EREÑO PS3A Cognitive Behavioral Therapy (CBT)


Cognitive behavioral therapy stresses the role of thinking in how we feel and what we do. It is based on the belief that thoughts, rather than people or events, cause our negative feelings. The therapist assists the patient in identifying, testing the reality of, and correcting dysfunctional beliefs underlying his or her thinking. The therapist then helps the client modify those thoughts and the behaviors that flow from them. CBT is a structured collaboration between therapist and client and often calls for homework assignments. CBT has been clinically proven to help clients in a relatively short amount of time with a wide range of disorders, including depression and anxiety. CBT can help you to change how you think ('Cognitive') and what you do ('Behavior'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. Change: your thoughts and actions Homework: practice makes perfect Action: don't just talk, do! Need: pinpoint the problem Goals: move towards them Evidence: shows CBT can work View: events from another angle I can do it: self-help approach Experience: test out your beliefs Write it down: to remember progress

Rational Emotive Behavioral Therapy (REBT) Rational emotive behavioral therapy is a highly action-oriented and deals with the client's cognitive and moral state. This therapy stresses the client s ability of thinking on their own and in their ability to change. The rational-emotive therapist believes that we are born with the ability of rational thinking but that my fall victim to irrational thinking. They stress the client s ability to think, in making good judgments, and in taking action. The therapist will use directed therapy. The therapist believes that a neurosis is a result of irrational behavior and irrational thinking. The Rational-emotive and Cognitivebehavioral therapist believe the clients problems are rooted in childhood and in their belief system, that was formed in childhood. Therapy will include method is solving and dealing with emotional or behavior problems. The therapist will help the client to eliminate any self-defeating outlooks they may have and to view life in a rational way. The therapist will never have a personal relationship with the client. The therapist will think of the client as a student and themselves as the teacher.

Commonalities between all Cognitive Behavioral Approaches y y y y y Collaborative relationship between therapist and client Premise psychological distress is largely a function of disturbance in cognitive processes Focus on changing cognitions and behaviors to produce desired changes Stresses thinking, judging, deciding, analyzing and doing Teaches that our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations

Assumptions y y y People contribute to their own psychological problems and symptoms by the way they interpret events and situations Reorganization of one s self-statements will result in reorganization of one s behaviors Operant conditioning, modeling and behavioral rehearsal applied to thinking and internal dialogue

View of Human Nature (neutral) We are neither all evil nor all good but have a little of God and the Devil in us. We are programmed to be rational and irrational in our thinking, to be self-actualizing and self-defeating. The focus is on the behavior, not the person a person is not good or bad, but the behavior is good or bad depending on the consensus of community standards. We have the inborn tendency toward growth and actualization but we sabotage ourselves with self-defeating patterns. We do not NEED to be accepted and loved, but we believe we do and when we don't feel loved and accepted we become anxious, depressed and filled with a sense of worthlessness. Key Concepts ‡ Although emotional disturbance is rooted in childhood, we continue to disturb ourselves through our irrational and illogical thinking. Emotional problems are the result of our beliefs, which need to be challenged. A-B-C theory of personality: A is the actual event, B is our belief system, C is the consequence. We do not need to change A to change C, we only need to change B.


Emotional Disturbances y y y y We actively reinforce self-defeating beliefs by the processes of autosuggestion and selfrepetition Blame is the core of emotional disturbances To recover from neurosis (personality disorder), we need to stop blaming ourselves and others We escalate desires and preferences into dogmatic and absolutist shoulds, musts, oughts, demands, and commands which are irrational beliefs which need to be changed

Irrational beliefs


Irrational ideas lead to self-defeating behaviors Some examples: y y y I must have love or approval from all the significant people in my life I must perform important tasks competently and perfectly If I don t get what I want, it s terrible, and I can t stand it

Therapeutic Relationship ‡ Warm relationship is not essential, but client must feel acceptance from the therapist. The therapist does not blame or condemn clients, but rather teaches them how to avoid rating and condemning themselves. Therapist is a teacher, client is student. Therapist is active and directive. Therapy is generally short-term clients are taught how to apply the model to other problems.

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Therapeutic Goals: ‡ ‡ ‡ ‡ The goal is to eliminate a self-defeating outlook on life and acquire a more rational and tolerant philosophy. Clients are taught that the events in life do not disturb us, but rather our interpretation of these events. Clients are taught how to identify and uproot their shoulds and musts and oughts . They are taught to substitute preferences for demands. Therapy is focused on the here-and-now; what is presently disturbing and how can client change the patterns of thinking and feeling that were constructed earlier.

Techniques and procedures Borrows many cognitive, affective and behavioral techniques from other models, and will fit techniques to individual client. Will use humor, imagery, role-playing, using force and vigor to dispute irrational beliefs, cognitive homework, and shame-attacking techniques. The techniques are used to induce clients to examine their present beliefs and behavior. Clients are given homework assignments to put into practice the changes. Disputing Intervention y y Challenges irrational beliefs Use principles of logic to destroy unrealistic, unverifiable hypotheses 1. Detect detect shoulds, I musts, awfulizing, self-downing 2. Debate learn to logically and empirically question beliefs, to argue self out of them 3. Discriminate irrational self-defeating from rational self-helping beliefs

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