COGNITIVE BEHAVIORAL THERAPY

[Audio] COGNITIVE BEHAVIORAL THERAPY GLAIZAMARIE J ELCHICO.

[Audio] AARON TEMKIN BECK (b 1921) -Was born in Providence, Rhode Island -his childhood, although happy, was interrupted by a life threatening illness when he was 8 years old, as a consequence, he experienced blood injury fears, fear of suffocation and anxiety about his health -used his personal problems to understand others -initially trained as a neurologist but switched to psychiatry -Through his research, Beck developed a cognitive therapy of depression , where he found out that depressed clients’ cognitions are characterized by errors in interpretation called “ cognitive distortions”.

[Audio] Cognitive Model Cognitive Therapy is based on the premise that : - what we think affects how we feel, what we do or what we avoid, and our physiological reactions -In fact, most situations remain neutral until we assign meaning based on how we interpret the situation.

[Audio] BASIC PRINCIPLES OF COGNITIVE THERAPY 1. Automatic Thoughts ( personalized notions that are triggered by particular stimuli that lead to emotional responses). 2. Individuals maintains their core beliefs about themselves, their world and their future. 3. People with emotional difficulties tend to commit logical errors that distort objective reality- cognitive distortions Beck observed that depressed clients exhibited a negative bias in their interpretation or thinking. He asked clients to observe their negative automatic thoughts that persisted eventhough they were contrary to objective evidence. A primary focus of cognitive therapy is to assist clients in examining their core beliefs and encourage to gather and weigh evidence in support of their beliefs, clients bring changes in their mood and behavior.

[Audio] COGNITIVE DISTORTIONS A Catastrophizing- you start your work as a counselor and you already assumed that you will not be liked. b. Measuring your worth based on your weaknesses , not be your successes.

[Audio] 4. Magnification and minimization – perceiving case or situation in a greater or lesser light than it truly deserves 5. Personalization-tendency for individuals to relate external events to themselves 6. Labeling and mislabeling- portraying one’s identity on the basis of imperfections and mistakes in the past allowing them to define one’s true identity 7. Dichotomous thinking – categorizing experiences in either-or extremes..

[Audio] Cognitive therapist assumes that to produce lasting change in dysfunctional emotions and behaviors is to modify inaccurate and dysfunctional thinking . The therapist teaches how clients can identify these distorted and dysfunctional cognitions through a process of evaluation.

[Audio] After they have gained insight into how their unrealistic negative thoughts are affecting them, clients are taught to test these automatic thoughts against reality by examining and weighing the evidence for and against them. Cognitive therapy is focused on present problems, the past may be brought to therapy when the therapist considers it essential to understand how and when certain core dysfunctional beliefs impacted the clients’ specific schema.

[Audio] SOME DIFFERENCES BETWEEN CT AND REBT REBT is highly directive, persuasive and confrontational ; it also focuses on the teaching role of the therapist. The therapist models rational thinking and helps clients to identify and dispute irrational beliefs. CT uses Socratic Dialouge by posing open-ended questions to clients to reflect on personal issues and arrive at their own conclusions, helping clients identify their own misconceptions for themselves than does REBT Cognitive therapists attempt to collaborate with clients in testing the validity of their cognitions ( collaborative empiricism).

[Audio] Ellis view of faulty thinking-persuade clients that certain of their beliefs are irrational and nonfunctional Beck view his clients’ belief as being more inaccurate than irrational and asks his clients to conduct behavioral experiments to test the accuracy of their beliefs Ellis view the therapist largely as a teacher and does not think that a warm relationship with clients is essential . In contrast , Beck emphasizes the quality of the therapeutic relationship Beck believes that effective therapists must combine empathy and sensitivity.

[Audio] Therapist must have a cognitive conceptualization of cases, be creative and active, be able to engage clients in Socrating questioning and be knowledgeable and skills in the use of cognitive and behavioral strategies Therapist act as a catalyst and a guide who helps clients understand how their beliefs and attitudes influence the way the feel and act. Clients are expected to identify the distortions in their thinking , summarize important points and collaboratively devise homework assignments that they agree to carry out.

[Audio] In Cognitive therapy, the aim is to identify specific measurable goals and to move directly into the areas that are causing the most difficulty for clients , teach clients how to be their own therapist Bibliotherapy- clients complete readings dealing with the philosophy of cognitive therapy. Readings are assigned adjunct to therapy Homework/ Action plans is often used as a part of cognitive therapy, tailored to clients’ specific problems.

[Audio] Homework is presented to clients as an experiment which increases openness of clients to get involved. Cognitive therapists realize that clients are more likely to complete homework if it is tailored to their needs, if they participate designing the homework and if they begin the homework in the therapy session.

[Audio] Applications Depression and other psychiatric disorders Strong empirical support for its theoretical framework and to the large number of outcome studies with clinical populations Successfully treat phobias, eating disorders, generalized anxiety disorders , narcissistic personality disorders, PTSD, suicidal behaviors, BPD, schizophrenic disorders , personality disorders, substance abuse, chronic pain , medical illness Initially gained recognition.

[Audio] Applying Cognitive Techniques - identifying and examining the client’s beliefs, exploring the origin of these beliefs, modifying them if the client cannot support these beliefs Behavioral techniques typically used cognitive theraists include scheduling, behavioral experiments . Skills training, role playing , behavioral rehearsal, exposure therapy Cognitive therapist is mainly interested in applying procedures that will assist individuals in making alternative interpretations of events in their daily living.

[Audio] Example -: Your professor does not call you during a particular class session . You feel depressed. Cognitively you are telling yourself “ My professor thinks Im stupid and that I really don’t have much value to offer in the class. Possible alternative interpretations- The teacher wants to include others , that she is short on time and wants to move ahead.

[Audio] Treatment of Depression Negative conclusions Anticipate difficulties Screen out , rigid, perfectionist.

[Audio] Depth of Depression- Beck Depression Inventory (1967) “ Tyranny of the Shoulds” If your friend were to make a mistake the way you do, would you be as critical as you are to yourself?.

[Audio] Establishing Aspirations Where do you want to see yourself after waking up? How do you want to feel when you wake up? What’s important to you in life? When you were growing up, what did you hope for?.

[Audio] Usual Questions to Set Goals What is a typical day for you? How would you like to be different as a result of this treatment?.

[Audio] Imagery Exercise Imagine a day ( specific time in the future). You are on your way in achieving your inspiration . Create a movie in your mind and let us see if we can use all your senses.

[Audio] Elements to Consider in Image Social Interactions Productivity Household management Leisure Activities Exercise Relaxation.

[Audio] Cost- Benefit Analysis Advantages of Taking Meds Effects is bigger than side effects Disadvantages of Taking Meds Medication can have side effects Advantages of Not taking Meds Psychotherapy is effective Disadvantages of taking Meds Presence of severe symptoms.

[Audio] Problem- Solving Identify the Problem Think about Possible Solutions Choose a Solution to Implement How well does it work?.

[Audio] Cognitive Conceptualization Relevant History Core Beliefs Coping Strategies Situation- Automatic Thought- Meaning of Automatic Thought- Emotion- Behavior.

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[Audio] Dysfunctional Thought Record Coping Cards A-B-C Worksheets.

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