I Just Know

I KNOW WHAT TO DO, I JUST DON'T DO IT is for people who have spent a lifetime feeling bad about their body, and every Monday is a torturous new attempt to change. What's going on here? We know what to do, we just don't do it. The issue for us is deeper than any diet or program. That is because not loving ourselves is a symptom of being disconnected from the truth and our true selves. Sue takes us through the false beliefs that keep us stuck and replaces them with the truth about who we really are. We are encouraged to get healthy for good, not by finding the right diet, program, or other means of control, but by making the radical shift from weight loss to worthiness.

Issues are something that we all have, and some more than others. But it is okay. It is absolutely okay to have issues, as long as you can put things in perspective. Sometimes our issues are something that gives you strength, or they can zap the very strength from you! I am here to tell you having issues can be a blessing, as long as you can match them up with the word of God, and stand on top of them instead of them standing on top of you! I am excited about my issues! That hasn't been the case, a long time ago, but now I see the blessings, and I rejoice and praise the Lord for my issues, and the freedom I have received. Every t time I think about how many times in the name of Jesus, I have been blessed, because of, and in spite of my issues! I found out we are going to be alright!

The role of explicit, declarative knowledge in general health care and in psychotherapy is a growing field of research. In many areas of healthcare, knowledge is regarded as an important factor for successful interventions. Participants within mental-health interventions should ideally gain knowledge about their specific conditions and strategies to improve, in order to manage their problems in more helpful ways. In Cognitive Behaviour Therapy (CBT), explicit knowledge is a core feature when treating clients and educating them about their symptoms, problems and potential solutions. Still, the role of knowledge and its relation to treatment outcome within CBT treatments is unclear. CBT administered over the internet (ICBT), is mainly based on psychoeducative texts and thus provides a suitable format for an initial evaluation of explicit knowledge within a clinical research context. The role of explicit knowledge could be of particular importance in the study of younger target groups, who probably have their first treatment experience. Their knowledge gain and its use could be of importance both as separate constructs but also in relation to symptom reduction following treatment. The overarching aim of this thesis was to explore the role of explicit knowledge in internet-delivered CBT for adolescents with depression and anxiety. Study I explored the role of explicit knowledge in a randomised controlled trial with adolescents suffering from primary depression. A knowledge test was constructed and administered at pre- and post-treatment. Results showed that explicit knowledge and certainty of knowledge about depression, anxiety and CBT increased during treatment, but that these variables were unrelated to treatment outcome. Lower pre-treatment knowledge levels (certainty) however predicted greater improvement in depressive symptoms. Study II describes the procedure of developing a new knowledge test in the context of ICBT for adolescents with depression and anxiety. An explorative factor analysis was performed and resulted in a three-factor solution with the following factors: Act in aversive states, Using positive reinforcement, and Shifting attention. The procedure presented could illustrate one way of creating a test for knowledge evaluation in ICBT, but its clinical use needs to be evaluated further. In Study III, participants from a randomised controlled trial of ICBT for adolescent depression were asked about their acquired knowledge and knowledge use six months later. Qualitative methodology (thematic analysis) was used. The results showed two overarching ways that clients can remember and relate to CBT-principles after treatment; one more explicit way related to the active application of CBT principles, and another vague way of recalling treatment content and the passive usage of CBT. Both ways of recalling CBT principles were related to experiencing the treatment as helpful. Study IV evaluated the role of learning strategies and chat-sessions in ICBT for adolescents with anxiety and depression. A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 factorial design with the two factors: with or without learning support and/or chat-sessions. Overall, the results showed general reductions of anxiety and depressive symptoms, and increased knowledge levels. Participants receiving learning strategies during treatment obtained more immediate benefits in treatment outcome and knowledge levels, but at six months follow-up participants without learning support had reached equal amounts of knowledge and symptom reduction. Chat-sessions did not add any effect on treatment outcome or knowledge levels. In conclusion, this thesis suggests that explicit knowledge is a construct that is independent of symptom reduction and increases during ICBT treatments for adolescents with depression and anxiety. Increased knowledge, and increased certainty of knowledge, are valuable outcomes since CBT emphasises educating clients about symptoms, therapeutic principles, and strategies that they can remember and use later on. The lack of association between explicit knowledge gain and symptom reduction could indicate that explicit knowledge is a necessary but insufficient factor for symptom reduction. Adding learning strategies within a treatment programme could be of importance for enhancing short-term treatment effects. There is a continued need for more research on the role of knowledge in ICBT, both as an outcome and as a way to improve treatment effects. The findings in this thesis however suggest that research on explicit knowledge is important to understand what makes ICBT work. Explicit kunskap och dess roll i psykoterapi är ett växande forskningsområde. I kognitiv beteendeterapi (KBT) har explicit kunskap en kärnfunktion då man behandlar klienter och utbildar dem om deras symptom, problemområden och potentiella lösningar. Trots detta är kunskapens roll och dess relation till behandlingsresultat vid KBT oklar. KBT som administreras via internet (IKBT) baseras huvudsakligen på psykoedukativa texter, och kan således vara ett lämpligt format för en initial utvärdering av explicit kunskap. Syftet med denna avhandling var att undersöka om kunskap ökar under IKBT för tonåringar med depression och ångest, dess relation till behandlingsutfall, och om lärandestöd kan öka effekten av behandling. De fyra inkluderade studierna visar att explicit kunskap är ett unikt konstrukt som, oberoende av symtomminskning, ökar under behandling. Deltagare kan komma ihåg behandlingsinnehåll och uppleva KBT kunskap som användbart i deras vardag. Detta är ett värdefullt resultat då KBT betonar vikten av att utbilda klienter om symtom, principer och strategier som de kan komma ihåg och använda. Ett nytt kunskapstest utvecklades och validerades initialt för potentiell användning i framtida kliniska studier. En av studierna visade, via experimentell design, att lärandestöd i behandlingsmoduler kan förbättra kortvariga behandlingseffekter. Sammanfattningsvis är forskning om explicit kunskap viktigt för att förstå vad som får IKBT att fungera.

For most of my life I felt like a failure. Failures cast such a huge shadow over my life that at times they seemed too big to overcome. I became consumed with the non-success of my life. I constantly beat myself up for it and there may be a number of you reading this that feel the same way. It creates a cycle of negative reinforcement. We've all been in that cycle, some for a few minutes; some for a few days; some for most of our lives. If you've ever been in that cycle and felt that failure and the low self-esteem and the loss of hope associated with it, you've come to the right place. This book will serve as an inspiration to change the way you see yourself and open your eyes to what really matters - success in who you are, not what you are, and the happiness that comes from that!

How do some young animals know what to do and how to do it? Does someone teach a caterpillar what to eat? Who gives a baby shark swimming lessons? Sometimes young animals learn things from their parents, but other times… they just know! Explore animal instincts through engaging text and fanciful illustrations.

Forget the 10,000 hour rule— what if it’s possible to learn the basics of any new skill in 20 hours or less? Take a moment to consider how many things you want to learn to do. What’s on your list? What’s holding you back from getting started? Are you worried about the time and effort it takes to acquire new skills—time you don’t have and effort you can’t spare? Research suggests it takes 10,000 hours to develop a new skill. In this nonstop world when will you ever find that much time and energy? To make matters worse, the early hours of prac­ticing something new are always the most frustrating. That’s why it’s difficult to learn how to speak a new language, play an instrument, hit a golf ball, or shoot great photos. It’s so much easier to watch TV or surf the web . . . In The First 20 Hours, Josh Kaufman offers a systematic approach to rapid skill acquisition— how to learn any new skill as quickly as possible. His method shows you how to deconstruct com­plex skills, maximize productive practice, and remove common learning barriers. By complet­ing just 20 hours of focused, deliberate practice you’ll go from knowing absolutely nothing to performing noticeably well. Kaufman personally field-tested the meth­ods in this book. You’ll have a front row seat as he develops a personal yoga practice, writes his own web-based computer programs, teaches himself to touch type on a nonstandard key­board, explores the oldest and most complex board game in history, picks up the ukulele, and learns how to windsurf. Here are a few of the sim­ple techniques he teaches: Define your target performance level: Fig­ure out what your desired level of skill looks like, what you’re trying to achieve, and what you’ll be able to do when you’re done. The more specific, the better. Deconstruct the skill: Most of the things we think of as skills are actually bundles of smaller subskills. If you break down the subcompo­nents, it’s easier to figure out which ones are most important and practice those first. Eliminate barriers to practice: Removing common distractions and unnecessary effort makes it much easier to sit down and focus on deliberate practice. Create fast feedback loops: Getting accu­rate, real-time information about how well you’re performing during practice makes it much easier to improve. Whether you want to paint a portrait, launch a start-up, fly an airplane, or juggle flaming chain­saws, The First 20 Hours will help you pick up the basics of any skill in record time . . . and have more fun along the way.