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Cognitive Behavior Therapy

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It advocates a humanistic, educative model of treatment as opposed to a medical model. ... than undertake more rewarding forms of self-discipline. ... – PowerPoint PPT presentation

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Title: Cognitive Behavior Therapy


1
Cognitive Behavior Therapy
2
Rational Emotive Behavioral Therapy (REBT)
  • Stresses thinking, judging, deciding, analyzing,
    and doing
  • Assumes that cognitions, emotions, and behaviors
    interact and have a reciprocal cause-and-effect
    relationship
  • Is highly didactic, very directive, and concerned
    as much with thinking as with feeling
  • Teaches that our emotions stem mainly from our
    beliefs, evaluations, interpretations, and
    reactions to life situations

3
Overview
  • Developed by Albert Ellis in 1955. General REBT
    is virtually synonymous with cognitive behavior
    therapy. Preferential or elegant REBT seeks a
    deeper philosophic change in the client.

4
View of Human Nature
  • We are born with a potential for both rational
    and irrational thinking
  • We have the biological and cultural tendency to
    think crookedly and to needlessly disturb
    ourselves
  • We learn and invent disturbing beliefs and keep
    ourselves disturbed through our self-talk
  • We have the capacity to change our cognitive,
    emotive, and behavioral processes

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (3)
5
Major philosophies and nature of humans
  • REBT is a comprehensive approach to treatment and
    education that employs cognitive, emotive, and
    behavioral approaches. It advocates a
    humanistic, educative model of treatment as
    opposed to a medical model.
  • Human problems stem not from external events or
    situations but from peoples views or beliefs
    about them. Peoples emotions stem from their
    beliefs, evaluations, interpretations, and
    philosophies about what happens to them, not from
    the events themselves. (Gilliland James, p.
    232)

6
Irrational Ideas
  • Irrational ideas lead to self-defeating behavior
  • Some examples
  • The idea that you must have love or approval from
    all people you find significant.
  • The idea that you must prove thoroughly
    competent, adequate, and achieving.

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (5)
7
Irrational Beliefs
  • The idea that when people act obnoxiously and
    unfairly, you should blame and damn them and see
    them as bad, wicked or rotten.
  • The idea that you have to view things as horrible
    and catastrophic when you get seriously
    frustrated, treated unfairly or rejected.
  • The idea that emotional misery comes from
    external pressures and that you have little
    ability to control or change your feelings.

8
Irrational Beliefs
  • The idea that if something seems dangerous or
    fearsome, you must preoccupy yourself with it and
    make yourself anxious about it.
  • The idea that you can more easily avoid facing
    many life difficulties and self-responsibilities
    than undertake more rewarding forms of
    self-discipline.
  • The idea that your past remains all-important and
    that because something once strongly influenced
    your life, it has to keep determining your
    feelings today.

9
Irrational Beliefs
  • The idea that people and things should turn out
    better than they do and that you must view life
    as awful if you dont find good solutions to its
    realities.
  • The idea that you can achieve maximum human
    happiness by inertia or inaction or by passively
    or uncommittedly enjoying yourself. (Gilliland
    James, p. 245)

10
Major personality constructs
  • REBT suggests that there is a biological basis
    for human behavior.
  • Virtually all humans show evidence of major
    irrationalities.
  • No social or cultural group is devoid of
    irrational behavior.
  • Many irrationalities run counter to teaching by
    significant others and society at large.
  • Irrationality is not exclusive to the stupid or
    retarded bright and gifted humans can act
    irrationally.
  • Those who may oppose irrational activity and be
    most aware of it may also fall prey to it.
  • People often adopt new irrationalities after
    giving up old ones or go back to an irrational
    activity after working hard to overcome it.
    (Gilliland James, p. 233)

11
Major personality constructs
  • There is also a social basis for personality.
    However, it is only because people teach
    themselves as they aspire to succeed socially and
    live comfortably within society. (Gilliland
    James, p. 234)

12
Nature of maladaptivity
  • Maladaptivity stems from the way people think
    about things. It is ones belief system that
    leads to inappropriate emotional consequences
    such as rage, depression, and extreme anxiety.
    (Gilliland James, p. 237)

13
Major goals of counseling
  • The overall goal of REBT involves minimizing the
    clients central self-defeating outlook and
    acquiring a more realistic, tolerant philosophy
    of life. Two other central goals are reducing
    the clients anxiety (self-blame) and hostility
    (blaming others and the world) and teaching
    clients a method of self-observation and
    self-assessment that will ensure that this
    improvement continues.
  • Thus, a primary goal for counseling is to teach
    clients to detect and dispute irrational beliefs.
  • Another long-term goal is to assist clients in
    becoming involved in activities that are vitally
    absorbing to them. (Gilliland James, pp.
    241-242)

14
Major techniques/strategies
  • Major strategies for detecting irrational beliefs
    include education, problem exploration,
    ferreting out B. (Gilliland James, p. 246)
  • Strategies for disputing irrational beliefs
    include debating, discriminating and defining.
    (Gilliland James, p. 248)

15
Major techniques/strategies
  • Cognitive (rational) techniques include
    interpretation of defenses, presentation of
    alternative choices and actions, analogies,
    parables and metaphors, paralinguistics,
    therapeutic markers, reduction to absurdity,
    visual aids, bibliotherapy, contradiction with a
    cherished value, pragmatic disputes, paradoxical
    intention, humor and semantic precision.
    (Gilliland James, pp. 249-252)

16
Major techniques/strategies
  • Emotive techniques include negative imagery,
    stepping out of character, future imaging,
    labeling, role playing, and using emotionally
    charged language. (Gilliland James, pp.
    252-254)
  • Behavioral techniques include homework
    assignments, flooding, penalization, skill
    training, and practicing and reinforcing positive
    cognitions. (Gilliland James, pp. 255-256)

17
Major roles of counselor
  • The role of the counselor is to help the client
    discover how they block themselves from pursuing
    happiness and health and how they can remove
    those blocks. (Gilliland James, p. 242)
  • The counselor is active, directive and
    confrontive in approaching the clients needs.
    (Gilliland James, p. 244)

18
Major roles of the client
  • The clients role is to learn to identify their
    beliefs and seek ways to eliminate the ways they
    block themselves from becoming happy and healthy.
  • Clients may be asked to perform risk-taking
    activities in which they may intentionally set
    themselves up to fail to see that the results are
    not as fearsome as they imagined. They may be
    given hard tasks so that they can engage in tough
    activities and learn not to be upset or scared by
    them. (Gilliland James, p. 245)

19
The Therapeutic Process
  • Therapy is seen as an educational process
  • Clients learn
  • To identify and dispute irrational beliefs that
    are maintained by self-indoctrination
  • To replace ineffective ways of thinking with
    effective and rational cognitions
  • To stop absolutistic thinking, blaming, and
    repeating false beliefs

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (2)
20
The A-B-C theory
Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (4)
21
Aaron Becks Cognitive Therapy (CT)
  • Insight-focused therapy
  • Emphasizes changing negative thoughts and
    maladaptive beliefs
  • Theoretical Assumptions
  • Peoples internal communication is accessible to
    introspection
  • Clients beliefs have highly personal meanings
  • These meanings can be discovered by the client
    rather than being taught or interpreted by the
    therapist

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (6)
22
Theory, Goals Principles of CT
  • Basic theory
  • To understand the nature of an emotional episode
    or disturbance it is essential to focus on the
    cognitive content of an individuals reaction to
    the upsetting event or stream of thoughts
  • Goals
  • To change the way clients think by using their
    automatic thoughts to reach the core schemata and
    begin to introduce the idea of schema
    restructuring
  • Principles
  • Automatic thoughts personalized notions that are
    triggered by particular stimuli that lead to
    emotional responses

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (7)
23
CTs Cognitive Distortions
  • Arbitrary inferences
  • Selective abstraction
  • Overgeneralization
  • Magnification and minimization
  • Personalization
  • Labeling and mislabeling
  • Polarized thinking

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (8)
24
CTs Cognitive Triad
  • Pattern that triggers depression
  • 1. Client holds negative view of themselves
  • 2. Selective abstraction Client has tendency to
    interpret experiences in a negative manner
  • 3. Client has a gloomy vision and projections
    about the future

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (9)
25
Donald Meichenbaums Cognitive Behavior
Modification (CBM)
  • Focus
  • Clients self-verbalizations or self-statements
  • Premise
  • As a prerequisite to behavior change, clients
    must notice how they think, feel, and behave, and
    what impact they have on others
  • Basic assumption
  • Distressing emotions are typically the result of
    maladaptive thoughts

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (10)
26
Meichenbaums CBM
  • Self-instructional therapy focus
  • Trains clients to modify the instructions they
    give to themselves so that they can cope
  • Emphasis is on acquiring practical coping skills
  • Cognitive structure
  • The organizing aspect of thinking, which seems to
    monitor and direct the choice of thoughts
  • The executive processor, which holds the
    blueprints of thinking that determine when to
    continue, interrupt, or change thinking

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (11)
27
Behavior Change Coping (CBM)
  • 3 Phases of Behavior Change
  • 1. Self-observation
  • 2. Starting a new internal dialogue
  • 3. Learning new skills
  • Coping skills programs Stress inoculation
    training (3 phase model)
  • 1. The conceptual phase
  • 2. Skills acquisition and rehearsal phase
  • 3. Application and follow-through phase

Theory and Practice of Counseling and
Psychotherapy - Chapter 10 (12)
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