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Behavioral Therapy for Anxiety-Related Disorders (BTAD) (June 2024)

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About the Event

Cognitive Behavior Institute is excited to welcome Jason T Goodson, PhD for a live interactive webinar on: Behavioral Therapy for Anxiety-Related Disorders (BTAD)

Date: June 14th, 2024
Time: 8:30am - 4:30pm EST
Location: online via Zoom Webinars
*Participants will not have access to their cameras/microphones
Cost: $19.99
Level: Intermediate
Credit Hours: 7 CEs (6 hours of clinical content and 1 hour of content related to suicide prevention.)

BTAD is a simple, effective, and transdiagnostic treatment that focuses on reducing, eliminating, and countering safety behaviors to treatment anxiety-related conditions. It is well known that safety behaviors maintain, and often increase, anxiety ( Cougle & Summer, 2018; Korte et al., 2018). It is also established that anxiety disorders confers and independently higher risk of suicidal ideation and attempts, even when controlling for comorbidity (Thimodeau et al., 2013). In BTAD, education about safety behaviors and anxiety is provided. Through use of the Safety Behavior Assessment Form (SBAF) (Goodson et al., 2016), monitoring strategies, and collaborative exploration, a list of central safety behaviors is identified (along with fears/beliefs fueling the safety behaviors). Following, these safety behaviors are systematically reduced and/or eliminated. The second phase includes safety behavior countering which allows for direct confrontation of the safety behavior and underlying fear/belief. The program includes a host of strategies for eliminating and countering safety behaviors. Clients and therapists work collaboratively in selecting the safety behaviors to address and methods for doing so, however, the client always has the final say. There are two standard safety behavior elimination procedures which are part of the vast majority of treatment cases. These include: accepting anxiety and attention training. Accepting anxiety reverses the negative cycle of anxiety-related suppression/avoidance, which worsens anxiety over time (Hoffman et al., 2009) . Attention training facilitates greater attentional flexibility allowing clients to better disengage from negative attentional states or safety behaviors (worry, vigilance, monitoring, and rumination)(Vogel et al., 2016). As clients systematically reduce and counter their safety behaviors their anxiety decreases and their self-efficacy increases. BTAP also includes special consideration modules that may be used if necessary. These modules provide extra information and guidance on specific categories of safety behaviors that can prove challenging to address. Special consideration modules include: attentional safety behaviors, checking and reassurance, withdrawal and avoidance, and rumination. Some examples of special modules are: attentional safety behaviors (vigilance, monitoring, worry) which have been shown to be central maintaining factors and are often difficult to address. Specific techniques and recommendations are provided to help clients better reduce these deleterious safety behaviors. Rumination, while an attentional safety behavior, has been given its own special consideration module because of its toxic effects across the spectrum of mental health and quality of life. Moreover, rumination can be an important prognostic factor associated with suicidal ideation or attempts especially if the content of the rumination deals with belonging or perceived burdensomeness (Chu et al., 2017). Withdrawal and avoidance is another special module. Withdrawal (and avoidance) are important markers of quality of life and also relate feelings of belonging and loneliness, in addition to chronic anxiety. Checking and reassurance are particularly detrimental in the development of self-efficacy and maintaining anxious preoccupation. The final session involves “wrap up and moving forward” in which the client writes his own therapy guide for moving forward. Research has shown large effect sizes for safety behavior elimination therapy. Similarly, outcome data from social anxiety, generalized anxiety, panic, and anxiety disorder NOS cases will be presented. Additionally, education, clinical examples, pertinent research findings, clinical demonstrations, role-plays, and experiential exercises are all used to help participants gain a better understanding of BTAD. Client workbooks and therapists guides are provided to participants as well. Finally, case consultation for BTAD cases will be offered to interested participants.



Introduction 8:30am – 8:45am
What are safety behaviors? 8:45am – 10:15am
Break 10:15am – 10:30am
Why are safety behaviors important? 10:30am – 12:00pm
Lunch 12:00pm – 12:30pm
How to carry out BTAD 12:30pm – 2:30pm
Break 2:30pm – 2:45pm
Special Modules 2:45pm – 4:15pm
Question and answers 4:15pm – 4:30pm
Adjourn 4:30pm

Learning Objectives:
  1. Participants will identify safety behaviors in anxiety-related conditions
  2. Participants will define safety behaviors, identify different categories, and describe their function (how they maintain anxiety)
  3. Participants will identify core fears/beliefs that underlie safety behaviors and explain the mutual maintaining relationship between core fears/beliefs and safety behaviors
  4. Participants will describe the procedures for administering and scoring the safety behavior assessment form (SBAF) identify primary SBAF subscale, and use the primary SBAF subscale to measure progress throughout treatment
  5. Participants will identify central safety behaviors and create a master list of safety behaviors to be addressed in treatment.
  6. Participants will effectively explain the rationale for safety behavior elimination and countering as a treatment for anxiety
  7. Participants will describe strategies for reducing/eliminating safety behaviors and effective strategies for helping clients address all safety behaviors on master list
  8. Participants will identify approximately 3 core fears associated with clients safety behaviors and develop countering exercises for each of the fears (and related safety behaviors). or negative beliefs and effectively.
  9. Participants will describe Attention Training and Welcoming Anxiety, be able to provide rationales, and guide clients through them.
  10. Participants will describe when and how to assess clients for suicidality within the context of behavior therapy for anxiety disorders
  11. Participants will identify three factors that increase risk of suicidality in patients with anxiety disorders

Instructor Bio:

  Dr. Goodson earned his PhD from Utah State University after completing a pre-doctoral internship at the Milwaukee VA Medical Center. He then completed a 2 year postdoctoral fellowship at Dartmouth Medical School in exposure-based treatment for anxiety disorders. After his fellowship, he began working in the VA system where he treats veterans with PTSD, anxiety, and mood disorders and continues to work in this capacity. In addition, Dr. Goodson is a staff psychologist at the Center for Anxiety and Behavior Therapy. He has published several scientific articles in the areas of Safety Behaviors, anxiety, and PTSD. He is interested in behaviors that perpetuate anxiety and PTSD. Dr. Goodson and colleagues developed and published the Safety Behavior Assessment Form (SBAF). The SBAF is a transdiagnostic measure of safety behaviors appropriate for a wide-range of anxiety conditions, including PTSD, generalized anxiety, social anxiety, panic, and health anxiety. The SBAF has been used to predict treatment response in PTSD and anxiety as well as the development of future anxiety in non-clinical populations. Dr. Goodson also created Behavior Therapy for Anxiety-Related Disorders (BTAD), which has its conceptual roots in past safety behavior therapy, but represents his uniquely effective approach to addressing safety behaviors. He wrote a client workbook and therapist guide to help guide the implementation of BTAD. Dr. Goodson also was the first to create a version of BTAD for PTSD (also known as BTAP). Preliminary outcomes using BTAP have been excellent with large effect sizes. Additionally, Drs. Goodson and Haeffel are currently running an anxiety prevention study using his safety behavior approach.

Course bibliography:
Behavior Therapy for Anxiety-Related Disorders Manuals

Client Manual: Goodson, J.T. (2020). Behavior Therapy for Anxiety-Related Disorders (unpublished treatment manual).

Goodson, J.T. (2020). Behavior Therapy for Anxiety Related Disorders- Therapist Guide for Session-by-Session Implementation (unpublished).
Session guides 1-12
Special Modules (extra information and strategies for reducing, eliminating and countering specific safety behaviors)
1) Checking and Reassurance;
2) Withdrawal and Avoidance;
3) Attentional Safety Behaviors;
4) Rumination

Author Publications related to the treatment
Goodson, J.T. & Haeffel, G.H. (2018). Preventative and restorative safety behaviors: Effects on exposure treatment outcomes and risk for future anxious symptoms. Journal of Clinical Psychology,74, 1657-1672

Goodson, J.T, Haeffel, G.J., Raush, D.A.,& Hershenberg, R. (2016). The safety behavior assessment form: Development and validation. Journal of Clinical Psychology,
, 10, 1099-1111. DOI: 10.1002/jclp.22325.

Goodson, J.T. (2017). Outcome evaluation in psychotherapy. SAGE Encyclopedia of
Abnormal and Clinical Psychology. SAGE: Thousand Oaks.

Publications that influenced the development of the treatment

Chu, C., Buchman-Schmitt, J., Stanly, H., Hom, M., Tucker, R.P., ,Hagan, C.R., et al (2017). The interpersonal theory of suicide. A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143, 1313-13445.

Cougle, J. & Summers, B. (2018). An Experimental Test of the Role of Appearance-Related Safety Behaviors in Body Dysmorphic Disorder, Social Anxiety, and Body Dissatisfaction. Journal of Abnormal Psychology, 127, 770-780.

Hoffman, S.G., Heering, S. Sawyer, T., Anu, A. (2009). How to handle anxiety. The effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behavior Research and Therapy, 47, 389-394

Korte, K. J., Norr, A. M., & Schmidt, N. B. (2018). Targeting Safety Behaviors in the Treatment of Anxiety Disorders: A Case Study of False Safety Behavior Elimination Treatment. American Journal of Psychotherapy, 71(1), 9-20. doi:10.1176/appi.psychotherapy.20180001

Riccardi, C. J., Korte, K. J., & Schmidt, N. B. (2017). False safety behavior elimination
therapy: A randomized study of brief individual Transdiagnostic treatment for anxiety disorders. Journal of Anxiety Disorders, 46, 35–45.

Thibodeau, M.A, Welch, P.G., Sareen, J., Asmundson, J.G, (2103). Anxiety disorders are independency associated with suicide ideation and attempts: Propensity score matching in two epidemiological samples. Depression and Anxiety, 30, 947-954

Vogel, P.A, Hagenb, R., Hjemdal, O., Solem, S., Smeby, M.C;.B., Strand, E.R. Fisher, P. Nordahl, H.M., Well, A. (2016). Metacogntive therapy applications in social anxiety disorder: An exploratory study of the individual and combined effects of attention training technique and situational attentional refocusing. Journal of Experimental Psychopathology, 7, 608-618

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