Cognitive Therapy: The Aaron T' Beck Model

1
Cognitive Therapy The Aaron T. Beck Model

• Wesley J. Erwin, Ph.D.
• Tara Hollenbeck, B.S.
• Counseling and Student Affairs
• Minnesota State University Moorhead
• North Dakota Counseling Conference
• Bismarck, North Dakota
• February 1, 2009

2
Contact Information

• Wesley J. Erwin, Ph.D., LPC, NCC
• Director
• Phone [phone] E-mail erwin_at_mnstate.edu
• Tara Hollenbeck, B.S.
• Graduate Assistant
• E-mail hollenbeta_at_mnstate.edu
• Counseling and Student Affairs
• 209F Lommen Hall
• Minnesota State University Moorhead
• 1104 Seventh Avenue South
• Moorhead, Minnesota 56563
• Program Webpage http//www.mnstate.edu/cnsa/

3
Objectives

• To understand the impact of cognitive therapy on
  the evolution of psychology and counseling
• To gain a basic understanding of the theory
  behind cognitive therapy
• To learn the techniques common to cognitive
  therapy and the logic behind them
• To be able to use examples of cognitive therapy
  techniques in everyday practice

4
The Impact of Cognitive Therapy

• Freudian
• Humanistic
• Behaviorism
• Cognitive
• Empirical evidence
• Managed care
• Self-help

5
Overview of Becks Cognitive Therapy

• Utilizes concepts of core beliefs, intermediate
  beliefs, and automatic thoughts
• Emphasizes a warm, empathic client-therapist
  relationship
• Focus of therapy is identifying maladaptive and
  cognitive distortions, and actively changing
  those thoughts to more healthy ones
• Characteristics Active, directive,
  collaborative, time-limited, present-centered,
  problem focused, structured, empirical

6
A. T. Becks Cognitive Therapy

• Principle 1 based on an ever-evolving
  formulation of the client and his or her problems
  in cognitive terms
• Principle 2 Requires a sound therapeutic
  alliance
• Principle 3 Emphasizes collaboration and active
  participation
• Principle 4 Goal oriented and problem focused
• Principle 5 Initially emphasizes the present

Beck, 1995
7
A. T. Becks Cognitive Therapy

• Principle 6 Educative, teaches the client how to
  be his or her own therapist and emphasizes
  relapse prevention
• Principle 7 Time limited
• Principle 8 Sessions are structured
• Principle 9 Teaches clients to identify,
  evaluate, and respond to their dysfunctional
  beliefs
• Principle 10 Uses a variety of techniques to
  change thinking, mood, and behavior

Beck, 1995
8
Cognitive Therapy

• Core beliefs most fundamental, global, rigid,
  and overgeneralized
• Intermediate beliefs rules, attitudes, and
  assumptions
• Automatic thoughts words or images that go
  through a persons mind, are situation specific,
  and are most superficial level of cognition
• Peoples emotions and behaviors are influenced by
  their perception of events.

9
Cognitive Therapy
Core belief
Intermediate belief
Situation
Automatic thought
Emotion
10
Cognitive Therapy

• Goals for the first session
• Establish trust and rapport
• Socializing the client into cognitive therapy
• Educating the client about his or her disorder,
  about the cognitive model, and the process of
  therapy
• Normalizing the clients difficulties and
  instilling hope
• Eliciting the clients expectations for therapy
• Gathering additional information
• Using this information to develop a goal list

11
Cognitive Therapy

• Structure for the first session
• Setting the agenda
• Doing a mood check
• Briefly review presenting problem
• Identifying problems and setting goals
• Educating the client about the cognitive model
• Eliciting the clients expectations for therapy
• Educating the client about his or her disorder
• Setting homework
• Providing a summary
• Eliciting feedback

12
Cognitive Therapy

• Techniques/Strategies
• Cognitive distortions
• Cognitive conceptualization diagram
• Socratic questioning
• Experiments
• Coping card
• Core belief worksheet
• Problem solving and advantages/disadvantages
  analysis
• Logs or monitoring
• Many other techniques including a wide range of
  behavioral techniques

13
Cognitive Conceptualization Diagram

• Relevant childhood data related to core belief
• Core beliefs
• Conditional assumptions/beliefs/rules
• Compensatory strategies coping strategies
• Situation gt Automatic thought gt Meaning of the
  automatic thoughgt Emotion gt Behavior
• (Beck, 1995)

14
Demonstration of Cognitive Therapy Nora

• Nora is a 33 year old female with a partner and
  two children ages 11 and 9.
• Presenting symptoms feelings of sadness, loss of
  interest in everyday activities, low energy, and
  feelings of guilt and worthlessness.
• She continues to work and fulfill most of her
  responsibilities.

15
Case Scenario David

• David is a 35 year old man, married with two
  sons. He has been a firefighter in a small town
  for 15 years. He was referred by his family
  doctor after a physical from which he received a
  clean bill of health.
• David presents with symptoms of insomnia,
  difficulty concentrating, feeling more stressed
  than usual by his work, and frequent feelings of
  tightness in his chest.
• Despite a stellar track record and positive
  performance reviews, David worries about his
  performance as a firefighter. David says, I look
  in the mirror and see these grey hairs and think,
  Im too old to be firefighter. The other day
  during a training exercise, I made a mistake that
  cost us a whole minute in putting out the fire. I
  see these young 20 year old fire fighters and I
  think that I just dont measure up. What if I
  just cant physically be a firefighter anymore?
  I dont know anything else.
• In a small group discuss how you would apply
  Becks Cognitive Therapy with David.

16
Questions?
17
References

• Beck, J. S. (1995). Cognitive therapy Basics
  and beyond. New York Guilford.
• Beck, J. S. (2005). Cognitive therapy for
  challenging problems What to do when the basics
  dont work. New York Guilford.
• Corey, G. (2009). Theory and practice of
  counseling and psychotherapy. Belmont, CA
  Thomson Brooks/Cole.
• Greenberger, D., Padesky, C. A. (1995). Mind
  over mood A cognitive therapy treatment manual
  for clients. New York The Guilford Press.
• www.beckinstitute.org/