Y-CHUN THROUGH A CBT LENS

In working with Y-Chun, as a CBT counsellor, your job is to help her identify irrational
thoughts that are causing her distress and to teach her the process of disputing irrational
beliefs and replacing them with rational ones.

If counselling is successful, Y-Chun will be able to think more rationally, will exhibit better
emotional health (be less disturbed), and will select more adaptable behaviours.

After Y-Chun learns to identify and dispute irrational beliefs, she will be able to apply the
techniques used in counselling to other irrational beliefs in her life.

This is the second session with Y-Chun. The first was an intake session.

Hello, Y-Chun. We will be recording today’s session so you can take the tape with you at the end of the session and use it to review what we
discussed. Last week, in our first session, when we completed the intake forms and assessment, you talked about your family—your parents, your
children, and your siblings. You were feeling all alone and like a failure at relationships. While you expressed concern about all your family
Counsellor:
relationships, you talked most about your relationship with your parents. So let’s start with your relationship with them and talk about your belief
system. When I say “belief system,” I am talking about the messages that you give yourself about your relationship with your parents. Messages
like, “My parents should love me. My parents should take care of me.” Can you pick up here and talk about your beliefs related to your parents?

Y-Chun: Okay. I’m not sure I can do what you want. I might get it wrong.

Counsellor: Do you mean not give me the right answer?

Y-Chun: (She nods her head.)

Counselling is not about being right or wrong. It’s about identifying thoughts that are a problem for you so you can choose more rational ways of
Counsellor:
thinking that work better for you. Now let’s give it a try. Your parents should …

I have always thought that my parents did not want any more children. They already had children before they married, so there was no need for
Y-Chun:
me.

Counsellor: What made you think that?

Y-Chun: My parents were always busy with work and each other. And then there were my stepbrothers and stepsister. They hated me too.

Counsellor: Did your stepbrothers and stepsister live with you and your parents?

Y-Chun: Yes, we all lived together in a very small house. I just want them to love me as much as they love my brothers and sister.

Counsellor: What makes you think that your parents love you less than they love your brothers and sister?

Y-Chun: They always expect more of me. I have to go to college so they’ll be proud of me.

Counsellor: You would like for your parents to be proud of you?

Y-Chun: Yes, so they will love me.

Counsellor: Are you thinking, “I must be perfect and do everything my parents want or they won’t love me”?

Y-Chun: Yes, that’s pretty much it.

What we think affects our feelings and our actions. Can you look back and see when you started thinking, “I must be perfect and do everything
Counsellor:
my parents want or they won’t love me”?

Y-Chun: Um … it was a long time ago. Maybe when I was 10 or 11. My oldest brother kept telling me that my parents were too old and did not want me.

Counsellor: Tell me what is different about your thoughts now when you think about your parents than when you were 10 or 11.

Um … I guess I haven’t changed my thoughts since then. I’m still thinking maybe my parents really did not want me and that I need to please
Y-Chun:
them to be loved.

Ideas for next session:

Rational coping statements are written by the client and repeated during the change
process to help the client dispute his or her irrational beliefs and change thinking to rational
beliefs. For example, a man is laid off from work after 19 years because his company is
downsizing. He is eligible to draw unemployment benefit while he is searching for a new job.
His coping statement might be, “I would prefer to stay at my old job; however, I do have
unemployment income while I find a new job.”

Stop and monitor is a reminder technique that places cues in the client’s environment to
remind him or her to stop and monitor thinking. For example, a client had the irrational
thoughts, “I am a loser” and “No one likes me.” She had these irrational thoughts for many
years and was having trouble disputing them. To help her replace these irrational
thoughts with rational ones, her counsellor helped her select a door as an environmental
cue. Anytime she walked through a doorway, she was to check her thoughts and redirect
them by saying, “I am a winner, and many people like me.”

Rational emotive problem solving: The counsellor may re-create a problem situation from
the client’s life during the therapy session.