Workshop 15

 

Cognitive Behavioural Therapy and Decentering Techniques for Auditory Verbal hallucinations

Mark van der Gaag

 Mark van der Gaag
Originally, the assumed mechanism of change in CBT was the change of the content of dysfunctional cognitions and representations by challenging and integrating new information. The content of dysfunctional cognitions and schemes changes into more functional cognitions. Research shows that  not only cognitive change processes are involved, there are also associative processes involved in therapy of for instance anxiety and depressive disorders. Competing memory representations balance the dysfunctional representations in the process of therapy. Distancing and decentering describes this process of  learning to observe ones cognitions and symptoms in a more detached mode. This can be helpful in patients with persistent symptoms. The workshop teaches how to integrate decentering and distancing techniques in CBT for patients with psychosis.
 
Key Objectives: Participants will acquire the following skills:
1) Assess the theme and counter-theme in emotional distress in voice hearers.
2) Strengthen the competing memory representation of the counter-theme.
3) Use the competing memory representation to work within the delusion and to attain a more detached and less distressed experience of psychotic mental events such as for instance voices.

Training Modalities: The workshop will make use of: Explaining the theoretical evidence for the rational of the therapeutic approach, instruction, modelling and role-plays of the therapeutic skills and experience of the capacity of competing memories on emotional change.

Mark van der Gaag (clinical psychologist/psychotherapist) is a practitioner-scientist working with schizophrenia patients in the Netherlands. He has done research in cognitive remediation and cognitive behavioural therapy for schizophrenia patients and has been teaching many colleagues in the skills of CBT. At the moment he is involved in a multi-site trial to assess the cost-effectiveness of CBT for psychosis in routine care. On a pilot scale he is experimenting with decentring techniques that go beyond challenging the validity of delusional belief
 
References: 1) Brewin CR. Understanding cognitive behaviour therapy: A retrieval competition account. Behav Res Ther Jun 2006;44(6):765-784.
2) Chadwick P. Two Chairs, Self-Schemata and A Person Based Approach To Psychosis. Behavioural and Cognitive Psychotherapy 2003;31(4):439-449.
3) Bach P, Hayes SC. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. J Consult Clin Psychol Oct 2002;70(5):1129-1139.