What CBT for other chronic diseases is like

[WillowJ]

So I was looking through the Oxford books for Lenny Jason's new book listing, and I found a book on CBT for chronic and terminal illnesses. I clicked through to see what it was like. Not at all like what they offer for us. I can see how this could be useful as an adjunct therapy, particularly for a newer patient or someone who didn't have a support group.

http://www.oup.com/us/catalog/gener...tionerClientGuides/?view=usa&ci=9780195341638

Description

Individuals with serious and incurable illnesses often require care that goes beyond the body.
As they face the challenges of living with and eventually dying from their conditions, they may need to acquire new skills to cope and increase their quality of life.
Even those at the beginning of the end of life can take an active role in their treatment.

This skill-based program emphasizes flexibility and should be tailored to individual clients.

The first module introduces stress management techniques, including cognitive restructuring, relaxation, and problem-focused and emotion-focused coping.

The second module targets mood management, with sessions on depression, anxiety, and anger.

Social support is addressed in the third module where clients learn communication and conflict resolution skills. Special attention is paid to supporting caregivers and working with medical providers.

The fourth module focuses on quality of life and covers symptom management, goal setting, positive psychology, and spiritual issues.

An adaptation chapter details how to run the program as a group and discusses other possible formats.

Incorporating a wide variety of CBT techniques, this program can benefit patients suffering from a range of chronic and terminal diseases.
The corresponding workbook helps clients personalize the content of sessions and practice new skills.
The facilitator guide is invaluable to any mental health professional working in a medical or other palliative care setting.

(I added paragraph breaks)

 

[WillowJ]

There's also this:
http://www.oup.com/us/catalog/gener...tionerClientGuides/?view=usa&ci=9780195341645

This collaborative, skill-based program will teach you practical techniques to help you cope with your illness and the stress of everyday life.

You will learn strategies to improve your mood and deal with feelings of anxiety, depression, or anger.

Social support is key to successful coping and you may need to strengthen your relationships, especially with caregivers.

It is also important to work with your medical team and develop more effective ways to manage your symptoms.

You will set goals regarding your care as well as your quality of life.

In addition, you may choose to explore your spirituality and practice tools that promote personal growth.


Your facilitator will work with you to tailor the program to your individual needs.

Rather than figuring social support is enabling the illness as the (bio) psychosocial school illogically concludes for us, it is normally suggested to strengthen it. This seems a much wiser course of action.

 

[alex3619]

The pattern is simple, the psychobabblers put their content into somebody elses label then pretend its the same thing.

I still think traditional CBT is useful, but not the version promoted for ME.

 

[Firestormm]

I've never had CBT specifically for ME i.e. a course, but I have had plenty of counselling over the years that employed CBT and I participated in a long course of Mindfulness and CBT as part of a group.

The above sounds very much like my own experiences of CBT and of the experiences I do hear from others engaged locally with our ME Services.

Acceptance, adjustment, management. That's what it should be about and there's no general reason why we shouldn't be engaged with others who have different long-term conditions in this regard, although there is a case for specialists to help us through the hurdles explicit to ME.

Thanks Willow

This was posted on another forum I happened to notice this morning:

CBT helps adjustment to MS

http://www.mssociety.org.uk/ms-news/2012/07/cbt-helps-adjustment-ms

I haven't read it but can guess the content as I know that people with MS who have received professional CBT intervention and counselling have concurred when I asked them.

Edit:

Regardless of my comment - the above link also refers to a RCT carried out independently by the MS Society. It might be worth reviewing and comparing to similar studies for our own condition.

 

[Bob]

It does look better than what they provide to us, but I still have worries about how CBT is applied to terminal illnesses.
It says that they aim to reduce depression, anxiety and anger.
And I'd like to know the details of how they go about that before I could judge the therapy.
Anger, anxiety and depression can be part of an adjustment process.
Obviously, if they become too severe or too prolonged, then they are not helpful.
But all of these emotions help us to adjust to new situations, and to face up to new realities.
So if CBT is telling people that their emotions are harmful, or unwarranted, then I think they could be counter-productive.
Also, a bad therapist could do more harm than good.
The devil is in the detail, as always.

 

[Firestormm]

Again in my experience of counselling and even the mindfulness involving CBT, allowing one's emotions to flow as it were, was encouraged. Gods the stuff I needed to get off my chest! And to be able to do so with someone detached and independent from my family and friends was for me very helpful.

Take your point though Bob about terminal illnesses. I wonder though, do e.g. Macmillan Nurses employ CBT or something similar? I have certainly got the impression over the years that 'CBT' outside of a research trial involving a manual for example - is not something rigorously applied. If that makes sense?

It has long been my thought as to just how rigorously the e.g. PACE Manual for CBT is adhered to in the real world. I know you get 'bad therapists' who have seemed to apply (in the case I am thinking of) the FINE manual to patients with ME, but I have ditched some therapists I thought were not up to the job.

I don't know. It's not an easy one to quantify. Inside a the research it would seem that e.g. PACE tailored CBT specifically and unfairly towards ME, but in my experience the CBT I received or rather the professionals generally applying it - appeared more in line with that spoken of for MS (above) than anything I have heard relating specifically to ME a la PACE/Wessley/White.

Maybe it's all about interpretation, professionalism and application to individuals?

 

[WillowJ]

happy to hear some have gotten 'the good kind' and it's been useful and avoided the potential sorts of pitfalls mentioned by Bob

CBT helps adjustment to MS

http://www.mssociety.org.uk/ms-news/2012/07/cbt-helps-adjustment-ms

I accessed a cached version of the page, and this particular study is led by Rona Moss-Morris, a well-known proponent of the (bio)psychosocial or Wessely school, just FYI

 

[Firestormm]

Began reading this earlier today, and will finish it tonight. It had been posted on IiME Facebook and was not well received by the person who posted it. I am trying to be more circumspect but we shall see.

Not sure when it was published, but it affords some insight perhaps into the situation relating to CBT and our condition: http://www.kcl.ac.uk/innovation/groups/projects/cfs/health/index.aspx Might be interesting to compare the approaches.

Here's the author: http://www.northumbria.ac.uk/sd/academic/lifesciences/ad/psych/psychstaff/vincentdeary/