1. Introduction to CBT
The basic idea is that how we think (cognition) , how we feel (emotion) and how we interact (behaviour) all interact together.
COGNITION
EMOTION BEHAVIOR
Therefore unrealistic negative thoughts can cause distress

2. History Two of the earliest proponents are ELLIS AND BECK
Albert ellis- Rational Emotive Behaviour Therapy (REBT)- the primary cause of maladaptive bhvr is the continual repetition of certain irrational ideas e.g
“If everyone does’t like me, I am worthless`
One should be thoroughly competent, intelligent and achieving in all ways
Therapist is regarded as the teacher and does not believe that a warm relationship with a client is necessary, its highly directive , persuasive and confrontative

3. History conti…
2. Aaron Beck- proposed that emotional disorders are frequently the results of irrational thoughts about oneself and the external would
e.g Beck believes that depression is a result of three basic types of ideation (Beck`s cognitive triad ) which are:
Negative views abt the self (e.g……..)
Negative views abt the world (eg……)
Negative appraisals of the future( eg…)

4. CHARACTERISTICS OF CBT
Active participation of the client
Collaboration-both working as a team
Works on the problem in the here and now
Focus on cognitions and behaviour
Actively empowers the client-encourage the client
Encourages the client to question
Based on reality testing

5. CHARACTERISTICS OF CBT
Goal oriented and problem focused
Structured sessions with homework
Time-limited
Based on an evolving cognitive formulation
Evidence based-models which are empirically validated
Educational –teaching client skills to become their own therapist

6. Formulating in CBT
SIMPLE MAITANANCE MODEL
5 PS MODEL

7. SIMPLE MAINTANCE MODEL
Situation(modify/reduce impact)
Cognitions(change negative thoughts
Developing alternative beliefs)
Physical sensations(relaxation
Emotions(distress
Management skill) and medication)
Behaviour (change behaviour

8. 5 P`s model Predisposing factors(vulnerability from past experiences)
Precipitating factors(ie triggers immediately preceding onset)
Presenting problems( what are the difficulties that the client has at the moment)
Perpetuating factors Protective factors
What is keeping presenting (family,education
Problems work)
Cognitions
Affect
behvr

9. ACTIVITY SCHEDULING(the behavioural part of cBt
HOW INCERASING ACTIVITIES HELPS
(all the below can lift mood)
Takes mind off other problems
Gain sense of control
Feels less lethargic
Increases motivation
Gives opportunity to increase enjoyment
Breaks rumination
Gives sense of achievement
Decrease social isolation

10. ACTIVITY SCHEDULING OVERVIEW
Give rational
Doing more helps to lift mood
Monitor current activity levels(use a diary)and simple mood ratings and mood/pleasure ratings
Review current activity level to see
Overall pattern of activity-what is the client doing with their time
Use diary(hourly,set time period) to plan ahead and schedule more helpful activities
Demonstrate how to fill in the diary

11. Reviewing diaries
Don’t be worried if client did not finish completing the diary
Give them a lot of praise for the completed work
Ask them what they learnt(any patterns,surprises)
Use to find out more about their lives
Generate a list of positive activities
Use another diary to schedule more of these in the next week
Opt for activities that are not reliant on others

12. Working with cognitions
Guided discovery-therapeutic style of CBT
Thinking biases
Identify negative thoughts- find more helpful alternative

13. Guided discovery
Therapist adopts an open and inquisitive stlye that helps clients to reach their own conclusions
Help client get an alternative belief based on information provided
Clients should generate their own solutions
Don’t impose a point of view on the client

14. Guided discovery-main principles
Four main steps
Asking questions to uncover information outside the patient`s current awareness
Accurate listening and reflection
Summarising information
Help client to apply new info to his beliefs

15. Thinking biases
Beck identified distortions in thinking that maintain and exacerbate depression eg
All or none thinking
Overgeneralisation
These can be changed by
Psycho-education abt them
Normalising of them
Collaboratively identifying the client`s typical biases
Noticing them in and out of the sessions
Working to change any biases( identify the hot thought and PUT IT ON TRIAL. Use evidence for and against

16. Enhancing coping strategies
Ask abt the general ways of coping(
what do you do to make yourself feel better)
Find out the effectiveness of each on a scale of 1-10

17. Distress management skills
Self soothing strategies
Use all senses-touch, sound ,smell
Do something active
Controlled breathing
Breath in for 3 and breath out for 6
Relaxation
Progressive relaxation techniques
Imagery strategies
Vivid imagery of a peaceful place ( include all 5 senses)