CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit

CBT in Chronic Illness and Palliative Care: A Workbook and Toolkit is divided into three parts and is intended to give the reader grounding in the principles and techniques of Cognitive Behavioural Therapy (CBT). Ideally, it should be used in junction with a taught course on the use of CBT with people who have life-changing illness or are terminally ill. The course will offer the opportunity to discuss working with these patients and the people close to them. It will give the student the chance to practice the skills they are learning through role-plays and small group exercises; and it will provide time for going back over material that has been difficult to understand or has been misunderstood.
However, such courses are rare, so the book has been written with the expectation that many readers will be learning these skills without the benefit of a supportive course. With this in mind, there are a number of exercises included that have been adapted from the courses we have run and we would ask you to follow these through very carefully if you intend to apply CBT skills in your clinical practice.

Part 1: The Workbook examines important issues and themes that need to be understood and considered by clinical practitioners as well as the basic principles of the cognitive behavioural approach. These range from wider aspects of behaviour change through to the specifics of assessing psychological needs. This material, together with key reference books and supplemented by the exercises at the end of each chapter represent the knowledge base for these core skills when applied to people with life-changing illness.
In Part 2: The Issues some psychological problems, obstacles and needs are referred to as “Problems”. Relevant techniques and sample tactics are identified, providing an idea of how these CBT methods are applied in practice with each problem. Issues about implementing these procedures are covered in “Notes”. Although not written in chapter format, close familiarity with the contents of this part of the book is extremely important. Inevitably the selection of sample problems is far from comprehensive but the range is sufficiently wide to illustrate the scope of CBT usage. Consequently, when considering applying CBT methods, this part of the book should be consulted first. The intention is to give enough material for you to be able to:

• assess the problem or need
• indicate the typical cognitive-behavioural approach to coping
• where relevant include educational material that can be copied and passed to patients, carers or others
• assess improvement and need reduction.

Part 3: The Toolkit provides information on CBT methods in practice that may be of practical assistance when you are seeking to offer some help. There are plenty of different ideas for managing challenging psychological situations in the CBT literature and so, like the list of problems and needs, the suggestions for methods of helping included in this book could not claim to be exhaustive. Part 3 is divided into three sections.

• A fuller description of how to implement each CBT technique is provided in Section 1: Techniques. 
• Section 2: Information sheets includes further detailed guidance and information sheets which may be copied and used to assist in the CBT.  
• Section 3: Record forms provides methods for recording events, thoughts and plans in conjunction with the CBT techniques. These forms may also be photocopied. 

A4 versions of all information sheets and record forms can be downloaded from the website free of charge and without copyright restrictions by owners of this book, for their own clinical use only. PowerPoint slides for personal training are also available to view at the website.
About the Authors

• Nigel Sage is Consultant Clinical Psychologist in Cancer and Palliative Care at The Beacon Community Specialist Centre for Cancer and Palliative Care in Guildford, Surrey. He is an Accredited Cognitive Behaviour Therapist and also works in primary care mental health in Hampshire.
• Michelle Sowden is Consultant Clinical Psychologist at Frimley Park Hospital where she has provided and developed a service to patients with physical health problems across the Clinical Directorates. She has a special interest in the application of cognitive behavioural and systemic therapies to the management of chronic medical conditions.
• Elizabeth Chorlton is a Chartered Clinical Psychologist working at Frimley Park Hospital, in the Department of Psychological Medicine, with patients who are experiencing psychological difficulties as a result of physical health problems. In addition to her clinical psychology training, she has an MSc in the field of health psychology.
• Andrea Edeleanu is Director of Specialist Therapies and Service User Involvement for Surrey and Borders Partnership NHS Trust. She works clinically in Community Health Psychology and provides consultancy and clinical supervision to colleagues in health, mental health and community services. She is a Consultant Clinical Psychologist, Chartered Health Psychologist and an Accredited Cognitive Behaviour Therapist.

Contents
Part I: The Workbook: The Cognitive Behavioural Approach

• Chapter 1: What is the Cognitive Behavioural Approach?
• Chapter 2: The Relevance of a Cognitive Behavioural Approach for People with a Life-changing Illness
• Chapter 3: Does Cognitive Behaviour Therapy Work? The Evidence Base
• Chapter 4: Communication Skills in Health Care
• Chapter 5: Cognitive Behavioural Communication Style
• Chapter 6: Guided Discovery: Using the Socratic Method
• Chapter 7: Assessment
• Chapter 8: Formulation
• Chapter 9: Deciding on a Course of Action: Part 1
• Chapter 10: Goal Setting and the Step-by-Step Process
• Chapter 11: The Practicalities of Setting Goals
• Chapter 12: Bringing About Change
• Chapter 13: Methods of Behaviour Change
• Chapter 14: Methods of Cognitive Change
• Chapter 15: Challenging Unhelpful Thoughts
• Chapter 16: Managing Emotions and Unpleasant Physical Sensations
• Chapter 17: Decision on a Course of Action: Part 2
• Chapter 18: Applying a Cognitive Behavioural Approach to Clinical Practice

Part II: The Issues: Some Psychological Problems How to Use This Part of the Book

• Glossary of Everyday Terms
• Adjustment Difficulties
• Altered Body Image
• Anger
• Avoidance
• Denial
• Fatigue
• Fear of the Future
• Inactivity
• Indecisiveness
• Intrusive/Distressing Thoughts
• Lack of Motivation
• Loss of Pleasure or Ability to Enjoy Things
• Low Mood
• Low Self-Esteem
• Negative Outlook
• Pain
• Panic Attacks
• Special Note: Safety Behaviours
• Physical Tension
• Poor Concentration
• Problem Solving Difficulties
• Setbacks
• Sleep Difficulties
• Unassertiveness
• Worrying

Part III: The Toolkit: CBT Methods in Practice 
Section 1: Techniques Activity Monitoring

• Assertiveness Skills
• Assessing Psychological Distress
• Attention Strategies
• Basic Counselling Skills
• Behavioural Change Methods: A Summary
• Behavioural Experiments
• Behavioural Rehearsal
• Believable Alternative Thoughts
• Breathing Control
• Challenging Unhelpful Thoughts
• Cognitive Change Methods: A Summary
• Denial: Strategies for Encouraging Acceptance
• Denial: Strategies for Engaging the Patient
• Denial: Strategies for Reducing Distressing Thoughts
• Denial: Suggestions for Questions to Ask
• Effective Communication Skills
• Emotional Expression
• Expressive Writing
• Graded Activities
• Listening Skills
• Mental Distraction
• Mindfulness
• Pacing
• Problem Solving
• Psycho-education
• Purposeful Planning
• Relaxation Exercises
• Respectfulness Skills
• Socratic Questioning
• Stimulus Control
• Weighing the Pros and Cons

Section 2: Information Sheets Antidotes to Bad Days

• The Assertiveness Model
• Assertiveness Rights
• Assertiveness Techniques
• Bad Old Habits: Avoiding Relapsing Into Them
• Change: Bringing It About
• Change: The Desire for It
• Change: The Transition Curve
• Coping with Setbacks 1: Physical Health Setbacks
• Coping with Setbacks 2: Mental Attitude Setbacks
• Denial: Advantages and Disadvantages
• Experiential Learning Cycle
• Goal Setting and the Step-by-Step Approach
• Goal Setting: Examples
• Goal Setting Questions
• Mental Traps: Examining the Evidence
• Mental Traps: Examples of How to Get Out of Them
• Mindfulness Attitudes
• Mindfulness Exercises
• Pacing
• Pacing Examples
• The Reactions of Other People
• Reflective Practice Diary Guidance
• Relaxation: Mental Exercise
• Relaxation: Muscle Exercise
• Relaxed Breathing Exercise
• The Serenity Prayer
• Sharing and Mixing with Other People
• SMART Guidelines
• Socratic Questioning: Examples
• Stress: The Effect it Has
• The Stress Response
• A Vicious Cycle Model of Anxious Avoidance
• A Vicious Cycle Model of Anxious Preoccupation
• A Vicious Cycle Model of Hopelessness-Helplessness

Section 3: Record Forms Event-Emotion-Thought Analysis Form

• Example of Event-Emotion-Thought Analysis Form
• Believable Alternatives
• Thought Record
• Pacing Record Form
• Denial: Assessing its Costs and Benefits
• Denial: Example of Pros and Cons Assessment
• Action Plan for Denial
• Goal Planning: Step-By-Step Action Plan
• Your Ideas for Goals
• Reflective Practice Diary

Index 

Book Details

• Paperback: 386 pages
• Publisher: Wiley-Interscience; 1 edition (June 3, 2008)
• Language: English
• ISBN-10: 0470517077
• ISBN-13: 978-0470517079
• Product Dimensions: 9.6 x 6.8 x 0.5 inches

List Price: $68.00