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Theories of Counseling:

Cognitive Behavior Therapy

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Copyright Allyn & Bacon 2004

Cognitive Behavior Therapy


Basic Tenets

The main theories are Cognitive Behavior Therapy, Rational Emotive


Behavior Therapy and Cognitive Behavior Modification.

The way individuals structure and interpret experiences, determines their


moods and behaviors.

Changing conceptualizations lies at the heart of cognitive behavioral


therapy.

Combines both cognitive and behavioral approaches.


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Cognitive Behavior Therapy

What do
I think

Basic Tenets

Cognitive therapy rests upon the belief that what one thinks determines
how one feels.

The therapist is supportive and empathic and uses experiments and


empirical processes along with a collaborative alliance with the client, to
explore thinking and alternatives.

Cognitive therapy has been used with a variety of disorders and problems
(e.g. anxiety, phobias, depression).

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Cognitive Behavior Therapy


Theory of Personality

Personality includes both genetic endowment and social influence.

It reflects the individuals cognitive organization and structure.

Emotions and behaviors are based on perceptions, interpretations, and


assumptions.

Schemas have an important impact on how one operates cognitively.

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Cognitive Behavior Therapy


Theory of Personality

Schemas: A persons core beliefs and basic assumptions.

Schemas can either be functional or dysfunctional and more than one


schema can compete with another.

Cognitive Vulnerability: When a persons beliefs and assumptions


predispose him or her to psychological distress.

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Cognitive Behavior Therapy


Nature of Maladjustment.

Maladjustment stems from irrational beliefs and distorted cognitions.

Maladaptive cognitions come from:

Selective attention
Misperception
Maladaptive focusing
Maladaptive self-arousal
Repertory deficiencies

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Cognitive Behavior Therapy


Nature of Maladjustment.

Maladaptive cognitions lead to maladaptive, self-defeating behaviors.

Adaptive, self-enhancing behaviors come from a clients self-enhancing


thoughts and this can be taught.

Clients can be taught to shift from self-defeating thoughts to selfenhancing thoughts.

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Cognitive Behavior Therapy


The Counseling Process

Cognitive therapy and cognitive behavior modification uses a variety of


techniques or procedures to assist clients in changing negative, self
defeating responses.

The therapist might range from directive to unconditionally accepting, from


scientific to empathic, from systemic to open or from suggestive to
instructive.

It is highly eclectic and utilizes resources and techniques that fit with the
clients thought processes.

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Cognitive Behavior Therapy


The Counseling Process

Both cognitive and behavioral strategies might be used.

Client and therapist work together:

to help the client gain cognitive and behavioral control over his or her
problem.
to look at different ways of behaving.

to analyze thoughts and emotions.

to practice new cognitive and behavioral patterns.


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Cognitive Behavior Therapy


Strategies for Helping Clients
Becks cognitive psychotherapy

The goals are to correct faulty information processing and help clients
modify their assumptions that maintain their maladaptive behaviors and
emotions.

Collaborative Empiricism: Therapist and client are coinvestigators.

Guided Discovery: Guided by the therapist, the client engages in


experiments that result in more adaptive ways of thinking.

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Cognitive Behavior Therapy


Strategies for Helping Clients
Relaxation Training and Relaxation Therapy

A person cannot be in a state of complete physical relaxation while at the


same time be emotionally anxious.

Works well for stress, anxiety, physiological problems, workplace


pressures, and coping with modern lifestyles.

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Cognitive Behavior Therapy


Strategies for Helping Clients
Mental and Emotive Imagery

Mental Imagery is a process through which a person focuses on vivid


mental pictures of experiences or eventspast, present or future.

Emotive Imagery: It is a procedure where the client imagines the


emotional sensations and feelings of an actual situation or behavior.

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Cognitive Behavior Therapy


Strategies for Helping Clients

Cognitive Modeling: Identification of what maladaptive or bad thoughts or


emotions the client wishes to be rid of and then the therapist models with
self-talk that the client will incorporate.

Covert Modeling: A client imagines engaging in the desired behaviors he


or she wants to learn or adopt.

Thought Stopping: Interruption of unwanted thoughts when they occur by


shouting stop whenever the unwanted thought pops into consciousness.

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Cognitive Behavior Therapy


Strategies for Helping Clients

Cognitive Restructuring: Replacement of negative, maladaptive thoughts


with positive, adaptive ones.

Reframing: To modify or restructure a persons view or perception


regarding a problem or behavior.

Stress Inoculation: A process of teaching clients both cognitive and


physical skills for autonomously coping with future stressful and
distressing situations.

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Cognitive Behavior Therapy


Strategies for Helping Clients

Meditation and Relaxation: Helps the client concentrate on some internal


or external stimulus that serves to focus the clients attention away from
aversive stimuli.

Biofeedback: Uses technology to communicate to a client what his or her


own body is doing and then allows that person to use mental processes to
control bodily functions.

Neurolinguistic programming: Using the clients sensory language to fully


experience the clients inner world (e.g. I see that (visual); I feel that
(kinesthetic) ; I hear that auditory).
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Cognitive Behavior Therapy


Strategies for Helping Clients

Eye Movement Desensitization Reprocessing (EMDR):

Used primarily to treat traumatic memories.

The client imagines the scene, is aware of the negative statement


regarding that scene (along with noxious feelings), and then follows
the therapists finger with his or her eyes.

Then the client erases the image from his or her mind.

This is continued over a series of steps until hopefully the painful


image and noxious feelings and memories are removed.
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Cognitive Behavior Therapy


Advantages of Cognitive Behavior Therapy

It has established human thought processes as data or events that can be


studied.

It validated a number of relaxation techniques.

It has enhanced the rational therapies such as Rational Emotive Behavior


Therapy.

Uses the systematic scientist-practitioner model.

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Cognitive Behavior Therapy


Disadvantages of Cognitive Behavior Therapy

It has been harshly judged by feminists, multiculturalists and ecologists


because it mirrors masculine and Euro-American worldviews and does
not adequately take culture into consideration.

It requires a lot of training and skill.

The therapist needs to not only understand cognitive techniques but also
have a vast understanding of behavioral and learning theories.

The therapist needs to have strong discipline and there is less tolerance
for error.
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Cognitive Behavior Therapy


Cognitive Behavior Therapy with Diverse Populations

It matches problems to treatments without regard for race or cultural


considerations.

It can be used effectively if culture and the clients worldview is take into
consideration.

Therapy is a collaboration and depends upon trust between counselor


and client and this can work well with culturally diverse clients.

Copyright Allyn & Bacon 2004

Resources
Ivey, A. E., DAndrea, M., Ivey, M. B. and Morgan, L. S. (2002). Theories of counseling
and psychotherapy: A multicultural perspective, 5th ed. Boston, MA.: Allyn &
Bacon.
James, R. K. & Gilliland, B. E. (2003). Theories and strategies in counseling and
psychotherapy, 5th ed. Boston, MA: Allyn & Bacon.
Kottler, J. A. (2002). Theories in counseling and therapy: An experiential approach.
Boston, MA: Allyn & Bacon.

Copyright Allyn & Bacon 2004