Training In CBT & Other Evidence-Based Psychological Therapies
Introduction
The primary feature of generalized anxiety disorder (GAD) is excessive worry about daily life events, with the content of worry tending to be dynamic and regularly shifting according to the day. As a consequence, CBT for GAD is typically most effective when targeting processes that underlie excessive worry, rather than the specific worries themselves. Despite this, there are certain common worry themes that do emerge for many GAD clients, and can be more directly addressed within a larger CBT protocol for GAD. Among these is worries related to indecisiveness. Daily life decisions, such as what to wear on a given day or which colour to paint one’s walls, are inherently uncertain as there is no clear “right” answer. Within the CBT for GAD protocol targeting intolerance of uncertainty (CBT-IU), uncertain situations are a trigger for worry, such that daily life decisions can become a significant catalyst for worries. Indeed, many GAD patients will describe extreme indecisiveness, as well as significant worry and anxiety over even the most minor daily life decisions.
The event will be equivalent to 1 hrs of CPD.
Content
This workshop will discuss the clinical application of CBT-IU for GAD, with a particular focus on targeting the worry theme of indecisiveness in daily life situations. Although the role of intolerance of uncertainty in the development and maintenance of worry will be highlighted, its specific impact on decision-making worries and associated safety behaviours will be emphasized. This presentation will include a discussion of the following: 1) maximizer and satisficer decision-making styles, and their influence on how people approach daily life decisions and evaluate their choices; 2) the impact of cognitive dissonance with respect to the relationship of effort and value; 3) the ‘decision dance’ seen in worry-related safety behaviours when facing daily life decisions; 4) the unique goals of “straddling the line” and “controlled spontaneity” when developing behavioural experiments involving decision-making. Specific examples of decision-making worries and how to target them will be provided, and case vignettes will be provided throughout.
Learning Objectives
Workshop participants will learn to:
• Understand the unique presentation of decision-making worries within the larger framework of CBT-IU for GAD
• Describe decision-making styles and the problem with the search for a ‘perfect’ or ‘correct’ choice when making daily life decisions
• Identify worry-specific safety behaviours related to indecisiveness
• Develop behavioural experiments that specifically target negative beliefs about uncertainty within decision-making
Training Modalities
Didactic content, case examples, Q&A
Key References
Bullens, L., van Harreveld, F., Förster, J., & van der Pligt, J (2013). Reversible decisions: The grass isn’t merely greener on the other side; it’s also very brown over here. Journal of Experimental Social Psychology, 49, 1093-1099.
Rassin, E., & Muris, P. (2005). Indecisiveness and the interpretation of ambiguous situations. Personality and Individual Differences, 39, 1285-1291.
Robichaud, M., & Buhr, K. (2018). The worry workbook: CBT skills to overcome worry and anxiety facing the fear of uncertainty. New Harbinger: Oakland
Robichaud, M., Koerner, N., & Dugas, M.J. (2019). Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice (2nd ed.). Routledge: New York.
Schwartz, B. (2004). The paradox of choice: Why more is less. New York: Harper Collins
About the presenter
Dr. Melisa Robichaud is a Founding Director of the Vancouver CBT Centre, where she works as a clinical psychologist specializing in the assessment and treatment of anxiety disorders. She is currently an adjunct faculty member in the University of British Columbia (UBC) Department of Psychology, a clinical instructor in the UBC Department of Psychiatry, and a clinical associate in the Simon Fraser University (SFU) Department of Psychology.
Dr. Robichaud is a past President of the Canadian Association of Cognitive and Behavioural Therapies (CACBT) and has been certified as an expert in CBT by the organization. She also formerly served on the Anxiety Canada Board of Directors, and was a member of the Scientific Advisory Board. Her area of clinical specialization is CBT for anxiety disorders, with a special emphasis on generalized anxiety disorder (GAD). She has provided workshops internationally and has published numerous scientific articles and book chapters on the subject, as well as co-authoring several books on the cognitive-behavioural treatment of GAD.
Who should attend
This workshop is most suitable for mental health professionals with some prior exposure to CBT and its application to GAD and to excessive worry across the anxiety spectrum.