MOVIE QUESTIONS ANALYSIS
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Corey10e_PPT_ch10editedcognitivebehaviortherapy432111.pptx
Chapter 10
Cognitive Behavior Therapy
Spring 2021
Professor Petrie
Copyright © 2021 Cengage
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A-B-C model of personality: Temporal sequence of antecedents, behavior, and consequences. The theory that people’s problems do not stem from activating events but from their beliefs about such events. Thus, the best route to changing problematic emotions is to change one’s beliefs about situations.
Arbitrary inferences: A form of cognitive distortion that refers to making conclusions without supporting and relevant evidence.
Automatic thoughts: Maladaptive thoughts that appear to arise reflexively, without conscious deliberation.
Cognitive behavior modification (CBM): A therapeutic approach that focuses on changing the client’s self verbalizations.
Cognitive behavior therapy (CBT): A treatment approach that aims at changing cognitions that are leading to psychological problems.
Cognitive distortions: In cognitive therapy, the client’s misconceptions and faulty assumptions. Examples include arbitrary inference, selective abstraction, overgeneralization, magnification and minimization, labeling and mislabeling, dichotomous thinking, and personalization.
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Cognitive narrative perspective: Focuses on the stories people tell about themselves and others regarding significant events in their lives.
Cognitive restructuring: A process of actively altering maladaptive thought patterns and replacing them with constructive and adaptive thoughts and beliefs.
Cognitive structure: The organizing aspect of thinking, which monitors and directs the choice of thoughts; implies an “executive processor,” one that determines when to continue, interrupt, or change thinking patterns.
Cognitive therapy (CT): An approach and set of procedures that attempts to change feelings and behavior by modifying faulty thinking and believing.
Cognitive triad: A pattern that triggers depression.
Collaborative empiricism: A strategy of viewing the client as a scientist who is able to make objective interpretations. The process in which therapist and client work together to phrase the client’s faulty beliefs as hypotheses and design homework so that the client can test these hypotheses.
Constructivist approach: A recent development in cognitive therapy that emphasizes the subjective framework and interpretations of the client rather than looking to the objective bases of faulty beliefs.
Constructivist narrative perspective: An approach that focuses on the stories that people tell about them themselves and others regarding significant events in their lives.
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Coping skills program: A behavioral procedure for helping clients deal effectively with stressful situations by learning to modify their thinking patterns.
Dichotomous thinking: A cognitive error that involves categorizing experiences in either-or extremes.
Distortion of reality: Erroneous thinking that disrupts one’s life; can be contradicted by the client’s objective appraisal of the situation.
Generic cognitive model: Describes principles pertaining to all CT applications from depression and anxiety treatments to therapies for a wide variety of other problems.
Homework: Carefully designed and agreed-upon assignments aimed at getting clients to carry out positive actions that induce emotional and attitudinal change. These assignments are checked in later sessions, and clients learn effective ways to dispute self-defeating thinking. Internal dialogue: The sentences that people tell themselves and the debate that often goes on “inside their head”; a form of self-talk, or inner speech.
Irrational belief: An unreasonable conviction that leads to emotional and behavioral problems.
Labeling and mislabeling: Portraying one’s identity on the basis of imperfections and mistakes made in the past and allowing them to define one’s true identity.
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Magnification and minimization: Perceiving a case or a situation in a greater or lesser light than it truly deserves.
Musturbation: A term coined by Ellis to refer to behavior that is absolutist and rigid. We tell ourselves that we must, should, or ought to do or be something.
Negative cognitive triad: Negative views of the self (self-criticism), the world (pessimism), and the future (hopelessness).
Overgeneralization: A process of holding extreme beliefs on the basis of a single incident and applying them inappropriately to dissimilar events or settings.
Personalization: A tendency for people to relate external events to themselves, even when there is no basis for making this connection.
Rational emotive behavior therapy (REBT): A theory based on the assumption that cognitions, emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship.
Rational emotive imagery: A form of intense mental practice for learning new emotional and physical habits. Clients imagine themselves thinking, feeling, and behaving in exactly the way they would like to in everyday situations.
Rationality: The quality of thinking, feeling, and acting in ways that will help us attain our goals. Irrationality consists of thinking, feeling, and acting in ways that are self-defeating and that thwart our goals.
Theory and Practice of Counseling and Psychotherapy - Chapter 10
Theory and Practice of Counseling and Psychotherapy - Chapter 10
Relapse prevention: Procedure for promoting long-term maintenance that involves identifying situations in which clients are likely to regress to old patterns and developing coping skills for such situations.
Schema: Core beliefs that are centrally related to dysfunctional behaviors. The process of cognitive therapy involves restructuring distorted core beliefs (or schema).
Selective abstraction: A cognitive distortion that involves forming conclusions based on an isolated detail of an event.
Self-instructional therapy: An approach to therapy based on the assumption that what people say to themselves directly influences the things they do. Training consists of learning new self-talk aimed at coping with problems.
Self-talk: What people “say” to themselves when they are thinking. The internal dialogue that goes on within an individual in stressful situations.
Shame-attacking exercises: A strategy used in REBT therapy that encourages people to do things despite a fear of feeling foolish or embarrassed. The aim of the exercise is to teach people that they can function effectively even if they might be perceived as doing foolish acts.
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Socratic dialogue: A process that cognitive therapists use in helping clients empirically test their core beliefs. Clients form hypotheses about their behavior through observation and monitoring.
Strengths-based cognitive behavior therapy (SB-CBT): A therapeutic approach that emphasizes clients’ strengths, resilience, and resources for positive change.
Stress inoculation: Individuals are given opportunities to deal with relatively mild stress stimuli in successful ways, so that they gradually develop a tolerance for stronger stimuli.
Stress inoculation training (SIT): A form of cognitive behavior modification developed by Donald Meichenbaum that is a combination of information giving, Socratic discussion, cognitive restructuring, problem solving, relaxation training, behavioral rehearsals, self-monitoring, self-instruction, self-reinforcement, and modifying environmental situations.
Therapeutic collaboration: A process whereby the therapist strives to engage the client’s active participation in all 109 phases of therapy.
Thought records: Aimed at assisting clients in identifying negative automatic thoughts and testing them by looking for evidence that does and does not support the negative thoughts.
Introduction
The various cognitive behavioral approaches share the following attributes:
A collaborative relationship between client and therapist
The premise that psychological distress is often maintained by cognitive processes
A focus on changing cognitions to produce desired changes in affect and behavior
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The various cognitive behavioral approaches share the following attributes:
A present-centered, time-limited focus
An active and directive stance by the therapist
An educational treatment focusing on specific and structured target problems
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Albert Ellis’s REBT
Rational Emotive Behavior Therapy (REBT)
Assumes that cognitions, emotions, and behaviors interact and have a reciprocal cause-and-effect relationship.
Is highly cognitive and directive.
Teaches that our emotions stem mainly from our beliefs that influence the evaluations, interpretations, and reactions to life situations.
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American psychologist Albert Ellis developed Rational Emotive Behavior Therapy, or REBT for short. REBT is a humanistic approach that focuses on our ability to create our own positive and negative emotions
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Albert Ellis’s REBT
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Clients learn to identify the interplay of their thoughts, feelings, and behaviors and to identify and dispute irrational beliefs maintained by self-indoctrination.
Clients learn to replace detrimental ways of thinking with effective and rational cognitions.
View of Emotional Disturbance
Clients learn irrational beliefs and re-create it throughout their lifetime.
Clients learn to stop blaming themselves and learn to fully and unconditionally accept themselves.
Clients have strong tendencies to transform their desires and preferences into “shoulds,” “musts,” and “oughts.”
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View of Emotional Disturbance
Following are the three basics MUSTS we internalize that inevitably lead to self-defeat:
“I MUST do well and be loved and approved by others.”
“Other people MUST treat me fairly, kindly, and well.”
“The world and my living conditions MUST be comfortable, gratifying, and just, providing me with all that I want in life.”
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The A-B-C Framework
A is the existence of an activating.
C is the emotional and behavioral consequence or reaction of the individual.
B is the person’s belief about A, largely creates C, the emotional reaction.
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The A-B-C Framework (2 of 2)
A
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B
Belief
D
Disputing intervention
E
Effective philosophy
F
New feeling
C
Consequence
Activating event
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Therapeutic Goals
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To help clients differentiate between realistic and unrealistic goals and between self-defeating and life-enhancing goals
To assist clients in the process of achieving the following:
Unconditional self-acceptance (USA)
Unconditional other-acceptance (UOA)
Unconditional life-acceptance (ULA)
Therapeutic Techniques and Procedures
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Cognitive Techniques
Therapists practicing REBT use the following techniques:
Disputing irrational beliefs
Doing cognitive homework
Bibiliotherapy
Changing one’s language
Psychoeducational methods
Therapeutic Techniques and Procedures
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Emotive Techniques
Therapists practicing REBT use the following techniques:
Rational emotive imagery
Using humor
Role playing
Shame-attacking exercises
Standard behavior therapy procedures
Application to Group Counseling
Group members can do the following:
Learn how their beliefs influence what they feel and what they do
Explore ways to change self-defeating thoughts in various concrete situations
Learn to minimize symptoms through a profound change in their philosophy
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Application to Group Counseling
Group REBT affords many opportunities for the following:
Practice assertiveness skills
Take risks by practicing different behaviors
Challenge self-defeating thinking
Learn from the experiences of others
Interact therapeutically and socially with each other in after-group sessions
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Aaron Beck’s Cognitive Therapy
Tailored for specific diagnoses such as anxiety, panic, eating disorders, and phobias.
Treatments are standardized and based on empirical research.
Homework allows lessons learned in group to generalize to the client’s daily environment.
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Patients can learn to identify and evaluate their “automatic thoughts” (spontaneously occurring verbal or imaginal cognitions), and to correct their thinking so that it more closely resembles reality. When they do so, their distress usually decreases, they are able to behave more functionally, and (especially in anxiety cases), their physiological arousal abates.
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Aaron Beck’s Cognitive Therapy
Following are the three theoretical assumptions of CT:
People’s thought processes are accessible to introspection.
People’s beliefs have highly personal meanings.
People can discover these meanings themselves rather than being taught or having them interpreted by the therapist.
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Aaron Beck’s Cognitive Therapy
Pattern that triggers depression is the following:
Clients hold negative views of themselves.
“I am a lousy person.”
Selective abstraction
Client interprets life events through a negative filter.
“The world is a negative place where bad things are bound to happen to me.”
Client holds a gloomy vision of the future.
“The world is bleak and it isn’t going to improve.”
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A Generic Cognitive Model
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It provides a comprehensive framework for understanding psychological distress.
Psychological distress can be thought of as an exaggeration of normal adaptive human functioning.
Faulty information processing is a prime cause of exaggerations in adaptive emotional and behavioral reactions.
A Generic Cognitive Model
Beck identifies the following are the seven cognitive distortions:
Arbitrary inferences
Selective abstraction
Overgeneralization
Magnification and minimization
Personalization
Labeling and mislabeling
Dichotomous thinking
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Basic Principles of Cognitive Therapy
Psychological problems are an exaggeration of adaptive responses resulting from commonplace cognitive distortions.
It is an insight-focused therapy with an emphasis on changing negative thoughts and maladaptive beliefs.
Clients’ distorted beliefs are the result of cognitive errors.
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Basic Principles of Cognitive Therapy
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Socratic dialogue is a formal method by which a small group (5-15 people), guided by a facilitator, finds a precise answer to a universal question (e.g. "What is happiness?", "What is integrity?", "Can conflict be fruitful?", etc.)
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Through Socratic dialogue/reflective questioning, clients test the validity of their cognitions (collaborative empiricism).
Change results from reevaluating faulty beliefs based on contradictory evidence that clients have gathered.
Clients’ distorted beliefs are the result of cognitive errors rather than being driven solely by irrational beliefs.
The Client–Therapist Relationship
Cognitive therapists are continuously active and deliberately interactive with clients, helping clients frame their conclusions.
He or she functions as a catalyst and a guide who helps clients understand how their beliefs and attitudes influence the way they feel and act.
Homework facilitates more rapid and enduring gains.
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Applications of Cognitive Therapy
The length and course of CT varies greatly and is determined by the therapy protocols used for specific diagnoses.
Examples:
CT for depression: lasts 16 to 20 sessions and begins with behavioral activation
CT for panic disorder: lasts 6 to 12 sessions and targets catastrophic beliefs about internal physical and mental sensations
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Christine Padesky and Kathleen Mooney’s Strengths-Based Cognitive Behavioral Therapy
Developed by Christine Padesky and Kathleen Mooney,
S-B CBT is a variant of Aaron Beck’s cognitive therapy.
It involves identifying and integrating client strengths at each phase of therapy.
Active incorporation of client strengths encourages clients to engage more fully in therapy and often provides avenues for change that otherwise would be missed.
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Basic Principles of Strengths-Based CBT
SB-CBT is empirically based.
Therapists should be knowledgeable about evidence-based approaches pertaining to client issues discussed in therapy.
Clients are asked to make observations and describe the details of their life experiences, so what is developed in therapy is based in the real data of clients’ lives.
Therapists and clients collaborate in testing beliefs and experimenting with new behaviors to see if they help achieve desired goals.
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Applications of Strengths-Based CBT
Three applications are the following:
An add-on for classic CBT
A four-step model to build resilience and other positive qualities
The NEW paradigm for chronic difficulties and personality disorders
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Applications of Strengths-Based CBT
Following are the four steps:
Search
Construct
Apply
Practice
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Donald Meichenbaum’s Cognitive Behavior Modification
Theory and Practice of Counseling and Psychotherapy - Chapter 10
Renowned expert Donald Meichenbaum discusses Cognitive-Behavioral Therapy (CBT), treatment for trauma, and the search for expert psychotherapists
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Focus:
Client’s self-statements or self-talk
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.
Donald Meichenbaum’s Cognitive Behavior Modification
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Self-instructional therapy focus:
Trains clients to modify the instructions they give to themselves so that they can cope more effectively.
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”
How Behavior Changes
Following are the three phases of behavior change:
1. Self-observation
Starting a new internal dialogue
Learning new skills
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The Phases of Stress Inoculation Training
The three-stage model for SIT include the following:
1. The conceptual-educational phase
2. Skills acquisition and skills consolidation phase
3. Application and follow-through phase
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A Cognitive Narrative Approach to CBT
It focuses on the plots, characters, and themes in the stories people tell about themselves and others.
Meichenbaum claims that we are all “story tellers.”
In therapy, clients learn how they construct reality, examine the implications and conclusions they draw from their stories, and develop resilient-engendering behaviors.
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Strengths From a Diversity Perspective
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CBT uses the individual’s belief system, or worldview, as part of the method of self-exploration.
Emphasis on cognition, action, and relationship issues appeals to clients from diverse backgrounds.
CBT and multicultural therapy share common assumptions that make integration possible.
Shortcomings From a Diversity Perspective
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REBT’s negative view of dependency clashes with the view of interdependence as necessary to good mental health.
The “rapid-fire active approach,” used by some clinicians ,may alienate those who value being reflective.
Terms such as irrational or maladaptive may seem disrespectful and insensitive to clients who have felt marginalized in society.
Shortcomings From a Diversity Perspective
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The emphasis on assertiveness, independence, verbal ability, rationality, cognition, and behavioral change may limit CBT’s use in cultures that hold different values.
Inexperienced therapists may overemphasize cognitive restructuring to the neglect of environmental interventions.
Contributions of CBT
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Both Ellis’s REBT and Beck’s CT represent the most systematic applications of CBT.
The approaches are relatively brief and structured treatments that are cost effective.
The cognitive behavioral theorists have demystified the therapy process.
Contributions of CBT
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The credibility of this model grows out of the fact that many of its propositions have been empirically tested.
All cognitive behavioral approaches place emphasis on practicing new skills both in therapy and in daily life, and homework is a key part of the learning process.
Limitations and Criticisms of Cognitive Behavioral Approaches
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Extensive training is required to practice CBT.
Therapists may misuse power by imposing their ideas of what constitutes “rational” thinking on a client.
The strong confrontational style of Ellis’s REBT may overwhelm some clients.
Some clinicians think CBT interventions overlook the value of exploring a client’s past experiences.
More about CBT
https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets/
Theory and Practice of Counseling and Psychotherapy - Chapter 10
Theory and Practice of Counseling and Psychotherapy - Chapter 10
| Behavior Therapy Cognitive Behavior Therapy (CBT) Discussion of Paper Conceptualization due 4/26 6pm | Chapters 9/10 | Journal 5 assigned How did your midterm enable you to take the knowledge about the therapies explored thus far and apply them to our movie exam? |
| Choice Theory/Reality Therapy | Chapter 11 | Journal 5 due by 6pm Take home quiz chs 9/10 Due by 3 15 at 11:59pm |
