1. Cognitive Theory SSS 571 Human Behavior & the Social Environment
November 1, 2010
Eileen A. Dombo, MSW, PhD, LICSW

2. Today’s Plan Explore and challenge some misconceptions
Review a bit about theory in general
Present Cognitive theory via 7 questions
Focus on people's problems and how this theory helps us help them change
Put it all together by applying to case examples

3. Cognitive Theory as Response to Psychodynamic Psychotherapy

4. Theories of Cognition in Social Work
Conscious thinking is believed to be the basis for almost all behavior and emotions.
Our minds are actively engaged in constructing the reality we seek to understand.
So long as a person’s cognitive style helps to achieve his or her goals, it is considered healthy.

5. However, a person’s thinking patterns can become distorted, featuring patterns of bias that ignore relevant information from the environment.
Cognitive errors are habits of thought that lead people to distort input from the environment and experience psychological distress.
Social workers who practice from cognitive theory assert that the individual’s thought process, not their emotions, should be the focus of intervention.

6. Cognition vs. Emotion COGNITION EMOTION
Conscious & preconscious thinking processes
Personal beliefs & subjective interpretations
Erroneous beliefs result from misinterpretations and inaccurate conclusions; contribute to social dysfunction
EMOTION
Feeling states based on our appraisal of stimuli
Affect—physiological expression of emotion
Mood—a more stable feeling disposition; less intense and not situational

7. Meaning, Emotion and Cognition
Cognitive theorists explore the conscious meaning of events (Beck).
People are “meaning makers.”
Public (objective) vs. private (unique).
The private meaning is influenced by the emotional experience and is vulnerable to distortion; accounts for differences in emotional responses to situations.

8. Moving from Public to Private Meaning
Event Conscious Emotion Private Meaning Meaning

9. Why does Dr. Early get so irritated when she hears “CBT”?
Question: Is there such a thing as Cognitive/Behavioral theory?
Answer: No

10. Why Not? Cognitive theory
Assumes that reality is constructed “inside” - so each individual determines her/his subjective reality
According to cognitive theory, we behave and change based on internal mental processes

11. Why Not? Behavioral theory
Assumes that there is one objective reality “out there” that determines the individual
According to behavioral theory, we behave and change based on external environmental influences

12. “CBT” is not the name of a theory. . .
Cognitive-Behavioral Therapy (CBT)
is a practice model,
based on two theories:
cognitive theory and behavioral theory.

13. Ok, so what is theory? an interrelated set of concepts
that are based on observations
the relationship between concepts is expressed as hypotheses
These concepts and hypotheses are tested or testable
and are intended to explain or predict phenomena.

14. What is clinical practice theory?
An interrelated set of concepts that
Explains the bio-psycho-social-spiritual nature of human beings
Explains the development of stable patterns of adaptive and maladaptive thoughts, feelings, and behavior of human systems in transaction with their natural, built, and social environments
Predicts how those stable patterns may change

15. Practice Theories have two functions
Explanatory (or developmental) function
Change (or practice) function

16. Practice Theory: The explanatory function
Practice theory’s developmental or explanatory concepts explain how systems develop normally, why development goes awry, and/or how problems develop.
Explanatory concepts are used in assessment. This is the focus of 571.
Take out “client” between how and systems

17. Practice Theory: The change function
Practice theory’s change concepts predict why systems change and how change can be facilitated.
Change concepts are used in planning and intervention.
Takes out “client between why and systems

18. Implementing the change function of practice theory: roles and techniques
Practice roles and techniques are the concrete actions that flow from the abstract change concepts of practice theory. These actions, when performed by the helping person, facilitate client change.

19. 7 Questions about Theory
What are the major premises of the theory?
Who thought this theory up?
Who are the social workers building on this early thinking?
How does the theory understand problems?
How did problems come to be?
How do problems go away on their own?
How do social workers help make problems go away?

20. Cognitive Theory

22. QUESTION 1: What are the major premises of cognitive theory?
We are what we think.
We learn to think in the same ways we learn overt behavior (continuity assumption)
That is, we learn to think in a particular way due to exposure to experience.
To change what we are, we must change what we think by becoming aware of, evaluating, and challenging mediating thoughts

23. Mind as an information processing system
Repeated similar experiences are stored in memory as thoughts about expectation, causation, attribution, etc.
These patterns become automatic and outside of consciousness.
Patterns of thought mediate between events and actions (mediational model)
Memories are applied to multiple new events so they become less individual memory and more patterns for organizing experience (schema)
Change comes through disputing or altering mediating thoughts.

24. The Cognitive ABC Activating Belief Consequential Event Feelings and
Behavior

25. QUESTION 2: Who thought this theory up?
Albert Ellis, PhD
Aaron Beck, MD

26. The Fathers of Cognitive Theory: Aaron Beck and Albert Ellis

27. Albert Ellis
““Negative self rating is the major cause of human disturbance; we disturb ourselves.”

28. Aaron Beck
“The thesis that the special meaning of an event determines the emotional response forms the core of the cognitive model of emotions and emotional disorders: The meaning is encased in a cognition – a thought or an image.”

29. QUESTION 3: Who are the social workers building on this early thinking?
Sharon Berlin
Paula Nurius

30. Sharon Berlin & Paula Nurius
“This filtering is at the heart of the concept of mediation. As one kind of lens, or filtering mechanism, our self-conceptions tend to bias us in the direction of reconfirming what we already believe to be true about ourselves.”

31. QUESTION 4: How does cognitive theory understand “problems”?
Problems are generally feelings and behaviors that are maladaptive for a person
Problem feelings and behaviors emerge in response to activating events that are mediated by a distorted interpretive thought
These immediate (automatic) thoughts are triggered by external events but are shaped by internal schemata, or ways of thinking, that may be distorted
Present events “recruit” different schema that were learned in the past

32. QUESTION 5: How did problems come to be?
Problem feelings and behaviors are the result of patterns of thinking that were learned in the past
They are triggered in the present by activating events and mediated by situation specific automatic thoughts shaped by more general deeply held core beliefs

33. Problems (often feelings & behaviors)
A B C
Activating event belief consequential feeling
or behavior
feeling
(sadness)
activating automatic
event thought
(boyfriend breaks up (“of course it didn’t work”) behavior
with me) (get drunk)
core belief
(I’m unlovable)

34. Raylene Raylene Shame/Self-Blame Date-raped “It’s my fault”
Goes back to abusive ex
Bad things happen to me
because I am a bad person

35. Bob Fight with wife anger She doesn’t respect me storms out
anger abates
I am powerless

36. QUESTION 6: How do problems go away on their own?
Through changing one’s mind
Cognitive activity affects behavior
Cognitive activity may be monitored and altered
Desired behavior change may be affected through cognitive change.

37. We process much information that makes sense
Some information comes is easily processed through existing meaning structures (schema)
The information “fits,” or is congruent.
the information makes sense; it is meaningful

38. But we also process information that makes no sense
Other information cannot be processed easily through existing meaning structures (schema),
The information does not fit; it is discrepant, when we experience contrasts between
what we want and what we have;
how things were and how they are;
what we expect and what actually happens.
The information makes no sense; it is meaningless

39. How to Adapt to Discrepant Informational Cues (DIC)
When faced with discrepant informational cues (DIC), people adapt by
Retreat: Changing the DIC (removing oneself from poisoned environment or remove the stressor)
Assimilation: making the DIC fit with existing schema (distort the information to fit the schema)
Accommodation: Reorganizing existing schema to fit the new DIC (change schema to fit the information)

40. QUESTION 7: How do social workers help make problems go away?
Techniques to recognize maladaptive automatic thoughts and core beliefs
Techniques to evaluate maladaptive automatic thoughts and core beliefs
Techniques to challenge and restructure maladaptive automatic thoughts and core beliefs
Techniques to recruit and strengthen existing adaptive thoughts (the strengths perspective – introduced by the social workers!)

41. Cognitive Distortions/Errors
Absolute thinking
Overgeneralization
Selective abstraction (focus on negative)
Arbitrary inference (negative conclusion without sufficient evidence)
Magnification
Minimization
Personalization

42. The Cardinal Question of Cognitive Therapy
Aaron Beck directs, “Whenever you experience an unpleasant feeling, try to recall what thought you had prior to it.”
Judith Beck says the cardinal question of cognitive therapy is, “What was going through your mind when the mood changed?”

43. From concept to technique in cognitive therapy
Focus on mediating thoughts and beliefs
Recognizing or becoming aware of thoughts
Evaluating thoughts to determine viability
Challenging and restructuring those that do not serve one’s goals

44. Critiques
Cognitive theories are criticized for ignoring the environment
Behavioral theories are criticized for reducing all human behavior to simple responses to stimuli without critical thought or feeling involved (more on this next week).

45. Social Learning Theory
“People are neither entirely determined by internal causes nor environmental stimuli, but psychological functioning is accounted for by a reciprocal interaction of personal & environmental determinants.”
(Bandura, 1977)

46. Philosophical underpinnings:
Behavior is learned when individuals respond to environment through stimuli, reinforcement, & imitation
Behavior is influenced by personal interpretations & expectations about the environment

47. The central process in learning is imitation
Behavior is the result of modeling + thought and reasoning
Employs moral and cognitive development by addressing self-efficacy and self-reinforcement
We do what makes us feel personally competent
Behavior becomes self-regulated through self-reinforcement
Dysfunctional thoughts lead to dysfunctional behavior

48. In closing
We are what we think; to change what we are, we must change what we think.