Theories of Counselling > BT and CT Quiz > Flashcards
BT and CT Quiz Flashcards
Operant conditioning involves a type of learning in which behaviours are influenced mainly by the consequences that follow them.
True
Behaviour therapists look to current environmental events that maintain problem behaviours and help clients produce behaviour change by changing environmental contingencies.
True
Behaviour therapy focuses on environmental conditions that contribute to a client’s problems.
True
Acceptance and commitment therapy (ACT) is based on helping clients control or change unpleasant sensations and thoughts.
False
Behavioural techniques can be effectively incorporated into a group counselling format.
True
Typically, the goals of the therapeutic process are determined by the therapist.
False
Behaviour therapists tend to be active and directive, and they function as consultants and problem solvers.
True
Multimodal therapy consists of a series of techniques that are used with all clients in much the same way.
False
Relaxation training has benefits in areas such as preparing patients for surgery, teaching clients how to cope with chronic pain, and reducing the frequency of migraine attacks.
True
A program of behavioural change should begin with a comprehensive assessment of the client
True
Contemporary behaviour therapy is grounded on:
a scientific view of human behaviour.
Mindfulness and acceptance-based approaches:
have been subjected to empirical scrutiny.
In behaviour therapy it is generally agreed that:
the client, with the help of the therapist, should decide the treatment goals.
Which is not true as it is applied to behaviour therapy?
Insight is necessary for behaviour change to occur.
Most behavioural practitioners stress the value of establishing a collaborative working relationship with clients but contend that:
warmth, empathy, authenticity, permissiveness and acceptance are necessary, but not sufficient, for behaviour change to occur.
Applied behaviour analysis makes use of:
operant conditioning techniques.
Mindfulness-Based Stress Reduction practices rely on:
experiential learning and client self-discovery.
Dialectical behaviour therapy:
is a promising blend of behavioural and psychoanalytic techniques for treating borderline personality disorders.
Which is not true of dialectical behavior therapy (DBT)?
DBT is a blend of Adlerian concepts and behavioural techniques.
An exposure therapy that entails assessment and preparation, imaginal flooding, and cognitive restructuring—using the rapid, rhythmic eye movements aimed at treatment of traumatic experiences—is called:
eye movement desensitisation and reprocessing.
Prolonged/intense exposure—either in real life or in imagination—to highly anxiety-evoking stimuli is called:
flooding
A shortcoming of behavioural therapy from a diversity perspective is:
the focus on treating specific behavioural problems, overlooking significant issues.
Contemporary behaviour therapy places emphasis on:
the interplay between the individual and the environment.
Which is not true as it applies to multimodal therapy?
Great care is taken to fit the client to a predetermined type of treatment.
Which of the following is not considered one of the basic characteristics of contemporary behaviour therapy?
The therapy is an experiential and insight-oriented approach.
REBT makes use of both cognitive and behavioural techniques, but it does not use emotive techniques.
False
REBT practitioners strive to unconditionally accept all clients and to teach them to unconditionally accept others and themselves.
True
Cognitive therapy, an evidence-based therapy for depression, was developed by Meichenbaum.
False
A major contribution made by Ellis, the Becks, Padesky and Mooney, and Meichenbaum is the demystification of the therapy process.
True
Ellis shares Rogers’ view of the client–therapist relationship as a condition for change to occur within clients.
False
Beck developed a procedure known as stress-inoculation training.
False
According to Albert Ellis, to feel worthwhile, human beings need love and acceptance from significant others.
False
Ellis maintains that events themselves do not cause emotional disturbances; rather, it is our evaluation of and beliefs about these events that cause our problems.
True
A difference between Beck’s cognitive therapy and Ellis’ REBT is that Beck places more emphasis on helping clients discover their misconceptions for themselves than does Ellis.
True
According to Beck, people become disturbed when they label, interpret and evaluate themselves by a set of rules that are unrealistic.
True
Which of the following is not a part of stress inoculation training?
Exception questions
REBT is based on the premise that human beings:
learn irrational beliefs from significant others during childhood and then re-create these irrational beliefs throughout our lifetime
REBT is based on the assumption that:
cognitions, emotions, and behaviours interact significantly.
REBT views the core of emotional disturbances to be:
blame
One of the most common CBT group approaches is:
based on REBT principles and techniques.
REBT contends that people have three basic musts (or irrational beliefs) they internalise that inevitably lead to self-defeat. Which of the following is not one of them?
“I do not need to be accepted and loved.”
The main idea of SB-CBT is:
that active incorporation of client strengths encourages clients to engage more fully in therapy and often provides avenues for change that otherwise would be missed.
Meichenbaum’s ______________________focuses more on helping clients become aware of their self-talk and the stories they tell about themselves.
self-instructional training
In cognitive therapy the assumption is that a psychological disorder begins when normal emotion and behaviours become disproportionate to life events in degree frequency. Which of the following is not one of these processes?
Non-polarised thinking
Cognitive behaviour therapy tends to be culturally sensitive because:
it uses the individual’s belief system, or worldview, as part of the method of self-exploration
In cognitive therapy techniques are designed to:
identify and examine a client’s beliefs.
The type of cognitive error that involves thinking and interpreting in all-or-nothing terms or categorising experiences in either-or extremes is known as:
polarised thinking.
Beck’s cognitive therapy places more emphasis on:
helping clients identify misconceptions for themselves.
Beck’s cognitive therapy has been most widely applied to the treatment of:
depression
In self-instructional training, which of the following is given primary importance?
Helping clients become aware of their self-talk.
Textbook for Cognitive Therapy
Cognitive Behavioural Therapy
Albert Ellis rational emotive behaviour therapy (REBT) Aaron Beck and Judith Beck CT, Christine Padesky strengths-based CBT, Donals Meichenbaums CBT. Although the approaches are quite diverse, they do share these attributes, 1. A collaborative relationship between client and therapist, 2. The premise that psychological distress is often maintained by cognitive process, 3. A focus on changing cognitions to produce desired changes in affect and behaviour, 4. Present-centered, time-limited focus, 5. An active and directive stance by the therapist, 6. Educational treatment focusing on specific and structured target problems. Therapists help clients examine how they understand themselves and their world and suggest ways clients can experiment with new ways of behaving, CBT therapists apple beavioural techniques such as operant conditioning, modelling, and behavioural rehearsal to the more subjective processes of thinking and internal dialogue.
REBT – was the first CBT and continues to be a major cognitive behavioural approach. Emphasises thinking, assessing, deciding, analysis and doing. REBT has consistently emphasies all 3 of these modalities and their interactions thus qualifying it as a holistic and integrative approach. People are disturbed not by events but by the views which they take of them – Ellis. People disturb themselves as a result of the rigid and extreme beliefs they hold about events more than the events themselves. REBT basic hypothesis is that our emotions are mainly created from our beliefs, which influence the evaluations and interpretations we make and fuel the reactions we have to life situations. Taught skills that five them the tools to identify and dispute irrational beliefs that have been acquired and self-constructed and are now maintained by self-indoctrination. A large part of the therapy, is seen as an educational process. The client is the learner who then practices these new skills in everyday life.
View of Emotional Disturbance – REBT is based on the premise that we learn irrational beliefs from significant others during childhood and then re-create these irrational beliefs throughout our lifetime. It is largely our own repetition of early-indoctrinated irrational beliefs rather than a parents repetition that keeps dysfunctional attitudes alive and operative with us. Ellis asserted that balme can be at the core of many emotional disturbances. Ellis and Ellisa 2011 hypothesises that we have strong tendencies to transform our desires and preferences into dogmatic shoulds, when we are feeling disturbed it is a good idea to look to our hidden dogmatic musts, such demands create disruptive feelings and dysfunctional behaviours. Three basis musts:
1. I must do well and be loved and approved by others
2. Other people must treat me fairly, kindly and well
3. The world and my living conditions must be comfortable, gratifying, and just, providing me with all that I want in life.
ABC Framework:
Central to REBT theory and practice.
A – is the existence of an activating event of adversity, or an inference about an event by an individual
B – Instead B which is the person belief about A creates C the emotional reaction.
C – is the emotional and behavioral consequence or reaction of the individual; the reaction can be either healthy or unhealthy
The persons belief about his divorce or about his failure. Ellis maintains that the beliefs about the rejection and failure (at point B) are what mainly cause the depression (at point C) – not the actual event of the divorce or the person influence of failure (at point A). After, A, B, C, comes D (disputing), essentially D encompasses methods that help clients challenge their irrational beliefs. Clients learns to discriminate irrational beliefs from rational beliefs. Once they can detect irrational beliefs, particularly absolutistic should clients debate dysfunctional beliefs by logically, empirically, and pragmatically questioning them. Encouraged develop, E a new effective philosophy which also has a practical side.
Therapeutic Goals – minimising their emotional disturbances and self-deating behavirours by acquiring a more realistic, workable and compassionate philosophy of life. Involves a collaborative effort between therapists and client to choose realistic and life-enhancing therapeutic goals. Ellis and Ellis 2011, another goal of REBT is to assist clients in the process of achieving unconditional self-acceptance, unconditional other-acceptance, unconditional life acceptance.
Therapists Function and Role – the first step is to show clients how they have incorporated many irrational absolute should, into their thinking. A second step, in the therapeutic process is to demonstrate how clients are keeping their emotional disturbances active by continuing to think illogically and unrealistically. Third step – helping clients change their thinking and minizing their irrational ideas. Fourth step in the therapeutic process is to strongly encourage clients to develop a rational philosophy oflife so that in the future they can avoid hurting themselves again by believing other irrational beliefs.
Clients Experience In Therapy – may not devote much time to exploring clients earl history and making connection between their past and present behaviour unless doing so will ait the therapeutic process. Ellis and Ellis 2019 – maintain that transference is not encouraged, and when it does occur, the therapist is likely to confront it because it is fenerally based on the clients dire need to be liked and approved of by the therpists. Clients are encouraged to actively work outside therapy sessions. By carrying out behavioural homework assignments, clients become increasingly proficient at minimising irrational thinking and disturbances in feeling and behaving. Getting clients to carry out productive actions that contribute to emotional and attitudinal change. Focus on learning effective ways to dispute self-defeating thinking.
Relationship between Therapist and Client – practitioners strive to unconditionally accept all clients and to teach them to unconditionally accept others and themselves. The therapist takes the mystery out of the therapeutic process, teaching clients about the cognitive hypothesis of disturbance and helping clients understand how they are continuing to sabotage themselves and what they can do to change. Accept their clients as imperfect beings who can be helped through a variety of techniques including teaching, bibliotherapy, and behaviour modification.
The Practice of REBT – multimodal and integrative. Therapists are encourgaged to be flexible and creative in their use of methods making sure to tailor the techniques to the unique needs of each client. Draws from cognitive, emotive and behavioural techniques.
Cognitive Methods – incorporate a persuasive cognitive methodology in the therapeutic process. REBT relies heavily on thinking, disputing, debating, challenging, interpreting, explaining and teaching:
- Disputing irrational beliefs
- Doing cognitive homework
- Bibliotherapy
- Changings ones language
- Psychoeducational method.
Emotive Techniques – use a variety of emotion procedures, including unconditional acceptance, rational emotive role playing, modelling, rational emotive imagery and shame-attacking exercises, Their purpose is not simply to provide a carthartic experience but to help clients change some of their thoughts, emottions, and behaviours.
- Rational Emotive Imagery – clients are asked to vividly imagine one of the worst things that might happen to them and to describe their disturbing feelings.
- Humor – developing of a better sense of humor and helps put life into healthy perspective
- Role Playing – has emotive, cognitive and behavioural components
- Shame- attacking exercises – developed exercises to help people reduce shame and anxiety over behaving in certain ways. Practicing Shame attacking exercises can reduce, minimise, and prevent feelings of shame, guilt, anxiety and depression.
Behavioural Techniques – home work assignments carried out in real-life situations are particularly important. Practice new skills outside of therapy sessions. Doing homework may involve in-vivo desensitisation and live exposure in daily life situations.
Applications of REBT as a Brief Therapy – REBT is well suited as a brief form of therapy, whether is it applied to individuals, groups, couples and families.
Application to Group Counselling – practitioners employ an active role in encouraging members to commit themselves to practicing what they are learning in the group sessions in everyday life. Group members 1. Learn how their beliefs influence what they feel and what they do, 2. Explore ways to change self-defeating thoughts in various concrete situations, 3. Learn to minimise symptoms through a profound change in their philosophy. Behavioural homework and skills training are just two useful methods for a group format.
CT – emphasises education and prevention but uses specific methods tailored to particular issues. The specificity of CT allows therapists to link assessments, conceptualisation and treatment strategies. Beck, set out to create an evidence-based therapy for depression, and he tested each of his theoretical constructs with empirical studies and conducted controlled outcomes studies to determine how CT outcomes compared with existing psychotherapy and pharmacotherapy treatments for depression. Becks original depression research revealed that depressed clients had a negative bias in their interpretation of certain life events, which resulted from active processes of cognitive disortions. Unlike Ellis, Beck did not assert that negative thoughts were the sole cause of depression. Beck referred to as the negative cognitive triad; negative views of the self, the world and the future. CT has a number of similarities to both rational emotive behaviour therapy and behaviour therapy. All of these therapies are active, directive and time-limited, present-centered, problem-orientated, collaborative, structured, and empirical. CT is based on the theoretical rational that the way people feel and behave is influenced by how they perceive and place meaning on their experience. 1. That people thought processes are accessible to introspection, 2. That peoples beliefs have highly personal meanings, and 3. That people can discover these meanings themselves rather than being taught or having them interpreted by the therapists. Despite these differences, therapists who practice behaviour therapy REBT, and CT learn from each other, and considerable overlap exists in methods used by the 3 schools of therapy, in contemporary clinical practice.
A Generic Cognitive Model – to describe principles that pertain to all CT applications from depressions and anxiety treatments to therapies for a wide variety of other problems including psychosis and substance use. The generic cognitive model provides a comprehensive framework for understanding psychological distress, and some of its major principles are described here. A psychological disorder beings when these normal emotions and behaviours become disproportionate to life events in degree or frequency. Faulty information processing is a prime cause of exaggerations in adaptive emotional and behavioural reactions. Our thinking is directly connected with out emotional reactions, behaviours and motivations.
- Arbitrary inferences are conclusions drawn without supporting evidence, this includes catastronphising or thinking
- Selective abstractions consists of forming conclusions based on an isolated detail of an event while ignoring other information
- Overgeneralisation is a process of holding extreme beliefs on the basis of a single incident and applying them inappropriately to dissimilar events or settings
- Magnification and minimisation consists of perceiving a case of situations in a greater or lesser light than it truly deserves
- Personalisation – is a tendency for individuals to relate external events to themselves, even when there is no basis for making this connection. If a client does not return for a second counselling session
- Labeling and Mislabeling – involve portraying ones identity on the basis of imperfections and mistakes made in the past and allowing them to define one true identity
- Dichotomous thinking involves categorising experiences in either or extremes
- Our beliefs play a major role in determining what type of psychological distress we will experience - each emotional and behavioural disorder is accompanied by beliefs specific to that problem
- Central to cognitive therapy is the empirically supported observations that changes in beliefs lead to changes in behaviour and emotions
- If beliefs are not modified, clinical conditions are likely to reoccur. Even without counselling or a change in beliefs, people often recover from feelings of depression or anxiety and return to their usual healthy functioning.
Basic Principles of CT:
- Precieves psychological problems as an exaggeration of adaptive responses resulting from commonplace cognitive distortions. CT is an insight-focused therapy with a strong psychoeducational component that emphasises recognising and changing unrealistic thoughts and maladaptive beliefs. The goal of CT is to help clients learn practical skills that they can use to make changes in their thoughts, behaviours, and emotions and how to sustain these changes over time. From the start of treatment, clients learn to emply specific problem-solving and coping skills. The goals of this brief therapy include providing symptoms relief, assisting clients in resolving their most pressing problems, changing beliefs, and behaviours that maintain problems and teaching clients skills that serve as relapse prevention strategies.
Differences between CT and REBT – REBT is often highly directive, persuasive, and confrontational, and the teaching role of the therapist is emphasised. In contrast, CT uses Socratic dialogue, posing open-ended questions to clietns with the aim of getting clients to reflect on personal issues and arrive at their own conclusions, places more emphasis on helping clients identify misconceptions for themselves rather than being taught. Through this reflective questioning process, the cognitive therapist collaborates with clients in testing the validity of their cognitions (Collaborative empiricism). Ellis works to persuade clients that certain of their beliefs are irrational and nonfunctional. Becks views his clients distorted beliefs as being the result of cognitive errors rather than being driven solely by irrational beliefs. For Beck, people live by rules, they get into trouble when they label, interpret, and evaluate by a set of rules that are unrealistic or when they use the rules inappropriately or excessively.
The Client-Therapist Relationship – a therapeutic alliance is the necessary first step in cognitive therapy. Therpist must have a cognitive conceptualisation of cases, be creative and active, be able to engage clients through a process of Socratic questioning, and be knowledgeable and skilled in the use of cognitive and behavioural strategies aimed at guiding clients in significant self-discoveries that will lead to change. Clients are expected to identify the distortions. Cognitive therapists emphasise the clients role in self-discovery. Cognitive therapists identify specific, measurable goals and move directly into the areas that are causing the most difficulty for clients. Homework is often used as a part of cognitive therapy because practicing cognitive behavioural skills in real life facilitates more rapid and enduring gains. CT realise that clients are more likely to complete homework if it is tailored to their needs, if they participate in designing the homework, if they begin the homework in the therapy session, and if they talk about potential problems in implementing the homework.
Applications of CT – gained recognition as an approach to treating depression but extensive research has been devoted to the study and treatment of many other psychiatric disorders. Helped treat depression, anxiety, body dysmorphic, eating disorders, personality disorders etc… Moreover the effects of CT for depression and anxiety disorders seem to be more enduring that the effects of other treatments, with the exception of behaviour therapy, which sometimes matches CT in duration of positive outcome.
Applying Cognitive Techniques – cognitive methods focus on identifying and examining a clients beliefs exploring the origins of these beliefs, and modifying them in the evidence does not support these beliefs. Regardless of the nture of the specific problems, the cognitive therapist is mainly interested in applying procedures, that will assist individuals in making alternative interpretations of events in their daily living and behaving in ways that move them closer to their goals and values.
Treatment Approaches – depression usually lasts 16 – 20 sessions, activity has an antidepressant effect. Clients rate their moods in relation to the activities they do throughout the day. As depression begins to life, the therapist introduces additional skills such as, thought records, which help clients identify negative automatic thoughts and tests to them. Clients are helped to create an action plan to solve the problem rather than ruminating on it. In contrast, cognitive therapy for panic disorder generally lasts only 6 – 12 sessions and targets catastrophic beliefs about internal physical and mental sensations.
Application to Family Therapy – CT emphasises schema, elsewhere defined as core beliefs, as key aspect of the therapeutic process. Therapists help families restructure distorted beliefs in order to change dysfunctional behaviours.
SB-CBT – is a variant of Becks CT. is that active incorporation of client strengths encourages clients to engage more fully in therapy and often provides avenues for change that otherwise would be missed. Expands on the previous models of CBT to include methods that help people develop positive qualities. In a key note address at an international conference, proposed that the next frontier in psychotherapy would be development of methods to enhance human experience and strengths instead of working solely to alleviate suffering.
Basic Principles of SB-CBT – 1. Therapists should be knowledgeable about evidence based approaches pertaining to the clients issues discussed in therapy, 2. Clients are asked to make observations and describe the details of their experiences so what is developed in therapy is baed in the real data of clients lives, 3. Therapists and clients collaborate in testing beliefs and experimenting with new behaviours to see if they help achieve desired goals. Strengths are integrated into each phase of treatment in SB-CBT beginning with the intake interview. Kuyken, Padesky and Dudley 2009 show how positive interests and strengths identified in early therapy sessions can provide a wealth of information to help therapists and client collaboratively integrate strengths into case conceptualisation and treatment. SB-CBT therapists help clients develop and construct new positive ways of interacting in the world. The SB-CBT model for building and strengthening personal resilience can be used on it own or integrated with another evidence-based CBT treatment for diagnostic disorder.
Client-Therapist Relationship – collaborative, active, here and now focused, and client-centered. Therapists do not take an expert stance but instead serve as curious assistances or guides to their clients own discovery and growth. SB-CBT practitioners ask clients for imagery and metaphors to describe their experiences, both positive and negative.
Applications of Strengths Based CBT – 3 current applications for SB-CBT, 1. An add-on for classic CBT, 2. A four step model to build resilience and other positive qualities, 3. The NEW paradigm for chronic difficulties and personality disorders. Four steps – 1, search, 2. Construct, 3. Apply, 4. Practice. These everyday activities clients are motivated to do are areas of strength, this search for strengths is the first step in their model. The second step is to discover what obstacles clients encounter while doing these activities and how they manage these obstacles. The third step involves the therapist helping Joseph creatively consider ho he can apply his PMR to remain resilient in more problematic area o his life, such as daring. The fourth stage involves Joseph conducting a series of dating experiments while he practices maintaining a focus on resilience. The same principles can be used to build other positive qualities such as altruism, creativity and courage. The key is to find everyday areas of the persona life where these qualities are already in evidence. The final application of SB-CBT is the NEW paradigm for chronic issues and personality disorders. 1. Conceptualise the OLD system of operating and help clients understand they do things for good reasons, 2. Construct NEW systems of how clients would like to be, 3. Strengthen the NEW using behavioural experiments to try on NEW ways of being and edit them as needed and 4. Relapse management.
Donald Meichenbaums CBM – combines the best elements of behaviour therapy and cognitive therapy. A basic premise of CBM is that clients must become aware of how they think, feel and behave, and the impace they have on others before change can occur. Believes the quality of the therapeutic relationship is critical to positive outcomes, and he suggests working in a collaborative fashion with clietns to develop the skills necessary to achieve the treatment goals. Shares the REBT and CT assumptions that distressing emotions are often the result of maladaptive thoughts. Self-instructional training focuses more on helping clients become aware fo their self-talk and the stories they tell about themselves. Suggests that it may be easier and more effective to change our behaviour rather than our thinking. Furthermore, our emotions and thinking are two sides of the same coin: the way we feel can affect our way of thinking just as how we think can influence how we feel. Cognitive restructuring plays a central role in Meichenbaums, self-instructional training.
How behaviour changes – proposes that behaviour change occurs through a sequence of mediating processes involving the interaction of inner speech, cognitive structures and behaviours and their resultant outcomes.
Phase 1: self-observation – clients learning how to obsere their own behaviour
Phase 2: starting a new internal dialogue – as a result of the early client-therapist contacts, clients learn to notice their maladaptive behaviours and they begin to see opportunities for adaptive behavioural alternatives.
Phase 3: Learning new skills – clients learn to interrupt the downward spiral of thinking, feeling and behaving and the therapist teaches clients more adaptive ways of coping using the resources they bring to therapy.
Stress Inoculation Training – procedures that are psycholocial and behaviour analog to immunization on a biological level. Training I sbaed on the assumption that we can affect our ability to cope with stress by modifying our beliefs and self-statements about our performance in stressful situations. Is a combination of information giving, Socractic discovery-oriented inquiry, cognitive restructuring, problem solving, relaxation training, behavioural rehearsals, self-monitoring, self-instruction, self-reinforcement, and modifying environmental situations. Describes stress inoculation training as a complex, multifaceted, cognition behavioural intervention that is both preventive and a treatment approach.
- Expose clients to anxiety-provoking situations by means of role playing and imagery
- Require clients to evaluate their anxiety level
- Teach clients to become aware of the anxiety-provoking cogntiitions they experience in stressful situations
- Help clients examine these thoughts by reevaluating their self-statements
- Have clients note the level of anxiety following this reevaluation.
The phases of Stress Inoculation training – 3 stage model. 1. The conceptual-educational phase, 2. The skills acquisition and consolidation, 3. The application and follow-through phase. During the conceptual-educational phase, the primary focus is on creating a therapeutic alliance with clients. This is done by helping the clients gain a better understanding of the nature of stress and reconceptualising. Clients often being treatment feeling that they are victims of external circumstances, thoughts, feelings and behaviours over which they have no control. During the skill acquisition and consolidation phase, the focus is on giving clients a variety of behavioural and cognitive coping skills to apply to stressful situations. This phase involves direct ations, such as gathering information about their fears, learning, specifically what situations bring about stress, arranging for ways to lessen the stress by doing something different. During the application of ollow through phase, the focus is on carefully arranging for transfer and maintenance of change from the therapeutic situation to everyday life. Relapse prevention, which consists of procedures for dealing with the inevitable setbacks clients are likely to experience as they apply what they are learning to daily life, is taught at this stage. Follow up and booster sessions typically take place at 3, 6 and 12 momhts. Stress inoculation training has the potential useful applications for a wide variety of problems and clients and for both remediations and prevention.
A cognitive narrative approach to CBT – has embraced a cognitive narrative perspective which focuses on the plots, characters and therems in the stories people tell about themselves and other regarding significant events in their lives. Meichenbaum claims that we are all story tellers. Works in a collaborative fashion with clients to develop the coping skills necessary to achieve these treatment goals.
- Are clients now able to tell a new story about themselves and the world
- Do clients now use more positive metaphors describe themselves.
- Are clients able to predict high-risk situations and employ coping skills in dealing with emerging problems
- Are clients able to take credit for the changes they have been able to bring about
Strengths from a Diversity Perspective – the collaborative approach of CBT offers clients a structured therapy program, yet the therapist still makes every effort to enlist clients active cooperation and participation. The psychoeducational focus of CBT is a clear strength that can be applied to many clinical problems and use effectively in many settings with diverse client populations. A strength of CBT is integrating assessment of client beliefs, emotional responses, and behavioural choices throughout therapy, which communicates respect for clients viewpoints regarding their progress.
- Interventions are tailored to the unique needs and strengths of the individual
Shortcomings – many cultures view interdependence as necessary to good mental health. Clients with long cherished cultural values pertaining to interdependence may not respond favorable to forceful methods of persuation toward independence. Suggests therapists avoid challenging the core cultural beliefs of clients unless the client is clearly open to this. The emphasis of CBT on assertiveness, independence, change may limit it use in certain cultures. Another limitation of CBT from a multicultural perspective involves its individualistic orientation.
Contributions:
REBT – one of the strengths of REBT is the focus on teaching clients ways to carry on their own therapy without the direct intervention of a therapist.
Becks CT – Becks key concepts share similarities with REBT but differ in being empirically rather than philosophically derived, the processes by which therapy proceeds and the formulation and treatment for different disorders. Research demonstrates that the effects of cognitive therapy on depression and hopelessness are usually maintained for at least 1 year after treatment.
SB-CBT – successfully incorporated a wide range of modalities including imagery. Provides models that extend CBT from evidence-based treatment of client problems to evidence-based models for developing positive qualities and client strengths
Meichenbaums CBM – ounderstanding how stress is largely self-induced through inner dialogue. Newly acquired insights into action. Learn how to generalise coping skills to various problems situations and acquire relapse prevention strategies to ensure that their gains are consolidated.
Limitations:
- Attention would then very quickly move to exploring, disputing and replacing these beliefs.
- Involves the misuse of the therapists power by imposing ideas of what consititurtes rational thinking.
Becks CT – focusing too much power of positive thinking; being too superficial and simplistic, denying the importance of the clients past; being too technique oriented; failing to use the therapeutic relationships; working only on eliminating symptoms, but failing to explore the underlying causes of difficulties; ignoring the role of unconscious factors; and neglecting the role of feelings. Do not purse positive thinking but rather thinking based on actual experiences.
SB-CBT – still in its infancy
CBM – based on his level of caring and his creativity in implementing CBT interventions
Potential limitation of any of the cognitive behavioural approaches is the therapists level of personal development, training, knowledge, skill, perceptiveness and ability to establish a therapeutic alliance.
