1. Cognitive Behavior Therapy, Self-Directed Coping Methods, and ACT
Chapter 27
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2. Cognitive Behavior Therapy
Cognition
Belief, thought, expectancy, attitude, or perception
Cognitive Behavior Modification / Cognitive Behavior Therapy
Helping clients through behavior modification methods and through focusing on debilitating thoughts and beliefs
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3. Cognitive Restructuring Methods
Assumptions:
Individuals interpret and react to events in terms of their perceived significance
Cognitive deficiencies can cause emotional disorders
Focus of therapy: Cognitive restructuring
Changing faulty thinking patterns
Approaches include behavior modification components
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4. Cognitive Restructuring Methods
Rational-Emotive Behavior Therapy (REBT)
Developed to help individuals change irrational thought
Utilizes in vivo behavioral homework assignments
Procedure:
Identify irrational thoughts
Challenge thoughts
Teaching client (through modeling and homework) to replace the irrational self-statements with statements based on “rational” beliefs
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Effectiveness of REBT
More effective than no treatment
More effective than various other treatments in decreasing client’s irrational self-talk
More effective than other treatments in reducing emotional distress
No effect on behavioral measures (approaching feared object)
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6. Cognitive Restructuring Methods
Beck’s Cognitive Therapy
Faulty and negativistic, though patterns lead to behavioral and emotional problems
Procedure:
Identification of dysfunctional thoughts
Use various methods to counteract the dysfunctional thoughts
EX: Hypothesis testing
Use of homework assignments that utilize behavior modification procedures to develop desirable daily activities
Gentler, less confrontational approach than REBT
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7. Beck’s Distorted Thought Patterns
Dichotomous thinking – all-or-none evaluations
Overgeneralization – rule or belief applied too broadly
Arbitrary inference – drawing inaccurate conclusions based on insufficient, ambiguous, or contrary evidence
Magnification – exaggeration of the meaning or impact of an event
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8. Effectiveness of Cognitive Therapy
Effective in treating depression
Most research has focused on treatment of depression
More research needed to evaluate this treatment for other disorders
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9. Self-Directed Coping Methods
Self-Instructional Training
Five steps:
Adult demonstration of self-instructing
Child performs while adult verbalizes
Child performs the task and verbalizes out loud
Fading of overt self-instructions
Task performance with covert self-instructions
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10. Self-Directed Coping Methods
Meichenbaum’s Stress Inoculation Training
Teaches cognitive skills that allow clients to deal with stressful events
Three Phases:
Reinterpretation phase
It is not the stressor that is the cause of the stress reaction, but it is the way the client views the event
Coping training phase
Clients learn coping strategies
Relaxation, self-instruction, and self-reinforcement
Application phase
Clients practice skills in stressful situations
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11. Effectiveness of Stress Inoculation
Many of the components (relaxation, modeling, desensitization) have been validated when applied independently
Evidence suggests that this method is as effective as its component procedures
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12. Self-Directed Coping Methods
Problem Solving Training
Teaches people how to proceed through logical reasoning to satisfactory solutions to personal problems
Steps in personal problem solving:
General orientation
Problem definition
Generation of alternatives
Decision making
Implementation
Verification
Evaluation of problem solving methods
Adults and children can rapidly learn skills, but do not often apply them appropriately
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13. Mindfulness and Acceptance
Awareness, observation, and description of one’s overt and covert behaviors, as they occur, in a nonjudgmental way
Acceptance
Also called experiential acceptance
Set of behaviors in reaction to mindfulness
Refraining from judging one’s sensations, feelings, and behaviors
Thoughts are viewed as just responses, just passing events
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14. Mindfulness and Acceptance
Acceptance and Commitment Therapy (ACT)
Three phases:
Learning that past attempts to control troublesome thoughts and emotions have not only been unsuccessful, but increased the frequency of these thoughts
Learning to experience thoughts and emotions in a nonjudgmental way
Done through use of mindfulness training and acceptance exercises
Identifying values in various life domains and then translating these values into goals and actions
Evaluation
Early studies find positive results
Equivalent to systematic desensitization for treatment of math anxiety
Effective in reducing stress in the workplace
Relatively new approach and more research needed
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