Creative CBT with Youth: Clinical Applications Using Humor, Play, Superheroes, and Improvisation

Description

This book combines empirical support, clinical acumen, and practical recommendations in a comprehensive manner to examine creative augmentations to the robust cognitive behavioral therapy (CBT) model. It discusses augmentations that are supported by research and practice and are also clinical-friendly tools. Each chapter briefly summarizes research findings, offers parsimonious explanations of theoretical concepts and principles, presents vivid descriptions of therapeutic procedures, and describes rich case illustrations. The book addresses the use of humor in CBT with youth, playful applications of CBT, applications of improvisational theatre in CBT and integrating superheroes into CBT. Key areas of coverage include: Building stronger, more flexible, and enduring alliances with children and adolescents to improve treatment retention and impact.Using humor and irreverent communication in dialectical behavior therapy (DBT) to enhance outcomes with adolescents.Developing rapport between medical and psychosocial team members to alleviate stress during pediatric medical procedures and as an adjunct to therapeutic interventions. Cognitive behavioral play therapy (CBPT) with young children.Family-focused CBT for pediatric OCD (obsessive-compulsive disorder).Cognitive Behavioral Psychodrama Group Therapy (CBPGT) with youth. This unique and compelling volume is an authoritative resource for researchers, professors, clinicians, therapists and other professionals as well as graduate students in developmental psychology, pediatrics, social work, child and adolescent psychiatry, and nursing.   Acknowledgments Contents Contributors Chapter 1: Incorporating Humor, Superheroes, and Improvisational Theatre Exercises into CBT with Youth: “Just Because Something Works, It Doesn’t Mean It Can’t Be Improved” 1.1 A CBT Origin Story 1.2 What you Will Discover in this Book? 1.3 Conclusion References Chapter 2: Humor and Engagement with Children and Adolescents 2.1 Introduction 2.1.1 With All Due Respect to Fritz Perls 2.1.2 Why this Matters 2.1.3 It’s Not Vaccines, It’s Vaccinations 2.2 The More Things Change 2.3 How Few Is Few? 2.4 What Do Birds of Paradise, Sea Horses, and Therapists Have In Common? 2.5 Engagement 2.6 One Doesn’t Have a Sense of Humor: It Has You (Larry Gelbart) 2.7 Like Beauty 2.8 Humor Is the Affectionate Communication of Insight (Leo Rosten) 2.9 It’s the Ability to Take a Joke, Not Make a Joke, that Proves You Have a Sense of Humor (Max Eastman) 2.10 If this Is the Stuff Adults Have to Think About, I Never Want to Grow Up (Stephen King) 2.11 Everything Is Funny, As Long As It’s Happening to Someone Else (Will Rogers) 2.12 There’s Something Very Authentic About a Sense of Humor. Anybody Can Pretend to Be Serious, But You Can’t Pretend to Be Funny (Billy Collins) 2.13 If It Bends, It’s Funny. If It Breaks, It Isn’t Funny (Lester, in Crimes and Misdemeanors) 2.14 Wish I Wasn’t Here 2.15 The Problem with Having a Sense of Humor Is that Often, the People You Use It on Aren’t in a Very Good Mood (Lou Holtz) 2.16 Sometimes a Smile Is Better than a Laugh 2.17 How to Get that Smile 2.18 I Think the Next Best Thing to Solving a Problem Is Finding some Humor in It (Frank Clark) 2.19 Converting Problems into Goals 2.20 Part of Something Usually Beats All of Nothing 2.21 Humor Is Laughing at What You Haven’t Got when You Ought to Have It (Langston Hughes) 2.22 The Absolute Truth Is the Thing that Makes Most People Laugh (Carl Reiner) 2.23 When Humor Works, It Works Because It’s Clarifying What People Already Feel (Tina Fey) 2.24 Humor Do’s and Don’ts 2.25 Conclusion References Chapter 3: Humor, Irreverent Communication, and DBT 3.1 Introduction to DBT, and the Strategy of Irreverent Communication 3.1.1 What Is DBT? 3.1.2 Humor as a Reciprocal Communication Strategy 3.1.3 DBT Case Conceptualization 3.1.4 Use of Humor as an Effective Therapeutic Change Strategy 3.2 Clinical Applications 3.2.1 Reframing in an Unorthodox Manner 3.2.2 Plunging in Where Angels Fear to Tread 3.2.3 Using a Confrontational Tone 3.2.4 Calling the Patient’s Bluff 3.2.5 Oscillating Intensity and Using Silence 3.2.6 Expressing Omnipotence and Impotence 3.3 Conclusion References Chapter 4: Humor with Pediatric Patients 4.1 Introduction 4.1.1 The Use of Humor in Pediatric Populations 4.2 Assessment of Humor in Pediatric Patients 4.2.1 Cultural Factors 4.2.1.1 Humor Assessment in Action: Case Example in Cultural Context 4.2.2 Individual Factors 4.2.3 Methods for Assessing Humor 4.3 Clinical Applications of Humor with Pediatric Patients 4.3.1 Hospital Programs and Staff that Promote Humor 4.3.1.1 Therapeutic Clowning and Magic 4.3.1.2 Therapeutic Recreation, Child Life, and Creative Arts Therapies 4.3.1.3 Psychology 4.4 Humor Interventions for Pediatric Presenting Problems 4.4.1 Psychoeducation/Rapport Building 4.4.1.1 Humor in Rapport Building: Case Example 4.4.2 Humor as a Coping Skill 4.4.2.1 Humor as a Coping Skill Case Example 1 4.4.2.2 Humor as a Coping Skill Case Example 2 4.4.3 Humor in Medical Play/Exposure 4.4.3.1 Humor in Medical Play/Exposure Case Example 4.5 Risks and Benefits of Humor Among Medical Providers 4.6 Conclusion References Chapter 5: Cognitive Behavioral Play Therapy 5.1 Introduction 5.2 Foundations 5.2.1 Behavioral Therapy 5.2.2 Cognitive Therapy 5.2.3 Integration of Behavior and Cognitive Therapies 5.2.4 Modeling 5.2.5 Structured vs. Unstructured Play 5.2.6 Developmental Issues 5.3 Treatment Description 5.3.1 Stages 5.3.2 Introductory/Orientation 5.3.3 Assessment 5.3.4 Middle 5.3.5 Termination 5.4 Clinical Applications 5.5 Case Examples 5.5.1 Clark 5.5.2 Walker 5.6 Empirical Support for CBPT 5.7 Conclusions References Chapter 6: Incorporating Play into Cognitive Behavioral Therapy for Youth 6.1 Incorporating Play into Cognitive Behavioral Therapy for Youth 6.2 Overview of Cognitive Behavioral Therapy (CBT) 6.3 Process for Incorporating Play into CBT 6.4 Common CBT Practices and Play 6.4.1 Assessment and Rapport Building 6.4.2 Psychoeducation about the Problem 6.4.3 Psychoeducation about CBT 6.4.4 Self-monitoring 6.4.5 Cognitive Restructuring 6.4.6 Pleasant Activity Scheduling 6.4.7 Problem Solving 6.4.8 Relaxation 6.4.9 Social Skills 6.4.10 Maintenance 6.4.11 One-on-One Time 6.5 Multicultural Considerations 6.6 Telehealth Considerations 6.7 Conclusion References Chapter 7: Playful Approaches to CBT with Aggressive Children 7.1 Emotion Competence and Regulation in Young Children 7.2 Anger and Aggression in Young Children 7.3 The Role of Play 7.4 Turtle Magic 7.4.1 Turtle Magic Intervention Program Description 7.4.2 About Turtle Magic 7.4.3 TMI Treatment Description 7.4.4 Brief Review of Evidence for Turtle Magic Intervention 7.5 Summary References Chapter 8: Playful CBT with Children Diagnosed with OCD 8.1 Introduction 8.2 Clinical Applications for Pediatric OCD 8.2.1 Providing Psychoeducation 8.2.1.1 Our Body’s Alarm System 8.2.1.2 Goals of ERP 8.2.1.3 Normalizing Intrusive Thoughts 8.2.1.4 Externalizing OCD 8.2.2 Building a Fear Hierarchy 8.2.2.1 The Fear Thermometer 8.2.2.2 Creating and Climbing the Fear Ladder Create a Sticky Note Ladder Make a Bucket Game Create Videogame Levels 8.2.3 Exposure and Response Prevention (ERP) 8.2.3.1 Exposure Selection 8.2.3.2 Therapist Delivery of ERP 8.2.3.3 Approaches to Integrating Play into ERP Creating New Exposure Games Modifying Existing Games Creative Arts 8.2.4 Family Involvement 8.2.5 Relapse Prevention 8.3 Conclusion References Chapter 9: Superheroes and CBT for Youth 9.1 Introduction 9.2 Case Conceptualization and Superhero Narrative 9.2.1 Origin Stories 9.3 Superheroes and the Stories of Marginalized Groups 9.4 Coping Is a Superpower 9.5 Problem-Solving 9.5.1 Brainstorming 9.5.2 Experiential Learning 9.5.3 “Next Frame” 9.6 Emotion Recognition and Expression 9.6.1 Introducing Affect Labeling 9.6.2 The Incredible Hulk and Emotion Recognition 9.6.3 Superhero Rating Scales 9.7 Cognitive Coping Skills 9.7.1 Thought Bubbles 9.7.2 Villain Thoughts 9.7.3 Coping Self-talk 9.7.4 Strengths Check 9.7.5 Self-validating Thoughts 9.8 Behavioral Interventions 9.8.1 Exposures 9.8.2 Behavioral Activation 9.9 Somatic Management 9.9.1 Power Breaths and Superhero Breathing 9.9.2 “Riding the Wave” 9.10 Enhancing Superpowers: Supplemental Interventions for Enhancing CBT Intervention 9.10.1 Using Superheroes to Seek Social Support 9.10.2 Behavior Plans 9.10.3 Superhero Tools and Props 9.10.4 Finding your Superhero Song 9.10.5 Superhero Poses 9.11 Conclusions References Chapter 10: Using Superheroes with Children who have Chronic Illnesses 10.1 Introduction 10.2 Theoretical and Empirical Foundations 10.3 Clinical Applications 10.3.1 Medical Trauma and Anxiety 10.3.2 Learning Coping Skills 10.3.3 Coping with Pain 10.3.4 Storytelling 10.4 Case Example 10.4.1 Case Synthesis 10.5 Conclusion References Chapter 11: The Force Awakens: Mindfulness-Based Cognitive Therapy Using Star Wars 11.1 Introduction 11.2 Mindfulness Becoming Mainstream 11.3 Mindfulness-Based Cognitive Therapy 11.4 A Rey of Hope: Case Conceptualization 11.5 Early Successes: Mindfulness in Daily Living 11.6 Mindfulness and the Force: Behavioral Practices of Meditation 11.7 Confronting Discomfort—The Dark Side of the Force 11.8 Kylo Ren and the Dark Side Struggle 11.9 Reactivity to the Internal Experience 11.10 Holistic Practice: Luminous Beings We Are 11.11 Parasocial Relationships—Finding Connection Not So Far, Far Away 11.12 Conclusion References Chapter 12: Clinical Applications of Steven Universe in Cognitive Behavioral Therapy 12.1 Introduction 12.1.1 LGBTQ+ Representation 12.1.2 Mental Health Representation 12.2 A Mindfulness Education 12.2.1 The Mindful Self 12.2.2 Mind-Body Awareness 12.3 Here Comes a Thought, Feeling, and Behavior 12.3.1 Cognitive Distortion Cactus 12.4 Beach City—Identifying Networks of Safety and Support 12.5 Determining Your Path 12.6 Wrapping Up Therapy with a “Poof” 12.7 Conclusion References Chapter 13: Integrating Psychodrama [Experiential] and CBT with Adolescents in Groups 13.1 Introduction 13.1.1 Research Support 13.1.2 Clinical Application 13.1.3 Multi-cultural Considerations 13.2 One Teen’s Story 13.2.1 Warm-Up 13.2.2 Sharing 13.2.3 Alternative Behavior Plan (Homework) 13.2.4 Drawbacks 13.3 Conclusions References Chapter 14: Integrating Popular Culture, Movie Clips, and Improvisation Theater Techniques in Clinical Supervision; Add a Dash of Spice to CBT Supervision 14.1 Introduction 14.2 CBT Supervision 14.2.1 Teaching and Training with Movie Clips and Popular Culture 14.2.2 Integrating Superheroes and Therapy 14.2.3 Implications for Training, Teaching, and Supervision 14.3 Improvisational Theater and Supervising Trainees in CBT with Youth 14.3.1 Improvisational Theater Training 14.3.1.1 Application to Clinical Work 14.3.2 CBT Supervision and Improv: Arranged Marriage or Perfect Union? 14.3.3 Tips for CBT Supervisors 14.3.4 Improv in CBT: Specific Examples 14.4 Conclusion References Chapter 15: The Last Stanza: Creativity, Ingenuity, and Wisdom 15.1 The Last Stanza? 15.2 Humor 15.3 Play 15.4 Superheroes and Popular Culture Characters 15.5 Improv in CBT Practice and Training 15.6 Just Do It 15.7 Conclusion References Index