Problem Work, Pattern Work
- Author:
Yean Pak Cheong
1
Author Information
- Collective Name:ONG CHOOI PENG; GOH LEE GAN
- Publication Type:Journal Article
- Keywords: Problem work; Counter-conditioning; Contingency Management; Negative automatic thoughts; Cognitive behavioral therapy; Pattern work; Problem-saturated stories; Preferred positive stories.
- From:The Singapore Family Physician 2018;44(1):15-18
- CountrySingapore
- Language:English
- Abstract: In this Unit we describe the first 2 types of intervention arising out of the extended consultation. In Problem work, the basic idea is to determine whether the patient’s behavior is a maladaptive response to antecedent stimuli, or the result of cognitive bias. We use counter-conditioning and contingency management to deal with maladaptive response. We use cognitive therapy to trace cognitive distortions that give rise to NATs and take steps to counter them. The problem approach is integrated as Cognitive Behavioral Therapy. The SMART solution to problems is deployed when there is no maladaptive behavior or cognitive bias at play. In pattern work, the salient life experiences of the patient which are selectively stored as narratives are examined. Such narratives may reflect a negative life pattern of thought and feeling. This is the problem-saturated story. Patients can be helped to change their pattern of thought and feeling and thus store their life experiences as preferred positive stories. The 4Rs – Re-membering, Re-framing, Re-authoring and Re-telling – help us to construct the new stories. When we do this consistently, the pattern work creates present and future stories of hope for the sufferer.
