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Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions
Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions

Section 28
Appendix: Reproducible Client Worksheets

CEU Answer Booklet | Table of Contents
| Phobias
Psychology CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs, Nurse CEUs

Counting Automatic Thoughts
Review CD track 2 for more information regarding this technique.
Client reviews and utilizes the following procedures to overcome anxiety as a coping response to a feared stimulus.
1.  Obtain a stack of 3x5 cards or a counting device.
2.  Each time an automatic thought surfaces, write it down or count it.
3.  Think, ‘Well, there’s another fearful thought.  I’ll just count it and let it go.’
4.  Keep track of the number of automatic thoughts on a day to day basis to monitor your productivity.

Third Person Referencing
Review CD track 4 for more information regarding this technique.
Client reviews and utilizes the following procedures to increase self awareness.
1.  Refer to yourself by your first name.
2.  Comment on your phobic condition from a distance.

The Thought Record
Review CD track 4 for more information regarding this technique.
Client reviews and utilizes the following procedures to become aware of thinking between sessions.
1.  Record situations in which you feel anxious.
2.  Thank yourself for each fear producing thought that you record.
3.  Track the fears back to the original stimulus.

The Three Column Technique
Review CD track 5 for more information regarding this technique.
Client reviews and utilizes the following procedures to begin to identify thinking errors.
1.  Divide a sheet of paper into three columns.
2.  In the first column, describe the stimulus which triggers your phobia.
3.  In the second column, identify the accompanying automatic thoughts.
4.  In the third column, identify possible errors in your thinking.
5.  Or you can use the third column to comment on your thinking as an objective observer.

Hypothesis Testing
Review CD track 5 for more information regarding this technique.
Client reviews and utilizes the following procedures to disprove catastrophic predictions. 
1.  Write out predictions of dire consequences for later evaluation.
2.  Test as many maladaptive hypotheses as possible.
3.  Try to keep a no lose attitude regarding the experiments because no matter what the outcome, you can obtain useful data. 

Enlarging Perspective
Review CD track 6 for more information regarding this technique.
Client reviews and utilizes the following procedures to gain a broader perspective on the phobia stimulus. 
1.  Figure out what is causing the phobia.
2.  What is the purpose of being afraid of the given situation or stimulus?
3.  If you stick out the pain, you can put into practice the principle of getting better instead of feeling better. 
4.  Remember that pleasure follows pain, so you will likely feel good soon.

Action Strategies for Agoraphobia
Review CD track 6 for more information regarding this technique.
Client reviews and utilizes the following procedures to move from choosing to accept the phobia.
1.  Line up your images, choices, feelings, and actions and move them in concert toward acceptance.  When one of the three is out of line, focus on the other two.
2.  Act as if you accept the current reality.  Ask yourself what needs to be done behaviorally to reach acceptance, then do it.

Decentering
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures to challenge the basic belief that he or she is the focal point of social events.
1.  Adopt the perspective of a third party.
2.  If you believe others are watching you closely, consider how closely you are watching them.
3.  Consider that if your observations of others are limited, then it follows that the attention of most people is similarly restricted.

Time Projection
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures to overcome a social phobia.
1.  Think of the feared situation. 
2.  Project yourself into the future.
3.  Envision the feared situation occurring several months form now.
4.  Envision the feared situation occurring a year from now.
 
The Initiation Technique
Review CD track 14 for more information regarding this technique.
Client reviews and utilizes the following procedures to take a first step that will lead to direct contact with the feared situation.
1.  Make some move toward confrontation, such as telling a close friend when you are going to do it.
2.  When you feel as though you cannot follow through, remember what you told your friend.
3.  Remember that these commitments can never be more than serious intentions.  The unexpected can get in the way of even the most serious intentions.  While we try to follow through on our serious intentions, it is not always possible to do so.

Cognitive Avoidance
Review CD track 14 for more information regarding this technique.
Client reviews and utilizes the following procedures to prevent the use of cognitive avoidance strategies.
1.  Avoid thought stopping strategies such as ‘Don’t think about it.’ 
2.  Expose yourself mentally, physically, and emotionally.
3.  Draw a triangle with your thoughts, feelings, and optional actions at the three points. 
4.  Draw arrows between these points.
5.  Focus on the importance of getting all three systems going in the same direction. 

The Critical Decision Technique
Review CD track 14 for more information regarding this technique.
Client reviews and utilizes the following procedures to face his or her fears.
1.  Even though going with feelings or instincts is a good idea most of the time, critical decision phobic situations may require you to do the exact opposite.
2.  Force yourself to move forward. 
3.  Approach instead of avoid. 
4.  When you want to protect yourself, you make yourself more vulnerable.

 
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