An essential resource for anyone providing services for individuals with OCD or anxiety disorders. Cognitive-behavioral therapy using the techniques of exposure and response prevention has helped countless individuals with obsessive-compulsive disorder (OCD) overcome debilitating symptoms and live fuller, more satisfying lives. This volume opens with an overview of the diagnosis and assessment of OCD in adults and delineates an evidence-based conceptual framework for understanding the development, maintenance, and treatment of obsessions and compulsions. The core of the book that follows is a highly practical treatment manual, based on decades of scientific research and clinical refinement, packed with helpful clinical pearls, therapist-patient dialogues, illustrative case vignettes, sample forms and handouts. State-of-the-art strategies for enhancing exposure therapy using inhibitory learning, ACT, and couples-based approaches are described. Readers are also equipped with skills for tailoring treatment to patients with different types of OCD symptoms (e.g., contamination, unacceptable thoughts, challenging presentations such as mental rituals) and for addressing common obstacles to treatment. The book is an essential resource for anyone providing services for individuals with anxiety disorders.

The Hogrefe Publishing series "Advances in Psychotherapy - Evidence-Based Practice" provides readers with practical evidence-based guidance on the diagnosis and treatment of the most common disorders seen in clinical practice in a compact, reader-friendly manner.

Veterans who are also first responders (V-FRs) represent a distinct, underserved population with complex and compounded mental health challenges. In addition to facing high rates of posttraumatic stress disorder, depression, anxiety, substance use, insomnia, and chronic pain, V-FRs encounter significant cultural and logistical barriers to accessing mental health services. This article aims to provide clinical guidance on addressing these issues while considering the unique cultural context of V-FRs. It outlines evidence-based treatments and assessments, offering practical strategies for clinicians to adapt these approaches to meet the specific needs of this population.

Youth Peer Support Services (YPSS)—where youth with lived experience of mental health challenges support peers—address the growing, unmet need for youth mental health services. This article emphasizes the vital role of clinicians in training, supervising, and supporting youth peer support workers (YPSWs) to ensure effective service delivery. Clinical vignettes highlight how tailored supervision, role clarity, and boundary management help YPSWs leverage their lived experience while maintaining professionalism. The vignettes demonstrate the transformative potential of YPSS on recovery and underscore the importance of clinician-led training, supervision, and organizational support. Key considerations for clinicians in YPSS implementation are discussed, offering guidance for effectively supporting the integration of YPSS into mental health systems.

Rural trans and nonbinary (TNB) youth face a paradoxical mental health challenge. They increasingly must rely on social media for support and community, but online forums pose a significant risk to young people's mental health and social well-being. The broad accessibility, user anonymity, and group dynamics on social media tend to amplify bullying and violent speech. The authors examine the clinical and ethical challenges rural mental health providers (MHPs) face, such as navigating complex, ever-increasing state and federal laws and policies affecting TNB youth; operating as specialists in service deserts; and balancing ethical obligations with client safety. We propose a therapy intervention model called Digital Literacy for Resistance (DLR) that integrates Cognitive Behavioral Therapy (CBT) tools with digital literacy strategies to empower rural TNB youth and their families.

Over the last 10–20 years, there has been a significant increase in the amount of research on nonsuicidal self-injury (NSSI). Yet it remains misunderstood, highly stigmatized, and one of the more puzzling behaviors that present in the context of health service. In this article, we aim to help clinicians to better understand and address NSSI in their clinical practice. In reference to a clinical vignette, we provide an overview of the current knowledge regarding NSSI, outline a new person-centered framework of NSSI recovery, touch on key ethical and clinical considerations regarding NSSI, and provide concrete tips for working with clients who self-injure within the person-centered framework. We also offer suggested language that can be used to support clients who self-injure, in a non-judgmental and supportive way.

Autism spectrum disorder (ASD) is associated with challenges in areas such as social skills and behavior, with 1 in 36 children diagnosed in the U.S. Annually, over 100,000 adolescents with ASD transition to adulthood, often facing a “service cliff” where support diminishes. Group therapy can help autistic adults by enhancing social skills, executive functioning, and emotional regulation while fostering belonging and reducing isolation. Telehealth-based group therapy offers additional benefits, particularly for those with social anxiety, geographic barriers, or limited transportation. While telehealth is effective for autistic adults, practical guidelines for virtual group therapy are lacking. This article provides recommendations for conducting telehealth group therapy, incorporating insights from clinicians and an autistic self-advocate.

Clinical hypnosis has applications in a wide range of psychological and health related problems. Research into clinical hypnosis has seen an improvement in scientific rigor and, in the past two decades, new research has expanded to include both randomized control trials and meta-analyses. However, the use of hypnosis in psychology, medicine, and psychotherapy lags behind its empirical support. As illustrated in the cases of Darlene (breast cancer survivor with hot flashes), Paul (smoking cessation), and Linda (irritable bowel syndrome) evidence supports clinical hypnosis for anxiety/stress, menopausal hot flashes, smoking cessation, and irritable bowel syndrome. Increasingly, hypnotherapy apps are integrated into care to provide low-cost access to self-hypnosis sessions. Clinical psychologists can expand their practice and competency with training in clinical hypnosis.

Alcohol use is common and associated with varying degrees of harm. Heavy alcohol use can lead to the development of an alcohol use disorder (AUD). The stigma and discrimination that people with AUD often face can act as barriers to seeking clinical services and may negatively impact the quality of care they receive. This article outlines best practices for working with people who use alcohol, emphasizing the importance of addressing stigma in caring for and communicating with clients. Written from a harm-reduction perspective, it highlights the significance of client-driven goal setting and autonomy, meeting clients where they are regarding their behavior change goals, and maintaining a non-judgmental, compassionate stance.

Over a decade has passed since the inclusion of internet gaming disorder (commonly known as video game addiction) in the DSM-5. The purpose of this article is to provide an up-to-date overview of internet gaming disorder. The article further reviews the challenges health service psychologists could face in identifying and evaluating internet gaming disorder, such as the ambiguity in defining “excessive gaming,” the clinical utility of DSM-5 diagnostic criteria, and the lack of an internationally standardized tool in measuring internet gaming disorder. The authors provide recommendations on these issues based on empirical research findings and interviews with clinicians working with patients diagnosed with internet gaming disorder.

Obsessive–compulsive disorder (OCD) is a serious and debilitating psychiatric condition. It has historically been associated with anxiety. Recent analyses have identified a specific role for disgust as well. A clinical vignette underscores the relevant understanding of disgust in the context of OCD. While contemporary evidence-based treatment emphasizes exposure with response prevention (ERP) for OCD, there are special considerations for addressing symptoms that are a result of disgust reactions. The review provides greater insight into the recent research on disgust and how it differs from the emotion of fear. In addition to highlighting the complexity of treatment for contamination fears, evidence-based assessment and practice considerations are discussed, as well as the ethical challenges of exposure and response prevention (ERP). Future research targeting disgust symptomatology is warranted.

Mass shootings are increasingly common in the United States and associated with a range of adverse mental health outcomes. In this article, we summarize the small but growing empirical literature on the mental health consequences of mass shootings, describing commonly examined post-shooting outcomes (e.g., posttraumatic stress disorder [PTSD] symptoms), risk factors for poor mental health (e.g., higher exposure), and protective factors associated with lower symptoms (e.g., social support). We then discuss key clinical and ethical challenges that can arise after mass shootings, such as those related to competence and confidentiality, and provide recommendations for evidence-based assessment and practice, including Psychological First Aid and empirically supported treatments for PTSD. The clinical case study of Jason and his therapist Margaret illustrates the article’s key themes.

Regulation Focused Psychotherapy for Children (RFP-C) is a manualized, time-limited, psychodynamic approach for children who experience challenges with emotion regulation and demonstrate externalizing behavior problems (Hoffman et al., 2016). In research settings, it takes place over ten weeks and includes 16 sessions with the child and four with the child’s parents. This protocol can be extended or modified in regular clinical practice. The current study utilized a dual case study method to analyze pretreatment and post-treatment measures and compare psychotherapy outcomes and process in RFP-C between a successful and an unsuccessful case. Data examined included (a) quantitative outcome measures; (b) case conceptualizations and clinical vignettes drawn from review of session videos; (c) post-treatment interviews with parent, child, and therapist; and (d) psychotherapy process codings of child and parent sessions. These data were employed to (a) identify differential psychotherapy processes; (b) assess parental defense mechanisms; (c) assess parental attachment classifications; and (d) evaluate therapist countertransference ratings. Results indicated that many variables contributed to successful versus unsuccessful treatment outcomes, including but not limited to (a) child’s spontaneity; (b) active participation and emotional expression throughout treatment; (c) themes of child play; (d) therapist’s countertransference; (e) child and parental defense mechanisms; and (f) parental attachment styles. Taken together, findings from this study contribute to the literature on therapeutic outcomes for children and families and highlight some of the essential characteristics of successful psychotherapy process. Limitations of the study and directions for future research are also discussed.

Social anxiety is characterized by excessive anxiety or discomfort in situations where a person might feel judged or evaluated by others, including performance situations (e.g., being the center of attention, public speaking, working under observation, playing sports or music in front of an audience) and situations involving interpersonal contact with others (e.g., making small talk, meeting new people, dating). According to large-scale epidemiological studies, social phobia is one of the most prevalent psychological disorders. Although prevalence estimates vary, recent studies suggest that approximately 7% of Americans suffer from this disorder. In addition to the high percentage of people with symptoms meeting criteria for this disorder, many other individuals experience social anxiety or shyness to a lesser, but still impairing degree. Social phobia is also a common comorbid condition, often diagnosed along with other anxiety disorders. Taken together, this information suggests that practitioners are likely to encounter patients displaying some degree of social anxiety, no matter what specialty service or setting they occupy. Although social anxiety is a widely encountered problem, there are few resources available to provide straightforward, accessible assessment and treatment information for practitioners. This book aims to fill that gap. Over the past 20 years, effective tools have been developed to identify and treat individuals with social anxiety. The current book provides up-to-date information on the diagnosis, identification, conceptualization, and treatment of social anxiety and social phobia. This book is aimed at practitioners who practice in a broad range of settings, from specialty clinics to general practice, as well as students. Existing books tend to focus on the psychopathology of social anxiety, address multiple disorders in one volume, or provide extensive and detailed protocols for treating this disorder. In contrast, this book is a more concise guide to identification and treatment that is accessible for the busy practitioner. It focuses specifically on social phobia and social anxiety, making it an attractive reference book for professionals who require clear, easy to follow guidelines on treatments for social anxiety.

This indispensable volume in the Advances in Psychotherapy series has been meticulously crafted to address the nuances of diagnosing, assessing, and treating panic disorder and agoraphobia, using the latest interventions derived from cognitive behavioral therapy (CBT). Designed as a brief but comprehensive resource for treatment providers at all levels, this book gives a description of panic disorder and agoraphobia, reviews well-established, empirically derived theories and models, and guides readers through the diagnostic and treatment decision-making process before outlining a detailed 12-session treatment. Each chapter offers practical guidance, specialized insights, and adaptable strategies to tailor the treatment to individual patients. The step-by-step approach, detailed case vignette, and worksheets will enable practitioners to feel confident and competent in empowering clients to overcome their often debilitating fears and reclaim their lives. This is an ideal text for clinical psychologists, other mental health professionals, and students.