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Overcoming confounding sleep avoidance behavior in cognitive behavioral treatment for obsessive compulsive disorder

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TitleInfo
Title
Overcoming confounding sleep avoidance behavior in cognitive behavioral treatment for obsessive compulsive disorder
SubTitle
the case of Jack
Name (type = personal)
NamePart (type = family)
Ferreira
NamePart (type = given)
Mark S.
NamePart (type = date)
1977-
DisplayForm
Mark Ferreira
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Fishman
NamePart (type = given)
Daniel
DisplayForm
Daniel Fishman
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Rockmore
NamePart (type = given)
Lori
DisplayForm
Lori Rockmore
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
co-chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School of Applied and Professional Psychology
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2014
DateOther (qualifier = exact); (type = degree)
2014-10
CopyrightDate (encoding = w3cdtf); (keyDate = yes); (qualifier = exact)
2014
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Cognitive Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP) is widely accepted as the gold standard treatment for Obsessive Compulsive Disorder (OCD). Many efficacious treatment manuals have been developed over the years, resulting in clinicians being able to select protocols that best match their patient’s developmental stage, and thus helping to facilitate positive outcomes. However, challenges do present themselves when applying CBT treatment protocols with anxious patients. This requires the creation of an individualized case formulation and an associated treatment plan, which is specific to each particular patient. In this context the purpose of this case study is to analyze a particular deleterious confound to the therapy process: an OCD patient falling asleep during in-session ERP tasks. The case study chronicles the process of coming to understand the impact of the patient’s sleep behavior on his treatment, and the unfolding of both ineffective and effective interventions aimed at overcoming this obstacle. Importantly, a functional analysis of the sleep behavior determined that this behavior was, in fact, employed in avoidance of the feared stimuli presented during exposure tasks. Once this was established, the patient and I as the therapist worked collaboratively to develop novel interventions to eliminate the sleep avoidance behavior, in order for the established benefits of CBT with ERP to take hold. This proved to be a fluid process requiring frequent adjustments to each intervention, as they no longer proved effective over time. As the treatment process unfolded, the intervention of walking outside during exposure tasks was employed and proved to trump all other interventions in its effectiveness in eliminating the patient’s sleep avoidance behavior. This resulted in a complete eradication of the patient’s sleeping during therapy sessions and the development of rapid treatment gains from that point forward in the treatment process.
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
RelatedItem (type = host)
TitleInfo
Title
Graduate School of Applied and Professional Psychology Electronic Theses and Dissertations
Identifier (type = local)
rucore10001800001
Identifier
ETD_5691
Identifier (type = doi)
doi:10.7282/T3HM56W0
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
1 online resource (viii, 95 p. : ill.)
Note (type = degree)
Psy.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Mark Ferreira
Subject (authority = RUETD)
Topic
Clinical Psychology
Subject (authority = ETD-LCSH)
Topic
Cognitive-behavioral therapy
Subject (authority = ETD-LCSH)
Topic
Obsessive-compulsive disorder--Treatment
Subject (authority = ETD-LCSH)
Topic
Exposure therapy
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Ferreira
GivenName
Mark
MiddleName
S.
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2014-05-12 20:33:17
AssociatedEntity
Name
Mark Ferreira
Role
Copyright holder
Affiliation
Rutgers University. Graduate School of Applied and Professional Psychology
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

RULTechMD (ID = TECHNICAL1)
ContentModel
ETD
OperatingSystem (VERSION = 5.1)
windows xp
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