Cognitive Behavioral Therapy Workshop Wendy Danicourt, CAP, CET, CMHP Operation PAR, Inc. This product was supported by the Florida Department of Children and Families Substance Abuse and Mental Health Program Office funding.
Welcome Who is the trainer? Who are the participants? Break the ice exercise Welcome
Objectives Understand the basic principles of Cognitive Behavioral Therapy (CBT) and their application in clinical practice. Explore methods to engage a client/patient in CBT, establish a collaborative relationship and set goals. Practice basic CBT techniques, including cognitive exercises, behavioral exercises, and use of homework.
Why Are You Here Today? What are the participants wanting to get out of the training? How do you use CBT now? Where do you want a little help? Challenges of CBT?
Overview of CBT
What is CBT? Based on Cognitive Behavioral Theory Collaborative between therapist and client Learning skills and applying skills
Who Uses CBT? Mental Health Substance Abuse Medical Behavioral Who Else?
What Is It Good For? ……. Depression OCD Anxiety Chronic Pain Substance Abuse Eating Disorder Anger Management Insomnia Post Traumatic Stress Disorder (PTSD) ……. Personality Disorders
Cultural Implications Essential - understand and respect Who is in charge of the challenges and determination
Limitations or are they? Positive Thinking Superficial Technique-oriented No therapeutic relationship Focus on symptoms Ignoring client past Emotions are played down or result of faulty thinking While CBT does have limitations it remains to be one of the most effective and well-researched modality
Stand Alone? Counseling Style Evidence Based Practices 12 Step Vs. Other Theories actually - focus on incorporating techniques from other approaches challenges? you betcha
Premise
Thinking, feeling and doing separate realms of human process that become associated through learning Proximity of association increases the strength of the relationship between thinking, feeling and doing Associations can become triggers and cues or reinforce the desire for the associated behavior
B.F. Skinner Behavior that is positively reinforced will reoccur; intermittent reinforcement is particularly effective Information should be presented in small amounts so that responses can be reinforced (SHAPING) Condition vs. Innate Reflex
Carl Roger’s Significant learning takes place when the subject matter is relevant to the Learner Learning proceeds faster when threat to self if low Most lasting learning - self-initiated Client Centered
Bandura Highest level of observational learning is achieved by first organizing & rehearsing the modeled behavior Individuals more likely to adopt a modeled behavior if it results in an outcome they value Individuals are more likely to adopt a modeled behavior if the model is similar to the observer, has admired status & behavior has functional value Observational Learning
Miller and Rollnick Develop discrepancy, empathize, avoid arguments, roll with resistance, support self- efficacy (DEARS) Change elicited from the client Client in charge - articulate and resolve ambivalence Therapeutic relationship - partnership Motivational Interviewing
Key Concepts
Assessment Precise Goals Plan Evaluate
Dispute irrational beliefs/ catastrophizing/ misconceptions Break through isolation Skill development Realistic Homework Recognize px & link to consequences Change language Psych educational Feedback Role-playing
Promotes change Alleviate emotional distress Addresses whole person Collaborative Structured and focused
Role - Therapist Therapist: combine empathy and sensitivity Technical competence Client centered Creative, active, interactive Knowledgeable and skilled in strategies Able to educate Catalyst/guide emphasis on therapeutic relationship
Role - Client/Patient Very active - in session and out of session Identify the distortions in thinking Summarize Self-discovery Becoming their own therapist
Settings - Individual
Settings - Family Family schemata Exerting a mutual influence on one another Dattilio: selective attention, attributions, expectations, assumptions, and standards
Settings - Group Welcome Check-in Review Introduce new skill Education Use of skill Homework Commitment Summary
Sessions - Helpful Hints Go in with a goal Have and know information/education Structure Small steps Comfort with Role-play
Role Play
Summary