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By Gina Ulery

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The Heart and Soul of Change

The Heart and Soul of Change, 2nd Ed, is a new 8-hour book-based CEU course for psychotherapists.

The Heart and Soul of ChangeHow does psychotherapy work? As research on psychotherapy has accumulated, it has become increasingly clear that common factors like the therapeutic alliance constitute the primary mechanisms for change. This text reviews the empirical research literature, distills the common factors associated with change, and presents them in a clear and straightforward manner for practicing clinicians. Topics include client and therapist factors, the therapeutic alliance, the common factors approach, common factors within psychiatric drug treatment, outcome monitoring (practice-based evidence), and common factors for specific populations (youth psychotherapy, couple and family psychotherapy, and substance abuse/dependence treatment). This CE test is based on the book “The Heart and Soul of Change (2nd Edition): Delivering What Works in Therapy” (2009, 455 pages). The book can be purchased from Amazon.

CE Credit: 8 Hours
Target Audience: Psychologists | Counselors | Social Workers | Marriage & Family Therapists (MFTs)
Learning Level: Advanced
Course Type: Test Only $50

Professional Development Resources is approved as a provider of continuing education by the Association of Social Work Boards (ASWB #1046); the National Board of Certified Counselors (NBCC #5590); the American Psychological Association (APA); the National Association of Alcoholism & Drug Abuse Counselors (NAADAC #000279); the Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346); the California Board of Behavioral Sciences (#PCE1625); the Texas Board of Examiners of Marriage & Family Therapists (#114); the South Carolina Board of Professional Counselors and Marriage & Family Therapists (#193); and the Ohio Counselor, Social Worker and Marriage & Family Therapist Board (#RCST100501).

Internet Pornography Addiction Causes Discomfort for Some Therapists

By Stefanie Carnes, PhD

Internet Pornography Addiction Causes Discomfort for Some TherapistsWhen a client enters your office complaining of internet pornography addiction, your first response may be to run, hide from him or to refer him to another therapist. For many therapists discomfort in dealing with sexual issues will keep them from asking the most important question: “What kind of internet pornography are you viewing?”

Consider the difference in the pathology of the patient viewing videos of women being degraded and humiliated or other exploitive forms of pornography such as child porn or elder erotica (sometimes referred to as “granny porn”). The patient may be viewing consensual “vanilla” sex, “wife swapping” or voyeuristic websites.

For many individuals, the type of pornography that they are viewing may be reflective of a past trauma or deep-seated psychological issue, or it may tell a story about their sexual development. Our early childhood years can be formative for our developing sexuality.

Many clinicians use the term “arousal template” to describe an individual’s erotic map – or what it is they are stimulated by or attracted to. The arousal template includes things such as body types, partner characteristics, behaviors, sex acts, objects and settings that cause sexual pleasure for an individual.

For example, if one of your first sexual experiences included oral sex, this could be a powerful element on your arousal template. It is not uncommon for individuals who have arousal templates that are considered “deviant” to have experienced childhood trauma that distorted their sexuality at an early age.

The internet affords the opportunity for people to explore the far reaches of their sexuality, including viewing and/or participating in behaviors that they would be afraid to indulge in an intimate relationship. Cybersex users can explore new powerful templates that, when viewed repeatedly, can be strengthened and fixated. This is especially dangerous when the arousal template is unhealthy, such as child pornography.

The reality is that most therapists are unaware of the genres of pornography and the numerous typologies of fetish behaviors that exist online. Additionally, therapists may be uncomfortable exploring these issues with their clients. When this occurs, important assessment information is missed and clients are unable to process traumatic issues around their sexuality that may be confusing for them.

It is helpful for clinicians to have a general understanding of the common types of internet porn, so that they can ask pertinent questions during the assessment process.

Excerpt from Psychotherapy Practice Tips, Part 1

4 Ways To Help a Man Fight Depression

This guest article from YourTango was written by Julia Flood.

4 Ways To Help a Man Fight DepressionYou’ve noticed that your partner seems sad, irritable, or overly critical. Maybe he has expressed hopelessness or guilt. You have noticed a loss of interest in his usual activities, concentration trouble, or changes in his sleep pattern. All these could be signs that your man is struggling with some form of depression.

Depression isn’t only hard for him; mood disturbances also have a big impact on your relationship. But how do you bring up the subject? Many men have difficulty talking about their feelings in the first place. The prospect of having a mental health disorder is difficult to hear for anyone. Even gentle suggestions that the problem may lie within himself will likely not be appreciated.

As the saying goes, “People don’t care what you know until they know that you care.” So what can you do to help?

Let me start by explaining what not to do.

1. Don’t say “Look on the bright side.”

People with depression may have a long list of what is wrong with the world. You as a non-depressed person may not agree and will want to convince your partner otherwise. The goal however isn’t to fix a problem on the content level or even to change his negative feelings, but to help both of you feel less isolated. So don’t talk him out of it — this doesn’t work!

Instead, aim to be fully present and willing to listen to his strong feelings. Don’t take it personally. What he says is not so much about you, but a window into his experience. Connecting during the dark times will help heal your relationship.

2. Don’t ask “Why?” and “How come?”

While it is good to show interest in his feelings and adapt a curious, non-defensive attitude, these questions are too analytical. What you’re going for is not a rational explanation, but helping him vent the feelings that will otherwise fester.

Better questions are: “Tell me why this is important to you.” “What is the most difficult part for you?” “That really bothers you, doesn’t it?” “You sound worried, what are you afraid of in this situation?” Or simply, “Tell me more!”

3. Don’t blame each other.

Even though your partner may be nagging at you, many people suffering from mood issues secretly blame themselves. He may also worry about overwhelming you with his burden or fears you may leave him if you find out how dark his thoughts are. It might help to externalize the problem. Depression can be a “third party” in the relationship and must be acknowledged as such. If the problem is neither him or you, but “it,” you can be allies in battling this together, just like you would with any other illness.

4. Don’t hesitate to encourage professional therapy.

The timing and tone is important here. “Man, you really need therapy,” is blaming or dismissive, but if you have done the work of being present and demonstrating your willingness to listen to your partner’s feelings, education on the illness can have a tremendously normalizing effect.

According to the National Institute of Mental Health, about 16% of US Americans will get Major Depressive Disorder at some point in their lives, and there are many other types of “low-grade depression” as well. Depression is very treatable with psychotherapy and/or medication, so getting a thorough medical assessment is very important.

One last piece of advice: Don’t lose sight of your own needs in the process. Sooner or later you will need attention or assistance from your partner as well, so don’t postpone your desires and requests for him indefinitely. Make sure to take good care of your own body and mind, and surround yourself with people who can be supportive to you both.


Related Online Continuing Education Courses:

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Animal Assisted Therapy Approved for ASHA CEUs

Animal Assisted TherapyIn Animal-Assisted Therapy (AAT) the human-animal bond is utilized to help meet therapeutic goals and reach individuals who are otherwise difficult to engage in verbal therapies. AAT is considered an emerging therapy at this time, and more research is needed to determine the effects and confirm the benefits. Nevertheless, there is a growing body of research and case studies that illustrate the considerable therapeutic potential of using animals in therapy. AAT has been associated with improving outcomes in four areas: autism-spectrum symptoms, medical difficulties, behavioral problems, and emotional well-being. This course is designed to provide therapists, educators, and caregivers with the information and techniques needed to begin using the human-animal bond successfully to meet individual therapeutic goals.

Course #20-62 | 2012 | 30 pages | 20 posttest questions
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Cognitive Behavioral Therapy Effective for Bipolar Disorder


Cognitive Behavioral Therapy Effective for Bipolar DisorderWhen someone begins treatment for bipolar disorder, I always recommend therapy along with medication because we know from studies that the combination of the two treatments works better than either alone.

However, most people think about psychotherapy (talk-therapy) when the word therapy is mentioned. That is not a bad thing. Psychotherapy has helped many people with and without bipolar disorder lead fuller, happier lives.

But another option that is effective for many people is cognitive behavioral therapy. This therapy has only been applied to bipolar disorder in the last decade, but it has been used to treat depression even longer. Studies on its effectiveness in bipolar disorder are preliminary, but so far the evidence suggests it is effective.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is different than traditional therapy in that it is short-term and doesn’t involve delving into historic issues. Cognitive behavioral therapy is about the here and now and is about giving you tools to deal with the symptoms of bipolar disorder that you are experiencing today.

Cognitive behavioral therapy is an analytical process that encourages people to look at their behavior, feelings, and motivations to learn what triggers these situations and what can be done to handle them.

For example, in cognitive behavioral therapy:

  • The patient is asked to explore their distorted thinking such as “I am god” when manic or “I am worthless” when depressed.
  • Patients are encouraged to develop interpersonal routines such as sleeping and waking at the same time each day.
  • Patients work to understand the warning signs of oncoming mood episodes and learn how to cope with these symptoms to avoid episodes where possible (relapse prevention).
  • Patients are aided in exploring what triggers episodes or specific emotions.

Cognitive behavioral therapy may be delivered one-on-one or in groups.

For Whom Does Cognitive Behavioral Therapy Work?

It is my belief that anyone can benefit from cognitive behavioral therapy in some way; however, statistically, people with fewer than six mood episodes have been shown to have greater success with this therapy. Also, people who are in the midst of a crisis—either mania or depression—may not be in a place emotionally or intellectually to optimally benefit from cognitive behavioral therapy. Some degree of stability should be attained before attempting this therapy (medication and traditional psychotherapy may help achieve this).

It is recommended that specialists in cognitive behavioral therapy deliver the treatment for greatest success. If therapy is not available in your area, workbooks are available to walk you through the therapy although this likely won’t be as beneficial as a live therapist (and likely won’t be bipolar-specific).

Cognitive Behavioral Therapy Is About Tools

Cognitive behavioral therapy is not a magic bullet for mental illness but it is an assortment of tools that can help you battle the illness every day. It helps you deal with the symptoms that may linger in spite of treatment with medication or while searching for the right medication.

Find out more about cognitive behavioral therapy from Simon Fraser University’s Core Information Document on Cognitive Behavioral Therapy or visiting Healthline’s page on cognitive behavioral therapy.


Related Continuing Education Courses:


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Animal Assisted Therapy – New Online Course!

Animal Assisted Therapy

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In Animal-Assisted Therapy (AAT) the human-animal bond is utilized to help meet therapeutic goals and reach individuals who are otherwise difficult to engage in verbal therapies. AAT is considered an emerging therapy at this time, and more research is needed to determine the effects and confirm the benefits. Nevertheless, there is a growing body of research and case studies that illustrate the considerable therapeutic potential of using animals in therapy. AAT has been associated with improving outcomes in four areas: autism-spectrum symptoms, medical difficulties, behavioral problems, and emotional well-being. This course is designed provide therapists, educators, and caregivers with the information and techniques needed to begin using the human-animal bond successfully to meet individual therapeutic goals.

The author, Lois Jean Brady, MA, CCC-SLP, is a practicing speech-language pathologist registered in animal-assisted therapy. She has a very loveable potbelly pig named Buttercup who accompanies her to therapy sessions, where he enhances her work with students on the spectrum. Buttercup has made a lasting impression on students, staff, and caregivers – essentially all who meet him. He has helped some students attain their goals and others just feel safer and more secure in the therapy environment, allowing them to focus their attention on a task. He has heard many students utter their first words, start conversations, or ask questions. He has been combed, brushed, fed, and cared for by many students. Lois has found that having an animal creates an atmosphere of trust that motivates children to expand their skills, strive to do their best, and strengthen the relationship between them and her.

Rosy Chu interviews Lois and Buttercup on KTVU Bay Area People:

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Journal Writing to Aid the Therapeutic Process

Using journal writing as an aid to the therapeutic process is not an unfamiliar idea. Keeping a journal has been practiced by patients of cognitive therapists in an attempt to help identify and correct negative thought patterns, by Jungians to record dreams, and in the Japanese Morita therapy for the treatment of neurosis; Sigmund Freud professed his belief in the diary as “a key to the psyche” in his preface to Anne Frank: Diary of a Young Girl (Rainer, 1978).

One of the most well-reputed journal therapists is Ira Progoff, a psychotherapist trained in Jungian analysis and depth psychology, who developed the concept of “The Intensive Journal,” a complete, specific journaling format to be used in working toward the goal of bringing depth to the inner self (Progoff, 1992).

In 1990, James W. Pennebaker, professor of psychology at Southern Methodist University in Dallas, Texas, published “Opening Up: The Healing Power of Confiding in Others.” Pennebaker describes carefully controlled experiments and ten years of scientific research that caused him to conclude, “writing can be an avenue to that interior place where . . . we can confront traumas and put them to rest – and heal both body and mind.”

Dr. Edward J. Murray (1991), professor of psychology at the University Miami, claimed that although he initially questioned Pennebaker’s findings, his own later findings proved that “writing seems to produce as much therapeutic benefit as sessions with a psychotherapist.”

Learn more:

Writing it Out: Journaling as an Adjunct to Therapy

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Writing it Out: Journaling as an Adjunct to Therapy is a 2-hour online continuing education course that provides a brief monograph on the use of journal writing as an aid to the therapeutic process. While most psychotherapy is conducted through traditional “talking therapy,” having a client express himself through the written word offers another way to let him vent his thoughts and feelings, and to gain information about his internal and external experiences of life. This course includes descriptions of the various uses of journaling as well as detail on seven journal-writing techniques. 2003 | 21 pages | 12 posttest questions | Course #20-13

Writing in a journal can be an effective aid to traditional psychotherapy. It allows clients to vent and explore their personal thoughts and feelings even when the therapist is not available. The process of writing helps to bring obscure or overwhelming abstract concepts into concrete form, thereby making them more manageable and empowering the writer. Writing can act as a soothing behavior, a safe place to express affect, and a vehicle for tapping unconscious material, fostering the development of self-awareness. When used in a more structured form, such as a behavior log, writing can help to interrupt unwanted behaviors and provide insight into behavior patterns.

Journaling II: Directed Exercises in Journaling

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Journaling II: Directed Exercises in Journaling is the follow-up course to Writing it Out. This is a 4-hour continuing education course designed for the practitioner who would like to use journal-writing exercises with clients as an adjunct to traditional psychotherapy, and would like some topic ideas to suggest, rather than limiting writing only to the technique of “freewriting.” It is suggested, although not mandatory, that the practitioner has already completed the course, “Writing It Out: Journaling as an Adjunct to Therapy.” That course lays the basic foundation for understanding the benefits of journaling and how it can best be used with clients. It also teaches a number of basic writing techniques. Journaling II presents a brief overview of “freewriting,” as well as 36 directed exercises divided into three phases. It also offers interpretive questions coordinating with each exercise and an explanation of the use of a behavior log as a journaling exercise. 2005 | 41 pages | 20 posttest questions | Course #40-03

About the Author:

Lisa M. Schab, MSW, LCSW, is a Licensed Clinical Social Worker in private practice in Libertyville, Illinois. A graduate of Loyola University School of Social Work, Ms. Schab has specialized in anxiety and depression, blended families, and the treatment and prevention of eating problems and disorders. She has presented a number of professional training seminars on the use of journaling and is the author of several books, among them Writing it Out: Self Awareness and Self-Help through Journaling (Wainsley Press, 1996).