COGNITIVE-

BEHAVIORAL
THERAPY
BENEDICT ZULUETA
 Contents
Topics Covered
Overview

Rational Emotive Behavior Therapy

Cognitive Therapy

Mindfulness-Based Cognitive Therapy

Dialectical Behavior Therapy

Acceptance and Commitment Therapy

 Discuss the theoretical framework of CBT.
Lesson Compare various techniques under CBT.
Objectives Assess the appropriateness of CBT as an
intervention for different psychopathologies.
 Cognitive Behavioral Therapy (CBT) is a form of
psychotherapy that focuses on changing negative
thought patterns and behaviors to improve mental
health and emotional well-being.
Overview:
CBT is based on the idea that our thoughts, feelings,
and behaviors are interconnected and that changing
our negative thoughts and behaviors can lead to
positive changes in our emotions and overall mental
health.
 Theoretical Framework
Cognitive theory suggests that our
thoughts and beliefs play a significant role in
determining how we feel and behave.
According to this theory, negative and distorted
thinking patterns can lead to negative
emotions and behaviors.

Behavior theory suggests that our

behaviors are learned through our
experiences and interactions with the
environment.
 Forms of Cognitive Therapies

RATIONAL-EMOTIVE COGNITIVE MINDFULNESS-BASED

BEHAVIOR THERAPY THERAPY COGNITIVE THERAPY

Deals with emotional, behavioral, Identifies and challenges Combines elements of

and thinking components of negative automatic mindfulness and CBT
human disturbance. thoughts.

DIALECTICAL BEHAVIOR ACCEPTANCE AND

THERAPY COMMITMENT THERAPY

Combines elements of CBT with skills Focuses on psychological flexibility by

training and mindfulness techniques. acceptance of thoughts and emotions and
action commitment
Characteristics common to all forms of
Cognitive Therapy
COGNITIONS
Refer to a person's thoughts, beliefs, attitudes, and
interpretations of their experiences.

CHANGING THINKING PATTERNS

Replacing maladaptive thinking patterns to adaptive thinking
patterns.
Characteristics common to all forms of
Cognitive Therapy
DYSFUNCTIONAL THINKING IN EARLY LIFE
Dysfunctional thinking patterns can start early in life and can
dominate feelings and behavior.

SOCRATIC DIALOGUE
Inductive reasoning can relieve symptoms and promote
good mental health.
Characteristics Common to all Forms
of Cognitive Therapy
EDUCATIONAL, STRUCTURED, AND DIRECTIVE
Homework is assigned so learning can be applied outside the
clinic

COLLABORATIVE
Client must be involved in the treatment plan, but it is not the
primary focus of therapy.
RATIONAL EMOTIVE
BEHAVIOR THERAPY
Albert Ellis
 Theory of Rational-Emotive
Behavior Therapy

STOICISM
The belief about an event, not the event itself, makes people
unhappy.
People create their own misery due to their unnecessary
irrational thinking.
ABCDE model
 ABCDE Model
This model illustrates how humans disturb themselves and can
un-disturb themselves.

The activating The emotional The process of

event. and behavioral challenging and
consequences disputing
The thoughts of the beliefs. irrational beliefs.
and The process of
interpretations challenging and
about the disputing
activating event. irrational beliefs.
 ABCDE Model

A- Activating event
B- Belief
C- Consequence
D- Dispute
E- Effective philosophy
 Common Irrational Beliefs
It is an absolute
We have no control of
necessity for adults to
It is horrible when things our emotions, and we
be loved by significant
do not turn out the way cannot stop feeling
others for nearly
we want them. disturbed about things.
everything they do.

It is easier to avoid than

Certain actions are to face life's difficulties
If something once
awful or wicked, and the and self-responsibilities.
strongly affected our life,
people who perform the
it should continue to
acts should be severely
We must have certainty affect it indeffinitely.
damned.
and control over things.
 Three major core IrB

You must treat

me well The world
I must do well must be easy
 People will make themselves feel angry,
guilty, anxious, or depressed by:

Making dogmatic demands in the form of musts, shoulds,

and oughts.
Awfulizing
Low frustration tolerance
Rating self and others
Holding onto absolutist desires
Irrational Process
1. Demandingness is based on a belief in universal musts (must-ification,
must-urbation, and shoulds)
2. Awfulizing is catastrophizing or exaggerating the importance of
negative events leading to feelings of anxiety, fear, and panic.
3. Low frustration tolerance is a belief that the person cannot stand it
when things do not go the way the person wants.
4. Rating of self-worth and others are based on the belief that people can
be rated either negatively or positively.
 Disputation
Challenging irrational beliefs using scientifically testable
hypotheses about the self and the world. D is necessary for
effective E.
 Logically
Is my belief logical?
Empirically Does is follow from my
Is there any evidence for this precedence?
belief?
Is it consistent with social
Pragmatically
reality?
Is there any evidence against Even if this belief is true, is
this belief? it really that awful?
Can I not stand it?
Is it helpful?
 The process of replacing irrational
beliefs with more rational and
adaptive ones.
Effective
New Beliefs 1. Unconditional self-acceptance
2. Unconditional other acceptance
and 3. Unconditional acceptance of life
Philosophies
 Normal & Abnormal

Self-accepting, others Holds IrB that results in

accepting, life-accepting unhealthy emotions.
Constantly working to Have low frustration
maintain healthy tolerance
personalities. Absolutist demands
 THERAPEUTIC TECHNIQUE
Disputing and Challenging
Uses the Socratic method.
Analysis of causes of
disturbance within ABCDE Homework
format. Negotiated each session.
Helps in developing higher Indicates that the client is able to
frustration tolerance. take primary responsibility for
change and integrate the learning
from therapy to real lfe.
 THERAPEUTIC TECHNIQUE
REBT Self-help form
Learning the ABCDE
method outside the therapy Role Playing and Exercises
session Giving the client practice in
appropriate response to
Psychoeducation problem situation.
Key ingredient of REBT Helps the client to develop
Includes using books, higher frustration tolerance
videos, and audiotapes.
 The Process of Therapy
Familizaring the client with basic REBT principles.
Identifying the A-C connection, then the B-C connection,
integrating the ABCDE model.
Deepening the understanding of the ABCDE model and
Socratic dialogue and using self-help forms frequently.
If homeworks are missed, explore why.
Termination occurs when REBT is ingrained within the client.
Remissions can still happen, but clients become better at
handling activating events.
COGNITIVE
THERAPY
AARON BECK
 Emphasized the role of cognition in information
processing and its effect on motivation, emotion, and
physiology.
Specific learning experience teaches the client to
change maladaptive thinking to productive thinking.

Cognitive Triad:
Negative view Theory of
of the self
Cognitive
Negative view Negative view
Therapy
of the world of the future
 Automatic
Thoughts
What are the key Thoughts that occur

Theoretical spontaneously in
response to a situation
concepts of Beck's or stimulus

Cognitive Therapy? They are often negative,

irrational, or distorted,
and can contribute to
emotional distress.
 Arbitrary Inference
Personalization
Concluding without
Attributes the cause of
evidence.
(Example: catastrophizing)
tan external event to
himself.
Cognitive
Distortions Polarized or Overgeneralization
Dichotomous Thinking The person makes up a
These thinking patterns Seeing things in all-or- general rule about isolated
are biased or inaccurate nothing terms. incidents and then apply it
and can lead to negative inappropriately to other
automatic thoughts that Magnification and events.
maintain dysfunctional
Minimization
thinking .
Exaggerating or dismissing Selective Abstraction
the importance of a real Taking information out of
problem. context and ignores other
information.
 Cognitive Conceptual
Cognitive Core beliefs,
Schemas interpretations, meaning-
Systematic making
These are deeply
ingrained beliefs and Biases Affective
assumptions about Positive or negative
The ways in which
oneself, others, and the feelings
people's thoughts and
world.
beliefs are influenced by Affective
their experiences and Positive or negative
cultural context. feelings
Negative cognitive Behavioral
schema can lead to
Actions
unhealthy emotions and
behaviors. Motivational
 Mode
The action as a system
of the five different
schemas.
Maladaptive modes are
the basis of various
psychopathologies
 NORMAL BEHAVIOR
People who interpret life events accurately
have functional thoughts and a positive
Normal & cognitive schema.

Abnormal ABNORMAL BEHAVIOR

Behavior People who have faulty thinking,
makes logical errors and cognitive
distortions, and possesses systematic
biases.
Therapeutic Techniques
IDENTIFY, RECOGNIZE, AND QUESTION
UNDERLYING AUTOMATIC THOUGHTS
The client must learn to critique his thoughts for
inconsistencies, contradictions, and errors.

IDENTIFY, RECOGNIZE, AND QUESTION

MALADPTIVE ASSUMPTIONS OR
THEMES IN AUTOMATIC THOUGHTS
Look for inconsistencies, contradictions, and errors within
these assumptions.
Therapeutic Techniques
USE LOGIC, HYPOTHESIS TESTING, AND
SOCRATIC DIALOGUE TO CHALLENGE
AUTOMATIC THOUGHTS AND DYSFUNCTIONAL
COGNITIVE DISTORTIONS
Specific Techniques
Exercises
Activity scheduling
Decatastrophize Psychoeducation
Decenter
Daily records of dysfunctional
Redefine
thoughts
Advantages and disadvantages
Triple-column technique
Role-playing
Homework
Guided discovery
Coping cards
Group therapy
Specific Techniques
Cognitive Mapping for case
Analysis
Provides an outline to use in analysis of the client's core
belief, assumptions, coping strategies, situations, automatic
thoughts, and reaction
THE THIRD WAVE:
MINDFULNESS- AND
ACCEPTANCE-BASED
THERAPIES
 Theory
Mindfulness
Paying attention in Innate human
the present moment capacity to
Awareness of
to whatever arises deliberately pay full
present
internally or attention to where
experience with
externally without we are, to our actual
acceptance
wishing things were experience, and to
otherwise. learn from it.
 Acceptance and
Commitment Therapy
Steven C. Hayes

Internal psychological
Acceptance processes

Individuals with psychological

problems have not accepted
these private events but dodged
and ducked them via
distractions.
Basic Tenets of Acceptance

The longer we can

acknowledge our
thoughts without We need to stop
compulsively reacting, battling for control with
the better our chances these experiences
of psychological well-
being.
 Commitment to personal
Commitment values.

Taking Action Taking actions consistent

with personal values.
 Strategy to Psychological
Wellness
ussion with inner feelings

valuation of inner experience

voidance of an unpleasant experience by distraction or
numbing

eason-giving, illegitimate rationalizations

 Strategy to Psychological
Wellness

ccepting one's inner experiences for what they are

hoosing directions in life based on core values

aking action in matters large or small that are consonant

with valued
 Dialectical Behavior Therapy
Marsha Linehan

Problem-solving Validation Dialectics

Helping the client Focuses on Exchanges between
think through a validation of client and therapist to
situation. feelings resolve simultaneous

and contradictory
Discussing factors feelings.
that inhibits
problem-solving.

 Skills Training
Emotion regulation

Distress tolerance

Interpersonal effectiveness

Mindfulness Skill
 Mindfulness-based Cognitive
Therapy
Zindel Segal, Mark Williams, and John Teasdale

A combination of cognitive behavioral therapy (CBT),

meditation, and the cultivation of a present-oriented, non-
judgmental attitude called "mindfulness."​
Techniques
Body-scan exercise
Meditation This involves lying down and
bringing awareness and attention
Helps to gain a
to different areas of the body
greater awareness
of their body,
thoughts, and
breathing.
 Techniques
Mindfulness Practice Mindfulness Stretching
Mindfulness This activity involves stretching
involves becoming mindfully to help bring awareness
more aware of the to both the body and mind.
present moment.