1. CBTpsych.com Fjóla Dögg Helgadóttir

2. What is CBT? Cognitive Behavior Therapy Evidence based approach for treating anxiety Only one RCT has been published so far using CBT for anxiety in AWS.

3. Do AWS benefit from CBT? Prevalence of Social Phobia diagnosis may be as high as 60% in AWS In 200 AWS, 94% sought speech treatment vs. 0% sought Ψ treatment Ψ = psychology

4. Speaking is one of the core fears in social phobia … public speaking (21.2%) speaking in a meeting or class (19.5%).

5. Why do AWS not receive CBT? Lack of time? Lack of awareness of social phobia? Stigma associated with Ψ treatments? Exclusion criteria in the DSM?

6. The nature of social anxiety 3 rd most common of the Ψ disorders Most people never seek treatment Reason: shame & embarrassment

7. True or false? -I rarely worry about seeming foolish to others. -I worry about what people will think of me even when I know it doesn't make any difference. -I feel very upset when I commit some social error -I am frequently afraid of other people noticing my shortcomings. -The disapproval of others would have little effect on me Free feedback on http//www.fjola.com.au password: clinic2008

8. What can CBT do for AWS? Improve quality of life Decrease anxiety, anger, sadness With or without stutter

9. CBTpsych.com My PhD invovled using modern technology to deliver CBT to AWS over the internet (therefore robot theme) Demo 1 Questions?

10. Anger and frustration Tyranny of the shoulds Rules of for living

11. 50 Great Myths of Popular Psychology Myth #1 Blowing our Tops Defuses Anger Resource: Scientific American

12. Resource: Scientific American

14. Common should statements Everyone should treat me nicely I shouldn't stutter I should have grown up in a "perfect" family environment I should always say "yes" to requests from others I should always look good in other people's eyes

15. Everyone should treat me nicely BenefitCost I will be happy when I am treated nicely. A major disadvantage of this 'should' is that it is simply unrealistic. Some people are rude and inconsiderate. If I think that people should treat me nicely, I will become infuriated every single time it doesn't happen. I will experience anger and frustration regularly. My happiness is at stake here. This 'should' is damaging.

16. I shouldn’t stutter BenefitCost I will work hard to be fluent. I will be happy whenever I am fluent. I DO stutter from time to time. Therefore, insisting that I shouldn’t stutter will make me feel anxious, frustrated and sad. I will end up feeling ashamed and guilty, as if I am letting myself down. Furthermore, the anxiety that I create by insisting that I must remain fluent will increase the likelihood that I will stutter.

17. I should have grown up in a "perfect" family environment BenefitCost At times when I think that I have come from a "perfect" family I will feel very content If I see any signs of my family being imperfect, I will feel unhappy. I might feel anger toward my parents for failing to provide me with the 'perfect' upbringing. Since there is no such thing as a 'perfect' family, I will often be able to find flaws in my childhood experience. I will blame my childhood for my current difficulties, and I can't change the past.

18. I should always say "yes" to requests from others BenefitCost I will get lots of opportunities in the workplace to take on extra tasks. I will probably be taken advantage of in my personal and professional relationships. I will end up doing lots of things that I really would prefer to avoid. I will end up feeling overburdened. I will end up resentful of the demands of others.

19. Final note! As you can see, there are lots of serious disadvantages to this SHOULD. It is setting the person up for failure, shame and frustration. Consider the following syllogism: (A) Human adults with a history of stuttering tend to be dysfluent from time to time (B) I’m a human adult with a history of stuttering (C) Therefore, I SHOULD stutter from time to time If you did a Cost-Benefit analysis on this SHOULD you would see its merits!

20. Safety behaviours Function to maintain anxiety Definition remain in its function

24. Heightened self-focus Prevention of disconfirmation Contamination of the social situation Drawing attention to herself

25. Your safety behaviours What are are you doing to eliminate social threat?

26. ↓↓Quality of life means more: Frequent emotional turbulance Anxiety Anger Sadness Lack of motivation to engage in life

27. ↑↑ Quality of life means more: Attention to the postive things in life, such as: the nice weather in Sydney, the beautiful beach, great food, great nightlife, opportunity to meet new people, interesting things to do with friends, travelling, learning about new cultures, languages, doing your favorite exercise, listening to great music, engaging in hobbies of interest, great outdoors hiking, good sense of humour, interesting documentaries etc.

29. Do you have many causal thoughts? The best way to know that you are having one, is that you are feeling anxious, sad, or angry!

30. The End Thanks for your time! Any questions – ask me now, or email me on fjola@fjolad.com