Guest guest Posted May 24, 2000 Report Share Posted May 24, 2000 Deborah, A question is never dumb! I will describe how I work. Other therapists may conduct their sessions differently. I would have the client set goals that they can work towards. For example, getting out more often, or becoming more assertive, or getting along with my parents.... In cbt, a hierarchy of goals are developed and rated for level of ability it would take to change the behaviour. An example of a depression hierarchy may be: rating today rating after 6 weeks establish a routine 3/10 9/10 get up and get dressed 2/10 7/10 invite someone out for a walk 1/10 5/10 get more exersize 1/10 5/10 go out for 1/2 hour at least once a day 4/10 8/10 read something everyday 2/10 6/10 The client rates where they are after X amount of time. New goals can be defined at any time. It is up to her and the therapist to determine HOW she will get there. I believe in client-centred therapy, so the client would need to come up with ideas that work for her (like creating a daily calendar, picking out clothing the night before, join a gym,...). The client would report on her progress, but the goal is to be independant and not to be dependant on the therapist! During the sessions, the client and I discuss what factors are creating the depressive feeling (environmental depression, ie school, abuse, death of a loved one, divorce...) and help to develop tools to deal with this stress. The rapore your daughter has with her therapist is important, but since you are restricted, why not check with your daughter if she's working towards change/goals?! I hope this helps - wendy in canada wb4@... ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 What is E & RP therapy? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 HI Deborah: The effective CBT for OCD is E & RP. It is unfortunately an all-too-common problem that mental health professionals do not provide the correct behavior therapy to OCD sufferers. Supportive therapy usually involves " talk " therapy which has not been shown to be helpful for OCD and can even be a negative if patients are encouraged to analyze and put too much importance in interpreting the " meaning " behind their obsessions. Since E & RP can be tough to do, it can be a good sign that it is happening when our kids do not " really like " their therapists. At least in the early stages of therapy which can be very tough. Therapists often want to establish trust and this can end in postponing E & RP. Dr. Penzel gave me some excellent advice, do not continue taking my son to a therapist beyond 5 visits if proper E & RP has not yet happened. Good luck, take care, aloha, Kathy (H) kathyh@... At 05:42 PM 05/24/2000 EDT, you wrote: >Hi everyone, >My 16 yr. old daughter suffers from depression and mild OCD. With medication >the depression has lessened some and the OCD thoughts almost gone. How can >CBT work for depression? Is CBT the same as E & RP? She is seeing a therapist >now, but only talking about general things like school and life. She's not >really working on any specific issues. My daughter really likes this >therapist, but would she get more from doing CBT, or is this CBT? Our >insurance only allows 20 visits per year, so I want to use them where it will >be most effective. Sorry if the questions sound dumb, but I'm new at this. >Thanks, >Deborah Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 Dear , Thanks for your insight into CBT for depression. I talked with my daughter last night and asked a little about her sessions. So far, each time she returns she shares with me what they talk about. Her therapist is trying to get her to cut back on her involvement and committment to so many things. She is a " doer " and gets overwhelmed when she has so much to do. Everything has to be perfect for her (school work, etc.) She also is having her trying to cut out things she doesn't like and adding more things she does. her therapist told her they would begin behavior therapy next time (in 3 weeks). I guess what she's doing is easing her into it. Thanks again for your comments. Deborah Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 Dear Kathy, Thanks for your thoughts on therapy for OCD. My daughter has had 4 sessions with therapist, just " talk " therapy. We see a psychiatrist on June 2nd (before her next therapy visit) so I can ask him about E & RP then. Hopefully we will get somewhere. Her OCD thoughts are almost gone with the med. Thanks again, Deborah Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 Hi: E & RP = exposure and response prevention, the first line treatment for children with OCD. It involves agreeing not to carry out an anxiety-reducing ritual in response to having an OCD obsession triggered. For example someone who fears blood and sees some may obsess about dying of AIDS and wash their hands repeatedly to reduce their anxiety and try to make absolutely sure they have no contact with blood (avoidance). With E & RP they would be encouraged to approach blood (exposure), recognize their worries as error messages from the brain and learn how to reduce their handwashing (response prevention) to a level similar to someone without OCD. Aloha, Kathy (H) kathyh@... At 07:03 AM 05/25/2000 -0400, you wrote: >What is E & RP therapy? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2000 Report Share Posted May 25, 2000 Deborah, It sounds like you have a good relationship with your daughteter - congradulations!! It is my pleasure to help out!! This is such a terrific list, I dont know what I would have done without it!! take care, wendy, in canada ============================ >Dear , >Thanks for your insight into CBT for depression. I talked with my daughter >last night and asked a little about her sessions. So far, each time she >returns she shares with me what they talk about. Her therapist is trying >to get her to cut back on her involvement and committment to so many >things. She is a " doer " and gets overwhelmed when she has so much to do. >Everything has to be perfect for her (school work, etc.) She also is >having her trying to cut out things she doesn't like and adding more things >she does. her therapist told her they would begin behavior therapy next >time (in 3 weeks). >I guess what she's doing is easing her into it. >Thanks again for your comments. >Deborah ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 26, 2000 Report Share Posted May 26, 2000 Thanks for the info. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2000 Report Share Posted June 7, 2000 Deborah, You don't sound dumb at all. My son has recently went through a hospital program for diagnoses. It was determined he has Conduct Disorder with OCD features, Depression with Anxiety features, Avoidant/Denial Personality disorder. I am having one 'hell' of a time with therapist and my insurance. My insurance only allows one psychiatric firm for treatment. 10 months has gone by and not a thing has been done. With so reluctant to talk, to admit he has a problem (thus avoidance and denial) it makes it difficult. Hospital psychiatrist and therapist said my son needs someone who will not give up on him and will take the time to get my son to admit problem. Like I said, no one at the psychiatric firm my insurance allows is qualified. When myself or my mother calls my Horizon Mental Health care rep, they make him another appt. with the same therapist, a LCSW (license clinical social worker) who has done nothing in the last 8-10 months to even touch on the subject, no progress has been made. If anyone out there, or you Deborah, knows just how to go about getting help, let me know. Right now I feel as if I know a hell of a lot more about my son, his diagnoses, and what treatment he needs due to the research I have been doing versus the so called professionals... Deborah, don't feel dumb! You only want what is best for your child. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2000 Report Share Posted June 7, 2000 Hi Often universities have programs that are free.You can try this.My daughter goes to a psychologist that teaches the doctorate program at a university and he and some of the other psychologists oversee the free clinic.Our insurance company added him to their list of providers (only for my daughter)because his fees are below their set rates. Theresa in SC Re: CBT for depression > Deborah, > You don't sound dumb at all. > My son has recently went through a hospital program for diagnoses. > It was determined he has Conduct Disorder with OCD features, Depression with > Anxiety features, Avoidant/Denial Personality disorder. > I am having one 'hell' of a time with therapist and my insurance. > My insurance only allows one psychiatric firm for treatment. 10 months has > gone by and not a thing has been done. With so reluctant to talk, to > admit he has a problem (thus avoidance and denial) it makes it difficult. > Hospital psychiatrist and therapist said my son needs someone who will not > give up on him and will take the time to get my son to admit problem. > Like I said, no one at the psychiatric firm my insurance allows is qualified. > When myself or my mother calls my Horizon Mental Health care rep, they make > him another appt. with the same therapist, a LCSW (license clinical social > worker) who has done nothing in the last 8-10 months to even touch on the > subject, no progress has been made. > If anyone out there, or you Deborah, knows just how to go about getting help, > let me know. Right now I feel as if I know a hell of a lot more about my > son, his diagnoses, and what treatment he needs due to the research I have > been doing versus the so called professionals... > Deborah, don't feel dumb! You only want what is best for your child. > > > ------------------------------------------------------------------------ > Remember four years of good friends, bad clothes, explosive chemistry > experiments. > 1/4051/5/_/531051/_/960391676/ > ------------------------------------------------------------------------ > > You may subscribe to the OCD-L by emailing listserv@... . In the body of your message write: subscribe OCD-L your name. The Archives, Files, and Features List for the may be accessed by going to , enter your email address and password, then point and click. Subscription issues, problems, or suggestions may be addressed to Louis Harkins, list owner, at harkins@... . > > Quote Link to comment Share on other sites More sharing options...
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