Transcript Explaining cbt

Explaining cbt
The thought – feeling connection
• The way you think affects the
way you feel (and behave)
• One of the aims of CBT is to replace rigid,
unrealistic and unhelpful thoughts and beliefs
with flexible, realistic and helpful alternatives
Rob Willson, Rhena Branch (2006) Cognitive Behavioural Therapy for Dummies,
England: John Wiley & Sons.
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Digging deeper into our thoughts
Core beliefs – central ideas about the self
“I am incompetent”
Intermediate beliefs – assumptions, attitudes, rules
“If I don’t understand things perfectly I am dumb”
Core beliefs
Intermediate beliefs
Automatic thoughts
Automatic thoughts
“This training is too hard, I’ll
never understand it”
Judith Beck (1995) Cognitive Therapy: Basics and Beyond, New York: The Guilford Press,
p16.
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Activating
Event
Beliefs
Consequences
-Thoughts
-Feelings
-Situation
-Assumptions
-Behaviours
-Trigger
-Interpretations
Your underlying beliefs can influence your interpretation of an event
and the thoughts that follow, which results in a set of feelings and
behaviours…
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Same situation –
different thoughts and behaviours
• You receive an average mark on an assignment
– Person 1: “This mark proves I am a failure” (feels devastated, withdraws from
subject)
– Person 2: “Yes! I passed a tough assignment” (feels excited, jumps for joy)
– Person 3: “I will try something a little different on the next assignment” (feels
motivated, starts reading for the next assignment straight away)
• A friend passes you on the street without noticing you
– Person 1: “My friend obviously doesn’t like me anymore” (feels humiliated, doesn’t
contact her friend again)
– Person 2: “My friend is so distracted she must be in love” (feels amused, laughs it off)
– Person 3: “My friend might be stressed and distracted” (feels concerned, calls her friend
to see if she is ok)
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Use Helpful Metaphors
• Snow skiing
– Skiing down the mountain in the same path in the deep groves from your
previous runs
– Takes a while to develop new grooves to ski in
– Link to learning new thinking patterns and behaviour
• The “Depression Gargoyle”
– Sitting on your shoulder, the weight of the stone brings you down
– Whispering in your ear - negative self talk
– The Gargoyle wants you to blame yourself, and think you are worthless
– When you are depressed, the messages from the Gargoyle will seem true
– Provides an emotional symbol to help identify self-critical thoughts
Michael Otto (2000) Stories and Metaphors in Cognitive-Behavior Therapy, in Cognitive and
Behavioural Practice, 7(2), pp166-172.
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GettinG “buy in”
Acceptance of the CBT rationale is associated with
positive treatment outcomes
“What do you think about the idea that your thoughts play an important role in
determining your mood/anxiety/behavior?
What do you think about the idea of changing your thoughts and behavior as a way of
working on your mood/anxiety?
What are some possible downsides to these ideas?
What do you think about the idea of having weekly homework related to your
problem/situation?”
Michael Addis, Kelly Carpenter (2000) The treatment rationale in Cognitive Behavioral
Therapy: Psychological mechanisms and clinical guidelines, in Cognitive Behavioural Practice,
7(2), pp151.
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Explaining CBT role play
Types of Unhelpful Thinking (slide 1)
Dichotomous thinking
(Black and white thinking)
Thinking in extremes, often in terms of failures
or successes
Mind reading
Assuming you know what other people are
thinking - often assuming people are thinking
negative thoughts about you
Catastrophising
(magnification)
Predicting the future as catastrophic, blown out
of proportion
Mental filtering
Focusing on weaknesses, ignoring strengths
Lambert Maguire (2002) Clinical Social Work – Beyond Generalist Practice with
Individuals, Groups and Families, Chapter 9: Cognitive Interventions, USE: Brooks
/ Cole.
Grant Blashki et al (2003) Cognitive behavioural strategies for general practice, Australian
Family Physician, 32(1), pp910-917.
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Types of Unhelpful Thinking (slide 2)
Self blame
(personalisation)
Automatically blaming yourself when things are
going badly
Over generalising
(global labelling)
Sweeping and amplified statements used to
describe yourself or others
Blaming
Externalising the reason for your behaviour, not
taking responsibility
Questions with no answers Unhelpful negative questions with no answers
(why me?)
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Examples of unhelpful thinking
Any questions?
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