Modified Exposure and Response Prevention for the Treatment of Comorbid OCD-Like Repetitive Behavior and Developmental Disability: A Case Study
Adults with developmental disabilities are particularly vulnerable to experiencing obsessive-compulsive disorder (OCD). However, the application of evidence-based treatments such as Exposure and Response Prevention (ERP) to individuals with comorbid OCD and developmental disabilities is a relatively new and emerging field of study. The present article presents a case study of modified ERP for the treatment of an adult woman with comorbid OCD-like repetitive behavior and developmental disabilities. Target behaviors, including OCD-like repetitive behavior, verbal agitation, and physical aggression, decreased over the course ...
Source: Clinical Case Studies - October 31, 2016 Category: Psychiatry Authors: Benson, R., Stickney, L., Smetter, J., Steglitz, J. Tags: Articles Source Type: research
Home-Based In Vivo Desensitization Treatment of Bathroom Avoidance in a Child With Autism Spectrum Disorder
We report the case of a 7-year-old boy who had autism spectrum disorder and displayed disruptive and avoidant behavior when using the bathroom at home with people present in adjoining rooms or nearby the bathroom door. Desensitization treatment was implemented by gradually exposing the boy to proximity of an in-home therapist when he was in the bathroom and positively reinforcing the absence of disruptive behavior. Treatment effectively eliminated bathroom avoidance and generalized to settings outside the home. Intervention outcome was maintained 6- and 7-months post-treatment. (Source: Clinical Case Studies)
Source: Clinical Case Studies - October 31, 2016 Category: Psychiatry Authors: Flood, W. A., Luiselli, J. K. Tags: Articles Source Type: research
Cognitive-Behavioral Therapy for a 9-Year-Old Girl With Disruptive Mood Dysregulation Disorder
Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis in the field of childhood onset disorders. Characterized by both behavior and mood disruption, DMDD is a purportedly unique clinical presentation with few relevant treatment studies to date. The current case study presents the application of cognitive-behavioral therapy (CBT) for anger and aggression in a 9-year-old girl with DMDD, co-occurring attention deficit hyperactivity disorder (ADHD), and a history of unspecified anxiety disorder. At the time of intake evaluation, she demonstrated three to four temper outbursts and two to three episodes of ...
Source: Clinical Case Studies - October 31, 2016 Category: Psychiatry Authors: Tudor, M. E., Ibrahim, K., Bertschinger, E., Piasecka, J., Sukhodolsky, D. G. Tags: Articles Source Type: research
Family-Based Cognitive-behavioral Therapy for an Intelligent, Elementary School-Aged Child With Generalized Anxiety Disorder
This case study follows an 8-year-old Caucasian female who presented with symptoms of Generalized Anxiety Disorder (GAD). Given this child’s age but advanced cognitive skills, careful selection of an appropriate treatment was made. In the current case study, a family-based cognitive–behavioral therapy intervention (Wood & McLeod, 2008) was implemented to treat this child’s symptoms of GAD. Following completion of the intervention, the child demonstrated significant decreases in her symptoms. In addition, she demonstrated a thorough understanding of coping skills, successfully applied and generalized h...
Source: Clinical Case Studies - October 31, 2016 Category: Psychiatry Authors: Kolomeyer, E., Renk, K. Tags: Articles Source Type: research
Culturally Responsive Cognitive Behavioral Therapy: Making the Case for Integrating Cultural Factors in Evidence-Based Treatment
This study provides evidence of the value of initiating discussion of cultural factors at the beginning of treatment to shape the direction of evidence-based treatment. The study also suggests that integrating cultural factors with African American clients is important and does not reduce the quality of care or diminish from the fidelity of the evidence-based treatment. Based on these findings, recommendations for researchers and clinicians are also discussed. (Source: Clinical Case Studies)
Source: Clinical Case Studies - October 31, 2016 Category: Psychiatry Authors: Zigarelli, J. C., Jones, J. M., Palomino, C. I., Kawamura, R. Tags: Articles Source Type: research
FBT With Adjunctive Parent Emotion Coaching in an Adolescent Male With Anorexia Nervosa
Family-based therapy (FBT) is the gold standard of treatment for adolescents with anorexia nervosa (AN) and has shown to be more effective than other forms of treatment in several randomized controlled trials. However, FBT is a behaviorally based intervention that does not explicitly address emotional distress often exhibited by patients and their parents. This case study describes the treatment of a 14-year-old adolescent male with AN using FBT as the primary treatment modality. We also implemented an adjunctive treatment designed to address parents’ emotion communication skills (ECSs) to reduce emotion dysregulatio...
Source: Clinical Case Studies - September 6, 2016 Category: Psychiatry Authors: Peterson, C. M., Fischer, S., Loiselle, K., Shaffer, A. Tags: Articles Source Type: research
The Blending of Evidenced-Based Protocols in the Treatment of Borderline Personality Disorder: A Case Study
Borderline personality disorder (BPD) is regarded as one of the more difficult clinical presentations to treat, and psychotherapy provides the best outcomes for those suffering with BPD. Dialectical behavioral therapy (DBT) and schema-focused therapy (SFT) are two of the most common evidenced-based treatments for borderline pathology. While these treatments are often used individually, some theorists argue that blended approaches to care could provide more benefit to some clients than just one treatment package alone. The present case study illustrates a blended approach to the treatment of BPD. Specifically, DBT and SFT w...
Source: Clinical Case Studies - September 6, 2016 Category: Psychiatry Authors: Loveless, J. P., Whited, M. C., Rhodes, A. C., Cellucci, T. Tags: Articles Source Type: research
Treating Trichotillomania: Successful Application of Manualized Cognitive-Behavioral Therapy
Trichotillomania (TTM) involves the compulsive pulling of one’s bodily hair and is often associated with significant distress or impairment. The present case study concerns a college-aged woman, whose history of TTM extended over 5 years and had been unsuccessfully treated by psychotherapy and medication management. Although TTM can be a challenging disorder to treat, the literature indicates that cognitive-behavioral therapy (CBT) has been successful in this regard. Therefore, we implemented CBT based on the manual developed by Keuthen, Stein, and Christenson; specific elements of therapy used included relaxation, s...
Source: Clinical Case Studies - September 6, 2016 Category: Psychiatry Authors: Lootens, C. M., Nelson-Gray, R. O. Tags: Articles Source Type: research
Brief Behavioral Activation for Adolescent Depression: Working With Complexity and Risk
Given the long-term negative outcomes associated with depression in adolescence, there is a pressing need to develop brief, evidence-based treatments that are accessible to more young people experiencing low mood. Behavioral Activation (BA) is an effective treatment for adult depression; however, little research has focused on the use of BA with depressed adolescents, particularly with briefer forms of BA. In this article, we outline an adaptation of brief Behavioral Activation Treatment of Depression (BATD) designed for adolescents and delivered in eight sessions (Brief BA). This case example illustrates how a structured,...
Source: Clinical Case Studies - September 6, 2016 Category: Psychiatry Authors: Pass, L., Whitney, H., Reynolds, S. Tags: Articles Source Type: research
Comprehensive Treatment: Intensive Exposure Therapy for Combat-Related PTSD and Comorbid Conversion Disorder
This clinical case describes the assessment and treatment of Roger, a 31-year-old veteran who served in Operation Iraqi Freedom. In addition to combat-related post-traumatic stress disorder (PTSD), Roger presented with a conversion disorder (globus pharyngeus) and avoidance of consuming solid food without also consuming alcohol. A multicomponent treatment program for PTSD, trauma management therapy (TMT), was provided 5 times per week over a 3-week period. TMT included daily-exposure therapy (EXP) as well as daily social and emotion regulation (SER) group therapy to target anger, social withdrawal, and depression. In addit...
Source: Clinical Case Studies - September 6, 2016 Category: Psychiatry Authors: Neer, S. M., Trachik, B., Munyan, B. G., Beidel, D. C. Tags: Articles Source Type: research
Treating Emetophobia and Panic Symptoms in an Adolescent Female: A Case Study
Emetophobia is an understudied specific phobia, especially during the developmental stage of adolescence. Adult and child literatures suggest that a combined approach of psychopharmacological and cognitive-behavioral interventions may be an efficacious treatment for emetophobia. Despite evidence supporting the success of this therapeutic approach, research assessing treatment outcomes of adolescent populations with the disorder remains limited. The current study presents a case study of the successful use of combined treatment for emetophobia in an adolescent female. Therapy included psychoeducation, cognitive restructurin...
Source: Clinical Case Studies - July 7, 2016 Category: Psychiatry Authors: Fix, R. L., Proctor, K. B., Gray, W. N. Tags: Articles Source Type: research
Intensive Family-Based Therapy During an Acute Medical Admission for Anorexia Nervosa: A Case Report
Family-based therapy (FBT) is the evidence-based treatment of choice for anorexia nervosa (AN) in adolescents, with numerous studies providing support for its efficacy in the outpatient realm. This case report describes the application of a brief FBT intervention during an inpatient medical admission for an adolescent presenting with medical instability secondary to new onset AN. The intensive, four-session FBT-guided intervention included (a) psychoeducation and illness externalization, (b) parent skills training, (c) meal coaching, and (d) behavioral contracting. Self-report assessment and anthropometric data collected a...
Source: Clinical Case Studies - July 7, 2016 Category: Psychiatry Authors: Matthews, A., Peterson, C. M. Tags: Articles Source Type: research
The Use of Both Prolonged Exposure and Cognitive Processing Therapy in the Treatment of a Person With PTSD, Multiple Traumas, Depression, and Suicidality
Despite a high prevalence of comorbid disorders such as major depressive disorder (MDD), the empirical guidelines for how to manage co-occurring conditions in the treatment of posttraumatic stress disorder (PTSD) are lacking. In the context of a complicated presentation of PTSD, this case illustration demonstrates the application of an integrated treatment approach with "Amanda," a 28-year-old female with a history of multiple traumas, undiagnosed PTSD for 10 years, and comorbid MDD. In addition, Amanda began having suicidal thoughts mid-treatment. This case study demonstrates how the integration of coping skills training ...
Source: Clinical Case Studies - July 7, 2016 Category: Psychiatry Authors: Gurak, K. K., Freund, B., Ironson, G. Tags: Articles Source Type: research
Decreasing PTSD and Depression Symptom Barriers to Weight Loss Using an Integrated CBT Approach
This is a single-case study of an obese African American female Veteran who has posttraumatic stress disorder (PTSD) and depression. Her presenting psychological symptoms included clinically significant night terrors, insomnia, low self-worth, low motivation, and social isolation. Poor dietary and physical activity responses to her psychological symptoms contributed to her weight gain, as well as interfered with weight-loss efforts. A telephone-based cognitive behavioral treatment integrating mental and behavioral health principles was provided. Over the course of eight sessions, the Veteran learned psychological symptom a...
Source: Clinical Case Studies - July 7, 2016 Category: Psychiatry Authors: Trahan, L. H., Carges, E., Stanley, M. A., Evans-Hudnall, G. Tags: Articles Source Type: research
Persistent Family Stress in the Course of Cognitive-Behavioral Therapy for a 7-Year-Old Girl With Social Anxiety Disorder
This case study describes the use of cognitive-behavioral therapy (CBT) for a 7-year-old girl, "Lauren," who was diagnosed with social anxiety disorder (SAD) and was experiencing significant family stress. Manualized CBT was conducted and substantial reductions in SAD symptoms and impairment were demonstrated. Given additional difficulties remaining in the home setting, booster sessions were continued following manualized treatment to target Lauren’s functioning at home. These follow-up sessions were associated with maintained functioning, and only minimal additional benefits emerged. This case study calls attention ...
Source: Clinical Case Studies - July 7, 2016 Category: Psychiatry Authors: Babinski, D. E., Nene, N. V. Tags: Articles Source Type: research
