Cognitive therapy

INTRODUCTION

Cognitive therapy has its roots in the early 1960s research on depression conducted
by aaron beck (1963,1964).beck had been trained in the Freudian psycgoanalytic
view of depression as “anger turned in ward’’. In his clinical research, he began to
observe a common theme of negative cognitive processing in the thoughts and
dreams of his depressed clients (Beck & weishaar,2011).

COGNITIVE THERAPY

Cognitive therapy is a type of psychotherapy based on the concept

of pathological mental processing. The focus of treatment is on the modification
of distorted cognitions and maladaptive behavior.

DEFINATION- Cognitive therapy is a type of psychotherapy based on the concept

of pathological mental processing. the focus of treatment is on the modification of
distorted cognitions and maladaptive behavior.

INDICATION OF COGNITIVE THERAPY

Cognitive therapy was originally developed for use with depression . today it is
used for a broad range of emotional disorders. in addition to the
depression ,cognitive therapy may be used with the following clinical comditions
panic disorder, generalized anxiety disorder, social phobias, OCD, post tramatic
stress disorder, eating disorder, substance abuse, personality disorder,
schizophrenia, couples problems, biopolar disorder, hypocondriasis and
somatoform disorder.
GOALS AND PRINCIPLES OF COGNITIVE THERAPY

Beck and associates (1987) define the goals of cognitive therapy in a following
way :

1. Monitor his or her negative , automatic thoughts.

2. Recognize the connections between cpgnition,affect,and behavior.
3. Examine the evidence for and against distorted automatic thoughts.
4. Substitute more realistic interpretations for these biased cognitions.
5. Learn to identify and alter the dysfunctional beliefs that predispose
him or her to distort experienced.

Cognitive therapy is highly structured and short term,lasting from 12

to 16 weeks(Beck & Weishaar,2011). Sardock and Sardock (2007)
suggested that ,if a client does not improve with in 15 weeks of
therapy,reevaluation of diagnosis should be made. Although therapy
must be tailored to the individual,the following

PRINCIPLES UNDERLIE COGNITIVE THERAPY for all clients (Beck

1995).

Principle 1:- cognitive therapy based on an everevolving formulation of the

client and his or her problems in cognitive terms.

Principle 2:- cognitive therapy requires a sound therapeutic alliance.

Principle 3:- cognitive therapy emphasizes collaboration and active

participation.

Principle 4:- cognitive therapy is goal oriented and problem focused.

Principle 5:- cognitive therapy emphasizes the present.

Principle 6:- cognitive therapy is educative, aims to teach the client to be his
or her own therapist, and emphasizes relapse prevention.
 Principle 7:- cognitive therapy aims to be time limited.

Principle 8:-cognitive therapy sessions are structured. -

Each sessions are has a set structure that includes

1)reviewing the clients week.

2) collaboratively setting the agenda for this session,

3)reviewing the previous weeks session,

4)reviewing the previous weeks homework.

5)discussing the weeks agenda items,

6)establishing homework for next week, and

7) summarizing this week’s session. This format focuses attention on what

is important and maximizes the use of therapy time.

Principle 9:- cognitive therapy teaches clients to identify, evaluate, and

respond to their dysfunctional thoughts and beliefs.

Principle 10:- cognitive therapy uses a variety of techniques to changes

thinking mood, and behavior.

TECHNIQUES OF COGNITIVE THERAPY

There are four main groups of cognitive therapy technique.they are the
following:

 Techniques for stopping intrusive cognitions.

 Technique to counterbalance faulty cognition.
 Technique for altering cognitions.
 Technique to resolve problems directly.

TECHNIQUES FOR STOPPING INTRUSIVE COGNITIVE

These method aim at stopping intruding thoughts though distraction. attention is
directed to another mental act like doing mental arithmetic or copying a figure.
The method of ‘thought stopping’, as done in obsessional ruminations, is alao tried.

TECHNIQUE TO COUNTERBALANCE FAULTY COGNITION

This involves counterbalancing intruding cognitions and the emotions provoked by

them, with another thought. As an example, when an anxious patient with chest
pain becomes apprehensive thinking that he has a ‘heart problem,’ he may be
trained to think that it is only a muscular pain and does not relate to the heart.

TECHNIQUE FOR ALTERING COGNITIONS

These are aimed at changing the nature of cognitions. The patient is helped to
identify ‘maladaptive cognition’ and their ‘logical errors.’ Some errors which are
not mutually exclusive and which occur in depression are given below :

 Faulty inference : This is making faulty interpretation of a situation or an

event where there is no factual evidence to make such conclusions. For ex.
If a friend fails to respond to a letter sent by the patient , he considers it as a
sign of the friends hostility or dislike to the latter.
 Over generalization: this is making a general conclusion based on a single
incident. An example of generalizing all students of a particular class as
substandard, based on the poor marks scored by one student.
 Magnification or minimization: These are distorted evaluations. for ex. a
minor error is magnified or an important achievement is minimized in an
unrealistically distorted manner.
 Unrealistic assumptions : An ex. is the assumption that one can be happy
only if one is a top scorer all the time.

TECHNIQUE TO RESOLVE PROBLEMS DIRECTLY

These involve several steps and consist of :

 Defining the problem more clearly.

 Dividing in into small Sub problem which can be better managed.
  Finding out alternate methods of solving each sub problem
 Considering the merits and demerits of each method and
 Selecting one method which is most advantageous at that instance.

TECHNIQUES OF COGNITIVE THERAPY

PLAY THERAPY
Play therapy is a form of counseling or psychotherapy that uses play to
communicate with and help people, especially children, to prevent or resolve
psychosocial challenges. This is thought to help them towards better social
integration, growth and development, emotional modulation, and trauma
resolution.

WHAT IS PLAY THERAPY?

At KNBP we offer play therapy to 5-11 year olds. The therapy helps children to
express themselves, explore their thoughts and feelings and make sense of their life
experiences. The medium is considered highly effective as play is a natural activity
of learning, exploration and communication for children. It can help a child to
‘play out’ what they may find difficult to put into words.

Play therapists will work in a safe and trusting envrioment with the child, for
example at their school. This will help to shift perspectives of difficult experiences
and increase self-esteem and confidence. Play therapy aims to equip children with
adaptive behaviours and better coping mechanisms for everyday life. This is to
help them develop a more positive view of their place in the world.

WHAT CAN PLAY THERAPY HELP WITH?

Some of the common types of problems play therapists deal with include:

Children who have Attention Deficit Disorder (ADD/ADHD).

Children who are dealing with parental separation, divorce or conflict.

Children who have witnessed domestic violence.

Children who are in hospital.

Traumatised children who have experienced sexual, emotional or physical abuse.

Children in care – adoption and fostering.

Children dealing with stressful life experiences such as loss, illness or death of a
loved one.

Children who have experienced a serious accident or disaster.

WHAT ARE THE BENEFITS OF PLAY THERAPY?

Some of the specific benefits children can gain from play therapy include:

Reduced anxiety about traumatic events.

Improved confidence and a sense of competence.

Better able to form healthy bonds in relationships.

Improved ability to trust themselves and others.

Enhanced creativity Play therapy involves helping children from toddler to pre-
adolescent ages discover their interests and limits using movement that involves
playing. Play therapy is useful for helping children to overcome inhibitions and
improving the interactions these children have with other children and adults. It
also allows them to build confidence and self-esteem, besides establishing habits of
wellness that carry on beyond the time period of play therapy routines designed to
create specific outcomes. and playfulness.

Play is natural mode of growth and development in children.Through play a child

learns to express his emotions and it serves as a tool in the development of the
child.

CURATIVE FUNCTIONS
 It releases tension and pent-up emotions.
 It allows compensation for loss and failures.
 It improves emotional growth through his relationship with other
children.
 It provides an opportunity to the child to act out his fantasis and
conflicts, to get rid of aggression and to learn positive qualities from
other children.

DIAGNOSTIC FUNCTIONS

 Play therapy gives the therapist a chance to explore family

relationship of the child and discover what difficulties are contributing
to the child’s problem.
 Play therapy allow studying hidden aspects of the child personality.
 It is possible to obtain a good idea of the intelligence level of the
child.
 Through play inter-sibling relationships can be adequately studied.
 TYPES OF PLAY THERAPY
INDIVIDUAL VS GROUP PLAY THERAPY

In individual therapy, the child is allowed to play by himself and the

therapist’s attention is focused on this one child alone. In group play
therapy, other children are involved.

FREE PLAY VS CONTROLLED PLAY THERAPY

In free play, the child is given freedom in deciding with what toys he want
to play. In unstructured play therapy no situation is set and no plans are followed.

STRUCTURED VS UNSTRUCTURED PLAY THERAPY

Structured play therapy involves organizing the situation in such a way so as to

obtain more information. In unstructured play therapy no situation is set and no
plans are followed.

DIECTIVE Vs NON DIRECTIVE PLAY THERAPY

In directive play therapy, the therapist totally sets the directions, whereas in non-
directive play therapy, the child receives no directions. Play therapy is generally
conducted in a playroom. The playroom should be suitably stocked with adequate
play material, depending upon the problems of the child.