Problems in Cognitive-Behavioral Supervision : Theoretical Background and Clinical Application

Cognitive-behavioural therapists and trainees are encouraged to undergo supervision when offering therapy to troubled clients and to process personal attitudes and events likely to affect their therapeutic work. We discuss common problems in cognitive behavioural therapy (CBT) supervision, which may arise at the client, supervisee, or supervisor level. These issues include difficulties with case formulation, therapeutic strategies, and the therapeutic relationship. A supervisor can help their supervisee deal with clients with multifaceted or particularly challenging problems, such as difficulties with compliance, complex psychosocial problems, or chronic mental disorders. We also discuss matters related to the supervision process, the supervisor's role, different supervisory styles, and issues affecting a supervisee's feelings of vulnerability and shame. Furthermore, we analyze distinct supervision styles and potential problems arising from the supervision of experienced CBT therapists.Peer reviewe

Chairwork in cognitive behavioral therapy and schema therapy : Options in practice

Chairwork is a creative and emotionally charged technique that enhances therapeutic progress. It is based on the assumption that if individuals become aware and express their inner beliefs or conflicts, it would help them understand and choose solutions more freely than if they act unaware and automatically. When used within the conceptualization of the client's problems, it can liberate clients' intense emotional pain and change their maladaptive cognitions. This article shares the clinical experience using the chair techniques by describing and illustrating typical examples of chairwork in cognitive behavioural and schema therapy. Additional recommendations on how to do chairwork and consider the pace, tone of voice, or location of the chairs are also provided.publishersversionPeer reviewe

Homework in Cognitive Behavioral Supervision : Theoretical Background and Clinical Application

Funding Information: This paper was supported by the research grant VEGA no. APVV-15-0502 Psychological, psychophysiological and anthropometric correlates of cardiovascular diseases. Publisher Copyright: © 2022 Prasko et al.The homework aims to generalize the patient’s knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.publishersversionPeer reviewe

Adherence of obstructive sleep apnoea syndrome patients to positive airway pressure therapy - 10-year follow-up

Purpose. Continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnoea syndrome (OSAS). Long-term adherence is necessary; however, it may be widely variable based on current literature, where the predicting factors are also not well defined. The aim of this study was to assess ten-year adherence to CPAP and to define factors influencing it. Methods. In total, 107 patients (91 males) were enrolled in this study, with an average age of 53.5 years (SD 10.1), with CPAP therapy being indicated (Apnoea-Hypopnoea Index - AHI > 15). Anthropometric and social status data have been obtained as well as the average use of CPAP through device memory. Results. Sufficient adherence (> 4 h per night) was found in 57% of patients in the first year with no subsequent significant change during the next ­9 years. Adherence correlated significantly with the severity of OSAS - AHI (r = 0.321 over 5 years) and Epworth Sleepiness Scale (r = 0.317 over ten years) but did not correlate with the pressure used or the age of the patient. No statistically significant differences have been found between the sexes, the different mask groups, or the social status groups. Conclusion. Good adherence to CPAP therapy in OSAS patients is essential. According to our results, patients with more severe OSAS or more severe sleepiness seem to have better adherence