Module 3: Managing the Cortex

Credit

Speaker

Catherine Pittman Ph.D., PhD, HSPP Related seminars and products

Saint Mary's College

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Target Audience

Objectives

1. Demonstrate to clients the neurological processes underlying anxiety in a clearly understandable manner that enhances client motivation.
2. Incorporate personalized goals to increase client engagement and focus client efforts on making lasting changes in the brain.
3. Characterize the differences between amygdala-based and cortex-based anxiety symptoms in order to select the most effective treatment interventions.
4. Individualize practical and evidence-based methods to resist anxiety and improve symptom management in clients.
5. Demonstrate strategies for calming the amygdala without use of medication to improve client level of functioning.
6. Recommend exposure-based strategies that change the amygdala responses to triggers to reduce anxiety symptoms.
7. Employ a variety of strategies to improve clinical outcomes utilizing evidence-based strategies that target cortex-based responding, including cognitive restructuring, psychoeducation, cognitive defusion, distraction, and mindfulness.
8. Differentiate symptom-producing cognitions characteristic of specific disorders, including Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, and Post-Traumatic Stress Disorder as it relates to case conceptualization.
9. Analyze the clinical implications of how SSRIs and SNRIs promote the process of treating anxiety.
10. Determine detrimental effects of benzodiazepines as it relates to anxiety treatment outcomes.
11. Differentiate between rebound anxiety and relapse symptoms to inform the clinician’s choice of treatment interventions.
12. Breakdown the key elements of mindfulness practices in managing symptoms of anxiety.
13. Present client education exercises that can be utilized in session to train clients in the use of mindfulness techniques.
14. Appraise common reactions to aversion and utilize clinical strategies to replace them with mindfulness.
15. Reframe exposure as an opportunity to teach the amygdala new responses in order to improve client engagement and treatment compliance.
16. Utilize clinical strategies for exposure that reduce avoidance and train clients to push through anxiety.
17. Employ effective strategies for reducing anxiety symptoms utilizing imaginal and in vivo exposure, including use of SUDS and attention to interceptive triggers.
18. Provide clinical strategies for managing comorbid depression that reduce worry, rumination, and common cognitive errors while promoting positive thinking and social interaction.
19. Use cognitive restructuring and cognitive strategies for managing symptoms of OCD and GAD that focus on scheduling obsession/worries and promote client acceptance of uncertainty.
20. Implement interventions in a clinical setting that use a reconsolidation approach to reactivate a symptom-producing memory and disconfirm it.

Outline

Module 3: Managing the Cortex

• Explaining the Cortex’s Role in Anxiety
  • How the cortex constructs reality for us
  • Describing the cortex and its functions in understandable terms
  • The fear/anxiety response comes from the amygdala, but the cortex can initiate the response
  • Using the concept “Don’t scare your amygdala”
  • Understanding and resisting the detrimental effects of anticipation
  • Teaching the appropriate use of worry to minimize its detrimental effects
• Managing the Cortex
  • Cortex management is essential for GAD, SAD, OCD, PTSD, and Depression
  • Identifying specific cognitions, beliefs, attitudes, associated with specific anxiety disorders
  • “Survival of the busiest” - understanding how to modify the cortex
  • Changes in cortex responses can occur through education, logic, argument, and experience
  • “You can’t erase:  You must replace.” 
  • Modifying interpretations and using coping thoughts to manage anxiety
  • The appropriate use of distraction
  • Right vs. left hemisphere interventions
  • Cognitive Therapy - modifying the cognitions mediating emotional responses
  • Cognitive fusion - recognizing the problem and how to use cognitive defusion
  • CBT cognitive restructuring approaches for targeting cortex-based processes
  • Mindfulness approaches to reducing anxiety, and their effect on the cortex
  • A cognitive model for approaching OCD

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