Main description:

Cognitive-behavioral therapy is now the treatment of choice for individuals with health anxiety and related problems. The latest research shows that it results in reductions in health-related worries, reassurance-seeking behavior, and phobic avoidance, as well as increases in life satisfaction and everyday functioning. This compact, easy to understand book by experts Jonathan S. Abramowitz and Autumn E. Braddock opens with an overview of the diagnostic issues and assessment of health anxiety, and delineates a research-based conceptual framework for understanding the development, maintenance, and treatment of this problem. The focus of the book is a highly practical guide to implementing treatment, packed with helpful clinical pearls, therapist-patient dialogues, illustrative case vignettes, and sample forms and handouts. Readers are equipped with skills for engaging reluctant patients in treatment and tailoring educational, cognitive, and behavioral techniques for health-related anxiety. The book, which also addresses common obstacles in treatment, represents an essential resource for anyone providing services for individuals with somatoform or anxiety disorders.

Contents:

Dedication... v Preface ... vii Acknowledgments... viii 1 Description of Health Anxiety 1.1 Terminology... 1 1.2 Definition ... 1 1.3 Epidemiology ... 3 1.4 Course and Prognosis... 4 1.5 Differential Diagnoses ... 4 1.5.1 Somatization Disorder ... 5 1.5.2 Somatic Delusions ... 5 1.5.3 Illness or Disease Phobia... 5 1.5.4 Panic Disorder ... 6 1.5.5 Obsessive-Compulsive Disorder ... 6 1.5.6 Generalized Anxiety Disorder ... 6 1.5.7 Pain Disorder ... 7 1.6 Comorbidity ... 7 1.7 Diagnostic Procedures and Documentation... 7 1.7.1 Structured Diagnostic Interviews... 7 1.7.2 Semi-Structured Symptom Interviews... 8 1.7.3 Self-Report Inventories... 9 1.7.4 Documenting Changes in Symptom Levels... 9 2 Theories and Models of Health Anxiety 2.1 Development of Health Anxiety... 10 2.1.1 The Human Body Is NoisyA" ... 10 2.1.2 Beliefs and Interpretations Lead to Health Anxiety... 10 2.1.3 Origins of Dysfunctional Core Beliefs ... 12 2.2 Maintenance of Health Anxiety... 12 2.2.1 Physiological Maintenance Factors ... 13 2.2.2 Cognitive Maintenance Factors ... 14 2.2.3 Behavioral Maintenance Factors ... 15 2.3 Treatment Implications of the Model... 16 3 Diagnosis and Treatment Indications 3.1 Review of Medical Records... 17 3.2 Self-Report Inventories... 17 3.3 The Clinical Interview ... 18 3.3.1 Chief Complaint and History ... 18 3.3.2 Mood... 18 3.3.3 Social Functioning ... 19 3.3.4 History and Previous Treatment... 19 3.3.5 Family Issues ... 19 x Advances in Psychotherapy: Hypochondriasis and Health Anxiety 3.4 Identifying the Appropriate Treatment... 20 3.4.1 Medications... 20 3.4.2 Cognitive Behavior Therapy (CBT)... 21 3.5 Factors that Influence Treatment Decisions ... 21 3.6 Presenting the Recommendation for CBT... 22 3.6.1 Getting a Foot in the Door... 22 3.6.2 The Mind-Body Connection... 23 3.6.3 Body Vigilance and Body Noise ... 23 3.6.4 Effects of Behavioral Responses ... 23 3.6.5 Presenting the Treatment Rationale... 23 3.6.6 Eliciting Change TalkA"... 24 4 Treatment 4.1 Methods of Treatment... 27 4.1.1 Functional Assessment... 28 4.1.2 Self Monitoring... 32 4.1.3 Psychoeducation... 33 4.1.4 Cognitive Therapy Techniques... 39 4.1.5 Exposure and Response Prevention... 47 4.1.6 Implementing Appropriate Self-Care Behaviors ... 58 4.2 Mechanisms of Action ... 58 4.3 Efficacy and Prognosis... 59 4.4 Variants of the Treatment Procedures... 59 4.5 Problems in Carrying Out Treatment... 60 4.5.1 Nonadherence... 60 4.5.2 Arguments... 61 4.5.3 Unbearable Anxiety Levels During Exposure... 62 4.6 Multicultural Issues ... 62 5 Case Vignette... 63 6 Further Reading... 67 7 References... 68 8 Appendices: Tools and Resources... 70