Cognitive Behavioral Therapy

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Cognitive Behavioral Therapy

• Cognitive Restructuring
• Chapter Twelve

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Introduction

• Although behaviorists have traditionally tended
  to reject other psychological approaches, some
  blending has taken place between behaviorism and
  certain types of treatment approaches
  collectively, referred to as cognitive therapies.

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• A major theoretical assumption of cognitive
  therapy, is that individuals interpret and react
  to events in terms of their perceived
  significance. That is to say, that human
  behavior is mediated by cognition.
• A second assumption, is that cognitive
  deficiencies can cause emotional disorders.
• The primary focus of therapy, therefore, is to
  make fundamental changes in a persons
  cognition's, or belief system.

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Two basic models

• Cognitive Restructuring Therapy Teaches clients
  to change distorted and erroneous cognitions or
  beliefs that maintain their problem behaviors.

• Cognitive-Behavioral Coping Skills Therapy
  Teaches adaptive responses to deal effectively
  with difficult situations they encounter.

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The major players in the field

• Albert Ellis developed the principles of
  Rational Emotive Behavior Therapy
• Aaron Beck utilizes a cognitive approach to
  treat depression
• Donald Meichenbaum most prolific of the
  theorists today (chapter 13)
• Maxie Maultsby expanded on Elliss work to
  develop Rational Behavior Therapy

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Albert Ellis and REBT

• Trained originally in Freudian psychoanalytic
  methods
• Felt that insight had little value in solving
  problems
• REBT is based on the premise that there is a very
  close connection between what we say to ourselves
  and how we feel

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Aaron Becks Cognitive Therapy

• Developed a procedure similar to REBT
• Believed that neurotic individuals engage in
  dysfunctional thinking
• Major technique used was hypothesis testing
• Also utilized homework assignments
• Examples of dysfunctional thinking would be

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• Dichotomous thinking thinking in absolute terms
• Arbitrary inference drawing a conclusion on
  inadequate evidence
• Overgeneralization reaching a general
  conclusion based on too few instances
• Magnification exaggerating the meaning or
  significance of a particular event

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Rational Emotive Behavior Therapy

• Comprehensive short term therapy
• Makes maximal use of self-help techniques
• Based on the fact that the world is non-magical
  and that the events will occur if the conditions
  are present.

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Four Basic Theoretical Assumptions

• Brain is the main organ for learning/self control
• Coordinates the voluntary nervous system and the
  peripheral nervous system
• Words nouns, verbs, adjectives are self taught
  cries that trigger emotional and physical
  reactions. Your thoughts are largely words.
• Motivation comes from wanting something or
  avoiding something, combination of two!

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Features of REBT

• Easy to learn - does not take years of extensive
  training like psychoanalysis
• Increases efficiency gain quick insight into the
  nature of the behavior with immediate involvement
  of the client. Frees up professional time.
• Main therapeutic goal is to use the brain in the
  healthiest, most efficient manner.

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Process of REBT

• As indicated, the goal of REBT, is to modify a
  clients belief system. This is done by
• identifying thoughts that are based on irrational
  beliefs
• challenging the irrational beliefs
• replacing thoughts based on irrational beliefs
  with ones that are based on rational beliefs

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The ABCs of your emotions
Self Talk
Event
Actions
Feeling
A
B
C
D
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• A is the event as you perceive it
• Bis what you are telling yourself about the
  event
• C is how you feel about the event
• D are the actions you will tale based on your
  feelings

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Facts vs. Personal Truths

• Personal truth is based on your opinion.
  Personal truths can hurt you in many ways
  emotionally, financially, physically.

• Facts are based on objective reality. We dont
  have to like the facts, just accept them so that
  we can move on.

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As mentioned earlier, words provide the
emotional triggers for our faulty thinking...
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For example...

• It - it doesnt upset me I control how I
  feel
• What if? - If it happens, Ill do the best I
  can
• Awfulizing - Its not life or death, only
  inconvenient
• Absolutes- Always and never rarely tell it like
  it is
• Should - Wheres the law? Magical vs..
  Scientific
• Have to - I dont have to, I choose to.
• Yes, but - Justifying keeping faulty beliefs

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Characteristics of rational thinking

• They are based on objective reality
• They lead you to protect your health and life
• They help you attain your short an long range
  goals
• They help you feel the way you want to feel
• They keep you out of significant conflict with
  others

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Cognitive Therapy

• Conceived by Aaron Beck at the same time Ellis
  was developing REBT
• Goals of cognitive therapy are
• correct clients faulty information processing
• modify clients dysfunctional beliefs that
  maintain maladaptive behaviors and emotions
• provide clients with the skills and experiences
  that create adaptive thinking

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Socratic Dialogue

• The therapist asks the client a series of easily
  answerable questions that lead the client to
  recognize their faulty beliefs. Not as directive
  as REBT.

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All things considered...

• Ellis and other cognitive behaviorists report
  that this approach has been successful in
  treating a wide variety of problems such as
  depression, extreme fears, impotence, etc..
• However, there is not a great deal of empirical
  research since it is more of a practitioners
  approach.