Chapter 18 Flashcards
Cognitive Behavioral Therapy
the therapist uses various methods to create change in the client’s thinking and belief system to bring about lasting emotional and behavioral change
CBT, early 1960s
Aaron Beck, 1963, 1964
Goals of CBT
The client will:
- Monitor his or her negative, automatic thoughts.
- Recognize the connections between cognition, affect, and behavior.
- Examine the evidence for and against distorted automatic thoughts.
- Substitute more realistic interpretations for these biased cognitions.
- Learn to identify and alter the dysfunctional beliefs that predispose him or her to distort experiences.
Arbitrary Inference
In a type of thinking error known as arbitrary inference, the individual automatically comes to a conclusion about an incident without the facts to support it or even despite contradictory evidence.
Example
Two months ago, Mrs. B. sent a wedding gift to the daughter of an old friend. She has not yet received acknowledgment of the gift. Mrs. B. thinks, “They obviously think I have poor taste” (instead of considering what other reasons there might be for a delay in the recipient’s response).
Overgeneralization
Sweeping conclusions are overgeneralizations made on the basis of one incident—an “all-or-nothing” kind of thinking.
Example
Frank submitted an article to a nursing journal, and it was rejected. Frank thinks, “No journal will ever be interested in anything I write.”
Dichotomous Thinking
An individual who is using dichotomous thinking views situations in terms of all-or-nothing, black-or-white, or good-or-bad.
Example
Frank submits an article to a nursing journal, and the editor returns it and asks Frank to rewrite parts of it. Frank thinks, “I’m a bad writer” (instead of recognizing that revision is a common part of the publication process).
Selective Abstraction
A selective abstraction (sometimes referred to as a mental filter) is a conclusion based on only a selected portion of the evidence. The selected portion is usually the negative evidence or what the individual views as a failure, rather than any successes that have occurred.
Example
Jackie just graduated from high school with a 3.98/4.00 grade point average. She won a scholarship to the large state university near her home. She was active in sports and activities in high school and well-liked by her peers. However, she is very depressed and dwells on the fact that she did not earn a scholarship to a prestigious Ivy League college to which she had applied (instead of considering her many other accomplishments).
Magnification
Exaggerating the negative significance of an event is known as magnification.
Example
Nancy hears that her colleague at work is having a cocktail party over the weekend, and she is not invited. Nancy thinks, “She doesn’t like me” (instead of considering that this may have been an event for a specific group of people).
Minimization
Undervaluing the positive significance of an event is called minimization.
Example
Mrs. M. is feeling lonely. She telephones her granddaughter Amy, who lives in a nearby town, and invites her to visit. Amy apologizes that she must go out of town on business and would not be able to visit at that time. While Amy is out of town, she calls Mrs. M. twice, but Mrs. M. still feels unloved by her granddaughter (instead of acknowledging the positive efforts of her granddaughter to keep in touch).
Catastrophic Thinking
Always thinking that the worst will occur without considering the possibility of more likely positive outcomes is considered catastrophic thinking.
Example
On Janet’s first day in her executive assistant job, her boss asked her to write a letter to another firm and put it on his desk for his signature. She did so and left for lunch. When she returned, the letter was on her desk with a minor typographical error circled in red and a note from her boss to correct the letter. Janet thinks, “This is it! I will surely be fired now!” (without considering that this may simply be her boss’s way of orienting her to the expectations of the job).
Personalization
With personalization, the person takes complete responsibility for situations without considering that other circumstances may have contributed to the outcome.
Example
Jack, who is a car salesman, has just given a 2-hour demonstration to Mrs. W. At the end of the demonstration, Mrs. W tells Jack that she appreciates his demonstration, but she won’t be purchasing a car from him. Jack thinks, “I’m a lousy salesman” (instead of considering that they may not have extra money to buy a new car at this time).
Schemas (core beliefs)
Structures that contain the individual’s fundamental beliefs and assumptions. Schemas develop early in life from personal experience and identification with significant others. These concepts are reinforced by further learning experiences and, in turn, influence the formation of beliefs, values, and attitudes
Questioning the Evidence
With this technique, the client and therapist view the automatic thought as the hypothesis, and the client is assisted in questioning the facts associated with their cognitions.
Examining options and alternatives
To help the client see a broader range of possibilities than originally considered, the therapist guides the client in learning how to generate alternatives.
Decatastrophizing
With the technique of decatastrophizing, the therapist assists the client to examine the validity of an automatic negative thought. The client is assisted in examining “what is the worst thing that could happen?” and then to develop a plan of action. Even if some validity exists, the client is encouraged to review ways to cope adaptively and move beyond the current crisis.
