By Martin R Bamber
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Additional resources for CBT for Occupational Stress in Health Professionals: Introducing a Schema-Focussed approach
One well-known example of a vignette used by Beck (1967; 1976) is the ‘cat vignette’: ‘It is the middle of the night and you are fast asleep. Suddenly you are woken up and startled by a loud noise downstairs. You look at your clock and it is 2 am. What thoughts are going through your head? How does it make you feel? What do actually do? Suddenly you remember that you forgot to put the cat out. You usually put the cat out because it has a tendency to climb up on furniture and knock things oﬀ. What are your thoughts?
It is associated with activation of the hypothalamic–pituitary–adrenocortical (HPAC) system and raised cortisol levels. Raised cortisol levels in turn increase the individual’s susceptibility to a whole range of immuno-incompetence-type illnesses such as colds, infections, viruses, skin complaints and allergies. Thus, it can be seen that the duration of exposure to a stressor which is perceived to be uncontrollable, or is objectively uncontrollable, plays a critical role in determining the nature of stress-induced physical health problems (Palmblad et al.
These dysfunctional beliefs and maladaptive behavioural coping styles form the basis for the cognitive behavioural treatment interventions described later in this book. The stress syndromes described in the model have their correlates in the diagnostic classiﬁcations found in the Diagnostic and Statistical Treatment Manual (DSM-IV) of the American Psychiatric Association (APA 2000). The two most common DSM-IV mental health problems seen in NHS occupational health services are anxiety and depression (Bamber 1995; McPherson 2004).
CBT for Occupational Stress in Health Professionals: Introducing a Schema-Focussed approach by Martin R Bamber