Tailoring Therapy for Gender and Sexual Minority Clients

December 20, 2017

Portland Psychotherapy Team

Clients with minority identities related to their sexual orientation or gender seek therapy for a variety of concerns, and many therapists use the evidence-based approaches they are most comfortable with to respond to the presenting symptoms. The impact of possessing a stigmatized identity, encountering discrimination, or witnessing political debates regarding one’s belonging in society lead to vulnerabilities and challenges that set these clients apart. Some of the most researched difficulties experienced by gender and sexual minorities that traditional treatment packages may not respond to are internalized stigma, rejection sensitivity, and shame. When Our Worst Thoughts are About Ourselves Internalized stigma (i.e., internalized homophobia, biphobia, or transphobia) refers to those attitudes or stereotypes about a minority group present in our culture Read more

A look at the future of Acceptance and Commitment Therapy

November 7, 2017

Jason Luoma, Ph.D.

After many hours of work, the second edition of Learning ACT is out! I’m so thankful to all those who helped in its revision, putting in many hours of work and making fantastic suggestions for how to improve it. Thanks so much to those who resulted in this much improved book. Here’s a list of the key changes in the second edition: Most of the core competency exercises were updated based on reader feedback Experiential exercises added or updated The case conceptualization process and form was updated The flexible perspective taking/self-as-context chapter was completely rewritten A new chapter on considering culture in using ACT A new appendix on using ACT in different settings New audio recordings of exercises New videos Read more

Interoceptive Exposure in OCD Treatment

August 7, 2017

Brian Thompson Ph.D.

Interoceptive exposure (IE) involves using exercises (e.g., hyperventilation) to deliberately evoke feared bodily sensations (e.g., shortness of breath; tightness in chest). It is most commonly associated with panic disorder treatment. In a recent paper, anxiety disorders expert and UNC professor Dr. Jonathan Abramowitz and his grad student Shannon Blakely make a case for its use in OCD treatment. Anxiety Sensitivity as a Transdiagnostic Process At the 2016 International OCD Foundation Conference, I attended a workshop by the authors on this topic. They talked about anxiety sensitivity. Anxiety sensitivity refers to proneness towards interpreting physical symptoms of anxiety (e.g., increased heart rate) as signs of something dangerous (e.g., heart attack). People with anxiety sensitivity may assume that their anxiety is a Read more

SUDS vs. Willingness: Values-Based ACT Exposure for OCD

July 17, 2017

Brian Thompson Ph.D.

Throughout the years, I’ve written a series of blogs posts on exposure therapy, including the use of exposure therapy in Acceptance and Commitment Therapy. In the absence of much guidance on using exposure in ACT, I co-authored a theoretical paper on its use in treating PTSD. Recently I read an excellent paper outlining the use of ACT and exposure for OCD. Exposure therapy for OCD from an Acceptance and Commitment Therapy framework The article is a collaboration of 2 major research labs: Utah State professor Michael Twohig, a pioneer in the use ACT for OCD, and Jonathan Abramowitz, a professor at the University of North Carolina – Chapel Hill, and an incredibly prolific researcher in the field of anxiety. The Read more

A common figure for the dropout rate of exposure and response prevention (ERP) for people with obsessive-compulsive disorder is about 25%.  During one OCD workshop I attended, 2 different presenters insinuated that these high rates of dropout were the result of one particularly overzealous researcher who pushed clients too hard! They suggested that, anecdotally, most people with OCD can tolerate exposure-work reasonably well. A recent study from Utah State professor Michael Twohig’s lab decided to take a closer look at this. Meta-Analysis The researchers collected 21 studies of ERP for OCD and conducted a meta-analysis of dropout rates. In a meta-analysis, researchers try to compute variables in order to compare results across multiple studies with different methodologies. The researchers looked Read more