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1 results

  • 23 - Treating Complexity and Comorbidity in Anxiety Disorders and Depression

  • from Part Five - Complexity and Comorbidity in Anxiety Disorders and Depression:
  • Edited by Gillian Todd, University of East Anglia, Rhena Branch, University of East Anglia
  • Book:
    Evidence-Based Treatment for Anxiety Disorders and Depression
    Published online:
    06 January 2022
    Print publication:
    13 January 2022, pp 475-504

  • Summary

    An effective, parsimonious way to treat patients who present with comorbid conditions and other complexities is to use process-based, generic CBT employing case conceptualization. This approach allows therapists to assess and target the patient’s maladaptive processes in functioning that may underlie several areas of diagnostic concern, and whose remediation may produce multiple clinical benefits. The case conceptualization serves as a road map to understand the patient’s subjective phenomenology, thus facilitating well-targeted interventions and abetting the therapeutic relationship. The case of Zina demonstrates how the patient’s avoidance strategies and maladaptive schemas played roles in her mood disorder (with suicidality), anxiety, eating disorder, substance use, and purging – and how all of these interfered with her life goals. The therapist prioritized Zina’s safety and attended closely to the therapeutic relationship. The case conceptualization helped illuminate ways to enhance Zina’s participation in treatment (including pharmacotherapy). Eighty sessions produced positive results.