Chapter 8: Cognitive Theory & Therapy Flashcards
Michael Mahoney
Known for a technique called mirror time or streaming; free association while looking at himself in the mirror; founded Cognitive Therapy and research
Forms of Cognitive Theory and Therapy
Rational-Semantic Cognitive Therapies
Collaborative-Empirical Cognitive Therapies
Philosophical-Constructivist Cognitive Therapies
Albert Ellis
Credited with the discovery and promotion of modern rational approaches to therapy; formulated his apporach after progressively discovering in his psychotherapy practice that traditional psychoanalysis was ineffectual
Components of Rational-Emotive Behavior Therapy
People dogmatically adhere to irrational ideas and personal philosophies
These irrational ideas cause people great distress and misery
These ideas can be boiled down to a few basic categories
Therapists can find these irrational categories rather easily in their clients’ reasoning
Therapists can successfully teach clients how to give up their misery-causing irrational beliefs
Epictetus
First cognitive behavior therapist. born a slave in Phrygia; eventually influenced Marcus Aurelius as a Philosopher
Rational Emotive Behavior Therapy
Encourages therapists to objectively examine clients’ thoughts and accurately judge those thoughts as rational or irrational; constructivist theory of therapy; encourages therapists to actively identify and label thoughts that cause clients distress and misery as irrational thoughts
Aaron Beck
His approach to therapy became known as Cognitive Therapy
Cognitive Therapy
Psychological problems can be mastered by sharpening discriminations, correcting misconceptions and learning more adaptive attitudes. Since introspection, insight, reality testing, and learning are basically cognitive processes, this approach to neuroses has been labeled cognitive therapy
Collaborative Empiricism
Therapist works with clients to help them discover for themselves the maladaptive nature of their automatic thoughts
Difference Between Ellis and Beck’s Therapy Styles
Ellis emphasizes the forceful eradication of irrational thoughts while Beck emphasizes the collaborative modification of maladaptive thoughts
Donald Meichenbaum
Discovered that schizophrenics and children couldimproe their functioning after being taught to talk to themselves or to think aloud; focused on Self-Instructional Learning
Self-Instructional Training
A form of cognitive behavior modification; a sequence of mediating processes involving theinteraction of inner speech, cognitive structures, and behaviors and their resultant outcomes
Stress Inoculation Training
Developed by Meichenbaum, specific approach for helping clients more effectively manage difficult stressors.
Philosophical-Constructivism
Founded on the premise that humans actively construct their own reality
Essence of Cognitive Theory
People are disturbed not by things, but by the view which they take of them
Cognitive Theory
Stimulus-Organism-Response Theory; the individual organism’s processing of environmental stimuli is the driving force determining his or her specific response. S-O-R Theory, the O represents the brain or processing system of the individual
S-O-R Theory
Stimulus-Organism-Response Theory; there is a conscious thought between an external event and a particular emotional response
Rational Emotive Behavior Therapy Theory
Views humans as neither inherently good nor inherently bad; humans have the potential for thinking both rationally or irrationally
A-B-C Model
A = Activating Event that has occured in the individual's life B = the individual's belief about the activating event C = consequent emotion and behavior derived from the individual's belief
Main Thrust of REBT
To demonstrate that current beliefs are irrational; to help substitute a rational belief for a current irrational belief, which will result in morepositive and more comfortable consequent feelings; D=disputing the irrational belief, E=effect on the client; F=client experiences a new feeling
REBT Psychopathology
Direct function of irrational beliefs, consistent with Horney’s Tyranny of the Shoulds; the core of human disturbance is musterbation, absolutistic thinking or dogma
Basic Irrational Beliefs
I must do well and be approved by significant others
You other humans with whom I relate must, ought, and should treate me considerately and fairly
Conditions under which I live must be arranged so that i can easily and immediately (with no real effort, have a free lunch), get what I command.
Similarities between Beck’s Cognitive Therapy and Ellis’ REBT
Cognition is at the core of human suffering
The therapist’s job is to help clients modify distress-producing thoughts
Beck’s Teory of Personality and Psychotherapy
In the process of living, individuals are exposed to a variety of specific life events or situations, some of which trigger automatic, maladaptive thoughts.
These maladaptive thoughts are characterized by their faultiness; they are too narrow, to broad, too extreme, or simply inaccurate.
An individual’s maladaptive thoughts are usually derived from deeply held maladaptive core beliefs (schemas/dysfunctional attitudes)
Individuals generally acquire these core beliefs during childhood
These automatic thoughts, core eliefs, and their associated emotional disturbances can be modiefied via cognitive therapy - a procedure that does not require exploration of a client’s past
Socratic Questioning
Asking questions that help client focus on
Awareness of automatic thoughts and core beliefs
Evaluation of the usefulness and accuracy of automatic thoughts and core beliefs
Possible strategies for modifying automatic thoughts and core beliefs
Cognitive Distortions
Faulty assumptions and misconceptions; triggered by external events produce automatic thoughts, which are often linked to underlying core beliefs or schemas
Beck’s Cognitive Triad which Characterize Depressive Conditions
Negative evaluation of self “I am unworthy”
Negative evaluation of the world or specific events “Everything is just more evidence that the world is falling apart”
Negative evaluation of the future “Nothing will ever get better”
Beck’s Cognitive Distortions in Cognitive Therapy
Arbitrary Inference Selective Abstraction Personalization Dichotomous/Polarized Thinking Labeling and Mislabeling Magnification and Minimization Overgeneralization
Arbitrary Inference
Jumping to conclusions; similar to Ellis’ catastrophizing. clients conclude without any supporting or relevant evidence that the worst possible outcome will happen
Selective Abstraction
Most relevant information about a situation is ignored while one minor detail provides the basis for a negative conclusion
Personalization/Self-Referencing
Taking everything personally;
Dichotomous/Polarized Thinking
Common among clients with borderline or narcissistic personality traits; viewing people and situations as black or white, good or bad
Labeling and Mislabeling
Hanging on to inaccurate or maladaptive labels, despite their lack of utility; can have maladaptive features; overly positive and inappropriate level
Magnification and Minimization
Also referred to as Overestimation and underestimation; when a client makes a mountain out of a molehill and vice versa
Overgeneralization
Occurs when an individual generalizes and comes to a strong conclusion on the basis of a single or small number of incidents, the conclusion may be unwarranted
Treatment phases of Stress Incoluation Training Procedures
Conceptualization
Skills acquisition and Rehearsal
Application and Follow-through
Conceptualization
Includes the development of a collaborative relationship, the use of socratic questioning to educate clients about the nature and impact of stress, and conceptualization of stressful situations as “problems-to-be-solved”
Skills acquisition and rehearsal
Specific coping skills are taught and practiced in the office setting and eventually in vivo; examples include relaxation training, self-instructional training, emotional self-regulation, and communication skills training
Application and follow-through
Clients apply their newly acquired coping skills to increasingly challenging stressors. RElapse prevention strategies, attribution procedures, and booster sessions are built into this final phase of the stress inoculation training model
Assessment Issues and Procedures of Cognitive Theory and Therapy
Collaborative Interviewing
Self-Rating Scales
Cognitive Self-Monitoring
Collaborative Interviewing
The patient and the therapist work together to make a Problem List, propose some core beliefs, set goals for treatment, choose interventions, and monitor progress
Questions to ask during Collaborative Interviewing
What was going though your mind just before you started to feel this way?
What does this say about you?
What does this mean about you…your life..your future?
What are you afraid might happen?
What is the worst thing that could happen if this were true?
What does this mean about the other person (s) or people in general?
Do you have images or memories in this situation? If so, what are they?
Self-Rating Scales
Beck Depression Inventory
Cognitive Self-Monitoring
Using Thought Records
Thought Records
Date and time of emotional response
Situation that elicited the emotional response
The behaviors the client engaged in
Emotions that were elicited
Associated thoughts that occured during the situation
Any other related responses
Specific Cognitive Therapy Techniques
Generating Alternative Interpretations Vigorous and Forceful Disputing Thinking in Shades of Grey Exploring the Consequences of Giving up the "Should" Rule Other Therapy Techniques
Generating Alternative Interpretations
Useful technique with clients who hold onto maladaptive or irrational automatic thoughts despite the fact that other, more reasonable, interpretations or explanations exist
Misattribution of Hostility
Quickly and Incorrectly interpreting the behavior of others as hostile
Vigorous and Forceful Disputing
Repeated practice at more and more forceful cognitive disputing procedures
Thinking in Shades of Grey
Involves taking a client’s automatic thoughts, assmptions, or conclusions about a specific performance and placing them on a concrete, measurable scale
Exploring the Consequences of Giving up the “Should” Rule
Variation of response prevention; verbalizing the client’s should rule to predict what would happen if the should was not followed, to carry out an experiment to test theprediction, and to revise his should rule according to the outcome of the experiment
Validated Therapies with Cognitive Emphasis
Cognitive-Behavior therapy for Panic Disorder with and without Agoraphobia
Cognitive-Behavior Therapy for Generalized Anxiety Disorder
Stress Inoculation training for coping with stressors
Cognitive therapy for depression
Cognitive-behavior therapy for Bulimia Nervosa
Multicomponent Cognitive Behavior Therapy for pain associated with rheumatic disease
Multicomponent cognitive behavior therapy with relapse prevention for smoking cessation
