J.T.Stocks, Ph.D1J.T. Stocks, Ph.D. 1Internalizing DisordersInternalizing DisordersJ.T. Stocks, Ph.D. 2DepressionDepressionJ.T. Stocks, Ph.D. 3Depression/Depression/DysthymiaDysthymia//Melancholy/SadnessMelancholy/Sadness!Affective"dysphoria, mood change, weepiness, apathy!Cognitive"low self-esteem, guilt, indecision, pessimism!Motivational"escape/avoidance, passivity, low energy, decreased socialization!Vegetative & Psychomotor"sleep &/or appetite disturbance, somatic complaintsJ.T. Stocks, Ph.D. 4Depression InterventionsDepression Interventions!Social Skills Training!Activity-Level Increase Programs!Attribution Retraining!Cognitive Therapy!Self-Control TherapyJ.T. Stocks, Ph.D. 6Depression: Social Skills TrainingDepression: Social Skills Training!Shaping!Modeling!Direct TrainingJ.T. Stocks, Ph.D. 7Depression: Activity Increase ProgramDepression: Activity Increase Program!Baseline mood and activity level!Identify activities associated with positive mood and those associated with negative mood!Increase the activities associated with positive mood!Decrease the activities associated with negative mood!Set up environmental contingencies to reinforce increased “positive” activity and decreased “negative” activityJ.T.Stocks, Ph.D2J.T. Stocks, Ph.D. 8Depression: Attribution RetrainingDepression: Attribution Retraining!Environmental enrichment!Personal control training!“Resignation” training!Attribution retrainingJ.T. Stocks, Ph.D. 9Depression: Cognitive TherapyDepression: Cognitive Therapy!Recognizing connection between cognition, emotion, and behavior.!Monitoring negative automatic thoughts. !Examining evidence for and against distorted automatic thoughts.!Substituting more reality oriented interpretations for distortions.!Learning to identify and modify dysfunctional beliefs.J.T. Stocks, Ph.D. 10Depression: Special Issues with Depression: Special Issues with ChildrenChildren!Involve family of origin"Parents as co-therapists"Parents’ own cognitive distortions!Take into account child’s level of cognitive developmentJ.T. Stocks, Ph.D. 11Depression: SelfDepression: Self--Control TherapyControl Therapy!Increase behaviors/cognitions associated with improved mood!Identify immediate and delayed consequences of own actions!Set more reasonable self-standards!Make more appropriate attributions!Make more contingent self-reinforcementJ.T. Stocks, Ph.D. 12 J.T. Stocks, Ph.D. 13AnxietyAnxietyJ.T.Stocks, Ph.D3J.T. Stocks, Ph.D. 14Loss of support, loud noises.0-6 monthsFrom Morris, R.J. & Kratochwill, T.R. (1983). Treating children's fears and phobias: A behavioral approach. Elmsford, NY: Pergamon PressTests and examinations in school, school performance, bodily injury, physical appearance, thunder and lightning, death, dark (low percentage).9-12 yearsSupernatural beings, dark, fears based upon media events, staying alone, bodily injury.7-8 yearsSupernatural beings, bodily injuries, thunder and lightning, dark, sleeping or staying alone, separation from parent.6 yearsAnimals, "bad" people, dark, separation from parent, bodily harm.5 yearsParent separation, animals, dark, noises (including at night).4 yearsMasks, dark, animals, separation from parent.3 yearsMany fears including loud noises, animals, dark rooms, separation from parent, large objects/machines, change in personal environment.2 yearsSeparation from parent, toilet, injury, strangers.1 yearFear of strangers, fear of sudden, unexpected, and looming objects.7-12 monthsFearAgeJ.T. Stocks, Ph.D. 15Anxiety/Anxiety State/Fear/Anxiety/Anxiety State/Fear/Clinical Fear/Phobia/Phobic ReactionClinical Fear/Phobia/Phobic Reaction!Motor Reactions"avoidance, escape, tentative approach, trembling voice, crying, stuttering!Cognitive/Verbal Reactions"reports discomfort/distress/terror, self-deprecatory thoughts, thoughts of inadequacy!Physiological Reactions"faster heart rate, heart palpitations, sweating, rapid breathing, nausea, headacheJ.T. Stocks, Ph.D. 16Anxiety InterventionsAnxiety Interventions!Systematic Desensitization and Variations!Prolonged Exposure!Modeling!Contingency Management!Cognitive-Behavioral ApproachesJ.T. Stocks, Ph.D. 17Anxiety: Anxiety: Systematic DesensitizationSystematic Desensitization!Develop Anxiety Hierarchy!Relaxation Training!Exposure SessionsJ.T. Stocks, Ph.D. 18Anxiety: Prolonged ExposureAnxiety: Prolonged Exposure!Imaginal Exposure!In VivoExposure!Implosion!Reinforced PracticeJ.T. Stocks, Ph.D. 19Anxiety: ModelingAnxiety: Modeling!Live Modeling!Symbolic Modeling!Covert Modeling!Participant ModelingJ.T.Stocks, Ph.D4J.T. Stocks, Ph.D. 20Anxiety: Contingency ManagementAnxiety: Contingency Management!Positive Reinforcement!Shaping!Stimulus Fading!ExtinctionJ.T. Stocks, Ph.D. 21Anxiety: Cognitive/Behavioral Anxiety: Cognitive/Behavioral ApproachesApproaches!Self Instruction Training (SIT)"cognitive modeling"overt, external guidance"overt, self-guidance"faded, overt self guidance"covert self-instructionJ.T. Stocks, Ph.D. 22Anxiety: Cognitive/Behavioral Anxiety: Cognitive/Behavioral ApproachesApproaches!Cognitive Therapy (CT)"Identify dysfunctional thoughts"Challenge dysfunctional thoughts"Replace then with beneficial thoughtsJ.T. Stocks, Ph.D. 23Anxiety: Cognitive/Behavioral Anxiety: Cognitive/Behavioral ApproachesApproaches!REBT"Assessment"Teaching REBT Principles"Modifying Specific Irrational