Cognitive Behaviour Therapy (CBT) Gerhard Ohrband - ULIM University, Moldova 14th lecture CBT at school

Course Structure 1. Introduction: What is CBT? What are differences and similarities with other therapy schools? 2. Diagnostics in CBT 3. Classification of Psychological Disorders (ICD- 10, DSM-IV), Clinical Psychology (Etiology, prevalence, comorbidity and symptoms) 4. Etiological concepts in CBT: learning theories (classical and operant conditioning, vicarious learning, Mowrer’s Two-factor theory) 5. Systematic desensitization: in-vivo exposure and imaginatory 6. Aversion training: overt and covert

Course Structure 7. Response prevention: treating obsessive-compulsive disorder (OCD) 8. Social skills training: anger management, assertiveness training 9. Rational-emotive Therapy (RET) 10. Beck’s Cognitive Therapy for depression 11. Marital and Sex Therapy 12. Trauma Therapy: Expressive writing, work with affirmations, visualizations; working with victims of crimes, accidents and other difficult life-events 13. Relaxation techniques: yoga, meditation, Alexander technique, Feldenkrais 14. CBT at school: helping children with autism, hyperactivity, social phobia, social adjustment problems, learning difficulties and antisocial behaviour. 15. CBT in treating addiction and substance abuse

Attention deficit hyperactivity disorder (ADHD) Main features (Barkley, 1997): 1. Poor sustained attention 2. Impulsiveness 3. Hyperactivity There is evidence that ADHD runs in families, especially behaviourally disordered families (Faraone et al., 1997) It is six times more common in those children who had been sexually abused (Fergusson et al., 1996; Herrenkohl et al., 1997)

Prevalence ADHD occurs in 3 – 7 % of the child population Three times as many boys as girls exhibiting the disorder Between 50 and 80 % of children with disorder continue showing symptoms into adolescence % of affected adolescents showing symptoms in adulthood

Associated problems Because the nature of the disorder, the problems associated with it can be cognitively damaging Barkley, 1997: ADHD has been associated with Low academic achievement School performance Suspension/expulsion from school Poor family and peer relationships Mental disorder Substance abuse

Causes It is unclear why ADHD appears Different authors have associated social and family problems with the disorder Although determining cause and effect in these instances is difficult

Treatment Counselling Behaviour management Psychoactive medication

Disorders of emotional regulation Disorders of emotional regulation refer to problems that the child has in operating at an emotionally normal level Behavioural problems which impair the ability to undertake day-to-day activities For example: a child may be abnormally distressed, depressed, show sleep disturbance or feeding problems or exhibit anxiety

Classroom management techniques Contingency contracts Group consequence Token economies Time out

Literature Barkley, R.A. (1997). Behavioural inhibition, sustained attention and executive function: Constructing a unifying theory of ADHD. Psychological Bulletin, 121 (1), Faraone, S.V., Biederman, J., Jetton, J.G. and Tsuang, M.T. (1997). Attention deficit disorder and conduct disorder: Longitudinal evidence for a familial subtype. Psychological Medicine, 27,