Download - Cognitive behavioral therapy
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JOSHUA J. BATALLA IP
Cognitive Therapy
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Theory of Personality
• A Person’s charachteristic pattern of thinking, feeling and acting
Personality
• all mental activities associated with thinking, knowing, remembering and communicating
Thinking or Cognition
• Cognitive therapy perceives psychological problems as stemming from commonplace processes such as faulty thinking making incorrect inferences on the basis of inadequate or incorrect information and failing to distinguish between fantasy and reality..
CT on Personality
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July 18, 1921 Providence, Rhode Island
“Tim”His parents were Jewish ImmigrantHis family suffered the loss of first two
children.At age 7, Broke his arm and developed acutely
serious bone infection which required surgeryHe missed being promoted into Second gradeBad case of whooping cough, chronic Childhood asthmaInterest in Nature
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Significant Childhood Events
Event:
His mother was too emotional
Broke his arm; developed serious bone infection
Interest in Nature
Repercussions:
He became sensitive to others with strong EmotionsHe developed blood and injury phobiaBecame his primary motivation in entering medical schoolPiqued his interest in knowing “ what makes people tick; what makes them happy or sad and confident or insecure
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Cognitive Therapy at Present
Short Term ApproachMost number of research publishedCured Thousands for Depressions and other
psychological disorderScientificActivePresent FocusLearning Focus
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Aaron T. Beck M.D
“Father of Cognitive Therapy”
Professions: Psychiatrist, Psychologist, Researcher, Professor, Author
President Emeritus of Beck Institute of Cognitive Behavior Therapy
Recognized as one of the 10 individuals who shaped the face of American Psychiatry
Known for:Psychotherapy, Psychopathology, Suicide And Psychometrics
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Development of Theory
• Results from anger turned inward against the self, emerging outwardly as the patient’s “need to suffer”
Psychoanalytic View of Depression
Beck’s Experiment
The Conclusi
on
• “There’s still the unconscious hostility, but the way it’s showing up in the dreams is that the patient has a need to suffer and the need to suffer is then being expressed in these negative dreams.”
Depressed Person
Dreams with more themes of hostility
Dreams of being the subject of an
unpleasant occurrence
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Development of Theory
• Results from anger turned inward against the self, emerging outwardly as the patient’s “need to suffer”
Psychoanalytic View of Depression
Beck’s Experiment
The Conclusion
• “The motivation was not to suffer but to get positive reinforcement of some type.”
• “Dreams are representations of the way the patient perceives himself or herself, and the way they perceive their experiences, and that this could be rock bottom.”
Depressed Person
Will be upset by success
Reacted positively to successful outcomes
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View on Human Nature
1. An organism needs to process information in an adaptive way in order to survive
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View on Human Nature
2. Psychological distress is the ultimate consequence of the interaction of the innate, biological, developmental and environmental factors.
Biological Psychological Social
Mentally Healthy / Psychopathology
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View on Human Nature
3. It is our cognitions, which include our thoughts, beliefs and the manner in which we perceive a situation, that are the basis for what we believe, how we act and how we feel.
Action
Thoughts
Em
oti
on V
ision
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Cognitive Model
Core BeliefIntermediat
e BeliefsAutomatic Thoughts
Reactions:Emotional Behavioral
Physiological
Situation
I am incompetent
Attitude: It’s terrible to failRule: I should give up if a challenge seems great.Assumption: If I try do something difficult, I’ll fail. If I avoid doing it, I’ll be okay
Sit: Reading a new text
AT: This is just too hard. I’m so dumb. I’ll never master this. I’ll never make it as a therapist
Emotional: DiscouragementBehavioral: Avoids tasks and watches TV insteadPhysiological: Heaviness in body
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View on Human Nature
4. The Cognitive model proposes that dysfunctional thinking ( which influences the patient’s mood and behavior) is common to all psychological disturbances
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Cognitive Distortions
Black or white
Catastrophisizing
Discounting the positive
Emotional reasoning Labeling
Magnification
/minimization
Mental filter
Mind-reading
Overgeneralization
Personalization
Should and must
Tunnel vision
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Depression Vicious Cycle
1) Stressful Experienc
e
2) Negative explanatory Style
3) Depressed Mood
4) Cognitive Changes
5) Behavior
al Changes
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Therapeutic Approach
1) Building a strong therapeutic Alliance
Empathy
Caring
Optimism
Essential Techniques
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Therapeutic Approach
• Sample use of Three-Question Technique:
2. Socratic Questioning
Essential Techniques
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Therapeutic Approach
• Therapy involves formulating the case of the clients in “cognitive terms.” (Cognitive Conceptualization)
3. Educating the client about the Cognitive Model
Essential Techniques
Initial Questions To
Ponder On
• What is the patient diagnosis(es)?• What are his current problems? How did these
problems develop and how are they maintained?• What dysfunctional thoughts and beliefs are
associated with the problems? What reactions (emotional, physiological, and behavioral) are associated with his thinking?
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Therapeutic Approach
• “… the first step … is to help clients identify their automatic thoughts and images. These thoughts and images are the most readily understood aspect of the cognitive model because clients can easily “catch” them, and because clients can quickly see the direct connection between their thoughts and their negative feelings and dysfunctional behaviors.”
4. Identifying and Challenging Automatic Thoughts and Images
Essential Techniques
Are you aware of anything that you
are saying to yourself that may be causing you to feel this badly?
Can you imagine what kinds of self-
statements, thoughts, or
images you are having that could cause you to feel
this way?
Have you noticed any thoughts or images you have that kind of drift
through your mind while you
have been feeling this way?
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Therapeutic Approach
• This is important because automatic thoughts are often based on cognitive distortions
5. Identifying and Challenging Cognitive Distortions
Essential Techniques
Example: Decatastrophizing/ Scaling
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Therapeutic Approach
6. Identifying and Challenging Intermediate Beliefs
7. Identifying and Challenging Core Beliefs
8. Homework
Essential Techniques
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Commonly Used Techniques
1. Thought-stopping
Replacing a negative thought
with a newly identified
positive one
Yelling to oneself or out loud, “Stop it!” when a
negative thought is identified
Placing a rubber band
on one’s writs and
snapping it whenever one has a negative thought
Actively diverting
one’s thoughts to
more pleasant thoughts
Participating in a
relaxation exercise in
order to “move” one’s
thoughts to a different
place
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Commonly Used Techniques
2. Imagery-changing
Following Images to
CompletionJumping Ahead
in TimeCoping in the
ImageChanging the
Image
Reality-Testing the Image
Repeating the Image Image-stopping Image-
Distracting
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Commonly Used Techniques
3. Rational-emotional role play
It allows the client to debate between the rational and emotional parts of themselves
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Commonly Used Techniques
4. Behavioral and Emotive Techniques
Example:
Case
A mother who insists that she is a bad mother
because she yells too much
Behavioral Approach
To develop additional
parenting skills such as the use
of a sticker chart
Emotive TechniqueTo yell into a pillow every
time she becomes
overwhelmed with her children
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Recent Activities:
Becks Institute current researches focuses on:
Cognitive Therapy for schizophrenia
Cognitive Therapy for suicide prevention
Dissemination of cognitive therapy to community settings
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References:
David G. Myers Psychology 10th EditionTheory and Practice of Counseling and
Psychotherapy – Gerald CoreyCognitive Therapy – GaleNeukrug, Edward. Counselling theory and
practice. Brooks/Cole Cengage Learning: Belmont. CA. 2011
Annual Reviews Conversations: A Conversation with Aaron T. Beck
Thank You!