Therapy Approaches Flashcards
Cognitive Behavioral Therapy
*Cognition
–Belief, thought, expectancy, attitude, or
perception
–Helping clients through behavior modification
methods and through focusing on debilitating
thoughts and beliefs
–Overt and covert behaviors
Cognitive restructuring
methods
*Assumptions:
–Individuals interpret and react to events in terms of their
perceived significance
–Cognitive deficiencies can cause emotional disorders
*Focus of therapy: Cognitive restructuring
–Changing faulty thinking patterns
–“I can never do anything right”
–Replace with more rational self-statements
–Cog bias modification – targets predispositions to thinking
certain ways (e.g., pessimistically)
*Overgeneralizing – I’ll never be good at this
*Catastrophize - everything is the worst
* Can lead to frustration and anger
Approaches include behavior modification
components
Rational-Emotive Behavior
Therapy (REBT)
*Developed to help individuals change irrational
thought and replace with rational positive ones
*Utilizes in vivo behavioral homework assignments
*Procedure:
*Identify irrational thoughts
* Challenge thoughts
* Teaching client (through modeling and homework) to
replace the irrational self-statements with statements
based on “rational” beliefs
REBT effectiveness
*More effective than no treatment
*More effective than various other treatments in
decreasing client’s irrational self-talk
*More effective than other treatments in reducing
emotional distress
*No effect on behavioral measures (approaching
feared object)
Beck’s Cognitive Therapy
*Faulty and negativistic though patterns lead to
behavioral and emotional problems
*Procedure:
–Identification of dysfunctional thoughts
– Usually using visualization tasks
–Use various methods to counteract the dysfunctional thoughts
* Ex: Hypothesis testing, role-playing
–Use of homework assignments that utilize behavior modification
procedures to develop desirable daily activities
–Re-establishing behaviors no longer completed like cleaning
Distorted thought patterns
*Dichotomous thinking – all or none evaluations
*Overgeneralization – rule or belief applied too
broadly
*Arbitrary inference – drawing inaccurate
conclusions based on insufficient, ambiguous, or
contrary evidence
* Making assumptions like that someone doesn’t like you
but maybe they just have RBF
*Magnification – exaggeration of the meaning or
impact of an event
Effectiveness of cognitive
therapy
*Gentler, less confrontational approach than REBT
*Effective in treating depression and other psych
disorders
*Multiple components to CBT
* Restructing itself may only play small part for certain disorder types
Cog restructuring
Not effective if:
◦ they don’t identify specific circumstances for specific behaviors that
lead to supportive environmental consequences
◦ or (b) the client is deficient in the behaviors specified by the rules
Is effective if:
◦ a) they decrease the frequency of irrational self-statements that elicit
the respondent component of troublesome emotions
◦ (b) they teach a client to rehearse rules through verbal discourse and
homework assignments that identify specific circumstances for
specific behaviors that are likely to be maintained in the natural
environment.
Self-regulated coping
*2 types
*Automatic & effortless
*Deliberate effortful
* May use with therapist
*Moves person towards goal
*Not self-control
* Self control – choosing LLR over SSR, not about a
goal or sub-goal
Self-Instructional Training
*Originally developed for impulsivity in children
*With adults often coping skills for issues mostly out of their
control
* Can just be coping rather than getting rid of
* Steps:
◦ 1.Identify internal stimuli produced by the problem and neg. selfstatements
◦ Use internal stimuli as SDs for self-instruction
◦ 2.Modeling & rehearsal learn to counteract neg. statements
◦ 3. Client learns to self-instruct steps for taking action
◦ 4. Make self-reinforcing statements
Meichenbaum’s Stress
Inoculation Training
*Teaches cognitive skills that allow clients to deal
with stressful events
*Three Phases:
–Reinterpretation phase
* It is not the stressor that is the cause of stress reaction but it is the
way the client views the event
* Verbalize that they are capable of dealing with situation
–Coping training phase
* Clients learn coping strategies
–Relaxation, self-instruction, and self-reinforcement
–Application phase
* Clients practice skills in stressful situations
Effectiveness of stress
inoculation
*Many of the components (relaxation, modeling,
desensitization) have been validated when applied
independently
*Helpful for anxiety and stress problems
*Not more effective than other procedures like
flooding
Self-instructional methods
*Helpful with a number of issues
*Rely heavily on rule-governed behavior
*Specifying circumstances and deadlines increase
effectiveness
Problem Solving Training
*Teaches people how to proceed through logical reasoning to
satisfactory solutions to personal problems
–Based on rational problem solving
–Steps in personal problem solving:
* Problem definition
* Generation of alternatives
* Decision making
* Eliminating alternatives one at a time
* Implementation & Verification
*Evaluation of problem solving methods
–Adults and children can rapidly learn skills, but do not
often apply them appropriately
–People often have bad problem solving skills
Self-instructions & Problemsolving
Not effective:
◦ Not tied to environmental consequences
◦ If the focus had just been on self-instructions alone
related to the steps required to complete the task and not
combined with self-coping
Effective:
◦ Teaches rule-governed behavior leads to consequences
◦ Self-talk that is appropriately linked to overt behaviors and
to supportive environmental consequences
◦ Focus on performing the behavior successfully by
including coping self-statements
