| Technique | Use |
|---|
| Self-monitoring | The patient is asked to observe himself/herself, e.g. a harmful feeling or repeated problem behaviour. The patient writes down his/her observations which will be discussed at the beginning of the next therapy session. |
| Socratic method | The patient learns to reassess and modify conclusions and thinking processes that occur in certain problem situations (e.g. ”I am no good at anything”). The Socratic method will assist the patient to recognise and question distortions of thought (such as black and white thinking or false generalisations), which hinder effective behaviour and emotional regulation. Questions often asked by the therapist include ”What were your thoughts at that moment?”, ”What other way could you think about this matter?”, ”What does this mean to you?” or ”How do you know that the matter is like that?” |
| Functional analysis or chain analysis | An attempt is made to identify the external and internal factors that have both activated the problem behaviour, either directly or indirectly, and maintained it, including vulnerability factors (e.g. lack of sleep), activating factors, intermediate factors (thoughts, feelings, acts) and both short-term and long-term consequences. During the analysis, it is important to intersperse skills teaching and problem solving with each other in order to equip the patient with the knowledge of how to manage a similar situation in the future. |
| Forming and testing working hypotheses | The patient decides to act the opposite to his/her belief, e.g. he/she attends a party and initiates conversation with another guest even though he/she believes strongly that ”everyone will laugh at me if I blush”. |
| Applied relaxation | Guided self-dialogue, which is used to treat emotional and stress-related problems mediated by the nervous system, particularly the autonomic nervous system (e.g. tension headache, difficulties falling asleep) |
| Response prevention | In obsessive-compulsive disorders, exposure therapy often includes response prevention whereby the patient aims, with the aid of the therapist, to avoid avoidance behaviour in anxiety- or fear-provoking situations. The method allows the patient to experience the removal of anxiety without the need of avoidance behaviour. |
| Gradual exposure (interoceptive exposure, in vivo situational exposure, imaginal exposure) | If, for example, panic reactions are associated with avoidance behaviour, gradual exposure to fear-provoking situations is important. In addition to cognitive methods, breathing and relaxation techniques are also useful for the optimum management of physical symptoms during a panic attack. Moreover, the life situation at the start of panic symptoms will also be addressed as well as the significance of the patient's developmental history as regards the emergence of symptoms. |
| Modelling techniques and role play, communication training | With the aid of these techniques, the patient will learn social coping strategies and skills, including standing up for oneself and asking for things. Behavioural experiments are one of the most powerful interventions to change harmful beliefs. By experimenting with a new way of behaviour, followed by observation of its consequences, the patient will receive immediate, direct and concrete evidence against harmful beliefs and may obtain support for a new, more positive belief. |
| Stimulus control techniques | Control of the surroundings: the antecedents (events and situations) of behaviour as well as circumstances where non-desired behaviour is reinforced are altered in order to elicit desired behaviour, i.e. the surroundings are changed so that desired behaviour is reinforced and non-desired behaviour rendered less likely. |
| Sensitisation training | Learning observation and awareness skills, mindfulness training |
| Behavioural activation and activity scheduling | The patient is helped to identify poorly functioning aspects of his/her life, and the possibility of their elimination via behavioural activation is explored. The therapist both coaches and encourages the patient towards activity and modifies cognitions that hinder the process, such as ”There is no point in this”. The therapy also includes both the mapping of positive events and balancing of the weekly schedule between obligations and pleasurable events. |
| Recognising consequences and contingency management | Addressing the consequences may be used to encourage the patient's wish to engage in more appropriate behaviour; both desired and non-desired behaviour are taken into account (e.g. wrong behaviour is not rewarded or reinforced with empathetic crisis discussion and constructive behaviour is not ignored). |