FAQS
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I am responding to some Frequently Asked Questions (FAQs) on Cognitive Drill Therapy. The questions raised so far are being addressed here. In the course of further development of Cognitive Drill Therapy, I may encounter more questions, which would be incorporated as and when they are raised and opportunity of their inclusion arises.
1. Why Cognitive Drill Therapy? We already have many forms of psychotherapies like systematic desensitization, flooding, graded exposure, implosion, exposure response prevention and Cognitive Behavior Therapy, then what is the need for other therapy?
ANS: Science is not static. It keeps on advancing. The availability of effective therapies does not mean that the search for newer forms of therapies should cease. More and more newer forms of psychotherapies are coming up including meta-cognitive therapies. There are at least two unique components present in drill therapy (a) verbal exposure (b) Tense conversion. Since, this therapy make departure from the existing models of therapy and in case studies it is repeatedly producing positive results, hence, we consider that pursuing the cause of Cognitive Drill Therapy is legitimate, scientific and promising which is opening up new areas of research in clinical psychology.
2. How CDT is different from ERP?
ANS: ERP (Exposure and Response Prevention) is the most recommended form of behavior therapy in cases of OCD. Both CDT & ERP utilize the principles of Exposure to deal with OCD particularly compulsions. Verbal exposure through tense converted statements is the unique feature of CDT which is not present in ERP.
3. How many days/sessions are required for CDT?
ANS: No specific duration of treatment can be specified. In cases being worked out by us it is seen that in cases of Phobia it acts very fast within 2-3 sessions, there can be substantial improvement. OCD takes quite longer about 10-20 sessions or even more.
4. What are the chances of relapse after CDT?
ANS: Relapse can occur with any form of therapies and medical treatment. In phobic conditions, we have case feedbacks of several years duration in which therapeutic gains are maintained. Relapse do occur which can conveniently be handled with a few sessions of CDT during relapse.
5. Can I apply CDT on myself?
ANS. I recommend a few sessions guided by the CDT therapist. Later on you can apply it on yourself with minimal supervision from the therapist. It is very easy to learn and apply.
6. Are there any side effects of CDT?
ANS: It has the same side effects profile as Exposure and Response Prevention albeit in reduced quantity and severity. Till now, I have not seen any side effects of CDT. In some cases, the distress due to exposure may persist for a few days.
7. Is it safe to use CDT?
ANS: CDT can elicit overwhelming traumatic memories. If any person has cardiac vulnerability for traumatic memories, I do not recommend this procedure. Instead, cognitive restructuring and systematic desensitization can be considered which elicit minimal emotional reactions. Apart from that CDT can be a good choice specifically in phobias.
8. I am a therapist. How can I learn CDT?
ANS: You may conceptualize and practice CDT by reading this book. If you need supervised training then you can join us in any of our workshops on Cognitive Drill Therapy. It takes about 2-3 days to learn theoretical and practical aspects of drill therapy.
9. Can I discontinue my medications after improvement with CDT?
ANS: Being a psychologist, I do not advise on medications. The decision to continue, reduce or stop your medications rest with your treating psychiatrist. You need to consult your psychiatrist for the same.
10. How can I know if CDT is effective for my condition?
ANS: I recommend CDT trial of at least three days for making a decision whether it is working. If there is some improvement in three days applications of CDT, then it can be continued for further improvement.
11. Can I combine CDT with other psychotherapies?
ANS Certainly. CDT can conveniently be combined with other forms of psychotherapies like CBT.
12. If I combine CBT and Medicines with CDT, how do I know whether CDT is beneficial for me?
ANS: You can easily make it out. As and when you get spikes of fears, apply CDT on the spot for 5-10 minutes. If it reduces your fears, then consider that it is working for your problems.
13. How much time I spend on CDT per day?
ANS: During active therapy phase, I recommend approximately one hour application of CDT which may be divided in 2-3 applications of about 20-30 minutes. Gradually, you would feel a need of less duration of application.
14. Is CDT scientific?
ANS: Yes. CDT is based on scientific principles of exposure and appraisal theories. The component of linguistic need be investigated scientifically. CDT mostly utilizes existing and tested principles of psychology.
15. Is CDT an evidence based therapy?
ANS: CDT is being developed and applied on many cases. So far we are able to generate case studies. In the course of time, we shall conduct large scale scientific studies to gather evidence base for drill therapy.
16. Is CDT recognized internationally?
ANS: The principles of exposure are already recognized internationally. CDT is based on the principles of exposure. As we reach out the world and conduct more researches, we hope, it should be very much acceptable to the scientific community. There are many variants of exposure therapies like Prolonged Exposure in PTSD which are recognized worldwide. This may happen with CDT too.
17. Is CDT covered in standard textbooks/journals of psychiatry and clinical psychology?
ANS: Since it is a novel form of treatment which is still being developed, we hope that with accumulation of scientific database, it may appear in the textbooks and journals.
18. What are the indications of CDT?
ANS: CDT can be considered for most phobias except blood-injury type phobia and OCD. More effective in phobias and partly effective in OCD. In other emotional conditions like envy, feelings of inadequacy etc it can be explored. CDT is not applicable for positive emotions like joy.
19. What are the contra-indications and non-applicable conditions for CDT?
ANS: We are not using CDT for psychosis, organic conditions, intellectual disabilities, cardiac vulnerability.
20. Who are the affected persons on whom CDT is unlikely to work?
ANS: CDT is applicable when a person feels anxious/fearful by imagining or verbalizing the objects of fears/feared cognition. In the person, who do not feel anxious while exposed to the objects of fear, this therapy is unlikely to work. Also the persons who are extremely sensitive and intolerant of elicited distress due to exposure, CDT may not be feasible. The persons who fail to comply with home work assignments and continue to have symptoms in real life situations despite improvements in therapist’s chamber are unlikely to be benefitted with drill therapy.
21. When CDT therapy should be terminated?
ANS: When an affected person has cleared most objects of phobias and feared cognition through drill therapy and no longer feels anxious then therapy can be terminated.
22. What is the session duration and frequency of CDT?
ANS: A session of CDT usually lasts 60-90 minutes which can be conducted daily or on alternative days.
23. Is there any age criteria for CDT?
ANS: It can be applied from childhood onwards. If a child is able to comprehend the task and practice the drill, it can be considered.
24. Does CDT has any applicability in students of various education systems?
ANS: Very much applicable. Apart from specific phobias, the students have social anxiety and examination anxiety which can be addressed through CDT.
25. If CDT is not working on me, then what should I do?
ANS: Re-analyze your problems and see if you are doing it properly. If there is any gap in its application, then you may re-apply it after corrections. If still it does not work after three days application, then go for other therapies including CBT and psychiatric consultations.
26. CDT requires verbalizations of a few statements. How mere verbalizations can heal my condition?
ANS: See, it is not simple verbalization, it is backed by convergence of multiple theories and technically framed. If you can feel fearful merely by repeating the statements, then with continued repetitions that fear state will subside.
Many more questions may arise in the mind of users, therapists and researchers. I would request all of them to submit me the questions on my email ID so that I can respond to those questions in next revision of the book.
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