Outline of CBT In the Pre-Recorded Lecture

A. Introduction
a. A widely used approach in psychotherapy.
b. Commonly used in person who have depression, anxiety , panic disorder, PTSD,
and personality disorders.
c. It modifies the faulty thought processes.

B. Major Contributors
a. Albert Ellis developed the Rational Emotive Behavior Therapy (REBT).
b. Aaron Beck developed Cognitive Therapy.
c. Donald Meichenbaum developed cognitive behavior modification technique.

C. What is CBT?
a. The therapy is based on how we think, how we feel and how we act all interact
together.
b. our thoughts determine our feeling and our behavior.
c. Negative and unrealistic thoughts can cause us distress and result in problems.
d. The goal of CBT is to modify the negative and unrealistic thoughts or to identify
and modify the faulty thinking.

D. Rational Emotive Behavior Therapy- Albert Ellis

a. focuses on resolving emotional and behavioral problems that was caused by
irrational beliefs.
b. The goal of the therapy is to change irrational beliefs to more rational ones.
c. People create their psychological problems by the way they responded to and
interpret events in their life.
i. 11 irrational ideas that cause people develop maladaptive behaviors:
ii. Irrational Belief 1- must have love and approval from all people you find
significant.
iii. Irrational Belief 2 - nobody is good at everything and people do fall
sometimes.
iv. Irrational Belief 3- when people act obnoxiously and unfairly you should
blame and damn them and see them as bad, wicked or horrible people.
v. Irrational Belief 4- you have to see things as awful, terrible and horrible
when things go wrong.
vi. Irrational Belief 5- emotional unhappiness stems from external pressures and
that you have little capacity to control or to change your feelings.
vii. Irrational Belied 6- catastrophizing belief.
viii. Irrational Belief 7- avoiding life’s challenges is more rewarding than seeking
challenges.
ix. Irrational Belief 8- you need to be dependent on someone stronger that
yourself.
 x. Irrational Belief 9 - past events in our lives determine our destinies and that
because an event once had a strong influence on our lives, it will continue to
do so.
xi. Irrational Belief 10- it is irrational for us to become unduly upset about
people’s problems.
xii. Irrational Belief 11- it is irrational for you to believe that there is always a
right, precise and perfect solution to human problems, and it is catastrophic if
this perfect solution is not found.
d. A-B-C framework
i. A major aid in cognitive therapy is called the ABC Technique of irrational
beliefs.
ii. A- activating event.
iii. B- belief system
iv. C- cognitive and emotional effects of revised beliefs.
v. D- disputing irrational thought and beliefs.
vi. E- emotional consequences of A and B.
e. Therapeutic process
i. designed to help gain a more realistic, rational philosophy in life.
ii. intended to be brief therapy.
iii. practitioners do not devote a great deal of time listening to clients histories or
their long tales of distress.
f. Emotive Techniques
i. Rational emotive imagery
 a form of intense mental practice designed to establish new emotional
patterns.
 clients are asked to vividly imagine one of the worst things that might
happen to them.
ii. Using humor
 emotional disturbance often results from taking oneself too seriously,
thus a good deal of humor approach can be employed.
iii. Shame-attacking exercises
 Performing and practicing the behavior feeling of shame, guilt, anxiety
and depression; until it reaches the point of thinking that there is
nothing to be ashamed of.

E. Aaron Beck’ s Cognitive Therapy

a. Was developed as a result of his research on depression.
b. Rooted in psychoanalysis.
c. Perceives psychological problems as stemming from commonplace
processes:
i. faulty thinking
ii. making incorrect inferences on the basis on inadequate or incorrect
information
iii. failing to distinguish between fantasy and reality.
d. Basic Principles of Cognitive Therapy
i. Automatic Thoughts
  Occur spontaneously, without effort of choices.
 often distorted, extreme or otherwise inaccurate
 can cause an effective state to rise.
 can become habitual and pass so quickly that people may not be
aware of their presence even though these habits deeply affect
emotions and behavior.
ii. Cognitive Distortions-appears when information processing is
inaccurate or ineffective.
1. Arbitrary Inference
 Concluding directly even without relevant evidence to
support it and it ignores information that contradicts the
belief. Also do catastrophizing.
2. Magnification and Minimization
 The person conceptualizes something as more or less
significant than it is in reality.
3. Personalization
 Self-blaming
4. Overgeneralizing
 Generalizing that all can cause same isolated incident and
applies it inappropriate to other situations.
5. Selective Abstraction
 The person takes the information out of contact and ignores
other information.
 David Burns this negative mental filter where the person
picks out single negative details and dwells on it exclusively.
6. Polarized or Dichotomous Thinking
 The person pigeonholes events in extreme or as
dichotomies either/or, good/bad, black/white with no shades
of gray.
 This is also called all-or-nothing thinking or labeling.

e. Goals of Cognitive Therapy

i. To remove biases or distortions in thinking
ii. Attention is paid to the way individual’s process information which
may maintain maladaptive feelings and behaviors.
iii. Patient’s cognitive distortions are challenged, tested and discussed to
bring out more positive feelings, behaviors and thinking.
iv. Therapists attend not just to automatic thoughts but also to cognitive
schemas that may represent.
v. Cognitive therapist focused on being specified, prioritizing goals and
working collaboratively with clients.
f. Therapeutic Relationship
 Work collaboratively where therapist guides and helping the client
in determining and reaching the goals in the therapy. Whereas
 clients take responsibility in its progress by completing the assigned
homework.
g. Therapeutic Process
i. It is a structure approach.
ii. Initial session deals with:
 Assessment of the problem,
 Development of the client and therapist relationship
 Case conceptualization
h. Aspect of the Therapeutic Process
i. Guided discovery or Socratic Dialogue
 Helps to change maladaptive beliefs and assumptions by
asking series of questions that relates to the existing
information to challenge beliefs.
 Three-questions technique- a Socratic method to revise
negative feelings.
1. What is the evidence for the belief?
2. How else can you interpret the situation?
3. If it is true, what are the implications?
ii. Homework
 Specific assignments are given to help the client collect data,
test cognitive and behavior changes and work on material
developed in previous session.
iii. Session Format
 Therapists have their own format that they adapt for different
client problems.
 Therapist and client review homework to see how the client
could get more out of it.

F. Donald Meichenbaum’s Cognitive Behavior Modification

a. Focuses on charging the clients self-verbalizations. Identifying and modifying the
negative self-talk.
b. combines some of the best elements of behavior therapy and cognitive therapy.
c. A basic premise is that clients, as a prerequisite to behavior change, must notice
how they think, fee and behave and the impact they have on others.
d. For change to occur, clients need to interrupt the scripted nature of their behavior
so that they can evaluate their behavior in various situations.
e. How Behavior Changes
1. Phase 1: Self-observation
 Clients learning how to observe their own behavior especially their
negative self-statements and imagery.

2. Phase 2: Starting a new internal dialogue.

 Clients learn to notice their maladaptive behaviors and they begin
to see opportunities for adaptive behavioral alternatives.
3. Phase 3: Learning new skills.
  Helping clients interrupt the downward spiral of thinking, feeling and
behaving and teaching them more adaptive ways of coping using
the resources they bring to therapy.
G. Limitations
a. Lack of attention to unconscious factors in determining behavior.
b. Doesn’t pay attention to the feelings.
c. No insights or emphasis on the past issues like childhood issues.
Outline of CBT Structure of a CBT Session
A. Importance
a. Helps the therapist to be more time efficient.
b. Helps client to understand and what they can expect from the sessions.
B. The Flow of the structure of CBT
a. Maintaining and reestablishing the therapeutic alliance between therapist and
client.
i. Checking on how clients are doing.
ii. Checking clients mood.
iii. Asking on the responses of the session measures.
iv. Asking about the last session therapy.
b. Asking about the plan the action plan and collaboratively work to set an agenda
what is the most important to achieve in the therapy session.
c. Asking clients a summary in the end of every session or what are the learnings
that takes places from the end of each session.
i. Asking what is the most important for them to keep in mind in this week?
ii. Asking what was the most helpful part that was taken from the session?
d. Getting Feedback about the sessions itself.
i. Asking what they think about the session.
ii. Asking opinions and suggestion of how they think of the therapist
performance during the therapy session.
Outline of CBT In Case of Stan
A. Stan’s Problem
a. self-defeating beliefs
B. Therapist Goals
a. to identify Stan’s problems
b. to formulate specific goals
c. to help Stan to reconceptualize his problems to increase Stan’s chances of
finding solutions.

C. Structure of the therapy sessions

 a. Working collaboratively and guiding Stan in discovering some basic cognitions
that influence what he tells himself and how he feels and acts.
b. Assisting Stan in monitoring, evaluating, clarifying specific problems and learning
how to critically evaluate some of his faulty thinking.
c. Drawing on a variety of cognitive and behavioral techniques to help Stan make
the changes he most desires.
d. Working collaboratively with Stan in creating specific homework assignments to
help him deal with his fears.
D. Cognitive techniques
a. Socratic questioning
b. Guided discovery
c. Cognitive restructuring
E. Results of the therapy
a. he learns to label distortions and is able to automatically identify his dysfunctional
thoughts and monitor his cognitive patterns.
b. he is able to acquire new information, change his basic beliefs, and implement
new and more effective behavior.