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Cognitive Behavior Therapy


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This is a presentation on Aaron Beck's CBT.

Cognitive Behavior Therapy

  1. 1. COGNITIVE BEHAVIOR THERAPY AARON BECK Nothing is so terrible as activity without thought. Johann Wolfgang von Goethe © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  2. 2. AARON BECK • He was born in 1921 in Rhode Island, USA, the youngest of four siblings. • Childhood fears were handled with reasoning  • Graduated from Brown University and Yale Medical School • Studied psychiatry and was trained as a psychoanalyst • Eventually his research led him to formulate cognitive therapy, the focus of his career at the University of Pennsylvania where the Beck Institute for Cognitive Therapy and Research is housed © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  3. 3. AARON BECK Beck contended that various mental disorders have particular cognitive patterns and that the most effective and lasting therapy involves intervention into those patterns. © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  4. 4. BELIEFS People are not passive victims of their inborn tendencies  People are actively creating and moving toward goals that are vital to them Distress occurs when people experience a threat to their interests The more crucial a person considers the goal to be, the greater the response.  © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  5. 5. Cognitive Behavior Therapy Therapy which combines both cognitive and behavioral principles and methods in a shortterm treatment approach
  6. 6. Similarities with REBT & Behavior Therapy          Active Directive Time-limited Present-centred Collaborative Structured Empirical Make use of homework Require explicit identification of problems and situations
  7. 7. RELATIONSHIP OF BEHAVIOR TO AUTOMATIC THOUGHTS Situation Automatic thoughts(situation specific) Reactions (emotional, physiological, behavioral )
  8. 8. CT AND GROUP THERAPY Therapist may take a directing role, not in the sense of telling group members what to do but in the sense of organizing the group Group members collaborate with the therapist to suggest new ways of thinking and new behaviours to try out. Cognitive therapists conduct group standing and writing notes on a black board. Particularly in the beginning, the therapist takes responsibility for teaching new ways of thinking about the problems
  9. 9. HIERARCHICAL ORGANIZATION OF THINKING Automatic Thoughts These are thoughts that come rapidly, automatically and involuntarily to mind. It operates simultaneously with the more obvious, surface level of thinking. Underlying Beliefs/Intermediate Beliefs These are the often unarticulated beliefs that guide our everyday behaviour, set our standards and values, and establish our rules for living. Underlying assumptions are often identified by their ‘if … then’ or ‘unless … then’ construction (for example, ‘If not I’m respected by others then I can never have self-respect’). Rules are often expressed in ‘should’ and ‘must’ statements (‘I must never show any weaknesses’; ‘I should always be there for my friends when they need me’).
  10. 10. Hierarchical Organization of Thinking As long as the terms of these rules, standards and positive assumptions are met, individuals remain relatively stable and productive and thereby avoid activating the ‘bottom line’ – core belief. Underlying assumptions and rules apply across a range of situations. Assumptions and rules are also called intermediate beliefs as they link automatic thoughts with core beliefs. Beck suggested that maladaptive assumptions often focus on three major issues: acceptance (e.g. ‘I’m nothing unless I’m loved’); competence (e.g. ‘I am what I accomplish’); and control (e.g. ‘I can’t ask for help’). Core Beliefs These are the fundamental beliefs about ourselves (e.g. ‘I’m weak’), others (e.g. ‘People will walk all over me’) and the world (e.g. ‘It’s harsh and uncaring’) that help us to make sense of our life experiences. © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  11. 11. HIERARCHICAL ORGANIZATION OF THINKING  Core beliefs are usually formed through early learning experiences and become instrumental in shaping our outlook.  The most central or core beliefs are understandings that are so fundamental and deep that people often do not articulate the core belief, even to themselves. These ideas are regarded by the person as absolute truths, just the way things "are.”  Core beliefs can also be recently acquired, such as by experiencing a traumatic incident or accident.
  12. 12. COGNITIVE TRIAD Psychopathology results from maladaptive meanings. Self Environmental Context (experience) Future (goals)
  13. 13. COGNITIVE DISTORTIONS Distortions convert incoming information to keep cognitive schema intact.    © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  14. 14. THREE ASSUMPTIONS 1.Cognitive activity impacts behavior.  2.Cognitive activity can be monitored and changed.  3.A desired change in behavior can be accomplished through changing cognitions. © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  15. 15. COMMON INFORMATIONPROCESSING DISTORTION 1. Arbitrary Inference : This distortion is akin to jumping to conclusions wherein the person concludes without any supporting or relevant evidence that the worst possible outcome will happen. 2. Selective Abstraction : In this distortion, most relevant information about a situation is ignored while one minor detail provides the basis for a negative conclusion. 3. Personalization : This distortion is sometimes referred to as self-referencing. Victims of this distortion take everything personally. 4. Dichotomous or Polarized Thinking : This distorted thinking style is common among clients with borderline or narcissistic personality traits. People and situations are usually evaluated as black or white, good or bad.  
  16. 16. COMMON INFORMATIONPROCESSING DISTORTION 5. Labeling and Mislabeling : All humans use labels to describe themselves and others. Unfortunately, sometimes people hang onto inaccurate or maladaptive labels, despite their lack of utility. 6. Magnification and Minimization : This distortion is also referred to as overestimation and underestimation. It occurs when a client makes a mountain out of a molehill (and vice versa). 7. Overgeneralization : This distortion occurs when an individual generalizes and comes to a strong conclusion on the basis of a single or small number of incidents. Obviously, when overgeneralization occurs, the conclusion may be unwarranted.
  17. 17. COUNSELOR Both a guide to help the client understand how beliefs and attitudes interact with emotions and behavior, and a catalyst promoting corrective experiences, leading to cognitive change, and building skills. © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  18. 18. CASE FORMATION Dynamic process  Requires the counselor to generate and test their hypotheses Five parts:  1. 2. 3. 4. 5. problem list,  diagnosis,  working hypothesis,  strengths and assets, and treatment plan. © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  19. 19. FUNDAMENTAL CONCEPTS Collaborative empiricism  - the cooperative working relationship of jointly determining goals and seeking feedback  Socratic dialogue - a type of questioning designed to promote new learning  Guided discovery - when the counselor coaches the child in a voyage of self-discovery in which the child does his or her own thinking and draws his or her own conclusions © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  20. 20. SESSION OUTLINE • • • • • • • • • • Build an agenda that has meaning for the client Ascertain and measure the intensity of the person’s mood Identify and review presenting problems   Ask about the client’s expectation for counseling Teach the person about cognitive therapy and the client’s role in it Give information about the person’s difficulties and diagnosis Establish goals Recommend homework Summarize Obtain the client’s feedback © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  21. 21. STRESS INOCULATION CBT technique that includes  Self talk  Practice tests  Visualization  Relaxation training  Deep breathing exercises © 2011 BROOKS/COLE, A DIVISION OF CENGAGE LEARNING
  22. 22. JUST A THOUGHT… Once upon a time there was a man who was very afraid of snakes. He went for out for a walk in the twilight hours and his face brushed past a rope that was hanging from a tree. He died of shock. Who killed the man? Could it be a rope? But a rope is harmless! Could it be a snake? But there was none?
  23. 23. REFERENCES Beck, A. T., & Alford, B. A. (1997). The Integrative Power of Cognitive Therapy. The Guilford Press. New York. Corey, Gerald (2009). Theory and Practice of Counseling and Psychotherapy. Thomson Brooks/Cole. USA. Flanagan, J. S., & Flanagan, R. S. (2004). Counseling and Psychotherapy Theories in Context and Practice. John Wiley & Sons, Inc. New Jersey.