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Introduction to Counseling: An Art and Science Perspective

Chapter 9:

Cognitive-Behavioral Theories

The Art & Science of Cognitive-Behavioral Counseling

Goal to help clients understand how thoughts impact behavior

Identify dysfunctional thoughts

Explore the etiology of these thoughts

Focuses on overt and measurable behavior

The Cognitive-Behavioral Theories

The Cognitive-Behavioral Theories (continued)

Roots in Behavioral Theory

Classical Conditioning

Operant Conditioning

Social Learning Theory

Behavioral Therapy Concepts

Behavior therapy concentrates on overt, observable behavioral processes and cognitions.

Behavior therapy focuses on the here and now.

Maladaptive behaviors are primarily the result of learning.

Well-defined, concrete goals are used.

Behavior therapy is committed to the scientific method.

Behavior therapy is based on empiricism.

Behavior therapy is active and transparent.

Behavioral Therapy Techniques

Cognitive Behavioral Modification

Self-instructional therapy

Stress inoculation training

Cognitive structures and internal speech determine behavior

Self-Management and Self-Control

Helping clients become their own agent of change

Self-Efficacy

Enhancing person’s belief in his or her abilities

Behavioral Therapy Techniques (continued)

Participant Modeling

Based on Bandura’s Social Learning Theory

Role of observation and imitation in learning

Assertiveness Training

Involves identifying need, realizing how increase assertiveness can help, practicing then feedback

Behavioral Therapy Techniques (continued)

Systematic Desensitization

Teach deep relaxation

Develop a hierarchy

Proceed through the hierarchy

Address the fear in vivo

Follow up and evaluate

Token Economy

Tokens are used to reinforce desired behavior

Rational-Emotive Behavior Therapy (REBT)

Albert Ellis founding father

Named theory to highlight the interrelationship among thoughts, feelings and behaviors in functioning

Maintained that people were best understood through their self-talk

Rational-Emotive Behavior Therapy Key Concepts

The Role of Cognition

Self-defeating statements: Self-damnation, I-can’t-stand-it-it is, and Awfulizing:

The A-B-C-D-E Acronym

Activating event

Belief about the event

Emotional Consequence

Dispute self-defeating thoughts

Effect of dispute

REBT Techniques

Cognitive

Cognitive restructuring

Reframing

Referencing

Emotive

focuses on the client’s affect or emotional domain

helps clients learn how to accept themselves

REBT Techniques (continued)

Operant Behavioral

Conditioning

Assertiveness training

Systematic desensitization

Relaxation therapy

Self-management

Homework assignments

Cognitive Therapy

Aaron Beck founder

Rejected his early training in psychoanalysis

Best known for his work with depression

Developed Beck Depression Inventory

Cognitive Theory: Key Concepts

Based off of premise that people respond to life events through a combination of cognitive, affective, motivational, and behavioral responses.

Cognitive processes at the core of many mental health concerns.

Cognitive Theory: Key Concepts (continued)

The Role of Cognition in Mental Health

Cognitive Vulnerability

Cognitive Distortions

Arbitrary inference

Selective abstraction

Overgeneralization

Magnification and minimization

Personalization

Dichotomous thinking

Cognitive Theory: Key Concepts (continued)

Systematic Bias in Information Processing

Cognitive Triad of Depression

Cognitive Model of Anxiety

Cognitive Therapy Techniques

Decatastrophizing

Reattribution Technique

Redefining

Decentering

Behavioral Techniques

Transactional Analysis (TA)

Eric Berne founder

Emphasizes role of interpersonal relationships in psychological functioning

Commonalities among interpersonal theories:

Problems are conceptualized from an interpersonal perspective

Familial interaction patterns are the best means of understanding

oneself and others.

The counselor-client relationship can be used to work through relationship issues.

Transactional Analysis Key Concepts

The Interpersonal Perspective

psychopathology is understood as a manifestation of intrapersonal and interpersonal forces.

Ego States

parent ego state: represents the person’s morals and values

adult ego state: is the rational-thinking dimension

child ego state: is the uninhibited side of the personality- variety of emotions

Transactional Analysis Key Concepts (continued)

Transactional Analysis

Analyzing transactions between people

Assessing the three ego states for complementary, crossed or ulterior

Games People Play

Usually played at a unconscious level

Transactional Analysis Key Concepts (continued)

The Four Life Positions

“I’m OK, you’re OK”

“I’m OK, you’re not OK”

“I’m not OK, you’re OK”

“I’m not OK, you’re not OK”

Transactional Analysis Key Concepts (continued)

Life Scripts

Created in early childhood

Includes messages from parents and other sources, e.g. fairy tales

Strokes

Basis for human relations is for recognition

TA Counseling Process

Goal is to help client become more autonomous, self-aware and spontaneous.

New decisions (redecisions)

Rewriting their life script

Ceasing to play games

Understanding their three ego states of parent, adult, and child

Avoiding crossed or ulterior transactions

Learning how to obtain and give positive strokes

TA Counseling Techniques

Structural analysis

Transactional analysis

Script analysis

Analysis of games

Reality Therapy

William Glasser founder

Deterred labels for mental health

Desired a realistic approach

Theory emphasizes role of choice and responsibility in human functioning

Appropriate choices can create “quality worlds”

Reality Therapy Key Concepts

Success and Failure Identity

Emphasis on Responsibility

View of Psychopathology

Positive Addiction

Control Theory

Choice Theory

Feminist Therapy

Early pioneers: Laura Brown, Harriet Lerner, Edna Rawlings and Carolyn Enns

Roots early 1960s Betty Friedan and others associated with feminism and the Women’s Liberation Movement

Recognizes the inner strength and resiliency of the human spirit and inherent drive for freedom and equality

Contextual factors like sociopolitical forces can create

Oppression and undermine self-actualizing tendencies

Feminist Therapy Key Concepts

Relational Focus

Social Constructionist Perspective

Diversity and Complexity of Women’s Lives