tradition. New York: Guilford Press.

Optional Assignment:
Complete the very useful RFT Tutorial created by Eric Fox.

Nov-17

Acceptance and Commitment Therapy (ACT) (Cont'd)

Video:
We will watch Acceptance and Commitment Therapy by Steven C. Hayes.

Nov-24

Emotion Regulation Therapy (ERT) for GAD

No Class Wed, Nov 26-Thanksgiving Recess

Lecture:
ERT for GAD

Readings:
Mennin, D. S. & Fresco, D. M. (in press). Emotion regulation and anxiety. In A. M. Kring and D. M. Sloan. Emotion regulation in psychopathology. New York: Guilford.

Borkovec, T. D. & Sharpless. (2004). Generalized Anxiety Disorder: Bringing cognitive behavioral therapy into the valued present. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds). Mindfulness and Acceptance: Expanding the cognitive-behavioral tradition (pp. 209-242). New York: Guilford.

Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002).  Applying an emotion regulation framework to integrative approaches to Generalized Anxiety Disorder. Clinical Psychology:  Science & Practice, 9, 85-90.

Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Emotion regulation deficits as a key feature of generalized anxiety disorder: Testing a theoretical model. Behaviour Research and Therapy, 43, 1281-1310.

Dec-01