Cognitive Behavior Modification The use of cognitions to modify behavior
Assumptions of Cognitive Behavior Modification• Cognitions are behavior• Cognitions are part of the behavioral chain• Cognitions can control overt behavior• Cognitions, as behavior, can themselves be controlled• The same contingencies that control overt behavior also control cognitions
• The model that is assumed is as follows: Antecedents Beliefs Consequences environment rational emotional beliefs irrational behavioral (evaluative)• Beliefs can be either flexible or rigid.• Rigid (irrational) beliefs take the form of “musts,” “absolutes,” “shoulds,” “have tos,” “got tos,” and so forth.• When a person holds rigid beliefs, they tend to reach irrational conclusions.
• People don’t behave according to environmental antecedents but because of their interpretation of what those events mean• Interpretations are developed through past experiences• We develop expectations about what is going to happen under specific environmental situations based on what they have experienced in the past in similar situations• Patterns of reinforcement and punishment in the past lead to current expectations, beliefs, attitudes, etc.
How Cognitive Behavior Modification Works• Cognitions such as beliefs, attitudes and even emotions can cause behavior• Much maladaptive behavior is caused by inappropriate or illogical cognitions• Many of our cognitions may not be accurate representations of reality• By changing these cognitions, the behaviors that they lead to will in turn be changed
• While our cognitions may accurately reflect conditions that held in the past, they may no longer be appropriate in current situations• For example, a child may have been severely punished for expressing curiosity concerning sex and has thus suppressed this interest• However, as an adult such interest is appropriate but his beliefs may continue to generate fear surrounding this topic and he will be unable to express this drive (generalization)• What he needs to learn is that the punishment is no longer likely and it is okay to express his sexual interests
• Many such beliefs develop early in life and tend to be very persistent (avoidance behaviors)• The person may be afraid to “test the waters” by engaging in alternate behaviors due to this persistent fear• In other instances it may be a lack of cognitive skill that is leading to stereotyped behavior• For instance, poor problem solving strategies may lead the person to avoid situations that require these skills, or cause them to exhibit an ineffective behavior repeatedly• This failure to be able to control situations may also lead to avoidance of such situations
Modifying Cognitions• Most approaches change cognitions through argument, persuasion, consequences, and practicing alternate cognitions• By having clients see the illogic of their cognitions, clients are in a better position to change their behavior• By developing new cognitions focusing on more effective coping skills, the client can exhibit more appropriate behavioral patterns
Methods of Cognitive Behavior ModificationSelf-Instruction Training• Impulsive people have not developed the mediational skills necessary to solve problems• The goal is to get impulsive people to talk to themselves as a method of gaining self-control• Language can be used to develop, modify, or maintain certain behavior among impulsive people• Self-instruction is the covert, self-directed statements of an internal dialogue that a person uses to guide him/herself through a problem-solving process
• The self-statements serve as guides for a person to follow through the process of problem solvingAspects of self-instruction training:• 1. Cognitive modeling. The trainer performs a task while talking aloud; the student observes• 2. Overt external guidance. The client and trainer both perform the task while talking aloud together• 3. Overt self-guidance. The client performs the task using the same verbalizations as the trainer• 4. Faded self-guidance. The client whispers the instructions (often in an abbreviated form) while going through the task• 5. Covert self-guidance. The client performs the task, guided by covert self-speech
Thought-Stopping.• The goal is to help a child control unproductive or self- defeating thoughts and images by suppressing or eliminating them• Persons for whom thought stopping would be most helpful: 1. Persons who ruminate about a past event that cannot be changed 2. Persons who ruminate about an event that is unlikely to occur 3. Persons who engage in repetitive, unproductive, negative thinking or repetitive anxiety-producing or self- defeating images
• Stages of thought stopping:• 1. Treatment rationale. Explain to the client how self- defeating thoughts or images create anxiety and interfere with performing desirable behaviors• Point out how the person would be better off without being plagued by such thoughts or images; do not describe the thought stopping process in detail• 2. Practitioner-directed thought stopping. The client verbalizes all thoughts and images aloud that relate to the problem situation• This allows practitioner to determine the exact moment when the client begins engaging in negative thinking. The practitioner then says “Stop!” very loud and accompanies it with a loud noise (clap).
• The practitioner indicates how the unexpected and startling interruption terminated the negative thoughts• The client is then directed to repeat the same thoughts silently but to raise his/her finger when he/she reaches the negative thought that the practitioner previously stopped• The practitioner then repeats the interruption• 3. Child-directed thought stopping: Covert interruption• Clients substitute a covert interruption for the overt one• This time, when first verbalizing the thoughts out loud and then covertly, clients say “Stop!” to themselves while visualizing a big stop sign inches away from their face
• 4. Shift to assertive, positive, or neutral thoughts.• To maintain the effects of the initial thought interruption, clients should be taught to verbalize assertive, positive, or neutral thoughts.• 5. Homework and follow-up.• Once clients have mastered all the phases of thought stopping, they are ready to use it outside the training setting.• At first, clients should be instructed to practice the thought-stopping phases several times each day.• Also, clients can initiate thought stopping whenever they notice that they are engaging in negative or self- defeating thinking.
Cognitive restructuring• This is a method for correcting faulty thinking• It is a set of techniques that focus on identifying and altering individuals’ irrational beliefs and negative self-statements or thoughts
• Steps in cognitive restructuring• 1. Treatment rationale: Instill the belief that self-talk influences performance and that negative self-statements result in emotional distress and counterproductive behavior• 2. Identification of client thoughts in problem situations: Analyze the client’s thoughts during anxiety-provoking or distressing situations using interviewing and client and therapist modeling• 3. Introduction and practice of coping thoughts: Shift away from negative thoughts and on to coping statements; provide examples first
• 4. Shifting from self-defeating to coping thoughts: The therapist introduces a shift from self-defeating to coping thoughts during problematic situations• 5. Introduction and practice of reinforcing self-statements: Teach clients how to reinforce themselves for having coped.• 6. Homework and follow-up: Clients are instructed to use cognitive restructuring during real-life situations. The therapist provides homework log sheets containing written directions on how to practice learned skills
Rational-Emotive Therapy• Rational-emotive therapy• Most everyday emotional problems and behaviors stem from irrational self-statements people tell themselves when events do not turn out as they would like.• The approach is to teach persons to counteract such irrational beliefs with more positive and realistic statements.• This may be done by challenging the person to use words factually.