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Cognitive Behavior Therapy

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Presentation on theme: "Cognitive Behavior Therapy"— Presentation transcript:

1 Cognitive Behavior Therapy
Dr. Sparrow EPSY 6363 Cognitive Behavior Therapy

2 Founders Albert Ellis -- Rational Emotive Behavior Therapy (REBT) originated in mid-1950s Aaron Beck -- Cognitive Therapy (CT) Donald Meichenbaum -- Cognitive Behavior Therapy (CBT)

3 The Common Ground Collaborative relationship
Psychological distress originates in faulty cognitive processes Changing cognitions will change feelings and behaviors Short-term educational model homework client responsibility in and out of session variety of technique

4 Ellis’s REBT Thoughts, emotions and behaviors have a reciprocal cause and effect relationship We do not need to be loved or accepted. People are not disturbed by things, but the view they take of them Adlerian: social interest goals and purposes teaching and persuasion Emotions follow beliefs, so therapy focuses mainly on changing beliefs

5 Human Nature and Source of Distress
Humans are capable of rational lives, but also susceptible to faulty thinking We are self-talking, self-evaluating, and self-sustaining We mistake our preferences for essential needs

6 Sources of Faulty Thinking
Significant others Our own thought processes -- superstitions and dogmas Assumption that we need acceptance Assumption that there’s someone or something to blame Our preferences turn into shoulds and musts.

7 A-B-C Theory of Personality
A is activating event B is belief C is emotional and behavioral consequence D is disputing (either by therapist or client) -- by detecting, debating, discriminating E is effect of intervention, that is, an effective belief system or philosoph F is new feeling

8 Therapeutic Goals of REBT
Minimizing emotional disturbances Acquiring more realistic philosophy Acquiring unconditional self acceptance (USA) Developing unconditional other acceptance (UOA)

9 Therapist’s Function Encourages and persuades client to change “musts” into preferences Demonstrate how client is keeping emotional disturbance active Helping client modify thinking Challenge client to develop rational philosophy

10 The Client’s Experience in Therapy
Learner Doer Expected to work outside session Homework is carefully co-designed

11 Therapeutic Relationship
Relationship is minimized Therapist models UOA, encouraging clients to do likewise Therapist discloses in order to model healthy imperfection Transference is challenged as unnecessary, part of irrational beliefs

12 Interventions of REBT Cognitive Disputing irrational beliefs
Doing cognitive homework, making lists of problems, detecting absolutist beliefs and disputing them. Client is expected to take risks to overcome negative expectations. Changing one’s language Using humor, laughing at oneself

13 Interventions of REBT, continued
Emotive Techniques Rational emotive imagery-- imagining worst case scenarios and feeling appropriate reactions Role playing -- noting specific beliefs and feelings that arise as evidence of irrational philosophy Shame attacking exercises, going counter to usual efforts to win acceptance Use of force and vigor, role playing with therapist

14 Interventions of REBT, continued
Behavioral Techniques standard behavior therapy techniques, such as operant conditioning, systematic desensitization, etc. Research Efforts technical eclecticism makes research difficult.

15 Aaron Beck’s CT Similar to REBT in that focus is on changing faulty thoughts and beliefs But CT is based on three tenets. Client’s internal dialogue can be accessed through introspection Beliefs have highly personal meanings, so therapist can’t presume to know what’s best. These meanings have to be discovered by the client. By accessing cognitive content of upsetting experience, therapist can work with restructuring underlying “core schema.”

16 Aaron Beck’s CT, continued
Cognitive distortions arbitrary inferences -- conclusions that are without supporting evidence selective abstraction -- forming conclusions on the basis of one detail overgeneralization magnification and minimization personalization mislabeling polarized thinking, all-or-nothing, either-or

17 Differences Between REBT and CT
REBT is highly confrontive and focuses on teaching role of therapist. Beck uses an inquiring method. Disputes Ellis’s method of confronting irrational beliefs, believing that people think they are being rational. Beck prefers collaborative empiricism, arriving at the facts together, so that confrontation can be based on discovery, rather than on therapist’s impressions. Beck prefers to see problems as a misapplication of underlying rules that may be okay. Beliefs are not so much irrational as interfering.

18 Therapeutic Relationship in CT
Much more emphasis on quality of relationship Therapist functions as catalyst and guide Client expected to take an active role Therapist’s teaching role minimized in favor of supporting client’s role in self discovery Client becomes her own therapist

19 Applications of CT Applying CT
Helping clients become aware of automatic thoughts (cognitive distoritions) Helping clients make alternative interpretations

20 Applications of CT, continued
Treatment of depression: It’s basis: 1) negative self concept 2) interpreting experiences negatively 3) projection of negativity into future Treatment of depression: Interventiosn Getting client to do something Pointing out “tyranny of shoulds” Breaking tasks into manageable units to offset tendency of depressed persons to exaggerate the obstacles

21 Meichenbaum’s Cognitive Behavior Modification
Self instructional training helps clients become aware of self talk self observation starting new internal dialogue learning new “coping” skills practiced in real life situations

22 Meichenbaum’s CBM continued
Stress management stress innoculation conceptual -- becoming aware of nature of stress and how they are responding to it, as well as creating it skills acquisition and rehearsal -- strategizing new responses application -- transfer and maintenance of changes

23 Contributions of REBT, CT, CBM
RBT Confrontation is important Action orientation Becoming your own therapist CT Extremely effective for depression focuses on client’s inner world -- existentialist

24 Contributions of REBT, CT, CBM, continued
Meichenbaum Like CT, based on educational model; dymystifies therapy Encourages a working alliance Empowers the individual

25 Limitations of Cognitive Behavioral Approach
Ellis’s REBT Denies past Encourages misuse of power Beck’s CM and Meichenbaum’s CBM simplistic and superficial emotions are overlooked teaching isn’t only way learning takes place

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