Chapter 10 - Behaviour and Cognitive Theories

Question 1

Behavioural Therapy

Answer 1

Focus on a wide range of client behaviours.

approach of choice when working with clients who have specific behaviour problems such as eating disorder, substance abuse, psychosexual dysfunction. Useful for anxiety, stress, assertiveness, parenting and social interaction

Founded by: B.F. Skinner (Ivan Pavlov, John Watson, Mory Jones, Albert Bandura, John Kromboltz)

Question 2

View of Human Natural for Behavioural Counselling

Answer 2

• concentration on behavioural process
• focus on here and now as opposed to then and there
• assumption that all behaviour is learned, adaptive and maladaptive
  *focus on setting up well-defined therapy goals
• rejection of idea that human personality is composed of traits

Believe in obtaining empirical evidence and scientific support for any techniques they use.

Question 3

Role of counsellor in Behavioural counselling

Answer 3

Active.
functions as a consultant, teacher, adviser, reinforcer, and facilitator.

Question 4

Goals of behavioural counselling

Answer 4

Help clients make a good adjustment to life cirucstances and achieve personal and professional objectives.

modify or eliminate maladaptive behaviours that clients display while helping them acquire healthy, constructive ways of acting.

Question 5

Techniques for behavioural counselling

Answer 5

1) use of reinforcers (increase the probability of a behaviour repeating)
2) Schedules of reinforcement - reinforced every time a behaviour is done when its being learned, then reinforced less frequently when established
3) Shaping - break behaviour down into manageable units
4) Generalization - display of behaviours in environments outside of where they were originally learned (i.e at home/at work)
5) Maintenance - defined as being consistent in performing the desired action without depending on anyone else for support
6) Extinction - elimination of behaviour because of withdrawal of reinforcement
7) Punishment - an aversive stimulus to a situation to suppress or eliminate a behaviour.

Question 6

Strengths and Contributions of Behavioural Counselling

Answer 6

• Approach deals with symptoms, can provide help immediately
• focuses on here and now, does not have to examine the past to get help in the present
  *Saves time and money
• numerous techniques for counsellors to use
  *based on learning theory, a well-formulated way of documenting how behaviour is acquired
• supported by association for behavioural and cognitive therapies
  *supported by research
• objective in defining and dealing with problems and demystifies counselling process

Question 7

Limitations of Behavioural Counselling

Answer 7

• Approach does not deal with total person, just behaviour
• critics say they’ve taken the person out of the personality
• can be mechanically applied
• works best in controlled conditions, may not be as easy to replicate in normal circumstances
  *ignores past history and unconscious forces
• does not consider developmental stages
  *programs client towards minimal or tolerable levels of behaviour, reinforces conformity, stifles creativity, ignores clients needs for fulfillment, self-actualization, feelings of self-worth

Question 8

Cognitive and Cognitive Behavioural Counselling

Answer 8

Focuses on mental processes and their influences on mental health and behaviour. How people think largely determines how they feel and behave.

Question 9

Cognitive & CBT are good for what kind of people

Answer 9

• average + intelligence
• moderate to high levels of functional distress
  *able to identify thoughts and feelings
• not psychotic or disabled by present problems
• willing and able to complete systematic homework assignments
• process information on visual and auditory levels
• frequently have inhibited mental functioning such as depression

Question 10

Rational Emotive Behavioural Therapy (REBT)

Answer 10

Founders: Albert Ellis (Aaron Beck - cognitive theory)

Question 11

View of human nature in REBT

Answer 11

• people have both self and social interest
• Inherently rational, irrational, sensible and crazy
  *children more vulnerable to outside influences and irrational thinking than adults
• humans are gullible, highly suggestible and easily disturbed
• people have within themselves to control their thoughts, feelings, actions but must first realize what they are telling themselves (self talk) to gain command of their lives

Question 12

Role of Counsellor in REBT

Answer 12

active and direct.
teach and correct clients cognition
consistent repetition

Listen for faulty beliefs and challenge them

need to be bright, knowledgable, empathetic, respectful, genuine, concrete, persistent, scientific, interested in helping others, use REBT themselves

Question 13

Goals of REBT

Answer 13

help people realize they can be more rational and live productive lives

help clients stop catastrophizing.

avoid having more of an emotional response than is warranted.

Change self defeating habits.

Question 14

ABCDE model of REBT

Answer 14

A - activating experience (i.e a breakup)
B- how person thinks about the experience
C- emotional reaction to B (thoughts)
D- Disputing irrational thoughts…replace with
E- effective thoughts and hopefully new personal philosophy

Question 15

cognitions

Answer 15

thoughts, beliefs, internal images that people have about events in their lives

Question 16

Irrational thinking/Beliefs

Answer 16

include the invention of upsetting and disturbing thoughts.

Question 17

Techniques

Answer 17

Teaching
Disputing
Confrontation
Encouraging

Teaching involves having clients learn basic ideas of REBT and understand how thoughts are linked with emotions and behaviours didactic/directive and known as rational emotive education

Question 18

3 forms of Disputing

Answer 18

1) Cognitive disputation: use of direct questions, logical reasoning, and persuasion

2)Imaginal disputation - clients ability to imagine and employ a technique known as rational emotive imagery

3) Behavioural disputation - involves behaving in a way that is opposite of the client’s usual way - including role playing and doing activities thought impossible to do.

Question 19

Strengths and Contributions of REBT

Answer 19

• clear, easily learned, effective
• easily combined with other behavioural techniques to help clients more fully experience what they are learning
  *relative short in term, self-help
  *great deal of literature and research
  *evolved over years with refined techniques
  *effective in Major mental health disorders such as depression and anxiety

Question 20

Limitations of REBT

Answer 20

• cannot be used with those with severe mental problems such as schizophrenics
  *too closely associated with the eccentricities of Albert Ellis
  *direct, potential for the counsellor to be overzealous and not therapeutic
  *emphasis on changing thinking may not be the simplest way of helping clients manage emotions
• REBT de-emphasizes working alliance

Question 21

Reality Therapy (RT)

Answer 21

Founder: William Glasser (Robert Wubbolding)

View of Human Nature:
Major tenet is focus on consciousness, human beings operate on a conscious level, they are not driven by unconscious forces or instincts

Everyone has a health/growth force that is manifest on two levels - the physical and psychological. physically - we need food, water and shelter (old brain)

New brain focuses on psychological needs.
Love and belonging, power, freedom, fun . Associated with meeting these needs is the need for identity.

Humans can change their identity and the way they behave

Question 22

identity

Answer 22

Development of a psychologically healthy sense of self.

Question 23

Role of the counsellor in RT

Answer 23

teacher and model
accepting the client in a warm involved way

Counsellors use ing verbs to describe client thoughts and actions… such as angering, bullying etc and emphasis on choice - what the client chooses to do.

Question 24

Goals in RT

Answer 24

Help clients become psychologically strong and rational and realize they have choices in the ways they treat themselves and others

help clients clarify what they want in life

help client formulate a realistic plan to achieve personal needs and wishes

Have counsellor involved with client in a meaningful relationship - based on understanding, acceptance, empathy, and counsellors willingness to express faith in the clients ability to change

Focus on behaviour and the present. Glasser believes that behaviour (thought and action) is inter-related with feeling and physiology.

eliminate punishment and excuses from the client’s life.

Question 25

Techniques in Reality Therapy

Answer 25

action-oriented techniques that help clients realize they have choices in how they respond to events and people and that others do not control them any more than they control others.

teaching, employing humour, confronting, role-playing, offering feedback, specific plans and contracts

WDEP
Wants
Direction
Evaluation
Plan

Question 26

Strengths and Contributions of RT

Answer 26

• versatile, applied to many populations, especially conduct disorders, substance abuse disorders, antisocial behaviour, personality disorders, can be used in individual or group counselling and for various ages
• concrete. able to assess how much progress is being made

*short term treatment

*national training centres and taught internationally

*promotes responsibility and freedom in individuals without blame, criticism or attempt to restructure the entire personality

• approach has successfully challenged the medical model, rational and positive emphasis are refreshing alternatives to pathology centered models

*address conflict resolution

• stress the present because current behaviour is most amenable to client control. Not interested in the past.

Question 27

Limitations of RT

Answer 27

*emphasizes here and now, ignores other concepts such as unconscious and personal history
*holds all forms of mental illness are attempts to deal with external events (clients viewed as causing their own mental disorders)
*few theoretical constructs tied to choice theory and becoming more sophisticated
*does not deal with full complexity of human life, ignoring developmental stages
*susceptible to becoming overly moralistic
*dependent on establishing a good counsellor-client relationship

Question 28

Cognitive Therapy

Answer 28

Founder: Aaron Beck

Question 29

View of Human Nature in CT

Answer 29

how a person apprises a situation is generally evident in his cognitions (thoughts and visual images) , dysfunctional behaviour is caused by dysfunctional thinking. If believes do not change, there is no improvement in a persons behaviour or symptoms. If beliefs change, symptoms and behaviours change

Question 30

Role of the counsellor in CT

Answer 30

is active in sessions. Helps clients make cover thoughts overt …especially with automatic cognitions

Question 31

Goals of CT

Answer 31

examining and modifying unexamined negative thoughts. Hone in on cognition distortions such as all-or-none thinking, negative prediction, overgeneralization, labelling of oneself, self-criticism, and personalization.

Question 32

Techniques in CT

Answer 32

Challenging the way individuals process information
countering mistaken belief systems
doing self-monitoring exercises designed to stop negative automatic thoughts
improving communication skills
Increasing positive self-statements and exercise
doing homework including disputing irrational thoughts.

Question 33

Strengths and Contributions of CT

Answer 33

*has been adapted to treat a wide variety of disorders including depression & anxiety
* spawned in conjunction with CBT, dialectical behaviour therapy - treatment for individuals at risk for self-harm, such as people with BPD - objective is to help clients be more mindful and accepting of things that cannot be easily changed and live lives worth living.
* applicable in a number of cultural settings
*well researched, evidence based
*spawned assessments, beck anxiety inventory, beck hopelessness scale, beck depression scale
*throughout US & Europe

Question 34

Limitations

Answer 34

• requires client to be active, completing homework assignments
  *not appropriate for people seeking unstructured, insight approach
  *primarily cognitive, not best approach for people who are intellectually limited or unmotivated to change
  *demanding, clients and counsellors must be active and innovative, complex approach
  *criticized by feminist therapists and multi-cultural counsellors stating it is patriarchal and euro-centric

Question 35

Mindfulness Based Stress Reduction

Answer 35

Founder: Jon Kabat-Zinn, primary goal is to bring out a state of nonjudgmental awareness of body and mind without having any expectations of producing a result

Question 36

Acceptance and Commitment Therapy

Answer 36

Founder: Steven Hayes with Strasahl & Wilson. Designed to be an approach that integrates acceptance and mindfulness with commitment and behaviour strategies

Question 37

View of Human Nature in ACT

Answer 37

ACT says psychological disorders develop when people try to avoid events such as thoughts, feelings, memories and body sensations that are experienced as aversive

Question 38

Role of Counsellor in ACT

Answer 38

active in sessions. work to accomplish two tasks 1) promote values clarification to act in accordance with those values (commit to value based actions) and 2) promote diffusion between the valued endpoint and the private fear residing in the person.

Question 39

Goals in ACT

Answer 39

Help people become flexible to overcome avoidance behaviour. Clients bome able to experience the present moment more fully and consciously (mindfulness). Instead of fearing the event the client avoids, the client is taught to accept it rather than trying to control it.

Question 40

Techniques in ACT

Answer 40

makes us of metaphors, paradoxes and experimental exercises to obtain the objectives.

Not to reduce or extinguish the discomfort but to help clients learn to experience their privately feared events while achieving their valued goals

Question 41

Six core processes in ACT

Answer 41

1) Acceptance - encouraging clients to accept privately feared events
2) Cognitive Diffusion - targeting problems with fusion (which attempts to decrease the control that thoughts have without changing their content
3)Self as context - diffusing the effect that ones own words have on promoting avoidant behaviour (accepting the thought of I can’t do it, while doing it anyways)
4) Contract with the present moment - increasing clients awareness of current situation (thoughts, feelings, sensations)
5)Values - helping clients to identify and clarify their values
6) committed action, learn to become congruent with stated values and actual behaviour