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An Overview: Cognitive Behavior Therapy


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Cognitive Behavior Therapy as it relates to Student Affairs
Source: Theory & Practice of Counseling & Psychotherapy by Gerald Corey

Published in: Health & Medicine, Technology
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An Overview: Cognitive Behavior Therapy

  1. 1. Form  A  -­‐  Peter  ‘Max’  Quinn  Critical  Evaluation  Format  CN528  Counseling  &  Development  Professor  Ciri  -­‐  November  21,  2011    Theory:  Cognitive  Behavior  Therapy     KEY  Concepts  of  Cognitive  Behavior  Therapy:    View  of  Human  Nature  /  Basic  Assumptions  Underlying  Approach   • REBT  -­‐  Rational  Emotive  Therapy  -­‐  Help  students  restructure  their  life  styles   • Irrational  beliefs  are  learned  from  childhood  on  to  adulthood  (lead  to  self-­‐defeat)   o “I  must  always  do  well  and  win  the  approval  of  others  for  my  performances  or  else  I  am  no  good;     o Other  people  must  treat  me  considerately  fairly,  kindly,  and  in  exactly  the  way  I  want  them  to  treat  me.  If  they   don’t,  they  are  no  good  and  they  deserve  to  be  condemned  and  punished;   o I  must  get  what  I  want,  when  I  want  it;  and  I  must  not  get  what  I  don’t  want.  If  I  don’t  get  what  I  want,  it’s   terrible,  and  I  can’t  stand  it;   o I  must  do  what  I  want;  People  must  like  me”     • Thinking  &  Feeling  are  connected   • People  are  creative   • A  reorganization  of  one’s  self-­‐statements  will  result  in  a  corresponding  reorganization  of  one’s  behavior   • Operant  conditioning,  modeling,  behavioral  rehearsal  techniques  are  commonly  used   • Human  beings  are  born  with  a  potential  for  both  rational  or  “straight”  thinking  and  irrational  or  “crooked”  thinking   • People  have  predispositions  for  self-­‐preservation,  happiness,  thinking  and  verbalizing,  loving,  communion  with   others,  and  growth  and  self-­‐actualization,  self-­‐destruction,  avoidance  of  thought,  procrastination,  endless  repetition  of   mistakes,  superstition,  intolerance,  perfectionism  and  self-­‐blame,  and  avoidance  of  actualizing  growth  potentials   • Humans  are  fallible,  REPT  attempts  to  help  them  accept  themselves  as  creatures  who  will  continue  to  make  mistakes   yet  at  the  same  time  learn  to  live  more  at  peace  with  themselves    MOST  Important  Concepts   • Humor  is  a  good  trait  to  have/use   • A-­‐B-­‐C  Framework   o Actual  event  (Activity,  Event  or  Adversity)   o Belief  system  (What  students  believes  about  A)   o Consequence  (emotional  or  behavioral  consequence   o Disputing  -­‐  Application  of  methods  to  help  students  challenge  their  irrational  beliefs   § Detecting  -­‐  Detect  their  irrational  beliefs   § Debating  -­‐  Debate  their  dysfunctional  beliefs  by  learning  how  to  logically  and  empirically  question   them  and  vigorously  argue  themselves  out  of  an  act  against  believing  them   § Discriminating  -­‐  Discriminate  irrational  beliefs  from  rational  beliefs   o Effect  -­‐  A  new  and  effective  belief  system  consists  of  replacing  unhealthy  thoughts  with  healthy  ones   o F  (New  Feeling)  -­‐  If  we  are  successful,  we  create  a  new  set  of  feelings   • Philosophical  Restructuring   o Fully  acknowledge  that  we  are  largely  responsible  for  creating  our  own  emotional  problems   o Accept  the  notion  that  we  have  the  ability  to  change  these  disturbances  significantly   o Recognize  that  our  emotional  problems  largely  stem  from  irrational  beliefs   o Clearly  perceive  these  beliefs  /  See  the  value  of  disputing  such  self-­‐defeating  beliefs   o Accept  the  fact  that  if  we  expect  to  change  we  had  better  work  hard  in  emotive  and  behavioral  ways  to   counteract  our  beliefs  and  the  dysfunctional  feelings  and  actions  that  follow   o Practicing  REBT  methods  of  uprooting  or  changing  disturbed  consequences  for  the  rest  of  our  lives   • Cognitive  Restructuring   o Central  technique  that  teaches  people  how  to  improve  themselves  by  replacing  faulty  cognitions  with   constructive  beliefs   • Emotional  problems  are  the  result  of  one’s  beliefs,  which  need  to  be  challenges  by  SA  Professional   • Cognitive  restructuring  -­‐  Help  student  dispute  their  irrational  beliefs   • Help  student  to  become  aware  of  inaccurate  or  negative  thinking   • Allow  student  to  view  challenging  situations  more  clearly  and  respond  to  them  in  more  effective  ways   • Effective  for  treating  anxiety  &  depression  &  to  help  anyone  learn  how  to  better  manage  stressful  situations   • Operant  conditioning,  modeling,  behavioral  rehearsal  techniques  are  commonly  used  
  2. 2. Therapeutic  Process:  Most  important  Therapeutic  Goals   • Students  must  choose  &  want  to  live  differently   • SA  Professionals  help  student  identify,  test,  &  evaluate  their  belief  systems   • Warm  relationship  between  students  and  SA  Professional     o but  not  too  warm,  we  want  them  to  be  independent   • Student  needs  to  feel  unconditional  &  positive  regard   • Collaborative  relationship  between  students  and  SA  Professional   • Psychological  distress  is  largely  a  function  of  disturbances  in  cognitive  processes   • Focus  on  changing  conditions  to  produce  desired  changes  in  affect  and  behavior   • Generally  time-­‐limited  and  educational  treatment  focusing  on  specific  and  structured  target  problems   • Structured  psychoeducational  model   • Emphasis  on  homework   • Draw  from  a  verity  of  cognitive  and  behavioral  strategies  to  bring  about  change   • Teach  students  how  to  separate  the  evaluation  of  their  behaviors  from  the  evaluation  of  themselves     o Their  essence  and  their  totality   o And  how  to  accept  themselves  in  spite  of  their  imperfections   • Collaborate  on  choosing  realistic  and  self-­‐enhancing  therapeutic  goals   • Assist  students  in  the  process  of  achieving  unconditional  self-­‐acceptance  and  unconditional  other  acceptance  and  to   see  how  these  are  interrelated   • The  more  a  student  can  accept  themselves,  the  more  likely  they  can  unconditionally  accept  others    Functions  and  Role  of  the  Student  Affairs  Professional   • Acts  as  a  teacher   • Needs  understanding  of  cultural  backgrounds   • Teach  students  how  to  feel  un-­‐depressed  even  when  they  are  unaccepted  and  unloved  by  significant  others   • Encourage  students  to  experiences  healthy  feelings  of  sadness  over  being  unaccepted   • It  attempts  to  help  them  find  ways  of  over-­‐coming  unhealthy  feelings:   o  depression,  anxiety,  hurt,  loss  of  self-­‐worth,  and  hatred   • Help  students  differentiate  between  realistic  and  unrealistic  goals  and  also  self-­‐defeating  and  self-­‐enhancing  goals   • Teach  students  how  to  change  their  dysfunctional  emotions  and  behaviors  into  healthy  ones   • Show  students  how  they  have  incorporated  may  irrational  “shoulds”,  “oughts”,  and  “musts”   • Demonstrate  how  students  are  keeping  their  emotional  disturbances  active  by  continuing  to  think  illogically  and   unrealistically   • Help  students  modify  their  thinking  and  minimize  their  irrational  ideas   • Challenge  students  to  develop  a  rational  philosophy  of  life     o so  that  in  the  future  they  can  avoid  becoming  the  victim  of  other  irrational  beliefs   • Teach  students  about  the  cognitive  hypothesis  of  disturbance  and  showing  how  faulty  beliefs  lead  to  negative   consequences   • Unconditionally  accept  students  and  teach  them  to  unconditionally  accept  others  and  themselves   • Open  and  direct  in  disclosing  their  own  beliefs  and  values   • Start  with  students  distorted  feelings  and  intensely  explore  these  feelings  in  connection  with  thoughts  and  behaviors   • Flexible  and  creative  when  using  methods,  making  sure  to  tailor  techniques  to  the  unique  needs  of  the  student   • Rely  on  thinking,  disputing,  debating,  challenging,  interpreting,  explaining,  and  teaching   • Unconditional  acceptance,  rational  emotive  role  playing,  modeling,  rational  emotive  imagery,  shame-­‐attacking   exercises    The  students’  role  in  the  Therapeutic  Process   • Needs  to  actively  practice  changing  their  self-­‐defeating  behavior  and  convert  it  into  rational  behavior   • Responsibility  on  student  to  assume  an  active  role  both  during  and  outside  of  sessions   • Participate  effectively  in  the  cognitive  restructuring  process   • Focus  on  the  students  experiences  in  the  present   • Emphasize  the  here-­‐and-­‐now  experiences   • Focus  on  students  present  ability  to  change  the  patterns  of  thinking  and  emoting  that  they  constructed  earlier   • Homework  is  designed  to  get  students  to  carry  out  positive  actions  that  induce  emotional  and  attitudinal  change          
  3. 3. Applications:  Techniques  and  procedures  of  Cognitive  Behavior  Therapy-­‐    -­‐Techniques  and  Methods  of  Cognitive  Behavior  Therapy  incorporated  into  counseling  practice  in  Student  Affairs-­‐   • Albert  Ellis’s  Rational  Emotive  Behavior  Therapy     o Rational  Emotive  Behavior  (REBT)  and  its  Practice  in  Student  Affairs   § Cognitive  Methods   • Disputing  irrational  beliefs;  Doing  cognitive  homework;  Changing  one’s  language;   Psychoeducational  methods   § Emotive  Techniques   • Rational  emotive  imagery;  Using  humor;  Role  playing;  Shame-­‐attaching  exercises;  Use  of   force  and  vigor   § Highly  directive  &  confrontational  (Not  Mean/Nasty)   § Stresses  thinking,  judging,  deciding,  analyzing,  and  doing   § People  contribute  to  their  own  psychological  problems   § Cognitions,  emotions,  and  behaviors  interact  significantly  and  have  a  reciprocal  cause-­‐and-­‐effect   relationship   § Encourage  students  to  do  the  very  things  they  are  afraid  of     § “People  are  disturbed  not  by  events,  but  by  the  views  which  they  take  of  them”  -­‐  Epictetus   § Our  emotions  stem  mainly  from  our  beliefs,  evaluations,  interpretations,  and  reactions  to  life   situations   § Although  we  originally  learn  irrational  beliefs  from  significant  others  during  childhood,  we  create   irrational  dogmas  by  ourselves   • We  do  this  by  actively  reinforcing  self-­‐defeating  beliefs  by  the  process  of  autosuggestion  and   self-­‐repetition  and  by  behaving  as  if  they  are  useful   § People  do  not  need  to  be  accepted  and  loved,  even  though  this  may  be  highly  desirable   § Blame  is  at  the  core  of  most  emotional  disturbances                                                 § It  is  important  that  students  learn  to  fully  accept  ourselves  despite  our  imperfections   § We  have  tendencies  to  escalate  our  desires  and  preferences  into  dogmatic  “shoulds”,  “musts”,   “oughts”,  demands  and  commands   § We  have  a  strong  tendency  to  make  and  keep  ourselves  emotionally  disturbed  by  internalizing  self-­‐ defeating  beliefs     o Application  of  REBT  to  Students   § Through  the  therapeutic  process,  students  learn  skills  that  give  them  tools  to  identify  and  dispute   irrational  beliefs  that  have  been  acquired  and  self-­‐constructed  and  are  now  maintained  by  self-­‐ indoctrination   § Learn  how  to  replace  such  ineffective  ways  of  thinking  with  effective  and  rational  cognitions,  and  as  a   result  they  change  their  emotional  reactions  to  situations   § Allow  students  to  apply  REBT  principles  of  change  not  only  to  a  particular  presenting  problem,  but   also  to  many  other  problems  in  life  or  future  problems  they  might  encounter   § The  student  in  a  learner  who  practices  the  newly  learned  skills  in  everyday  life   § Applied  to  treat:  Anxiety,  Hostility,  Character  Disorders,  Psychotic  Disorders,  Depression,  problems   of  Sex,  Love,  and  Marriage     o REBT  as  a  Brief  Therapy   § The  focus  is  on  working  with  thinking  and  acting  rather  than  primarily  with  expressing  feelings   § Educational  process   § Collaborate  with  the  student  on  homework  and  in  teaching  strategies  for  straight  thinking   § Learn  how  to  apply  REBT  techniques  their  present  as  well  as  future  problems   § 1  -­‐  10  sessions  &  practiced  at  home     o Application  of  REBT  to  Group  Counseling   § Active  role  in  getting  members  to  commit  themselves  to  practicing  in  everyday  situations  what  they   are  learning  in  the  group   § Consistent  work  between  group  sessions  is  crucial   § Group  provides  members  with  tools  they  can  use  to  become  self-­‐reliant  and  to  accept  themselves   unconditionally  as  they  encounter  new  problems  in  daily  living   § Teach  members  to  apply  principles  to  one  another  in  the  group   § Emphasis  placed  on  education  &  prevention    
  4. 4. • Aaron  Beck’s  Cognitive  Therapy  (CT)     o Basic  Principles   § Socratic  dialogue   § Help  the  student  discover  their  misconceptions  for  themselves   § We  have  the  capacity  significantly  change  our  cognitions,  emotions  and  behavior   § Active,  directive,  time-­‐limited,  present-­‐centered,  problem-­‐oriented,  collaborative,  structured,   empirical,  make  use  of  homework,  require  explicit  identification  of  problems  and  the  situations  in   which  they  occur   § Problems  stem  from  commonplace  processes  such  as  faulty  thinking,  making  incorrect  inferences  on   the  basis  of  inadequate  or  incorrect  information,  making  incorrect  inferences  between  fantasy  and   reality   § Insight-­‐focused  therapy  that  emphasizes  recognizing  and  changing  negative  thoughts  and   maladaptive  beliefs   § Theoretical  rationale  that  the  way  people  feel  and  behave  is  determined  by  how  they  perceive  and   structure  their  experience   • People’s  internal  communication  is  accessible  to  introspection   • Students’  beliefs  have  highly  personal  meanings   • These  meanings  can  be  discovered  by  the  students  rather  than  being  taught  or  interpreted   by  the  SA  Professional   § Automatic  Thoughts  -­‐  Personalized  notions  that  are  triggered  by  particular  stimuli  that  lead  to   emotional  responses   § Cognitive  Distortions   • Arbitrary  Inferences;  Selective  Abstraction;  Overgeneralization;  Magnification  and   Minimization;  Personalization;  Labeling  and  Mislabeling;  Dichotomous  Thinking   § The  most  direct  way  to  change  dysfunctional  emotions  are  behaviors  is  to  modify  inaccurate  and   dysfunctional  thinking   § After  they  have  gained  insight  into  how  their  unrealistically  negative  thoughts  are  affecting  them,   students  are  trained  to  test  these  automatic  thoughts  against  reality  by  examining  and  weighing  the   evidence  for  and  against  them.  They  can  begin  to  monitor  the  frequency  with  which  these  beliefs   intrude  in  situations  in  everyday  life   § Critically  examining  core  beliefs   • Actively  engage  in  Socratic  dialogue   • Carry  out  homework   • Gather  data  on  assumptions  made   • Keep  record  of  activities   • Forming  alternative  interpretations   • Guided  discovery  about  insight   • Connection  their  thinking  and  the  way  they  act  and  feel   o Applications   § Cognitive  Restructuring   • Student  observes  &  monitors  their  own  behavior   • Student  identifies  negative  thoughts  &  feelings   • Help  to  create  NEW  internal  dialogue  by  substituting  positive  self  statements   • Students  will  acquire  effective  coping  skills  that  they  can  practice  in  and  out  of  sessions   • Helping  students  learn  to  monitor  their  self-­‐talk,  identify  maladaptive  self-­‐talk,  and   substitute  adaptive  self-­‐talk  for  their  negative  self-­‐talk   § Used  to  treat:  phobias,  psychosomatic  disorders,  eating  disorders,  anger,  panic  disorders,  and   generalized  anxiety  disorders,  posttraumatic  stress  disorder,  suicidal  behavior,  borderline  personality   disorders,  narcissistic  personality  disorders,  and  schizophrenic  disorders,  substance  abuse,  chronic  pain,   medical  illness,  crisis  intervention,  couples  and  families  therapy,  child  abusers,  divorce  counseling,  skills   training,  and  stress  management   § Alternative  interpretations  -­‐  Help  students…   • Become  aware  of  the  distortions  in  thinking  patterns  by  examining  automatic  thoughts   • Learn  about  the  process  of  magnification  or  minimization  of  their  thinking   • Learning  how  to  disregard  important  aspects  of  a  situation;  engage  in  overly  simplified  and   rigid  thinking;  and  generalize  from  a  single  incident  of  failure   § Treatment:  Cognitive  Triad  &  Selective  Abstraction   § Emphasis  on  Schema  or  core  beliefs   § Self-­‐criticism  -­‐  “If  I  were  to  make  a  mistake  the  way  you  do,  would  you  despise  me  as  much  you  do  yourself?”  
  5. 5. • Donal  Meichenbaums’s  Cognitive  Behavior  Modification  (CBM)  (VERY  USEFUL  FOR  STUDENT  AFFAIRS)   o Eclectic  -­‐  “I  focus  on  using  a  variety  of  cognitive,  affective,  and  behavioral  techniques  to  help  students  grow”   o Disputing  irrational  statements;  homework;  changing  one’s  language;  role  playing;  humor;  self  management   strategies;  Social  Skills  Training;  Assertiveness  Training;  Relaxation  Techniques;  Behavior  Modification   Contracting   o Change  the  students’  self-­‐verbalizations   o Self-­‐statements  affect  a  person’s  behavior  in  much  the  same  way  as  statements  made  by  another  person   o Students,  as  a  prerequisite  to  behavior  change,  must  notice  how  they  think,  feel,  and  behave  and  the  impact   they  have  on  others   o Self-­‐instructional  Training   § Focus  more  on  helping  students  become  aware  of  their  self-­‐talk   § Teaching  students  to  make  self-­‐statements   § Training  students  to  modify  the  instructions  they  give  to  themselves  so  that  they  can  cope  more   effectively  with  the  problems  they  encounter   § Collaborate  on  in  practice  of  the  students  self-­‐instructions  and  the  desirable  behaviors  in  role-­‐play   situations  that  stimulate  problem  situations  that  stimulate  problem  situations  in  the  students’  daily   life   § Emphasize  on  acquiring  practical  coping  skills  for  problematic  situations   • E.g.)  Impulsive  and  aggressive  behavior,  fear  of  taking  tests,  and  fear  of  public  speaking   § Cognitive  Structure   • The  organizing  aspect  of  thinking,  which  seems  to  monitor  and  direct  the  choice  of  thoughts   • An  “executive  processor”  which  “holds  the  blueprints  of  thinking”  that  determine  when  to   continue,  interrupt,  or  change  thinking   o How  Behavior  Changes   § Behavior  change  occurs  through  a  sequence  of  mediating  processes  involving  the  interaction   of  inner  speech,  cognitive  structures,  and  behaviors  and  their  resultant  outcomes   § For  change  to  occur,  students  need  to  interpret  the  scripted  nature  of  their  behavior  so  that  they  can   evaluate  their  behavior  in  various  situations   § Distressing  emotions  are  typically  the  result  of  maladaptive  thoughts   § Three-­‐Interwoven-­‐Phase  processes  of  Change     • Self-­‐Observation  -­‐Students  must  learn  to  observe  their  own  behavior   o Students  must  develop  a  willingness  and  ability  to  listen  to  negative  self  -­‐ statements,  imagery,  and  internal  dialogue   o Increased  sensitivity  to  their  thoughts,  feelings,  actions,  physiological  reactions,  and   ways  of  reacting  to  others.     o Students  must  realize  that  they  are  not  “victims”  of  negative  thoughts  and  feelings   o They  contribute  to  their  depression  through  the  things  they  tell  themselves   • Starting  a  New  Internal  Dialogue  -­‐  Students  learn  to  notice  their  maladaptive  behaviors   and  begin  to  see  opportunities  for  adaptive  behavioral  alternatives   o New  behavioral  chain  emerges  through  wanting  to  change  and  becomes   incompatible  with  prior  maladaptive  behaviors   o Students  then  can  change  their  internal  dialogue  which  serves  as  a  guide  new   behavior   • Learning  New  Skills  -­‐  Teaching  students  more  effective  coping  skills   o Students  need  to  practice  new  skills  in  real-­‐life  situations   o Help  to  change  their  negative  view,  making  them  more  willing  to  engage  in  desired   activities   o Focus  on  telling  themselves  NEW  sentences  and  observing  and  assessing  the   outcomes   o As  they  behave  differently,  the  will  get  different  reactions  from  others   o The  stability  of  what  they  learn  is  greatly  influenced  by  what  they  say  to  themselves   about  their  newly  acquired  behavior  and  its  consequences   o Coping  Skills  Programs   § Students  can  acquire  more  effective  strategies  in  dealing  with  stressful  situations  by  learning   how  to  modify  their  cognitive  “set”,  or  core  beliefs   § Expose  students  to  anxiety-­‐provoking  situations  by  means  of  role-­‐playing  and  imagery   § Requiring  students  to  evaluate  their  anxiety  level   § Teach  students  to  become  aware  of  the  anxiety-­‐provoking  cognitions  they  experience  in  stressful   situations   § Help  students  examine  these  thoughts  by  revealing  their  self-­‐statements   § Have  students  note  the  level  of  anxiety  following  this  reevaluation  
  6. 6. § Stress  Inoculation  Training  (SIT)  Procedures   • Individuals  are  given  opportunities  to  deal  with  relatively  mild  stress  stimuli  in  successful   ways,  so  that  they  gradually  develop  a  tolerance  for  stronger  stimuli   • We  can  affect  our  ability  to  cope  with  stress  by  modifying  our  beliefs   • Used  to  prepare  students  for  intervention  and  motivate  them  to  change   • Deals  with  issues  such  as  resistance  and  relapse   • Combination  of  information  giving,  Socratic  discussion,  cognitive  restructuring,  problem   solving,  relaxation  training,  behavioral  rehearsals,  self-­‐monitoring,  self-­‐instruction,  self-­‐ reinforcement,  and  modifying  environmental  situations   • Designed  to  teach  coping  skills  that  can  be  applied  to  both  present  problems  and  future   difficulties     • The  Conceptual  Education  Phase  -­‐   o Focus  on  creating  a  working  relationship  with  students   o Help  them  gain  a  better  understanding  of  the  nature  of  stress  and  re-­‐conceptualizing  it  in   social-­‐interactive  terms   o Rethink  the  nature  of  the  problem,  collaboratively   o Provide  student  with  conceptual  framework  in  simple  terms  that  educates  them  about  ways   of  responding  to  a  variety  of  stressful  situations   o Help  them  to  learn  the  role  that  cognitions  and  emotions  play  in  creating  and  maintaining   process  through  didactic  presentations,  Socratic  questioning,  and  by  a  process  of  self-­‐ discovery   o Help  students  learn  the  role  they  play  in  creating  their  own  stress   o Systematically  observe  the  statements  they  make  internally  and  monitor  the  maladaptive   behaviors  that  flow  from  this  inner  dialogue   o Keep  and  open-­‐ended  diary  to  systematically  record  their  specific  thoughts,  feelings,  and   behaviors   o Strive  to  be  flexible  when  using  techniques  and  be  sensitive  to  the  individual,  cultural,  and   situational  circumstances  of  each  student     • Skills  Acquisition,  Consolidation,  and  Rehearsal  Phase  -­‐   o Give  students  a  variety  of  behavioral  and  cognitive  coping  techniques  to  apply  to  stressful   situations   o Direct  actions;  gathering  information  about  their  fears;  learning  specifically  what  situations   bring  about  stress,  arranging  for  ways  to  lessen  the  stress  by  doing  something  different’  and   learning  methods  of  physical  and  psychological  relaxation   o Cognitive  coping;  students  are  taught  adaptive  and  maladaptive  behaviors  are  linked  to  their   inner  dialogue   o Students  acquire  and  rehearse  a  new  set  of  self-­‐statements  (See  pg.  299)   o Students  must  make  lifestyle  changes:  Re-­‐evaluating  priorities,  developing  support  systems,   and  taking  direct  action  to  alter  stressful  situations   o Teach  students  variety  of  methods  of  relaxation  to  gain  skills  to  decrease  arousal  due  to   stress     • The  Application  and  follow-­‐through  Phase  -­‐   o Focus  on  carefully  arranging  for  transfer  and  maintenance  of  change  from  the  session  to   everyday  life   o Practice  self-­‐statements  and  apply  their  new  skills  in  real-­‐life  situations   o Imagery,  behavior  rehearsal,  role  playing,  modeling,  and  in  vivo  practice   o Practice  behavioral  assignments,  which  should  become  increasingly  demanding   o Write  down  homework  assignments,  if  homework  is  not  completed,  collaborate  consider  the   reasons  for  the  failure    o The  Constructivist  Approach  to  CBT   § Constructivist  Narrative  Perspective  (CNP)  -­‐  Focuses  on  the  stories  students  tell  about  themselves   and  others  regarding  significant  events  in  their  lives   § There  are  multiple  realities  -­‐  Help  students  appreciate  how  they  construct  their  realities  and  how   they  author  their  own  stories   § The  Constructivist  Approach  -­‐  Discovery-­‐oriented  -­‐  More  emphasis  to  past  development  -­‐  Targets  deeper   core  beliefs  -­‐  Explores  the  behavioral  impact  and  emotional  toll  a  student  pays  for  clinging  to  certain  root   metaphors   • Are  students  able  to  tell  a  new  story  about  themselves  and  the  world?   • Do  students  use  more  positive  metaphors  to  describe  themselves?   • Are  students  able  to  predict  high-­‐risk  situations  and  employ  coping  skills  in  dealing  with  emerging  problems?   • Are  students  able  to  take  credit  for  the  changes  they  have  been  able  to  bring  about?  
  7. 7. -­‐Major  strengths  of  Cognitive  Behavior  Therapy  from  a  diversity  perspective-­‐   • Culturally  sensitive  because  it  uses  the  student’s  belief  system  or  worldview   • Ideal  for  working  with  students  from  diverse  backgrounds   • Short  term  approach   • Addresses  the  role  of  environment  (where  the  students  ‘lives’)   • Strive  to  be  flexible  when  using  techniques  and  be  sensitive  to  the  individual,  cultural,  and  situational  circumstances   of  each  student   • Seek  to  understand  the  core  values  of  their  culturally  diverse  students,  SA  Practitioners  can  help  students  explore   these  values  and  gain  a  full  awareness  of  their  conflicting  feelings,  they  can  work  collaboratively  to  modify  these   feelings   • Group  living  and  the  students  happiness  depends  largely  on  the  quality  of  their  functioning  within  their  community   • Stresses  the  relationship  of  individuals  to  the  family,  community,  and  other  systems   • Values  diversity  and  the  interdependence  of  being  an  individual  and  a  productive  member  of  the  community   • Collaborative  nature  of  the  approach  allows  students  to  structure  the  relationship  the  way  they  want,  as  the  SA   Practitioner  enlists  students’  active  cooperation  and  participation   • Inherently  suited  to  treat  diverse  students  -­‐  Individualized  treatment,  focusing  on  the  external  environment,  active   nature,  emphasis  on  learning,  reliance  on  empirical  evidence,  focus  on  present  behavior,  and  brevity    -­‐Evaluation  as  applied  to  Student  Affairs  Practice-­‐   • Empirically  valid   • REBT  is  aimed  at  inducing  students  to  examine  and  change  some  of  their  most  basic  values   • Modifications  in  the  SA  Practitioners  style  need  to  be  made  depending  on  the  students  culture   • Comprehensive  and  integrative  approach  the  emphasizes  thinking,  judging,  and  doing   • The  interconnectedness  of  thinking,  behaving,  feeling  are  endemic  to  the  work  done  in  Student  Affairs   • Active  and  directive  techniques  -­‐  Teaching;  suggestion;  Persuasion;  “homework”  assignments;  Challenging  students  to   substitute  a  rational  belief  system  for  an  internal  one  is  a  major  aspect  of  the  daily  interaction  a  SA  Professional  has   with  students   • SA  Professionals  demonstrate  how  and  why  dysfunctional  beliefs  lead  to  negative  emotional  and  behavioral  results   • SA  Professionals  teach  students  how  to  dispute  self-­‐defeating  beliefs  and  behaviors  that  might  occur  in  the  future   • SA  Professionals  explain  to  students  how  change  comes  about  mainly  by  a  commitment  to  consistently  practice  new   behaviors  that  replace  old  and  ineffective  ones   • Personal  style  plays  a  major  positive  role   • Creativity  is  a  must!   • Integrative  approach,  using  many  methods  to  assist  students  in  modifying  their  self-­‐talk   • Collaborative-­‐partnership  is  crucial  for  student  growth   • Cognitive  processes  are  determinants  of  behavior,  once  students  learn  this,  the  possibilities  are  endless    -­‐The  most  significant  contributions  of  Cognitive  Behavior  Therapy  applied  to  Student  Affairs-­‐   • Individualized  treatment,  focusing  on  the  external  environment,  active  nature,  emphasis  on  learning,  reliance  on   empirical  evidence,  focus  on  present  behavior,  and  brevity   • Aim  to  change  students’  subjective  views  of  themselves  and  the  world   • Undermining  faulty  assumptions  and  beliefs  and  teaching  students  the  coping  skills  needed  to  deal  with  their   problems   • We  are  responsible  for  maintaining  self-­‐destructive  ideas  and  attitudes  that  influences  our  daily  transactions   • Confronting  students  with  questions  such  as  “What  are  your  assumptions  and  basic  beliefs”   • Interpretation  of  events  is  crucial   • Human  disturbances  can  occur,  but  problematic  behavior  can  be  changed  (A-­‐B-­‐C  Framework)   • Emphasis  on  putting  newly  required  insights  into  action   • Homework  assignments  are  well  suited  to  enable  students  to  practice  new  behaviors  and  can  assist  them  in  the   process  of  their  re-­‐conditioning  -­‐  A  natural  outgrowth  of  what  is  taking  place   • Collaboration  is  stressed   • Emphasis  on  a  comprehensive  and  integrative  practice   • Present-­‐centered  and  problem-­‐oriented   • Focus  on  a  detailed  case  conceptualization  as  a  way  to  understand  how  students  view  their  world   • Effective,  focused,  and  practical  treatments  for  specific  problems   • Not  complicated,  it  simply  facilitates  the  transfer  of  knowledge  from  SA  Professional  to  the  student(s)   • Students  are  active,  informed,  and  responsible  for  the  direction  of  therapy  because  they  are  partners  in  the  enterprise   • Encouragement  of  self-­‐help  provides  for  continuous  feedback  from  students  on  how  well  treatment  strategies  are   working,  and  provide  a  structure  and  direction  to  the  therapy  process  that  allows  for  evaluation  of  outcomes  
  8. 8.  -­‐The  most  significant  limitation(s)  of  Cognitive  Behavior  Therapy-­‐   • Negative  view  of  dependency  (REBT  -­‐  Diversity)  -­‐  Many  cultures  view  interdependence  as  necessary  to  good  mental   health  -­‐  Students  with  certain  long-­‐cherished  cultural  values  pertaining  to  interdependence  are  not  likely  to  respond   favorly  to  forceful  methods  of  persuasion  toward  interdependence   • SA  Professionals  level  of  training  will  have  an  impact  on  their  knowledge,  skill,  and  perceptiveness   • Misuse  of  SA  Professionals  power  by  imposing  ideas  of  what  constitutes  irrational  thinking   • Students  may  feel  pressured  to  adapt  goals  and  values  the  SA  Professional  sells  rather  than  acting  within  the   framework  of  their  own  value  system   • SA  Professionals  must  have  a  high  emotional  intelligence  so  that  they  avoid  imposing  their  own  philosophy  of  life  on   students   • Some  students  may  have  trouble  with  a  confrontational  style