Cognitive-Behavioral TherapyCognitive-Behavioral Therapy

Michelle Fournier

Sarah Peara

Psyc 5790

Michelle Fournier

Sarah Peara

Psyc 5790

Cognitive TherapyCognitive Therapy

Developed by Aaron Beck Cognitive pertains to mental processes, such as

thinking, remembering, perceiving, and planning Attempts to modify client’s cognitive processes Beck focused on depression

Developed by Aaron Beck Cognitive pertains to mental processes, such as

thinking, remembering, perceiving, and planning Attempts to modify client’s cognitive processes Beck focused on depression

Behavioral TherapyBehavioral Therapy

Behavioral Parent Training Goal is to help parents learn to have more

effective control of their child’s behavior 4 steps Precisely define targeted problem bx Analyze the antecedent/consequences Monitor the frequency of bx to establish a baseline

Behavioral Parent Training Goal is to help parents learn to have more

effective control of their child’s behavior 4 steps Precisely define targeted problem bx Analyze the antecedent/consequences Monitor the frequency of bx to establish a baseline

Behavioral Parent Training Behavioral Parent Training

Train parents in specific procedures for changing the targeted bx Define rules Changing conditions of antecedent Procedures to positively reward compliance

(reinforcement) Discipline I.e. time out/ loss of privilegesBefore implicating BPT look at Gordan/Davidson’s 4

factors

Train parents in specific procedures for changing the targeted bx Define rules Changing conditions of antecedent Procedures to positively reward compliance

(reinforcement) Discipline I.e. time out/ loss of privilegesBefore implicating BPT look at Gordan/Davidson’s 4

factors

Behavioral Marital TherapyBehavioral Marital Therapy

Goals are to increase the frequency of + bx and decrease in - bx; increase skill in communication and problem solving

Initial interview is important source of data (history)

Tools - Areas of Change Questionnaire(A-C)- Martial Status Inventory (MSI)- Locke-Wallace Marital Adjustment Test (MAI)- Dyadic Adjustment Scale (DAS)

Goals are to increase the frequency of + bx and decrease in - bx; increase skill in communication and problem solving

Initial interview is important source of data (history)

Tools - Areas of Change Questionnaire(A-C)- Martial Status Inventory (MSI)- Locke-Wallace Marital Adjustment Test (MAI)- Dyadic Adjustment Scale (DAS)

Behavioral Marital TherapyBehavioral Marital Therapy

Teach skills

- contracts (contingency contract and good faith contract)

- Modeling (done by therapist)

- Defining the problem

Teach skills

- contracts (contingency contract and good faith contract)

- Modeling (done by therapist)

- Defining the problem

Functional Family TherapyFunctional Family Therapy

Combines systems theory, behaviorism, cognitive therapy in an integrated approach

Therapist take position that all bx by all family members is adaptive

Focus is on cognitions/bx Bx change and skill training (education)

relabeling is crucial

Combines systems theory, behaviorism, cognitive therapy in an integrated approach

Therapist take position that all bx by all family members is adaptive

Focus is on cognitions/bx Bx change and skill training (education)

relabeling is crucial

Conjoint Sex TherapyConjoint Sex Therapy

Behavioral sex therapist is an educator who teaches sexual physiology, techniques, changes maladaptive bx patterns & cognitions and uses direct methods to reduce anxiety & improve skill performance

Came of age w/the publication of Masters and Johnson’s Human Sexual Inadequacy (1970)

Behavioral sex therapist is an educator who teaches sexual physiology, techniques, changes maladaptive bx patterns & cognitions and uses direct methods to reduce anxiety & improve skill performance

Came of age w/the publication of Masters and Johnson’s Human Sexual Inadequacy (1970)

Conjoint Sex TherapyConjoint Sex Therapy

Discuss general factors important in the sexual relationship such as

- Flexibility in sex role- Openness or being receptive & expressive- active intimacy or involvement- Trust & commitmentAssessment should be multidimensional and include

physiological and medical factors

Discuss general factors important in the sexual relationship such as

- Flexibility in sex role- Openness or being receptive & expressive- active intimacy or involvement- Trust & commitmentAssessment should be multidimensional and include

physiological and medical factors

Conjoint Sex Therapy cont..Conjoint Sex Therapy cont..

It involves setting specific goals and increasing communication

Therapist plays active role: provides info, facilitates communication and corrects misinformation

Teaching methods- systematic desensitization- Assertiveness training- Sensate focus (key to anxiety reduction)

It involves setting specific goals and increasing communication

Therapist plays active role: provides info, facilitates communication and corrects misinformation

Teaching methods- systematic desensitization- Assertiveness training- Sensate focus (key to anxiety reduction)

What is Cognitive-Behavioral Therapy?What is Cognitive-Behavioral Therapy?

“A set of of therapeutic procedures that attempts to change feelings and actions by modifying or altering faulty thought patterns or destructive self-verbalizations.” (Goldenberg & Goldenberg, 1991)

“A set of of therapeutic procedures that attempts to change feelings and actions by modifying or altering faulty thought patterns or destructive self-verbalizations.” (Goldenberg & Goldenberg, 1991)

Major TheoristsMajor Theorists

Gerald Patterson 1960’s Began practice of applying behavioral

theory to family problems. Taught parents to act as agent of change in

children’s environment. Candy, modeling, time-out

Gerald Patterson 1960’s Began practice of applying behavioral

theory to family problems. Taught parents to act as agent of change in

children’s environment. Candy, modeling, time-out

Major Theorists cont…Major Theorists cont… Neil Jacobson 1970’s Developed clinical practice based on

research Contributed to marital therapy & DV On leading edge of family therapy Longitudinal research w/ couples

Some findings controversial

Neil Jacobson 1970’s Developed clinical practice based on

research Contributed to marital therapy & DV On leading edge of family therapy Longitudinal research w/ couples

Some findings controversial

Role of the TherapistRole of the Therapist

Expert, teacher, collaborator and coach Tailors tx to fit ea. case Reinforces pos. alternative to target bx to rid of

problem bx Applies learning theory principals to rid of problem Teaches communication, problem solving and

negotiation skills Acknowledges importance of therapeutic

relationship.

Expert, teacher, collaborator and coach Tailors tx to fit ea. case Reinforces pos. alternative to target bx to rid of

problem bx Applies learning theory principals to rid of problem Teaches communication, problem solving and

negotiation skills Acknowledges importance of therapeutic

relationship.

TechniquesTechniques

Classical Conditioning- A neutral stimulus paired with another to elicit certain emotions through association. (Pavlov’s dog, ringing the bell when presenting food).

Coaching- Therapist helps clients make appropriate responses giving verbal instructions. (Marcy, when you want Mike to stop and pay attention to you, tap him gently. Mike, this will be your cue that she needs your attention).

Contingency Contracting- Sets the terms for exchanging of behaviors and reinforcers between individuals.

Classical Conditioning- A neutral stimulus paired with another to elicit certain emotions through association. (Pavlov’s dog, ringing the bell when presenting food).

Coaching- Therapist helps clients make appropriate responses giving verbal instructions. (Marcy, when you want Mike to stop and pay attention to you, tap him gently. Mike, this will be your cue that she needs your attention).

Contingency Contracting- Sets the terms for exchanging of behaviors and reinforcers between individuals.

Techniques cont…Techniques cont…

Extinction- Previous reinforcers are withdrawn so behavior returns to original state. (Important that replacement behavior be positively reinforced to take place of extinguished).

Positive Reinforcement- Usually a material used to increase desired behaviors. (Money, medals, praise)

Quid Pro Quo “something for something”- A spouse agrees to do something as long as other does something comparable.

Reciprocity- Two people will reinforce each other at approximately equitable rates over a period of time.

Extinction- Previous reinforcers are withdrawn so behavior returns to original state. (Important that replacement behavior be positively reinforced to take place of extinguished).

Positive Reinforcement- Usually a material used to increase desired behaviors. (Money, medals, praise)

Quid Pro Quo “something for something”- A spouse agrees to do something as long as other does something comparable.

Reciprocity- Two people will reinforce each other at approximately equitable rates over a period of time.

Techniques cont…Techniques cont…

Shaping- Process of learning in small steps. (potty training) Systematic Desensitization- Dysfunctional anxiety is reduced through

pairing with mental relaxation. Time-Out- Removal of person from an environment in which they are

reinforced for certain actions. Job Card Grounding- Behavior mod technique used with pre &

adolescents (age 11-18) . Grounding- Disciplinary technique used with adolescents where

individual is removed from stimuli, limiting reinforcement.

Shaping- Process of learning in small steps. (potty training) Systematic Desensitization- Dysfunctional anxiety is reduced through

pairing with mental relaxation. Time-Out- Removal of person from an environment in which they are

reinforced for certain actions. Job Card Grounding- Behavior mod technique used with pre &

adolescents (age 11-18) . Grounding- Disciplinary technique used with adolescents where

individual is removed from stimuli, limiting reinforcement.

Techniques cont…Techniques cont…

Charting- Asking a client to keep an accurate record of problematic behaviors. (Used to find a baseline before interventions).

Premack Principle- Behavioral intervention where family member must do less pleasant task before allowed to engage in pleasurable activities.

Disputing Irrational Thoughts- Using ABC format. A is the event, B is the thought, C is the emotion. (Who says all your needs should be filled in marriage?)

Thought Stopping- Therapist teaches individual to stop unproductively obsessing by yelling, “Stop”.

Charting- Asking a client to keep an accurate record of problematic behaviors. (Used to find a baseline before interventions).

Premack Principle- Behavioral intervention where family member must do less pleasant task before allowed to engage in pleasurable activities.

Disputing Irrational Thoughts- Using ABC format. A is the event, B is the thought, C is the emotion. (Who says all your needs should be filled in marriage?)

Thought Stopping- Therapist teaches individual to stop unproductively obsessing by yelling, “Stop”.

Techniques cont…Techniques cont…

Self-Instructional Training- Form of self-management focusing on people instructing self. Can interrupt automatic behaviors encouraging more adaptive coping strategies. (Children & self-talk)

Modeling and Role Playing- Individual asked to act “as if” they were person they wanted to be. Feedback and correction given by therapist or family member.

Self-Instructional Training- Form of self-management focusing on people instructing self. Can interrupt automatic behaviors encouraging more adaptive coping strategies. (Children & self-talk)

Modeling and Role Playing- Individual asked to act “as if” they were person they wanted to be. Feedback and correction given by therapist or family member.

Cons of CBTCons of CBT

Some therapist are rigid Client picks out problem. Therapist only works on that

problem and typically won’t address other maladaptive bx Brings about linear changes, which can hinder a complete

family change Lack of spontaneity could result in losing rapport with

families. Therapist & family could end up becoming frustrated and therapy won’t be as effective

Too much emphasis may be given to using methods like time out without the family members understanding the root of problem

Some therapist are rigid Client picks out problem. Therapist only works on that

problem and typically won’t address other maladaptive bx Brings about linear changes, which can hinder a complete

family change Lack of spontaneity could result in losing rapport with

families. Therapist & family could end up becoming frustrated and therapy won’t be as effective

Too much emphasis may be given to using methods like time out without the family members understanding the root of problem

Pros of CBTPros of CBT

Offers techniques for treating problems with children and troubled marriages

Weakness can be corrected by boarding the focus of conceptualization and scope of tx to include family systems

Greatest strength is its insistence on observing what happens and then measuring change

Developed many reliable assessment methods Teaches general problem solving,cognitive and

communicational skill (addresses distorted cognitions) Modular tx interventions organized to meet the specific and

changing needs of the individual and family

Offers techniques for treating problems with children and troubled marriages

Weakness can be corrected by boarding the focus of conceptualization and scope of tx to include family systems

Greatest strength is its insistence on observing what happens and then measuring change

Developed many reliable assessment methods Teaches general problem solving,cognitive and

communicational skill (addresses distorted cognitions) Modular tx interventions organized to meet the specific and

changing needs of the individual and family

ReferencesReferences

Bevcar, D. S. &Bevcar, R. J. (2003). Family therapy: A systematic integration. (5th ed.). Boston: Pearson.

Gladding, S. T. (2007). Family therapy: History, theory, and practice. (4th ed.). New Jersey: Pearson.

Goldenberg, I. & Goldenberg, H. (1991). Family therapy: An overview (3rd ed.). Pacific Grove: Brooks/Cole.

Piercy, F. P., Sprenkle, D. H., & Associates. (1986). Family therapy sourcebook. New York: The Guildford Press.

Bevcar, D. S. &Bevcar, R. J. (2003). Family therapy: A systematic integration. (5th ed.). Boston: Pearson.

Gladding, S. T. (2007). Family therapy: History, theory, and practice. (4th ed.). New Jersey: Pearson.

Goldenberg, I. & Goldenberg, H. (1991). Family therapy: An overview (3rd ed.). Pacific Grove: Brooks/Cole.

Piercy, F. P., Sprenkle, D. H., & Associates. (1986). Family therapy sourcebook. New York: The Guildford Press.