cognitive behavioral theory Flashcards
background of cognitive behavioral
founder is Aaron Beck, he was trained as a psychiatrist (psychoanalyst), being a psychoanalyst is how people entered the field, however he found that through his experience and learning that it was better and handled better through reasoning and challenging thoughts (rather than long term analysis), understanding how negative thoughts impact behavior and emotions, REBT was more directly but Beck thought collaboration was important (gathering information), FOCUSED ON: Socratic dialogue, open ended questions, reflections and clarifications, collaborative empiricism allows client’s to gain insight into thoughts and how they are assigning meaning to each different thought; felt it was very important to ask questions, not be seen as the expert and therapy is about collaboration/ build therapeutic alliance; not trying to direct persuade or confront clients (like REBT); not reflecting (like person centered) but he is using these techniques to build relationship with client; CBT does not engage so much into insight as origins like psychodynamic; most utilized; therapist has to understand how client perceives something and this is connected to cognitive distortions
summary of process of therapy
set agendas for sessions, then problem list, then thoughts/behaviors, and by the end have an idea what might be causing it and some ways to change it
ideas of Aaron Beck’s therapy
Insight-focused therapy
-Into thoughts and how they are assigning meaning to thoughts, not origins like psychodynamic
Emphasizes changing negative thoughts and maladaptive beliefs
Theoretical Assumptions
- People’s internal communication is accessible to introspection
- Clients’ beliefs have highly personal meanings
- These meanings can be discovered by the client rather than being taught or interpreted by the therapist
basic theory of therapy
- To understand the nature of an emotional episode or disturbance it is essential to focus on the cognitive content of an individual’s reaction to the upsetting event or stream of thoughts
- People are not passive victims of their tendencies, people are actively creating and moving towards goals that are salient/vital to them
- Important for us to understand the nature of the consequences of various situations
- How does an event impact individual’s thoughts and behaviors
goals of therapy
To change the way clients think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructuring
principles of therapy
automatic thoughts, intermediate thoughts, core beliefs, therapist pattern
what are automatic thoughts
personalized notions that are triggered by particular stimuli that lead to emotional responses
-Come to mind when person is faced with and responds to an event (even if the situation is positive), what we think first
intermediate thoughts
rules and guidelines and expectations we follow, if the situation (if then statements)
-If I do not do well on this exam, then …
core beliefs
schemas, deepest level of a person’s thinking
- What something means about who you are
- Ex. I’m a failure, I am worthless
- Steady throughout situations, how we view and understand selves
- Therapist tries to access these
therapist pattern
What is the problem, how do we set an agenda, column (three tiers) what are the thoughts what are the emotions what are the behaviors and what are some of the alternative ways you can be/engage, you provide them with psychoeducation
-Conceptualization, going through different situations client is dealing with, talking about the automatic and intermediate
what are cognitive distortions
(people favor assimilation over accommodation- prefer to take in information that confirms schema rather than adjusting to new information, find ways to maintain beliefs), a way to maintain maladaptive thoughts
what are arbitrary inferences
- Draw conclusions without supports
- I will be bad at yoga
selective abstraction
- Drawing conclusion based off of isolated event/situation
- I fell off the stairs last week so I will be bad at yoga
what is overgeneralization
- Taking response to one situation and applying it to everything else
- I am not good at yoga so clearly I will have balance problems when I am older
- Moving into catastrophizing (applying to different situations), my friend will hate me because I am not going to yoga with them
what is magnification and minimization
- When you magnify a flaw and minimize a strength, more emphasis on something you did poorly than something you did well
- I tried yoga and could not keep balance (minimizing fact you tried it, magnify fact you lose balance)
what is personalization
- When we take a situation and personalize it, try to identify it and connect it to oneself even if it has nothing to do with us
- When someone does not text back it means they are mad at you (even though they were mad at you)
what is labeling and mislabeling
- Based off of isolated incidents or situations we label ourselves
- Funny kid vs. smart kid (mislabels everyone else, if they are the smart one that must mean I am not smart)
what is polarized thinking
-Dichotomous thinking, see everything in split black/white terms
explain theory’s definition of depression
- Depressed: maladaptive thought about self world and future; feel worthless and that the world is not a good place and that things will never get better
- Different from anxiety (more fear and worry), troubled weak and cannot handle it, others are harmful and dangerous and I will be harmed in the future
- Pattern that triggers depression
Becks cognitive triad
- Clients hold negative views of themselves
- “I am a lousy person”
- “I am not good enough” - Client interprets World through a negative filter
- “The world is a negative place where bad things are bound to happen to me”
- “People will betray me.” - Client holds a gloomy vision of the future
- “The world is bleak and it isn’t going to improve”
- “It will always be this way.”
techniques of therapy
Challenging Absolutes:
- “everyone”, “never”, “always”
- ask and probe more about these statements
Reattribution
-Taking something client is internalizing and finding other ways to explain situation
Scaling
-Also called grading, understand where something is on scale of 1-10, what is important to client, what is most concerning to you
Cognitive rehearsal/positive imagery
-Picturing self getting ready for exam and you feel confident and ready, find a good seat in classroom, read first question and know answer, do not know second response and think about what you can do
Cost benefit analysis
-What would be the advantages and disadvantages of doing this
Examining evidence
- What proof do you have
- What proof do you have that you are stupid
Generating alternatives
-Different ways of understanding
Letter writing, journaling
Thought log
- in handouts on Canvas keeping log of where person was, what they were feeling, automatic thought, evidence they have for and against thought, emotions and feelings from thought, behaviors coming from thought
- activity logs are also used
Borrowing someone else’s perspective
- If friend was in same situation as you, how would you respond to friend (most people are more generous and understanding when it comes to friends)
- So how come you cannot apply these things to you? Can you try to apply them to you?
explain Meichenbaum’s cognitive behavioral modification (CBM)
combines behavioral work with CBT tenants, have to be able to reflect on thoughts and meaning of thoughts (CBT) but you also have to be able restructure and change irrational thoughts (Ellis, behavioral), goal is to restructure thoughts we engage in negative self talk and we have to engage in more positive ways of self talk, train our brain in how we respond to situations
explain self instructional therapy focus on CBM
- Trains clients to modify the instructions they give to themselves so that they can cope
- Emphasis is on acquiring practical coping skills
what is cognitive structure in CBM
- The organizing aspect of thinking, which seems to monitor and direct the choice of thoughts
- The “executive processor,” which “holds the blueprints of thinking” that determine when to continue, interrupt, or change thinking
explain behavior change and coping CBM
3 Phases of Behavior Change
- Self-observation
- trying to be aware of what is going on in terms of stress, maladaptive thoughts, understanding nature of distress and emotions - Starting a new internal dialogue
- learning techniques and applying them - Learning new skills
explain coping skills programs (stress inoculation training) in CBM
- The conceptual phase
- all about collaborative empiricism, curious with the client, trying to understand what is going on, going to be stressed (by talking about things), but then you give skills to practice and engage with in order to increase anxiety, you want them to continue process outside of treatment - Skills acquisition and rehearsal phase
- lets learn about different techniques - Application and follow-through phase
- which techniques can you practice
- re-evaluating, what worked and what did not, how well do you think you did
client practices and engages more actively in changing thoughts and ways of being
CBM and CBT?
CBM is not as popular as CBT but it is still used and there are a lot of trainings and workshops
-Should understand this as a part of Cognitive behavioral work
limitations of CBT
Therapist has potential to misuse power by imposing their ideas of what constitutes “rational” thinking on a client especially in regards to culture.
- Example: “I always have to take care of my family” in a collectivistic culture, this is true
- Therapists must take special care to encourage clients to act rationally within the framework their own value system and cultural context
- Different people consider different things irrational
Some clinicians think CBT interventions overlook the value of exploring a client’s past experiences/cultural expectations/patterns.
