Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention

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Hauptverfasser: Gumley, Andrew (VerfasserIn), Schwannauer, Matthias (VerfasserIn)
Format: Buch
Sprache:English
Veröffentlicht: Chichester [u.a.] Wiley 2008
Ausgabe:Repr.
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adam_text CONTENTS About the Authors ....................................... ix Preface ................................................ xi Foreword by Max Birchwood .............................. xv Acknowledgements ...................................... xvii PART I THEORETICAL OVERVIEW ...................... 1 1 Current Perspectives on Relapse, Relapse Detection and Prevention ........................................ 3 Introduction ........................................ 3 Psychological Therapies and Relapse Prevention ........... 4 Affect, Meaning and Relapse ........................... 18 A Cognitive Behavioural Model of Early Signs and Relapse . . 23 Antipsychotic Medication and Relapse ................... 27 Implications for Staying Well after Psychosis .............. 32 2 Attachment Theory, Self-regulation and Psychosis ......... 34 Introduction ........................................ 34 Patterns of Attachment ................................ 36 Attachment Theory and Later Psychopathology ............ 38 Stability of Attachment Organisation ..................... 42 Attachment Organisation and Psychosis .................. 43 3 Psychological Factors in Vulnerability and Transition to Relapse .......................................... 47 Introduction ........................................ 47 The Interpersonal Context ............................. 48 The Wider Social Context of Psychosis ................... 54 Significant Life Events ................................ 56 Trauma ............................................ 57 Interpersonal Coping ................................. 59 vi CONTENTS Appraisals of Psychosis and Emotional Distress ............ 62 Conclusions ......................................... 63 PART II OVERVIEW OF STRUCTURE, STYLE AND ORGANISATION OF THERAPY .......................... 65 4 Overview of Principles and Procedures .................. 67 Introduction ........................................ 67 Primary and Secondary Outcomes ....................... 67 Assessment ......................................... 68 Structure of Therapy .................................. 73 Style of Therapy ..................................... 75 Basic Elements of the Therapeutic Stance ................. 79 General Outline of Therapy Sessions ..................... 79 Service Model ....................................... 84 5 Strategies for Engagement and Formulation .............. 86 Introduction ........................................ 86 Attachment Organisation, Recovery and Distress ........... 86 Validation .......................................... 91 The Evolution of Therapeutic Discourse .................. 95 Case Formulation .................................... 97 Case Formulation in SWAP ............................ 99 Conclusions ......................................... 102 PART III SPECIFIC COGNITIVE AND INTERPERSONAL STRATEGIES FOR RECOVERY AND RELAPSE PREVENTION AFTER PSYCHOSIS ..................................... 103 6 Reorganisation of the Self in Recovery: Working with Humiliation, Entrapment and Loss .................... 105 Introduction ........................................ 105 Life Events and their Dimensions ....................... 106 Bowlby on Loss ..................................... 109 Clinical Interventions and Techniques .................... Ill Conclusions ......................................... 122 7 Working with Interpersonal Distrust: Developing a Conceptualisation of the Paranoid Mind ............... 124 Introduction ........................................ 124 Paranoia as an Interpersonal Threat Response ............. 124 The Paranoid Mind is Strategically Deployed .............. 126 CONTENTS vii Attachment and Paranoia.............................. 126 Problems with the Term Paranoia ...................... 128 Working with the Personal Distress of the Paranoid Mind .... 129 Awareness of the Paranoid Mind ........................ 132 Development of an Accepting Rationale for Paranoia as a Response ......................................... 133 Benefits and Costs of the Paranoid Mind ................. 135 Development of Alternative Interpersonal Strategies ........ 137 Conclusions ......................................... 138 8 Working with Traumatic Reactions to Psychotic Experiences ....................................... 140 Introduction ........................................ 140 Psychosis as a Traumatic Event ......................... 141 Trauma Theory ...................................... 144 Assimilation and Accommodation ....................... 147 Exploring Traumatic Reactions ......................... 150 Explaining Traumatic Reactions ......................... 152 Exploring Meaning within Traumatic Memories and Imagery . 154 Contrasting Experiences of Psychosis and PTSD ........... 158 Conclusions ......................................... 160 9 Interpersonal Strategies .............................. 161 Introduction ........................................ 161 The Social Environment ............................... 161 Interpersonal Environments as a Basis for Psychological Intervention ....................................... 165 The Role of Interpersonal Anxieties and Social Withdrawal ... 167 Areas of Interpersonal Difficulties ....................... 173 Working with Interpersonal Sensitivity ................... 177 Conclusions ......................................... 181 10 Working with Underlying Schemata and Core Beliefs ...... 182 Introduction ........................................ 182 Early Parental Loss and Psychopathology ................. 182 Childhood Abuse and Neglect .......................... 183 Psychological Sequelae of Childhood Abuse and Neglect .... 183 Unresolved Attachment Status .......................... 185 Early Childhood Trauma and Psychosis .................. 186 Trauma, Dissociation and Schizotypy .................... 187 Schemata and Internal Working Models .................. 189 Identifying Schemata ................................. 192 Schemata and Behaviour Relationships ................... 193 Core Belief Change Strategies in Cognitive Therapy ......... 195 viii CONTENTS Working with Underdeveloped Strategies ................. 196 Conclusions ......................................... 201 11 Awareness, Intrusiveness and Fear of Relapse ............ 202 Introduction ........................................ 202 Phenomenology of Relapse ............................ 202 Subjective Experiences and Psychosis .................... 203 Appraisals and Relapse ............................... 205 Awareness, Intrusiveness and Fear ...................... 206 Cognitive Behavioural Therapy (CBT) and Relapse Prevention ........................................ 209 Exploring Experiences of Relapse ....................... 210 Explaining Beliefs .................................... 212 Early Signs Monitoring ................................ 213 The Initial Interview for Targeted CBT ................... 214 Testing the Formulation ............................... 215 Decatastrophising Relapse ............................. 215 Contracting Intervention .............................. 216 Subsequent Sessions .................................. 216 Introducing Flexibility into Beliefs ....................... 218 Transforming Beliefs .................................. 219 Testing Transformed Beliefs ............................ 221 Conclusions ......................................... 222 12 Conclusion ......................................... 224 Introduction ........................................ 224 Overview of the Treatment Manual ...................... 224 Therapist Training ................................... 229 Therapeutic Context .................................. 229 Appendix I Fear of Recurrence Scale (FoRSe) Questionnaire .... 231 Appendix II Diagrammatical Formulation of Early Signs ....... 233 Bibliography ............................................ 235 Index ................................................. 283
adam_txt CONTENTS About the Authors . ix Preface . xi Foreword by Max Birchwood . xv Acknowledgements . xvii PART I THEORETICAL OVERVIEW . 1 1 Current Perspectives on Relapse, Relapse Detection and Prevention . 3 Introduction . 3 Psychological Therapies and Relapse Prevention . 4 Affect, Meaning and Relapse . 18 A Cognitive Behavioural Model of Early Signs and Relapse . . 23 Antipsychotic Medication and Relapse . 27 Implications for Staying Well after Psychosis . 32 2 Attachment Theory, Self-regulation and Psychosis . 34 Introduction . 34 Patterns of Attachment . 36 Attachment Theory and Later Psychopathology . 38 Stability of Attachment Organisation . 42 Attachment Organisation and Psychosis . 43 3 Psychological Factors in Vulnerability and Transition to Relapse . 47 Introduction . 47 The Interpersonal Context . 48 The Wider Social Context of Psychosis . 54 Significant Life Events . 56 Trauma . 57 Interpersonal Coping . 59 vi CONTENTS Appraisals of Psychosis and Emotional Distress . 62 Conclusions . 63 PART II OVERVIEW OF STRUCTURE, STYLE AND ORGANISATION OF THERAPY . 65 4 Overview of Principles and Procedures . 67 Introduction . 67 Primary and Secondary Outcomes . 67 Assessment . 68 Structure of Therapy . 73 Style of Therapy . 75 Basic Elements of the Therapeutic Stance . 79 General Outline of Therapy Sessions . 79 Service Model . 84 5 Strategies for Engagement and Formulation . 86 Introduction . 86 Attachment Organisation, Recovery and Distress . 86 Validation . 91 The Evolution of Therapeutic Discourse . 95 Case Formulation . 97 Case Formulation in SWAP . 99 Conclusions . 102 PART III SPECIFIC COGNITIVE AND INTERPERSONAL STRATEGIES FOR RECOVERY AND RELAPSE PREVENTION AFTER PSYCHOSIS . 103 6 Reorganisation of the Self in Recovery: Working with Humiliation, Entrapment and Loss . 105 Introduction . 105 Life Events and their Dimensions . 106 Bowlby on Loss . 109 Clinical Interventions and Techniques . Ill Conclusions . 122 7 Working with Interpersonal Distrust: Developing a Conceptualisation of the Paranoid Mind . 124 Introduction . 124 Paranoia as an Interpersonal Threat Response . 124 The Paranoid Mind is Strategically Deployed . 126 CONTENTS vii Attachment and Paranoia. 126 Problems with the Term 'Paranoia' . 128 Working with the Personal Distress of the Paranoid Mind . 129 Awareness of the Paranoid Mind . 132 Development of an Accepting Rationale for Paranoia as a Response . 133 Benefits and Costs of the Paranoid Mind . 135 Development of Alternative Interpersonal Strategies . 137 Conclusions . 138 8 Working with Traumatic Reactions to Psychotic Experiences . 140 Introduction . 140 Psychosis as a Traumatic Event . 141 Trauma Theory . 144 Assimilation and Accommodation . 147 Exploring Traumatic Reactions . 150 Explaining Traumatic Reactions . 152 Exploring Meaning within Traumatic Memories and Imagery . 154 Contrasting Experiences of Psychosis and PTSD . 158 Conclusions . 160 9 Interpersonal Strategies . 161 Introduction . 161 The Social Environment . 161 Interpersonal Environments as a Basis for Psychological Intervention . 165 The Role of Interpersonal Anxieties and Social Withdrawal . 167 Areas of Interpersonal Difficulties . 173 Working with Interpersonal Sensitivity . 177 Conclusions . 181 10 Working with Underlying Schemata and Core Beliefs . 182 Introduction . 182 Early Parental Loss and Psychopathology . 182 Childhood Abuse and Neglect . 183 Psychological Sequelae of Childhood Abuse and Neglect . 183 Unresolved Attachment Status . 185 Early Childhood Trauma and Psychosis . 186 Trauma, Dissociation and Schizotypy . 187 Schemata and Internal Working Models . 189 Identifying Schemata . 192 Schemata and Behaviour Relationships . 193 Core Belief Change Strategies in Cognitive Therapy . 195 viii CONTENTS Working with Underdeveloped Strategies . 196 Conclusions . 201 11 Awareness, Intrusiveness and Fear of Relapse . 202 Introduction . 202 Phenomenology of Relapse . 202 Subjective Experiences and Psychosis . 203 Appraisals and Relapse . 205 Awareness, Intrusiveness and Fear . 206 Cognitive Behavioural Therapy (CBT) and Relapse Prevention . 209 Exploring Experiences of Relapse . 210 Explaining Beliefs . 212 Early Signs Monitoring . 213 The Initial Interview for Targeted CBT . 214 Testing the Formulation . 215 Decatastrophising Relapse . 215 Contracting Intervention . 216 Subsequent Sessions . 216 Introducing Flexibility into Beliefs . 218 Transforming Beliefs . 219 Testing Transformed Beliefs . 221 Conclusions . 222 12 Conclusion . 224 Introduction . 224 Overview of the Treatment Manual . 224 Therapist Training . 229 Therapeutic Context . 229 Appendix I Fear of Recurrence Scale (FoRSe) Questionnaire . 231 Appendix II Diagrammatical Formulation of Early Signs . 233 Bibliography . 235 Index . 283
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spellingShingle Gumley, Andrew
Schwannauer, Matthias
Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
Psychotic Disorders therapy
Psychotic Disorders prevention & control
Recurrence prevention & control
Cognitive Therapy methods
Kognitive Psychotherapie (DE-588)4164472-4 gnd
Psychose (DE-588)4047734-4 gnd
subject_GND (DE-588)4164472-4
(DE-588)4047734-4
title Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
title_auth Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
title_exact_search Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
title_exact_search_txtP Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
title_full Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention Andrew Gumley and Matthias Schwannauer
title_fullStr Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention Andrew Gumley and Matthias Schwannauer
title_full_unstemmed Staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention Andrew Gumley and Matthias Schwannauer
title_short Staying well after psychosis
title_sort staying well after psychosis a cognitive interpersonal approach to recovery and relapse prevention
title_sub a cognitive interpersonal approach to recovery and relapse prevention
topic Psychotic Disorders therapy
Psychotic Disorders prevention & control
Recurrence prevention & control
Cognitive Therapy methods
Kognitive Psychotherapie (DE-588)4164472-4 gnd
Psychose (DE-588)4047734-4 gnd
topic_facet Psychotic Disorders therapy
Psychotic Disorders prevention & control
Recurrence prevention & control
Cognitive Therapy methods
Kognitive Psychotherapie
Psychose
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