Theories (Lecture 8 – Ch 10) Cognitive-Behavior Therapy – Flashcards

-developed rational emotive behavior therapy (REBT) -grandfather of cognitive behavior therapy

-both optimistic and pessimistic; fairly undeterministic -Ellis sees people as having the capacity for and tendency toward both rational and irrational thinking -Beck sees people as ultimately capable of realistic thinking and positive, healthy functioning, but as encumbered by distorted thinking that originates outside the self (but is internalized)

-Stresses thinking, judging, deciding, analyzing, and doing -Assumes that cognitions, emotions, and behaviors interact and have a reciprocal cause-and-effect relationship -Is highly didactic, very directive, and concerned as much with thinking as with feeling -Teaches that our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations

-To identify the interplay of their thoughts, feelings and behaviors -To identify and dispute irrational beliefs that are maintained by self-indoctrination -To replace ineffective ways of thinking with effective and rational cognitions -To stop absolutistic thinking, blaming, and repeating false beliefs

A - activating event B - belief C - consequence D - disputing intervention E - effective philosophy F - new feeling

1) I absolutely MUST perform well (or outstandingly well) and win the approval (or complete love) of significant others at all times in all ways. If I fail at anything, that is awful and I am a bad, incompetent, unworthy person, who will probably always fail. 2) Other people absolutely MUST treat me kindly and fairly at all times. Otherwise, that is awful and they are rotten, unworthy people who will always treat me badly and do not deserve a good life and should be punished. 3) The conditions in which I live absolutely MUST be safe, hassle-free, comfortable, and enjoyable, and if they are not that is awful and horrible and I cannot tolerate it.

-Disputing irrational beliefs -Cognitive restructuring -Changing one's language -Modeling, explaining, and encouraging radical acceptance -Rational emotive imagery (REI) -Using humor -Shame-attacking exercises -Standard behavior therapy procedures (see book/notes for definitions of these if needed)

founder of cognitive therapy (CT)

-Insight-focused therapy with an emphasis on changing negative thoughts and maladaptive beliefs Theoretical Assumptions: -People's internal communication is accessible to introspection -Clients' beliefs have highly personal meanings -These meanings can be discovered by the client rather than being taught or interpreted by the therapist -Hundreds of outcome trials have established efficacy for a wide range of problems -Cognitive techniques focus on identifying and examining a client's beliefs and the origins of these beliefs, and modifying them if the client cannot support these beliefs

Basic theory: To understand the nature of an emotional episode or disturbance it is essential to focus on the cognitive content of an individual's reaction to the upsetting event or stream of thoughts Goals: To change the way clients think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructuring

Automatic Thoughts - responses to the environment that stem from unrealistic schemas Cognitive schemas - templates for making sense of the world Core beliefs - underlying beliefs that form the basis for schema

-Assessment & thought monitoring -Gathering evidence -What if's -Playing lawyer -Taking perspective -Socratic dialogue -Homework

pattern that triggers or results from depression: negative views of the self, the world, and the future

describes principles that pertain to all CT applications from depression and anxiety treatments to therapies for a wide variety of other problems including psychosis and substance abuse

1) psychological distress can be thought of as an exaggeration of normal adaptive human functioning 2) faulty information processing is a prime cause of exaggerations in adaptive emotional and behavioral reactions 3) our beliefs play a major role in determining what type of psychological distress we will experience 4) central to cognitive therapy is the empirically supported observation that "changes in beliefs lead to changes in behaviors and emotions" 5) if beliefs are not modified, clinical conditions are likely to reoccur

-All-or-nothing thinking / dichotomous thinking (splitting, black-and-white thinking, polarization) -Overgeneralization -Mental filtering (AKA framing) -Jumping to conclusions / selective abstraction -Mind reading -Fortune telling -Magnification and minimization -Catastrophizing / arbitrary inferences -Emotional reasoning -Personalization -Labeling & Mislabeling (see book/notes for definitions of these if needed)

Behavioral techniques used by cognitive therapists -include activity scheduling, behavioral experiments, skills training, role playing, behavioral rehearsal, and exposure therapy -Behaviors usually follow cognitions reasonably. When they don't, the mismatch is examined. When they do, but the cognition is distorted, the cognition is examined and an appropriate new behavior is determined -Occasionally, behaviors are targeted first, usually to develop evidence against distorted or illogical thinking

-Faulty, negative, distorted thinking leads to ineffective behavior and distressing emotions -There is some utility, but not ultimate utility, in understanding the origins of faulty thinking -The therapist acts as an educator

REBT: -"irrational beliefs" -A->B->C model Activating event Belief Consequence (emotional or behavioral) -Therapist acts as a coach, as well r/ship may not be emphasized (but is still necessary) CT: -"cognitive distortions" -Automatic thoughts Cognitive Schema Core Beliefs -Therapist acts as a collaborator, as well r/ship is emphasized

cognitive therapist collaborates with clients in testing validity of their cognitions

help clients identify negative automatic thoughts and test them - generate alternative explanations OR create an action plan to solve problems rather than ruminating

Strength's-Based Cognitive Behavioral Therapy (SB-CBT)

-one of the founders of CBT & CBM

Focus: Client's self-verbalizations or self-statements Premise: As a prerequisite to behavior change, clients must notice how they think, feel, and behave, and what impact they have on others Basic assumption: Distressing emotions are typically the result of maladaptive thoughts

1) Self-observation (building awareness) 2) Starting a new internal dialogue 3) Learning new skills

-a three-phase coping skills program, also CBT-based, used for stress management 1) The conceptual-educational phase 2) Skills acquisition and skills consolidation phase 3) Application and follow-through phase 4) Relapse prevention

consists of procedures for dealing with the inevitable setbacks clients are likely to experience as they apply what they are learning to daily life

-CBT uses the individual's belief system, or worldview, as part of the method of self-exploration -Clients from diverse backgrounds tend to appreciate the emphasis on cognition and action, as well as the stress on relationship issues -CBT and multicultural therapy share common assumptions that make integration possible

-A potential limitation of REBT is its negative view of dependency, yet many cultures view interdependence as necessary to good mental health -The "rapid-fire active approach," used by some practitioners of REBT may alienate those who value being reflective -Therapists who rely on jargon (using terms such as "irrational" or "maladaptive") may come across as disrespectful and insensitive to clients who have felt marginalized in society -The emphasis of CBT on assertiveness, independence, verbal ability, rationality, cognition, and behavioral change may limit its use in certain cultures that hold different values -An inexperienced therapist may overemphasize cognitive restructuring to the neglect of environmental interventions

-Both Ellis's REBT and Beck's CT represent the most systematic applications of CBT -Both follow a defined plan of action; they are relatively brief and structured treatments that are in keeping with the spirit of cost effectiveness and evidence-based practice -Meichenbaum's work in self-instruction and stress inoculation training has been applied successfully to a variety of client populations and specific problems -A major contribution made by Ellis, the Becks, and Meichenbaum is the demystification of the therapy process

-Extensive training is required to practice CBT -Therapist may misuse power by imposing their ideas of what constitutes "rational" thinking on a client -The strong confrontational style of Ellis's REBT may overwhelm some clients -Some clinicians think CBT interventions overlook the value of exploring a client's past experiences