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Imagery-Based Cognitive Therapy for Trauma and PTSD

Mervin Smucker
November 15, 2013
110

Imagery-Based Cognitive Therapy for Trauma and PTSD

Mervin Smucker

November 15, 2013
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  1. 1
    Imagery-Based Cognitive
    Therapy for Trauma and PTSD

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  2. 2
    Cognitive Therapy Model
    (Beck)
    Mental Activity consists of
    • Words or Phrases
    Thoughts  verbal cognitions
    (e.g. depression)
    • Mental Pictures
    Images  visual cognitions
    (e.g. anxiety)

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  3. 3
    Earliest CBT Applications of Imagery
    Beck et. al. (1985)
    Imagery Modification techniques used to activate,
    challenge, and modify distressing images
    - Repetition, De-catastrophization, Exaggeration
    of negative images
    - Time Projection
    - Imaginal Cognitive Flooding
    - Substituting Positive Imagery
    - Coping Imagery
    - Goal Rehearsal Imagery

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  4. 4
    Cognitive Therapy (Beck)
    • If affective disturbance is encoded verbally,
    use verbal techniques for cognitive
    restructuring
    • If affective disturbance is embedded in
    imagery, use imagery techniques for
    cognitive restructuring

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  5. 5
    IMAGERY (when skillfully applied)
    • Can access a client’s affective distress and
    related underlying cognitive structures not
    previously available for scrutiny
    • Can enable these structures to be identified,
    challenged, and modified in new ways

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  6. 6
    Verbal Processing of Distressing
    Imagery (outside reliving)
    • Often less effective
    • Too intellectual, superficial
    • Doesn’t really get at the deep stuff
    “I understand it my head, but I don’t
    feel it in my gut”

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  7. Imagery-Based Cognitive Therapy
    with Trauma
    • involves varying amounts of
    – visual imagery
    – exposure
    – cognitive restructuring
    • focus on emotional and cognitive processing
    of trauma-related material

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  8. Targeted Trauma-Related Cognitions
    in Imagery-based Cognitive Therapy
    • Intrusive memories, recurring flashbacks, repetitive
    nightmares
    • Maladaptive trauma-related beliefs
    • Avoidance behaviors
    • Maladaptive self-calming / affective self-regulation
    strategies

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  9. Empirically-Supported Imagery-based
    Cognitive Treatments for PTSD
    • Prolonged Exposure (PE)
    • Imagery Rescripting and Reprocessing
    Therapy (IRRT)
    • Cognitive Restructuring within Reliving

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