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Cognitive behavioral therapy
Cognitive behavioral therapy aims to change distorted and dysfunctional thinking patterns that contribute to emotional distress and maladaptive behaviors. It involves identifying and modifying automatic thoughts, core beliefs, and cognitive distortions through techniques like thought records and cognitive restructuring. CBT has been effectively applied to treat various mental health issues like depression, anxiety, eating disorders, and substance abuse.
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Cognitive behavioral therapy
- 1. COGNITIVE BEHAVIORAL THERAPY BY AOUNALI WADHO M-PHIL-1 ICP KARACHI
- 2. COGNITIVE THERAPY Psychotherapy aimedat changing way of thinking Several approaches to cognitive-behavioral therapy Cognitive behavioral therapy (CBT) Rational Behavior Therapy Rational Living Therapy Dialectic Behavior Therapy Rational Emotive Behavior Therapy
- 3. COGNITIVE BEHAVIORAL THERAPY Itis a talking therapy that can help you manage your problems by changing the way you think and behave. It is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.
- 4. CAUSATION AND PSYCHOLOGICALDISORDERS According Aron Beck distress can be caused by a combination of biological environmental Social early childhood experiences Lack of experience These factors, interacting in a variety of ways, and lead to later so that causes for disorders
- 5. AUTOMATIC THOUGHTS Theautomatic thought is a key concept in Beck’s cognitive psychotherapy. Such thoughts occur spontaneously, without effort or choice. In psychological disorders, automatic thoughts are often distorted, extreme, or otherwise inaccurate. Example, Nancy put off applying to department stores for a job as an assistant buyer. Unhappy with her job as a sales clerk, she had such thoughts as “I’m too busy now,” “When the holiday season is over, I will apply for a job,” and “I cannot get time off to go to other stores to get job applications.” Recognizing these thoughts as excuses,
- 6. Cognitive Development model Early childhood experiences Developmento schemas, basic beliefs, and conditional belief Critical incidents Automatic thoughts Emotions Behaviors Physiologic responses
- 7. COGNITIVE SCHEMAS INTHERAPY schemas develop from personal experience and interaction with others. There are two types of basic cognitive schemas positive (adaptive) negative (maladaptive)
- 8. COGNITIVE CONCEPTUALIZATION Current Situation Automatic Thoughts Aboutself, world And others Physiology Feelings Behavior Childhood And Early Life Events Underlying Assumptions and Core Beliefs Compensatory Strategies
- 9. EXAMPLE 1 Situation Partner says: “Ineed time to be with my friends” Automatic Thoughts Automatic response: “Oh no, he’s losing interest and is going to break up with me….” Physiology Heart racing Lump in throat Feelings Sadness Worry Anger Behavior Seek reassurance Withdraw Cry Childhood Experiences Parental neglect and criticism Underlying Assumptions & Core Beliefs “I’m flawed in numerous ways, which means I’m not worthy of consistent attention and care. People only care when they want something.” Compensatory Strategies Be independent and you’ll be safe. Watch out – people are careless with you.
- 10. EXAMPLE 2 Situation Disappointing exam result AutomaticThoughts “I am not going to get through this program - I’m not as smart as everyone else. People will discover this and I will be humiliated.” Physiology Pit in stomach Dry mouth Feelings Worry, shame, Disappointment Humiliation. Behavior Use alcohol, Procrastinate with homework Childhood Adversities Parental standards reinforce academic achievement Underlying Assumptions “If I don’t excel in school, I’m a total failure” Compensatory Strategies Work extra hard to offset incompetence.
- 11. COGNITIVE DISTORTIONS • All-or-nothingthinking. By thinking that something has to be either exactly as we want it or it is a failure, we are engaging in all-or-nothing, or dichotomous, thinking. • Selective abstraction. Sometimes individuals pick out an idea or fact from an event to support their depressed or negative thinking • Mind reading. This 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.
- 12. COGNITIVE DISTORTIONS • Catastrophizing.In this cognitive distortion, individuals take one event they are concerned about and exaggerate it so that they become fearful. • Overgeneralization. Making a rule based on a few negative events, individuals distort their thinking through overgeneralization. • Labeling and mislabeling. A negative view of oneself is created by self-labeling based on some errors or mistakes.
- 13. COGNITIVE DISTORTIONS • Magnificationor minimization. Cognitive distortions can occur when individuals magnify imperfections or minimize good points • Personalization. Taking an event that is unrelated to the individual and making it meaningful produces the cognitive distortion of personalization.
- 14. CORE BELIEFS • Corebeliefs underlie and produce automatic thoughts. • These assumptions influence information processing and organize understanding about ourselves, others, and the future. • These core beliefs remain dormant until activated by stress or negative life events. • Categories of core beliefs (helpless, worthless, unlovable) Automatic ThoughtsCore Beliefs
- 15. EXAMPLES OF COREBELIEFS • Helpless core beliefs • I am inadequate, ineffective, incompetent, can’t cope • I am powerless, out of control, trapped • I am vulnerable, weak, needy, a victim, likely to be hurt • I am inferior, a failure, a loser, defective, not good enough, don’t measure up • Unlovable core beliefs • I am unlikable, unwanted, will be rejected or abandoned, always be alone • I am undesirable, ugly, unattractive, boring, have nothing to offer • I am different, flawed, defective, not good enough to be loved by others • Worthless core beliefs • I am worthless, unacceptable, bad, crazy, broken, nothing, a waste • I am hurtful, dangerous, toxic, evil • I don’t deserve to live
- 16. SAMPLE THOUGHT LOG SituationThoughts Emotions Rational Response Outcome Going on vacation— Ask a colleague to do some work for me She’ll say no… I’m not doing a good job The boss thinks I take too much time off Anxiety (70%) Guilt (40%) Sadness (20%) Cognitive Distortions: All/nothing Mindreading Fortune-Telling Over-generalization I haven’t taken a day off in 6 months. We work as a team, so it’s also her job to track the samples. Anxiety (10%) Guilt (0%) Relief (40%)
- 17. GOALS OF THERAPY •Remove biases or distortions in thinking so that individuals may function more effectively Attention is paid to the way individuals process information, which may maintain feelings and behaviors that are not adaptive Patients’ cognitive distortions are challenged, tested, and discussed to bring about more positive feelings, behaviors, and thinking • Changing cognitive schemas can be done at three different levels schema reinterpretation
- 18. THERAPEUTIC PROCESS Guided discovery The three-questiontechnique. 1. What is the evidence for the belief? 2. How else can you interpret the situation? 3. If it is true, what are the implications? Specifying automatic thoughts Homework Session format. Termination.
- 19. THERAPEUTIC TECHNIQUES • idiosyncraticmeaning. Different words can have different meanings for people, depending on their automatic thoughts and cognitive schemas • Challenging absolutes. Clients often present their distress through making extreme statements such as “Everyone at work is smarter than I am.” Such statements use words like everyone, always, never, no one, and all the time • Reattribution. Clients may attribute responsibility for situations or events to themselves when they have little responsibility for the event
- 20. THERAPEUTIC TECHNIQUES • Labelingof distortions. Previously, several cognitive distortions such as all-or nothing thinking, overgeneralization, and selective abstraction were described. Labeling such distortions can be helpful to clients in categorizing automatic thoughts that interfere with their reasoning • Challenging all-or-nothing thinking. Sometimes clients describe things as all or nothing or as all black or all white • Listing advantages and disadvantages. Sometimes it is helpful for patients to write down the advantages and disadvantages of their particular beliefs or behaviors
- 21. THERAPEUTIC TECHNIQUES • Cognitiverehearsal. Use of imagination in dealing with upcoming events can be helpful • Decatastrophizing. Clients may be very afraid of an outcome that is unlikely to happen. A technique that often works with this fear is the “what-if” technique. It is particularly appropriate when clients overreact to a possible outcome,
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- 23. APPLICATIONS OF CBT •Mood Disorders • Unipolar Depression (1979) • Bipolar Disorder (1996) • Dysthymia and Chronic MDD (2000) • Anxiety Disorders • GAD (1985) • Social Phobia (1985) • Panic Disorder (1986) • OCD (1988) • PTSD (1991) • Emotional Disorders (2006)
- 24. APPLICATIONS OF CBT(CONTINUED…) • Eating Disorders (1981) • Marital Problems • Behavioral Medicine • Headaches (1985) • Insomnia (1987) • Chronic Pain (1988) • Smoking Cessation • Hypochondriasis • Body Dysmorphic Disorder