1. Presentation.Level 4 Psychotherapy and Counselling. By Anna Sandford Pike
amp;
Tamsin Neal.

2. Aaron T. Beck. Founding Father. Cognitive Therapy.lt;/divgt;

3. quot;Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behaviors. Keep your behaviors positive because your behaviors become your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.quot;
Mohandas K. Gandi

4. Aaron T. Beck. From Birth to Present Day.

5. How it all began. Born on the 18 July 1921, in Rhode Island, USA to Jewish immigrants, Beck attended Brown University in 1942, graduating magnum laude. After receiving a Francis Wayland Scholarship he went to Yale medical school graduating with a M.D. He embarked on his career at Valley Forge Army Hospital as assistant chief of neuropsychiatry. Later he became an instructor in 1954 at the University of Pennsylvania where eventually he was appointed Professor Emeritus at the department of psychiatry since 1992. He is also a professor at Temple University and The University of medicine and dentistry of New Jersey. He completed residencies in pathology and psychiatry. It was whilst working at the University of Pennsylvania that he pioneered Cognitive Therapy back in the decade of the 60’s having originally studied and practised psychoanalysis. Aaron Beck became the father of Cognitive therapy. Some of his most renowned creations were the Beck Depression Inventory, Beck Hopelessness Scale and Beck Anxiety Inventory.

6. How his theory began.
“Cognitive Therapy is a system of psychotherapy that attempts to reduce excessive emotional reactions and self-defeating behaviour, by modifying the faulty or erroneous thinking and maladaptive beliefs that underlie these reactions”
Beck 1976, 1979, 1993.
Just before Beck was born his sister unfortunately died from Spanish influenza. Beck’s mother was distraught and subsequently became deeply depressed. Upon Beck’s birth his mother’s condition somewhat improved and thus this claimed where Beck’s interested in curing the human mind of mental health problems began.
Later in life Beck managed to work through his own emotional feelings of inadequacy and fearfulness simply by relearning his cognitions which further began to develop his theory of Cognitive Therapy. These beliefs were formed after he developed a fatal illness from an injury.
In the 1960’s Beck was performing experiments to prove some of the psychoanalysis theories of depression only to find they did the exact opposite. This led into the development of a new theory cognitive therapy.
“The problem with non directive therapy is that it is non directive.” Aaron Beck.

7. The 1950’s.
Development.
Just prior to Beck’s career at the University of Pennsylvania he did study psychiatric science at Austen Riggs in Stockbridge and Philadelphia Psychoanalytic Society.
In 1952 Beck published his first case study. It was an examination of schizophrenic delusions which later became an important influence on the development of Cognitive Therapy.
Beck was appointed assistant chief of neuropsychiatry at Valley Forge Army Hospital until becoming an instructor at the University of Pennsylvania in 1954. After serving many years he finally was appointed a Professor of Psychiatry.
Towards the end of this decade Beck had developed a different theory based upon experiments he conducted whilst trying to prove concepts from the psychoanalytic theory. He wanted to prove the masochism, or anger turned inwards concept, but instead found that depressed patients would spontaneously expressed thoughts of a negative nature which fell into different categories. He called these thoughts automatic negative thoughts, these are now called automatic thoughts. They fell in to three categories; the world, themselves and the future. These thoughts would become valid without rational reflection.

8. The 1950’s.
Cognitive Therapy Development.
Beck came to realise that these thoughts or cognitions, once discovered, could evaluated and rationalised which led to patients feeling emotionally liberated and their behaviour would improve. This gave way to foundations of Cognitive Therapy.
Interestingly he discovered that different distorted thoughts linked to particular disorders. If a client is intervened affectively the negative thoughts can be identified and the predictions we believe are the outcomes of our beliefs can be challenged. Our life experiences have a massive influence upon what we believe about our life. These frequent negative thoughts become our beliefs.
“We ‘feel’ these beliefs to be true”. Beck.
“Men are disturbed, not by things, but by the principles and notions which they form concerning things”. Epictetus 55 - 135 AD

9. The 1960’s.
As research developed, Beck eventually published an article called Depression- Causes and Treatment in 1967 which detailed depression as a cognitive disorder rather than how psychodynamic analysis had perceived it previously as rooted within the clients thoughts. From this understanding he developed The Beck Depression Inventory which is a 21-question, multiple-choice self-report inventory. It is used to measure the severity of depression and widely used in the health care profession as an assessment tool.
Triad example: Brown 1995. The Student.
World: “The student has negative thoughts about the world, so he may come to believe he does not enjoy the class.”
Future: “The student may think he may not pass the class.”
Self: “The student may feel he does not deserve to be in the college.”
Depression is viewed as being sustained through Negative Cognition and the treatment is to find the cognitions and restructure these.
Depression is thought of as having two-factor aspects; mood and somatic. The BDI assesses these two aspects to help determine the source of the depression.

10. The 1970’s.
Beck published a book n 1979 Cognitive Therapy for Depression. He has been working in the field of Cognitive Therapy at the University of Pennsylvania.
This brought him to the introduction of two new concepts;
Collaborative empiricism;
Both therapist and client work together to explore the negative cognitions with the intention of testing the hypotheses, on occasion through behavioural experiments, to supply empirical evidence to their negative thoughts and predictions.
The Working Alliance is similar in to this concept although it requires therapist and client working together systematically to establish targets and goals of which the client wishes to achieve within the therapeutic process.
Each concept above are implemented to increase efficacy of the treatment and reducing the time the process takes and reducing the need for future therapy by essentially making the client the therapist.

11. The Hopelessness Scale.
Another development that occurred in the 1970s was the invention of the hopelessness scale developed by Beck. Similar to the Beck Depression Inventory it is a questionnaire designed to measure hopelessness. It is focused upon someone’s views of the future including their motivations and expectations in multiple choice questions. It was designed to assist health care professionals assess a clients suicide risks and depression. It consists of 20 true or false questions and has been positively reviewed.
“Depression is the prison of which only you have the key”.

12. The 1980s.
This decade saw Beck receive huge recognition for his break through theory of psychiatry and psychopathy. He was made honouree Doctor of medical science at Brown’s University. He won the Paul Hoch award for American Psychopathological society and the Louis Dublin Award for suicide research not to mention the The distinguished scientific award for the applications of psychology. His career had began to really take recognition for his new theory and the millions of lives it was benefiting.
His work was now focused on anxiety, substance abuse, stress and anger. He published a book called Anxiety disorders and phobias: A cognitive perspective in 1985.
On the 31st October 1988 Beck’s infamous book on couple relationships was published- Love is Never Enough. Throughout this decade he worked on anxiety, stress and anger which he began to apply to marriages and couple. This book describes again how we underpin meanings to events that maybe distorted and thus we react in a certain way. More often than not we will repeat the same negative thought to situations and thus our behaviour repeats and becomes problematic. In this way using the theory of cognitive therapy we can “untangle the knot” of marriage especially when hold high expectations of what we expect from a spouse.

13. The 1990s.
Cognitive Therapy was becoming mainstream by the 1990’s. In North America it had become first choice for anxiety disorders and depression.
Its popularity heralded a new empirical book was written about Beck’s new theory- “Scientific Foundations of Cognitive Theory and Therapy of Depression.” (Clark amp; Beck 1999). Another significant publication of this decade was Cognitive Therapy with Inpatients: Developing a cognitive Milieu (Wright, Thase, Beck amp; Ludgate 1993) in the recognition of work being carried out with inpatients.
As Cognitive Therapy was refined and further developed and applied to anxiety, suicide, depression for treatment the theory was being developed to be used in more complex disorders such as personality disorders, panic disorder and schizophrenia. The book Cognitive Therapy of Personality Disorders (Beck, Freeman, et al.,1990) was an in-depth discussion of long term treatment of personality disorders. His concepts of schemas were introduced in this book, later in the decade schemas concept included “Networks of cognitive, affective, motivational, and behavioural components,” and “modes and charges”.
His theory that explained how “beliefs” alone could alter the personality leading to personality disorders, and towards the later part of the decade he continued to develop models therapies to treat schizophrenia.

14. Beck also turned his attention to anger and wrote a now infamous book “Prisoners of Hate, The Cognitive basis of anger, hostility and Violence.” (1999). He describes in this book parallels of various acts of murder, war, terrorism and cultural conflicts.
He explains interfamilial interpersonal conflicts and models of anger which lead to large scale conflicts and even War.
He describes what he coined as “hostile framing” of which when two people begin conflict for example each perceive the other as bad, evil, dangerous and wrong and themselves as righteous thus closing down their perceptions that another possible perception is correct and locking themselves into a prison of hate. The false image is very difficult to remove or negotiate with and is a form primal thinking. Once primal thinking has taken hold of this image, we believe the morals of life need not to be applied to such undeserving humans and thus acts of mass genocide, rape, war, high school shooting and ethnic cleansing etc. become justified and even righteous. Beck asserts that acts of hate are not inevitable and correcting these distorted cognitions are quite possible, for humans have the ability to be good and moral people.

15. The 2000’s.
The early part of this century Beck continued to develop and compile research in the application of cognitive therapy to schizophrenia soon to move on to Cognitive therapy treatment for bipolar disorder. “Bipolar Disorder: A Cognitive Therapy Approach (Newman, Leahy, Beck, Reilly-Harrington, amp; Gyulai, 2002) was just one of his 40 publications over the decade.
Beck turned 80 this decade.
He developed the Clark-Beck Obsessive-Compulsive Inventory (2002) as well as the The Beck Youth Inventories of Emotional and Social Impairment (J.S Beck amp; Beck with Jolly 2002). The CBOCI is a 25 question assessment to ascertain the severity and frequency of a client’s symptoms. The Beck Youth Inventories was an assessment for young people from the age of 7-18. It is to assess depression, anxiety, anger, disruptive behaviour and self-concept. The assessment is 20 questions or statements about feelings, thoughts and behaviour.

16. Cognitive Theory.
Introduction.
Cognitive Therapy is part of the larger umbrella of Cognitive Behavioral Therapies.
Cognitive therapy aims to change irrational and/or negative thought about the self, the world or the future which in turn change unwanted feelings and behaviors. It is widely used to treat disorders and is most affective in the treatment of depression.
Cognitive Therapy focuses on the present way we think, feel and behave.
Cognitive Therapy has been used to unlearn, learned behavior and cognitions by understanding that learning processes are an important aspect in the continuation of negative thoughts.
The learning process’s were compared to that of the computer, introduced during the 1940’s-1950’s. Computer have goals, process information and make estimates and have memories. So cognitive scientists began to consider that if they can do all this with a metal object perhaps they alter cognitive dysfunctions in humans by understanding how we process information.
It assumes that the mind is similar to that of a computer; input, storage and retrieval of information. The stimuli we receive form our environment is mediated with our responses.
Cognitive Theory was developed mainly on experiments performed in laboratories.

17. Stimuli -gt; Processing -gt; Response.

18. Cognitions
Cognitive Model ~ Event – Cognition – Emotion
Beck looked at / worked to explain and bring to the forefront of therapy, that people’s emotional reactions and behaviours are strongly influenced by cognitions. It is not just the event that determines the emotion; it is the ‘interpretation’ by the mind (cognition). Cognition is not a single concept, there are different levels of cognition and these can be categorised differently.
Examples of cognitions are – core beliefs, automatic thoughts, dysfunctional assumptions.

19. Cognitive vulnerability to Psychological Disturbance.
We as people can be vulnerable to things – so can our cognitions.
Some cognitions can be ‘faulty’ in their construction and this can mean that a person may develop a specific syndrome; when a certain event triggers a vulnerable cognition, a stable characteristic can/will change.

20. Cognitive Content Specificity.
This concerns the relationship between cognition and emotion and is a component of Becks ‘Cognitive Theory and the Emotional Disorders. Becks theory offered a number of testable hypotheses with attention drawn to the overlap of depressive and anxious states – one such hypothesis is that mood states can be discriminated on the basis of the cognitive content/specificity – such as developed automatic thought patterns.
Here is an example direct from Beck’s book mentioned above;
“A teacher remarked to her class that Tony, a bright student, received a low grade on a test. One student was pleased- he thought, “This shows I'm smarter than Tony.” Tony’s best friend felt sad (as did Tony): He shared Tony’s loss. Another student was frightened: “If Tony did poorly, I may have done poorly also.” Still another student became incensed at the teacher: “She probably marked unfairly if she gave Tony a low grade”.
This is a great example of the meanings we apply to events and the inevitable emotion attached to the meaning. This is the “specific content” that each people interpret events. As you can see interpretations contain themes. Unfair=Anger, Loss=Sadness, inferiority=happiness of someone's failures, inadequacy=fear.
Here we can see that the interpretations form the basis of our emotional response which unveil a spectrum of emotional disorders.

21. Continuum of emotional reaction.
Beck saw that the cognitive content of syndromes such as mental health issues like depression, are distorted by cognitions – often to extremes and they can have a direct impact on the emotion/behaviour of a person. In the cognitive approach it is important to see that these can be exaggerated versions of a ‘normal’ thought process.

22. Theory of Personality.
This looks at our evolutionary history and the ultimate goals of survival and reproduction – we learn behaviours and these become programmed ‘into’ us – such as our patterns of feeling, thinking and acting. It is about our characters, personalities and family heritage.
The goals of cognitive therapy are to help individuals achieve a remission of their disorder and to prevent relapse. Much of the work in sessions involves aiding individuals in solving their real-life problems and teaching them to modify their distorted thinking, dysfunctional behaviour and the distressing affects. A developmental framework is used to understand how life events and experiences led to the development of core beliefs, underlying assumptions and coping strategies - particularly in patients with personality disorders.

23. Processing Distortion.
Overgeneralization.
This is where a singular negative experience is presumed to reoccur as a never ending pattern of defeat.
Catastrophizing.
This is also referred to magnifying and minimizing. It is the presumption of a disaster striking or the “what ifs”. It is also the attempt to minimize significant occurrences or magnifying occurrences.
Personalization.
This is where the person believes that others reactions are directed towards themselves. This person will also compare themselves to others in order to feel of worth. They may also take responsibility for others wrong doings or mistakes and blame themselves.
Filtering or Selective Abstraction.
This is to filter out all positivity and only focus on the negative. This negative aspect will be dwelled over leaving this persons reality distorted and miserable.

24. Dichotomous or Polarization.
This is a black or white form of thinking. Aspects of life are either terrifying or safe, good or bad, perfect or failure. There are no middle roads here or shades of gray.
Arbitrary Inference.
Similar to jumping to conclusions, this person will make a presumption that the worse possible outcome will occur.
Fallacies of control.
Externally we feel controlled, victims of the world around us. Internally we take responsibility for others and their experiences of life.
Global Labeling.
Also known as labeling and mislabeling this is an extreme form of generalizing. This person looks at a situation or themselves and makes a emotive and overly negative assumption. An example would be: A parent buys their child a pet hamster. The person will say she has imprisoned that hamster for the rest of its poor life.

25. Blaming.
The act of blaming ourselves or blaming others for how we feel. We are responsible for our feelings.
Emotional Reasoning.
This is where a person feels a certain way and reaches the conclusions that we must be that way. I feel boring, I am boring.
Should.
Should’s, musts and ought's are condition we place on ourselves and others. When we or others violate these rigid rules we feel anger, resentment and frustration.
Heavens Reward Fallacy.
This distortion is about receiving reward, as if someone is keeping score. When reward is not granted we feel better because we feel eventually it will come and each day that goes by we will rewarded greater for our sacrifices and self-denial.

26. Always being right.
The feeling of being judged about our rightness. The emotions other may feel is not as significant as being right and who is hurt in the process does not matter.
Fallacy of Change.
Applying pressure or cajole to manipulate someone to change to serve the distorted person. We place our emotional well being onto someone else and try to change them.

27. Hierarchy of Organisational Thinking.
Automatic Thoughts:
Rapid, Automatic and Involuntary thoughts.
These are thoughts that spontaneously and very swiftly enter the conscious mind, brought about from events/experiences.
These are so brief that we do not notice them usually. Suffers of mental health problems usually have irrational thoughts stemming from irrational beliefs we may apply to various aspects of life which in turn, change our behavior.
Some automatic thoughts are ‘unhelpful’ thoughts often built up into a pattern. Encouraging clients to step back and observe the thought pattern, they can be encouraged to see that it may not be a factually based thought; and to work to label the thinking process, rather than to dwell on the main content/words.

28. Underlying Beliefs.
These are the irrational beliefs that suffers of disorders engage in. They are similar to rules that we live by that hinder our progress and behavior. It is the should’s and shouldn't’ts, musts and mustn’ts statements. The core beliefs are not activated as long as experiences remain relatively positive and without distress. When the underlying's beliefs which mediate between automatic thoughts and core beliefs activate the core belief, the individual starts to enter into psychosis.
These set our standards and values and establish our rules for living. They can be seen in the cognitive approach as something which maybe unspoken yet guides the behaviour of a person. They are often set out by a person as a rule and contain words such as ‘should’ or ‘must’ – also can be assumptive e.g. ‘Unless this happens …. I can’t do’.

29. Core Beliefs.
These are what a person fundamentally believes about themselves, about other people or in general. Becks research into depression and anxiety found people with these conditions have a range of core beliefs – these are not always immediately accessible to consciousness. They are usually learned early on in life as a result of childhood experiences and represents a person’s ‘bottom line’. Looking at core beliefs is something important when working with lifelong problems such as complex personality disorders.
Examples of these could be a statement such as – ‘I am bad’ or ‘I am useless’.
Core beliefs are what schemas are developed from according to Aaron Beck. These are fundamental beliefs we have about ourselves, others and the world. These are central to the maintenance of psychiatric abnormalities. These are often viewed as just the way things are and are born from childhood experiences. In some cases traumatic events later in life can unhinge our beliefs and we adapt in some way as a form of survival.

30. Maladaptive Schemas.
Schemas are extremely stable and enduring patterns, comprising of memories, bodily sensations, emotions, cognitions and once activated intense emotions are felt - the most basic concept in Schema Therapy is an Early Maladaptive Schema; Schemas develop in childhood and adolescence and because they begin early in life, schemas become familiar and comfortable; they can distort views/ events in order to maintain the validity of a person’s schemas - Schemas may remain dormant until they are activated by situations relevant to that particular schema. One of the reasons that schemas are hard to change is because they are not stored through logic, but in an emotional part of the brain, as opposed to a logical or analytical part - they are self-perpetuating, very resistant to change and usually do not go away without therapy.

31. Schemas.
A schema is an organized pattern of thought which holds a perception or pre-conceived framework regarding some aspect of the world, others or ourselves.
Cognitive Therapy believes that the processing of stimuli model, whilst under distress, the client’s thinking becomes overgeneralized and distorted about the self, others and the world. Many of these negative cognitions are rooted in the past and/or childhood.
Schemas which are developed and unchallenged for long periods of time can be compared to beliefs. We will notice aspects of our experiences which fit into our schemas, almost like a filter and often we distort or re-interpret information or stimuli to fit into our schemas. The owners of schemas are unlikely to believe that their schema is wrong even when faced with contradiction. Schemas are usually reinforced over the years by negative thoughts which are so automatic that seldom are ever noticed. The theory of Cognitive Therapy is to try to identify these schemas and test the prediction or pre-conceptions in order to remove unhelpful schemas which hinder people reaching their true potential.

32. According to Beck’s book- Cognitive Therapy and the emotional disorders whilst using free association with one of his patients, his patients expressed anger towards him. Beck asked “what he was feeling. The patient replied, I was feeling guilt. With further discussion Beck found that the patient had a second parallel dialogue.
From this point forth Beck began to ask his patients about how they felt during free association and it became evident that there was an internal inter come.

33. Self-Schema.
“I think, therefore I am.”
Self-Schema is the generalization of how we think about ourselves. It could be about physical attributes, social aspects, personal interests. Their own self definition will be accumulations of memories and experiences and will reflect how they act and behave.
Self-schema becomes self-perpetuating and self-maintaining due to the schema being bias and choosing to process information in reality in various distortions that fit its agenda. For example, a person who thinks of themselves as outgoing and friendly, will become outgoing and friendly.
The concept of oneself is introduced in early childhood by our caregivers or parents. The most fundamental concept is good or bad. We begin to develop our schemas from what we believe our parents or caregivers teach us to believe who we are. This is stored in our long term memory and later in life we may distort our processing of information to appease the schemas.
Schemas in respects to the world are called world-schemas and schemas regarding others are called other-schemas.

34. Schemata. Schemata is a schema that a person adopts to a specific dimension or aspect of their lives. A person may be a parent, who also works in an office, who also visits their parents once a week. Schemata is applied to being a mother schemata. Schemata is applied to the working schemata. Schemata is applied to visiting elderly parent schemata. Culture and environment also have affect on schemas. Aschematic is to not have an opinion on a subject, the person has no interest or not concerned with a particular dimension or aspect. The business man had no aschemata on gardening. On occasion people can have multiple schemata which is helpful to make decisions efficiently and appropriately in situations. They can activate “scripts” (combination of cognitive and behavioral action sequences) to help meet their goals. Multiple schemata is not the same as multiple personalities.

35. Identifying Schemas.
The therapist will try to begin to investigate the negative schemas/schemata which bring the most emotional distress to the client. When the point of crisis and the peak of emotion heightens, the therapist tries to gather schemata or automatic thoughts. Through out sessions the therapist can begin to gather re-occurring schemata and automatic thoughts from which the therapist can build a theory of maladaptive schemata. The first technique would be to ask the client what their meanings are to these automatic thoughts to test their hypothesis, and investigate into which brings the most emotional distress.
To decipher other-schemata we can ask “What does this say about other people?” in regards to other people.
To decipher world-schemata we can ask “What does this say about life in general?”
To decipher self-schemata we can ask “What does this say about you?”

36. Sentence completion technique.
First developed by Christine Padesky and commonly used in cognitive therapy. The patient uses one word to complete each sentence:
“I am” says the therapist and the patient replies with one word to describe how they feel about themselves.
“The world is” the patient replies with one word to describe how they feel about the world.
“People are” ” the patient replies with one word to describe how they feel about the world.
Due to schemas being rules or rigid sentences that people live by, the phrases above can usually be summed up in one word.

37. Another technique is to fill in psychometric tests such as Weissman’s Dysfunctional Attitude Scale, Beck’s Schema Checklist or Young’s Schema Questionnaire. A series of statements are either agreed or disagreed with by the patient.
The result give the therapist a schematic overview of the patient.

38. Downward arrow technique:
The technique asks the questions; if this were the case, what does this mean to you. Each automatic thought that the client replies, the question is asked again, each layer revealing the next until the core belief is revealed.
When the patient becomes highly emotional, this can mark that the core belief is reached.
It maybe a time of which the therapist could ask what it means to the patient if the core belief were true.
If the core belief has a significant effect on the clients life then the therapist begins to adjust the core belief to something more rational.

39. Reversing Schemas.
Once maladaptive schemas have been identified, the therapist and client together work out alternative and more rational schemas. This should be a relatively major focus to be completed as early in the relationship as possible to begin the process of change to other preferable schemas.
The best way to determine alternative schemas is to ask the client;
Self-schemas- “If you were not … how would you like to be?”
World-schemas- “If life/world were not … how would you like it to be?”
Other-schemas- “If others were not … how would you like it to be?”
Some clients may not be able to give a cohesive response. In this case explore people, situations or experiences that they really admire or appreciate. “You see yourself as worthless, how do you see other people you admire? Would you like to be like those people? If you were more like those people, would you still see yourself as worthless?”.

40. New schemas should be made in the client’s own words.
More often than not the new schema should be the opposite of the maladaptive schema due to the absolute nature of the old schemas.
Schemas maybe modified over several weeks as the therapeutic process proceeds.
By using a new and positive schema the old schema will be weekend.
The therapist will attempt to teach the client to identify thoughts, emotions and automatic thoughts.
The therapist, depending on the client and the presenting problem, will also test the negative automatic thought/s by working with the client to accumulate evidence or on occasion challenge the automatic thought.
The therapist will teach the client to test problematic and negative automatic thoughts to assist the client in autonomy.

41. Therapist can use graphs and charts to plot the alternative and positive schemas. The new schemas will in range from 0 – 100% This can only be done once the client has learnt to identify their negative automatic thoughts and schemas. The therapist each week will ask the client to rate how many times during the week has the client held these schemas. The idea is that if the client can rate a percentage it is in fact removing the absolute nature of schema and catharsis will begin to develop. The aim, which may take several months is to allow the client to rate themselves somewhere between 40-60%. Examples of graphs are Bidirectional Continuum, Unidirectional Continuum, global continuum and two dimensional

42. Positive Data Logs. These aim to correct errors in the processing of life “events”. Upon agreement from the client, the therapist can explore the nature of schema maintenance. This can be done by perhaps looking at someone the client knows who holds a prejudice the client does not share. From here the therapist, through questioning, can guide the client to the understanding that to change schema prejudices the client must accumulate contradictory evidence. A positive data log is the record of contradictory information and observations. that can begin the process of reducing the bias in information processing that the client perceives in their daily lives. This is a difficult task due to the client having probably developed distorted processing, so that the client will perceive information using a distortion. To begin with this task is difficult but over several weeks or months the distortion will disperse.

43. Historical Data Logs.
This is another data log of which a client and therapist can test evidence of absolute schemas.
Since schemas are developed over the history of a persons life and can be schemas such as “I’m unlovable”, “I’m weird”… The client and therapist can historically go through their past and test such schemas throughout the client lifetime.
The therapist tried to encourage the client to have compassion towards themselves.
The client and therapist can test all types of schemas such as self-schema, other-schema and world schemas.

44. Psychodrama.
This is a method to reevaluate early maladaptive schemas in the developmental context from where is first originated.
It is a role play, usually from which the client reenacts scenes from childhood.
The therapist also can participate if necessary and asks the client to convey their feelings, emotions, beliefs and behaviors or suppression.
Comparisons can be made to present life experiences for the client.
Whilst in role play the client can now address the situation presenting new views i.e. depending the right to make mistakes or expressing feelings and emotions perhaps to a abusive parent etc.
Sometimes scripts are necessary and this process may need to repeated and adapted for the client to feel congruent towards the changes.
This is not a process of which aims to reach catharsis but rather to activate old schemas and understand from where they came. From here the therapist can assist the client to develop new schemas.
This process can be too overwhelming for some clients of which other methods would be more appropriate.

45. Core Beliefs Worksheets.
Core belief worksheets are also used in cognitive therapy as a form of data record.
Clients are asked to write down old schemas and then new schemas and rate their believability from 0-100%.
This is done over several weeks.
The clients is also instructed to write down any experiences or information that supports the new schema.
The client is also asked to write down information that supports the old schema and then asked to give another explanation which would support the old schema.
Keeping written data records is highly recommended because the more data a client is able to actually see, perceive, interact with and store the more change from negative views to positive views.
Seeing is believing.

46. To Conclude.
Changing schemas as cognitive therapy suggests can change problematic disorders previously considered untreatable. If the client believes negative views about themselves, the world and others, and these views develop problematic behavior, the cognitive therapy can assist the client to change these views and relieve the client of their problematic behaviour. Various methods have been developed and continue to be developed to provide treatment standards for other therapists to use and develop.
With the notion of evidence based therapy the fundamental idea is to assist through trust, empathy and congruence, to believe in healthy and flexible schemas. The methods are all aimed towards building new positive beliefs.
I hope you enjoyed this presentation.