Transcript Cognitive Behavioral Therapy - Santa Barbara Therapist

Cognitive Behavioral Therapy
Rational vs Irrational
Thinking
Essential Concepts
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Thinking  Feeling  Behavior
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This is an Automatic Process
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Merges Cognitive Principles with Behavioral
Approaches
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Psychological distress is due to disturbances in the
cognitive process
ABC’s of CBT and RET
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A= activating event
B= belief about event
C= emotional and behavioral consequence
Ellis Rational Emotive Therapy and
Interventions
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A (event) - B (beliefs )  C (consequence)
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D (disputing intervention)  E (effect)
F (New Feeling)
Examples of Beck’s Biases in Thinking
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Depression – negative view of self,
experience, and future
Hypomania- Inflated view of self and future
Anxiety- Sense of physical or psychological
danger
Phobia- Sense of danger in specific,
avoidable situations
Paranoia- Attribution of bias onto others
Ellis’s Eleven Irrational Beliefs
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It is essential that a person be loved or approved of by virtually
everyone in the community
Some people are bad/wicked and therefore should be blamed
and punished
A person must be perfectly competent, adequate and achieving
to be considered worthwhile
It is a terrible catastrophe when things are not as we want them
to be
Unhappiness is caused by outside circumstances, and a
person has no control over it
Dangerous or fearsome things are a great cause for concern
and their possibilities must be dwelt opon
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It is easier to avoid certain difficulties and selfresponsibility than to face them
A person should be dependent on others and should
have someone stronger on whom to rely
Past events are determinants of present behavior;
the influence of the past can not be eradicated
A person should be quite upset over other people’s
problems
There is always a right or perfect solution to every
problem, and it must be found or the results will be
catastrophobic
Beck’s Cognitive Therapy and Errors in
Information Processing
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Arbitrary Inference- drawing conclusions without
enough evidence
Selective Abstraction-Focusing on details out of
context
Overgeneralizing- Drawing a conclusion about all
events based on only a few
Magnification and minimization- Errors in evaluating
the significance or magnitude of an event
Personalization- Relating external events to yourself
with no rational basis for doing so
Absolutist dichotomous thinking- splitting
Beck’s Core Schemas
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Systems of beliefs in which we consistently
view situations.
Developed from past experiences,
upbringing and trauma (Beck was trained
psychodynamically and holds more from this
theory than Ellis does-thus these schema’s
can lie dormant and be triggered by events)
Beck’s Cognitive Triad
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How you see self, experience and future
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Example of a depressed person:
Sees self as defective, inadequate, deprived and
diseased
Interprets experience as negative, even when
evidence exists for a neutral or positive
interpretation.
See future as continuing in this grim fashion and
expect failures
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Process of Therapy
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Identify problem and dysfunctional thought
patterns
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Challenge thought patterns
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Change thought patterns
CT and REBT differences
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Cognitive Therapy-Beck
Therapist uses Socratic
Dialog to elicit exceptions
and counter arguments to
challenge thoughts
Client does not take on
philosophical system
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REBT- Ellis
Structured Induction to
Philosophical system
Therapist is more
directive and
confrontational
Specific Worksheet
Techniques
Glasser’s Reality Therapy
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The tough, smart drill sergeant approach
Excuse making, assigning blame to external events, upbringing
or bad environment is discouraged
Emphasizes Natural Consequences
Individual choice and responsibility is emphasized
Meeting needs for survival, belonging, power, freedom,
independence and fun leads to vision of what we want
Choice theory- Maladaptive behavior arises from flaws in
matching desired outcomes to our actions due to 1) lack of
knowledge, 2) previous failure and giving up or 3) faulty beliefs
about what will work
Glasser’s Realty Theory Interentions
WDEP
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Wants- Cl. Identifies and understands wants from life
in all arenas.
Direction and Doing- Is the client’s behavior taking
them closer or further away from their wants
Evaluating- Look at behavior and it’s impact on
others and their own wants. Evaluation of wants is
also conducted for realism and worthwhilness to
client
Planning- Client’s evaluation leads to formulation of
action plan
Attributes of a Reality Therapist
beyond empathy, congruence and
positive regard
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High energy
Actively able to confront with a caring attitude
Positive, but not naïve view of human behavior
High hope and ability to reframe lazy, resistant, and
manipulative behaviors into creative expressions
Culturally sensitive in realizing reality is not the same
for all clients
Lazarus’s Multimodal Therapy
BASIC-ID
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Patients are troubled by seen problems and
all seven realms should be explored as
possible
Behavior, affect, sensations, imagery,
cognition, interpersonal relationships, and
biological functions
Very Intergrative
Linehan’s Dialectical Behavioral
Therapy
DBT
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Designed for use with Borderline Clients
Looks at interrelatedness of client’s behaviors,
thoughts, and emotions
Focuses on Dialects of clients need to accept self
and change; getting what she needs and loosing it in
order to grow, and client maintaining the validity of
her experience while learning to interpret it differently
Focus on emotional regulation and mindfulness
Shapiro’s Eye Movement
Desensitization Reprocessing
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EMDR
Other Techniques
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RET BOOK
DTR Daily Thought Record
Self-talk
Relaxation techniques
Visualizations
Meditation
1-10 symptom report and log