As you are probably already aware, scientific studies have shown that CBT is extremely effective in treating all forms of anxiety disorders because it combines cognitive and behavioral theories to treat both the underlying thought process and subconscious behavioral response to anxiety triggers that cause a particular disorder.

Cognitive Restructuring

One of the most common issues that people with anxiety disorders experience is a string of negative thoughts that cause them to become worked up. CBT addresses this issue by challenging those negative thoughts and eventually replacing them with more realistic positive thoughts. This process is formally called “cognitive restructuring”, and it takes three simple steps to perform.

Step #1: Spot the negative thoughts that trigger anxiety.

Before you can start working towards changing your client’s train of thought during stressful situations, you have to first understand what their current train of thought is. What are they thinking that’s causing their distress?

Does the agoraphobe think spiders are going to rush him the second he steps out of the house? Does the socially awkward high school student think he’ll be laughed at the second he steps in front of class to deliver his oral report? As you know, you have to fully understand the problem before you can start working towards a solution.

Step #2: Challenge the client’s negative thought process.

As you have found, you don’t want to be overly directive, but you need to find a way to show your client that their thoughts are irrational and get them to start questioning the legitimacy of their anxiety-provoking logic. Their fears may even be justifiable, in which case, as you know, you need to show your client why their disabling anxiety-inducing reaction is still irrational even should the worst case scenario come to pass.

Step #3: Introduce your client to a more positive and realistic outlook.

Once you have the client questioning their own thought process it’s time to introduce them to a better one. Walk your client down a more realistic and positive path so that he or she can start acting in a more positive manner when faced with an anxiety-inducing situation.

Clearly this is just one way CBT can help your clients get control of their anxiety-inducing triggers and turn around their lives in ways they never thought they could before.

By onlineceucredit.com

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Need #1: Preventing Humiliation
The first concept related to a narcissistic client’s need for power and control is preventing humiliation.  As stated earlier in the track, narcissistic clients often control the emotions of sadness and fear as a prevention against vulnerability.  This desire to remain seemingly powerful and in control often results as a defense mechanism developed in early childhood.  As children, I have found that these clients suffer a severe narcissistic injury or a blow to self-esteem that scars and shapes their personalities.

This injury most often entails humiliation, specifically the experience of being powerless while another person enjoys the exercise of power.  Often, this other person is a parent or guardian who uses physical strength to force the child into submission.  To regain their own sense of power, narcissistic clients will use their inability to feel in order to control others around them.

Holly, age 26, described many repeated instances of feeling powerless in her early childhood and adolescence.  She stated, “My parents were contemplating putting me in a mental hospital without telling me.  This was when I was seventeen.  On another occasion, when I was fourteen and away at camp, they changed my high school without asking me.”

When I asked about her parents, Holly stated, “My father is a bull!  He’s a person who controls people.  He always appears as a nice guy, and most people see him that way, but he causes so much disorder!  In business, he is ruthless.  His only trip is power—power and money.  He is rather handsome, but big and burly.  When he was angry, he was very frightening.”

From her description, I could deduce that Holly’s father was a narcissistic character who valued power and control.  Because of his own need for power, he took the control away from Holly in making decisions for her.  This left her feeling powerless and to regain that power, she suppressed her own feelings of sadness and fear.  Think of your Holly.  How has his or her own need for power affected his or her emotions and feelings?

For Need #2 & #3  and Technique : Rage Control go to Narcissism Course

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Manifestation #1 – Behavioral
The first type of depression in relation to PTSD is behavioral depression.  As you know, behavioral theory states that depression is the natural result of inadequate reinforcement, inadequate rewards, or inadequate recognition.  This kind of depression can also occur when clients aren’t loved or supported enough by others or themselves.  Trauma survivors, those clients most in need of both, sometimes do not get the amount of either love or support that they require.

Many times this may be a recurring circumstance yet other circumstances, it may be a direct result of the nature of the client’s trauma.

Luanne had been raped by her uncle at the age of 12.  When Luanne promptly reported the uncle to police, he was convicted and sent to prison.  Although the prosecutor had sufficient DNA evidence to support Luanne’s charge, her family refused to believe her and shunned Luanne from all activities, gatherings, and vacations.

Without the love and support of her loved ones, Luanne quickly slipped down into depression.

Think of the level of love and support you PTSD has received.  Would this be an appropriate topic in your next session and how they can acquire this love and support now?

For Manifestation 2, 3 , and 4 go to PTSD Course

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However, my client Andrew found a way to observe his daughter Lacy’s behavior when he drove Lacy and her friends home from soccer practice.  Andrew stated, “I heard Lacy plotting with her friends to tease another girl in the class.  When I told Lacy later that I disapproved of her behavior, she just laughed and said that the girl was annoying and deserved to be teased.  I was horrified!”

Step Two: Watching
A second step is for parents to watch how their child treats his or her siblings. I explain to parents that if their son or daughter teases or bullies his or her younger siblings, chances are he or she acts the same way in the classroom.  My client Max had two boys, Larry, age 12, and Simon, age 8.  Max stated, “I never picked up on it before, but the other day I noticed Larry demanding Simon lend him his CD player.  When Simon said no, Larry started to push him around.”

Step Three: Talking to Teachers
In addition to listening when the student talks about his or her friends, and observing how the student treats siblings, a third step is for parents to talk to the student’s teacher, and to other parents. Clearly, teachers are good sources of information about a child’s social interactions.  Additionally, other parents may have information about children who may be involved in bullying.

Step Four: Monitoring the Media
A fourth step is for parents to monitor their child’s media diet.  I ask parents to notice if their son or daughter is hooked on violent video games or movies.  Could they be bringing the modeled confrontational attitudes to school.  Or, does their son or daughter spend leisure time watching shows in which characters frequently ‘dis’ each other?  Does she or he seem to admire these characters?  I encourage parents who answer yes to these questions to take an opportunity to make it clear to their child how they feel about the matter.

For 5th, 6th and 7th Steps for Assessing Bullying go to Risk Management Course

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#1  Schneider’s 11 Guidelines for Suspicion of Schizophrenia
In addition to DSM criteria for diagnosing schizophrenia, you may also find Schneider’s Guidelines for Suspicion of Schizophrenia useful as guideline for the elevation of suspicion regarding suspected schizophrenia.  Schneider’s list contains eleven Guidelines for Suspicion of Schizophrenia.  As I list the eleven symptoms, you might consider your schizophrenic client and evaluate him or her for one or more of the following symptoms.

1. Auditory hallucinations in which the voices speak one’s thoughts aloud.
2. Auditory hallucinations with two voices arguing.
3. Auditory hallucinations with the voices commenting on one’s actions.
4. Hallucinations of touch when the bodily sensation is imposed by some external agency.
5. Withdrawal of thoughts from one’s mind.
6. Insertion of thoughts into one’s mind by others.
7. Believing one’s thoughts are being broadcast to others, as in radio or television.
8. Insertion by others of feelings into one’s mind.
9. Insertion by others of irresistible impulses into one’s mind.
10. Feeling that all one’s actions are under the control of others, like an automation.
11. Delusions of perception, as when one is certain that a normal remark has a secret meaning for oneself

As you can see, some of Schneider’s Guidelines for Suspicion of Schizophrenia correlate to DSM criteria. However, studies show that while 75% of schizophrenic clients present Schneider’s symptoms, so do about 25% of manic-depressive clients.  Therefore, Schneider’s list is an informal guide to suspicion, rather than a guideline for diagnosis like the DSM.  Even so, you might consider your diagnostic interview process.  Would you find Schneider’s Guidelines for Suspicion of Schizophrenia a  helpful adjunct the DSM ?

For #2  Symptoms of Schizophrenia and #3  Subtypes of Schizophrenia go to  Schizophrenia Course

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Stay Healthy
Walking, swimming or doing some other form of exercise can help control the anxiety and stress you feel. It might also help relieve symptoms of depression associated with body dysmorphia. Another benefit to physical activity is that it helps prevent the side effect of weight gain that occurs with some medications used to treat this disorder. Don’t drink or take drugs since this can cause serious interactions with the medications you take. Alcohol and drugs can also make your symptoms worse. It’s also important to eat healthy and make sure you get enough sleep.

Get Help From Others
Even if you feel self-conscious, make an effort to hang out with family and friends on a regular basis instead of isolating yourself. Having other people around can help distract you enough to take your focus off of your perceived flaw. You should also consider joining a support group for people with body dysmorphia so that you can talk to others who can relate to what you’re going through. Being able to discuss your thoughts and feelings with people who are having the same struggle as you can help put things in perspective.

Focus on Recovery
Write down your goals so that you can look at them regularly. Seeing a written version of what you are working toward accomplishing can give you the motivation you need. It can also encourage you to focus more when you find yourself obsessing about your appearance again. Recovering from body dysmorphia takes time and can be challenging, so it’s important to remind yourself of why you’re doing it and think of how much better you’ll feel.

Relaxation Techniques
Taking up yoga, deep breathing exercises or some other type of relaxation technique can go a long way toward helping you manage the stress that body dysmorphia causes. When you start to focus on your flaw, stop and practice the relaxation technique you’ve learned instead. This will help you feel calmer and encourage you to focus on what you’re doing to relax instead of continuing to think about your physical appearance.

Self-help Books
Ask your therapist for recommendations on self-help books that can help you cope with body dysmorphia. Since some of these books have questionable advice, it’s important to get a professional opinion on which ones are genuinely helpful. The books you read might give advice on how to accept yourself, how to improve your self-esteem or how to change your outlook on life to a more positive one.

related course:
http://www.onlineceucredit.com/ceus-online/bdd-body-dysmorphic/continuing-education.html

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Other states may not have whopping tallies, but they do have their own requirements. In fact, even states such as Indiana and Maryland, which house merely 5,805 and 6,115 social workers respectively, have clearly specified the number of CEU hours required by the state boards. Here, it is worth mentioning that irrespective of what the requirements are, you can complete the number of hours with exemplary ease. For this, you can really use some Social Work Continuing Education CEU courses. However, with numerous courses easily available these days, you may find it a challenge to choose between them.

Things that can help

To begin with, you need to ensure that the course you go for meets all the requirements of the state board that would be renewing your license; else, taking the course is unlikely to serve any purpose. Nevertheless, some of the other things that may come in handy when making the choice are:

• Medium of learning: When considering CEU courses, you can either attend classes by going to an institute in person, or learn in the comfort of your home as per your convenience. Especially if you have a hectic schedule, it makes more sense to go for the latter.
• Course content: Whether you are a social worker or a counselor, or for that matter even a marriage & family therapist, you cannot expect to see an improvement in the way you have been handling your clients if the courses you take do not provide you with useable information. Therefore, it is important that you take a closer look at the content, find out if there are some case study examples or not, and then make the pick.

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