Biomedical subjects

Cory F Newman

Publications and source records attributed to Cory F Newman.

7 recordsLinked to original sources

PubMed2006

Hypothesized mechanisms of change in cognitive therapy for borderline personality disorder.

Preliminary evidence suggests that cognitive therapy (CT) is effective in treating borderline personality disorder (BPD). According to cognitive theory, BPD patients are characterized by dysfunctional beliefs that are relatively enduring and inflexible and that lead to cognitive distortions such as dichotomous thinking. When these beliefs are activated, they lead to extreme emotional and behavioral reactions, which provide additional confirmation for the beliefs. It is hypothesized that a change in dysfunctional beliefs is the primary mechanism of change associated with CT. However, additional mechanisms of change are likely also at work in CT, including enhancement of skills, reduction in hopelessness, and improvement in attitude toward treatment. Each of these mechanisms is discussed in light of cognitive theory, data from an open clinical CT trial, relevant literature, and therapeutic interventions. Findings from the CT trial support the role of cognitive change during therapy and its continuation after termination.

Attitude to Health↗

PubMed2006

Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive-compulsive personality disorders.

Participants were 30 adult outpatients diagnosed with avoidant personality disorder or obsessive-compulsive personality disorder who enrolled in an open trial of cognitive therapy for personality disorders. Treatment consisted of up to 52 weekly sessions. Symptom evaluations were conducted at intake, at Sessions 17 and 34, and at the last session. Alliance variables were patients' first alliance rating and "rupture-repair" episodes, which are disruptions in the therapeutic relationship that can provide corrective experiences and facilitate change. Stronger early alliances and rupture-repair episodes predicted more improvement in symptoms of personality disorder and depression. This work points to potentially important areas to target in treatment development for these personality disorders.

Adult↗

PubMed2005

After the attempt: maintaining the therapeutic alliance following a patient's suicide attempt.

The risk of a patient's suicide is a prominent occupational hazard for psychotherapists. The precise number of patients who attempt suicide while in treatment and then resume therapy with the same therapist is not known, but this situation is a relatively common occurrence in clinical practice. Such scenarios can pose significant challenges to the reestablishment of the therapeutic trust and a workable treatment alliance. The aim of this paper is to identify the challenges facing a clinician treating a patient who resumes therapy following a serious suicide attempt, and to offer guidelines for maintaining the viability of the therapeutic alliance.

Humans↗

PubMed2004

An open clinical trial of cognitive therapy for borderline personality disorder.

Although borderline personality disorder (BPD) is a major public health concern, psychotherapeutic trials have been limited. The present uncontrolled clinical trial examines whether cognitive therapy for BPD is associated with significant improvement on measures of psychopathology. A total of 32 patients with BPD, who also reported suicide ideation or who engaged in self-injury behavior, received weekly cognitive therapy sessions over a 1-year period as described by Layden et al. (1993). The results revealed significant and clinically important decreases on measures of suicide ideation, hopelessness, depression, number of borderline symptoms and dysfunctional beliefs at termination and 18-month assessment interviews. Implications for further research with this difficult-to-treat patient population are discussed.

Adult↗

PubMed2003

Cognitive therapy for chronic depression.

Recent literature indicates that there are important clinical differences between chronic and non-chronic depression. This article considers the implications of these differences when conducting cognitive therapy (CT) with chronically depressed patients. CT with chronic patients requires a greater emphasis on combating hopelessness, helplessness, and perfectionism, addressing early life-adverse experiences, and modifying maladaptive schemas. In addition, the effectiveness of CT may be enhanced by focusing on patients' poor social skills, ineffective reasoning skills, and their depressive identity. The case example presented illustrates CT with a chronically depressed patient.

Chronic Disease↗

PubMed2002

A case illustration of resistance from a cognitive perspective.

Brian, a 36-year-old, single, white male, entered cognitive therapy in response to a depressive episode precipitated by the loss of a job. In addition to his Major Depression, the client met diagnostic criteria for Dysthymia and Personality Disorder Not Otherwise Specified. The first three sessions focused on Brian's unemployment crisis and related dysphoria, as well as his passive-avoidant approach to life. Brian collaborated with the therapist in formulating a treatment plan and quickly found a new job, whereupon he abruptly withdrew from therapy. Shortly thereafter, Brian contacted the therapist in a renewed state of "crisis" and returned for a fourth session. The therapist attempted to draw a link between Brian's passive-avoidant style and his vulnerability to problems such as those he currently was experiencing. The client had difficulty understanding the therapist's thread of logic, became somewhat defensive and combative, and did not return for further sessions.

Adult↗

PubMed2002

A cognitive perspective on resistance in psychotherapy.

The phenomena that comprise resistance in therapy are described and discussed from a cognitive viewpoint. The cases of Brian, Julie, and Victoria are reviewed to illustrate similar and contrasting manifestations of resistance, and suggestions for further individualized conceptualization and intervention are presented. Emphasis is placed on gaining an accurate, empathic understanding of the client's difficulties in changing. This is coupled with methods that allow the client some autonomy in charting the course of therapy, at the same time reinforcing the importance of the therapist's active involvement in educating and stimulating the client toward greater awareness and adaptability. In order to be maximally effective in encouraging such changes, therapists must be aware of their own tendencies to react adversely to client resistance. It is vital that therapists maintain their professionalism and confidence in persevering toward a better understanding of what will be helpful to their clients.

Adaptation, Psychological↗