CBT Presentation (Therapy Techniques).pptx

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Introduction.
• Approaches to psychotherapy fall under five broad categories:
Psychoanalysis
&psychodynamic
therapies
Sigmund
Freud,
Erikson
Behaviour
therapy
Pavlov,
Skinner,
Thorndike
Cognitive
therapy
Albert Ellis,
Aaron Beck
Humanistic
therapy
J.P. Satre, V.
Frankl, R. May,
Maslow, Rogers
Integrative/
holistic therapy

First wave
psychotherapy (BT)
Behaviour therapy
Second wave
psychotherapy (CBT)
Cognitive (Beckian)
therapy
Third wave CBT
• Mindfulness therapies
• Acceptance &
commitment therapy

Cognitive Behavioural Therapy (CBT)
Beck (1960s)
“The stronger person is not the one making the
most noise but the one who can quietly direct
the conversation toward defining and solving
problems.”
Aaron Temkin Beck.
(1921-2021)

Introduction.
• Initially developed in the early 1960s by Dr. Aaron Beck of the University of
Pennsylvania.
• During clients’ cognitive development they learn incorrect habits of
processing and interpreting information.
• Aim is thus to unravel these distortions and help them to learn more
different and realistic ways of processing and reality-testing information.

Basic concepts.
• ‘Cognition’ is defined as that function that involves inferences about
one’s experiences and about the occurrence and control of future
events. It includes the processes involved in identifying and predicting
complex relations among events for the purposes of adaptation.
• Humans have capacity for both primal/primitive and for higher level
cognitive processing.

Basic concepts.
• Schemas.
Structures that consist of people’s fundamental beliefs and assumptions.
They are meaning making cognitive structures. They are relatively stable
cognitive patterns that influence through their beliefs, how people select and
synthesize incoming information. Developed early in life through personal
experiences and identification with significant others and reinforced by
further learning experiences.

Basic concepts.
• Modes.
Networks of cognitive, affective, motivational and behavioural
schemas. Modes are fundamental to personality since they interpret
and adapt to emerging and ongoing situations. CBT approaches
dysfunctional modes by deactivating them, modifying their content
and structure and by constructing adaptive modes to neutralize them.

Basic concepts.
• Cognitive vulnerability.
Refers to humans’ cognitive frailty. Because of their schemas, each
person has a set of unique vulnerabilities and sensitivities that
predispose them to psychological distress. When they exhibit
psychological problems, their dysfunctional schemas and beliefs lead
them systematically to bias information in unhelpful ways.

Basic concepts.
• Automatic thoughts.
Thoughts which occur spontaneously, without effort or choice. In
psychological disorders, automatic thoughts are often distorted, extreme, or
otherwise inaccurate.
Not so deeply buried as beliefs and schemas. People’s self-evaluations and
self-instructions appear to be derived from deeper structures- their self-
schemas (deeper beliefs and assumptions).

Cognitive distortions.
Dichotomous thinking By thinking that something has to be either exactly as we want it or it is a failure.
“Unless I do extremely well in this exam, I’m a failure.”
Selective abstraction Picking out an idea or fact from an event to support their depressed or negative
thinking. The boyfriend who becomes jealous at seeing his GF tilt her head
towards a man at a noisy event.
Mind reading Refers to the idea that we know what another person is thinking about us.
Negative prediction When an individual believes that something bad is going to happen, and there is
no evidence to support this, this is a negative prediction.
Catastrophizing Taking one event that one is concerned about and exaggerating it so that he/she
becomes fearful. Stomach pain=cancer.
Overgeneralization. Making a rule based on a few negative events, individuals distort their thinking
through overgeneralization. A woman concludes after a disappointing date that
“All men are alike.”

Cognitive distortions.
Labeling and mislabeling A negative view of oneself is created by self-labeling based on some errors or
mistakes. “I faltered while speaking. I’m a horrible speaker.”
Magnification or
minimization
Cognitive distortions can occur when individuals magnify imperfections or
minimize good points. They lead to conclusions that support a belief of inferiority
and a feeling of depression.
Magnification= “If I appear the slightest bit nervous in class, it’ll be a disaster.”
Minimization= A man describing his terminally ill mother as having a slight ‘cold.’
Personalization Taking an event that is unrelated to the individual and making it meaningful
produces the cognitive distortion of personalization. “I must have done
something to offend him.”

Cognitive model of development of schemas.
• Individual beliefs begin in early childhood and develop throughout life. Early
childhood experiences lead to basic beliefs about oneself and one’s world.
• These beliefs can be organized into cognitive schemas.
• Positive experiences of support and love from parents, lead to beliefs such
as “I am lovable” and “I am competent,” which in turn lead to positive
views/cognitive schemas of themselves in adulthood.

• Persons who develop psychological dysfunctions, in contrast to those with healthy functioning, have
negative experiences that may lead to beliefs such as “I am unlovable” and “I am inadequate.”
• These developmental experiences, along with critical incidents/traumatic experiences, influence
individuals’ belief systems.
• Negative experiences, such as being ridiculed by someone, may lead to conditional beliefs such as “If
others don’t like what I do, I am not valuable.”
• Such beliefs may become basic to the individual as negative/maladaptive cognitive schemas.

• Early maladaptive schemas.
Assumed to be true about themselves and their world.
Resistant to change
Cause difficulties in individual’s lives.
Usually activated by a change in one’s world (triggering event), such as
a loss of a job.

When these conditions occur, individuals often react with strong negative
emotions.
Are the result of previous dysfunctional childhood interactions with family
members.
Through these belief systems that children develop, they start to view reality in
ways that cause problems in functioning internally or with others.
Likely to continue through adolescence and adulthood.

The cognitive developmental model (for depression).

The cognitive model (for GAD).

The cognitive developmental
model (for social anxiety).

Young (1999) identified 18 early maladaptive schemas which he
classified into the following 5 domains.
Disconnection &
rejection
Impaired autonomy &
performance
Impaired limits
Over-vigilance &
inhibitions
Other directedness

Goals of therapy.
Identifying negative automatic thoughts (NATs) and the cognitive
schemas that they represent.
Changing the dysfunctional cognitive schemas through:
Schema
reinterpretatio
n
Schema
modification
Schema
restructuring

Goals of therapy.
To remove biases or distortions in thinking so that individuals may
function more effectively.
• NOTE: Generally, when establishing goals, cognitive therapists focus on
being specific, prioritizing goals, and working collaboratively with clients.
The goals may have affective, behavioral, and cognitive components.

Assessment in CBT.
• Careful attention is paid to
assessment of client problems and
cognitions, both at the beginning
of therapy and throughout the
entire process, so that the therapist
may clearly conceptualize and
diagnose the client’s problems.
• client interviews
• self-monitoring
• thought sampling,
• assessment of beliefs and
assumptions
• self-report questionnaires
Techniques.

Therapeutic process.
• Structured in approach.
Initial phase:
assessment of the problem
development of collaborative therapeutic
relationship
Case conceptualization
Middle phase:
helping client identify/learn about his
inaccurate thinking
identifying NATs
Guided discovery approach employed;
Homework assigned.
Termination phase:
insight developing
implementing learned strategies
moving towards change.

Therapeutic interventions.
Cognitive Behavioural
• Eliciting and identifying automatic thoughts.
 Providing reasons
 Questioning
 Encouraging clients to engage in feared activities.
 Focusing on imagery
 Self-monitoring of thoughts
 Reality testing and correcting automatic thoughts
 Conducting Socrates dialogue
 Identifying cognitive distortions
 Decatastrophizing
 Daily record of rational responses
 Identifying and modifying underlying beliefs
 Socrates questioning
 Hypothesis testing
 Using imagery
 Reliving childhood memories
 Activity scheduling
 Rating mastery and pleasure
 Hypothesis testing
 Rehearsing behaviour and role play
 Assigning graded tasks
 Diversion techniques
 Assigning homework

Socratic questioning

Activity scheduling

CBT effective treatment for:
• Depressive disorders
• Anxiety disorders
• Phobias
• Panic disorder
• Obsessive compulsive
disorder
• Addictive behaviours
• Personality disorders
• Eating disorders

CBT Presentation (Therapy Techniques).pptx

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