Cognitive Restructuring and Graded Behavioral Exposure for Persecutory Paranoia and Agoraphobic Anxiety in Complex Psychosis

Abstract

Cognitive behavioral models of psychosis assert the notion of cognitive mediation, in which threat-oriented subjective misinterpretations of anomalous experiences lead to increased levels of emotional distress. Thus, paranoid appraisals of auditory hallucinations often result in hypervigilance and associated anxiety. The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been shown to be considerable. Among the evidencebased psychological treatments for complex mental ill-health, Cognitive Behavioral Therapy for psychosis (CBTp) has been supported with particularly promising research outcomes. Yet, despite such encouraging empirical data, the treatment provision often remains insufficient, predominantly among individuals with more acute presentations. Likewise, literature demonstrating the actual utilization of CBTp with complex psychoses appears above all relevant to the daily clinical practice in the specialism of severe mental ill-health. This methodologically rigorous case study describes a successful implementation of CBTp undertaken with a socially withdrawn individual diagnosed with paranoid schizophrenia and comorbid agoraphobic anxiety disorder. The intervention focused on cognitive restructuring of paranoid appraisals of voices and graded behavioral exposure to anxiety-inducing stimuli. Standardized measurement, behavior frequency sampling, and subjective data were utilized to evaluate the outcomes, indicating a considerable reduction in both paranoia and associated anxiety, and an overall improvement in the client's behavioral and interpersonal functioning. The article highlights the importance of direct intellectual engagement with the content of paranoia, alongside methodically facilitated graded behavioral exposure and response prevention in the treatment of severe, socially debilitating psychoses with comorbid mood disorders.

The Effectiveness of Cognitive Behavior Group Counseling to Improve Career Decision Making Self-Efficacy of Senior High School Students

“…These findings are in accordance with the cognitive behavior counseling theory which emphasizes that humans have the potential to absorb rational and irrational thinking, where irrational thinking can cause emotional disturbances and deviant behaviour [18,20,21]. Therefore, in this study, the first focus in the CBGC intervention is understanding and correcting the cognition of members who are still irrational.…”

“…CBCG emphasizes on dysfunctional cognitive restructuring. Changes between warming that occur changes that trigger doubtful decision-making problems that arise by students will quickly decrease, so that students can think, act, and act appropriately and can make a steady career [17,18,19].…”

Keefektifan Teknik Cognitive Restructuring untuk Meningkatkan Kejujuran Akademik Siswa Sekolah Menengah Atas

“…Berdasarkan hasil pengamatan yang dilakukan oleh guru mata pelajaran, IR, MAC, dan GSA menjadi lebih tenang dalam menghadapi ujian dan tidak melakukan aktivitas lain yang mengarah pada kecurangan. Hal ini sejalan dengan penelitian terdahulu bahwa pikiran serta persepsi positif terhadap diri menjadikan individu mampu bersikap dan bertindak lebih baik, menjadi pribadi yang lebih sehat, tidak mengintimidasi diri, serta selalu menjadi jiwa yang positif (Aliem et al, 2020;Chrétien et al, 2017;Mankiewicz, 2019;Marasigan, 2019;Saputra, 2017).…”

“…Konseling dengan teknik cognitive restructuring sangat sesuai digunakan untuk konseli dengan masalah distorsi kognitif dan pikiran yang disfungsional. Sedangkan rendahnya kejujuran akademik siswa muncul akibat proses berpikir siswa yang salah atau tidak sesuai dengan harapan lingkungan (Karekla et al, 2020;Mankiewicz, 2019).…”

Cognitive Behavioral Therapy for Foreign Accent Syndrome: A Single-Case Experimental Design

“…Cognitive restructuring was certainly a mechanism of change for Becky and is recommended to others working with people with FAS. As Mankiewicz (2019) denotes, recovery can be achieved when formulation-driven cognitive restructuring occurs in the context of a positive therapeutic relationship. As this remains an under-researched area, it is recommended that clinicians and students consider undertaking SCED studies in future and ensure that follow-up data are collected to assess the stability of change over time.…”