Cognitive \ Behavioural Core Terminology Cognitive Event Thoughts and images that occur seemingly of their own volition in our stream of consciousness Cognitive Processes The process we use to appraise and transform external stimuli Cognitive Structures Beliefs, values and attitudes concerning ideas, people and personal experiences Inner speech Self talk, covert self instruction or inner dialogue

Cognitive \ Behavioural Three Focal Areas of Cognitive Behavioural Approach Cognitive Structures Inner Speech or Inner Dialogue Behaviour

Cognitive \ Behavioural Three Major Theories Rational Emotive Behavioural Therapy Cognitive Behavioural Therapy Cognitive Behavioural Modification

Cognitive \ Behavioural Albert Ellis – Rational Emotive Behaviour Therapy Ellis “It is not the events in our lives that directly influence our feelings and our behaviour, it is what we believe about these events that directly influences our feelings and subsequent behaviour”

Cognitive \ Behavioural The ABC’s A Activating event B Belief C Consequence Affect

Cognitive \ Behavioural Activating Events Events in our lives that draw our attention or involvement Beliefs How we understand the activating events Rational Beliefs Ideas based on logic and factual information Irrational Beliefs Ideas that are illogical (defy reason) or untrue (not supported by evidence)

Cognitive \ Behavioural What you think( B ) How you feel ( C ) What you do Friend is "She might have Worried or Call hospital ERs late for been hurt on the anxious to find out if she's dinner way here." there "She didn't bother Annoyed Chew her out, or to let me know she or angry act chilly, when was delayed." she does show up "It doesn't matter Indifferent Nothing in to me whether particular people are on time." "I needed the time Relieved Relax and enjoy to fix the house up yourself anyway." Dr. John Winston Bush - Cognitive-Behavior Therapy: New York Institute for Cognitive & Behavioral Therapies - A

Cognitive \ Behavioural Learning Beliefs We learn our beliefs about ideas and concepts through modeling, operant conditioning and conceptual development Levels of Belief 1. The objective object, idea or event 2. Language that represents the object idea or event 3. The concept that allows classification, differentiation and generalization 4. The value, feeling or judgment of quality of the object,event or idea

Cognitive \ Behavioural Source of Irrational Belief 1. Problem in assigning language 2. Problem in classification, generalization or discrimination 3. Problem in judgment

Cognitive \ Behavioural Process of Unlearning Beliefs: Cognitive Restructuring Steps 1. Client recognizes emotional and or behavioural signals that something is wrong 2. Client identifies events (A) associated with signals 3. Client identifies beliefs (B) that mediate between A & C 4. Client attempts to dispute the beliefs 5. Client generates rational beliefs 6. Client develops plan to internalize rational beliefs

Cognitive \ Behavioural Identifying Rational Thoughts - AFROG 1. Does this thinking keep me A live? 2. Does this thinking make me F eel better? 3. Is this thinking based on R eality? 4. Does this thinking help me get along with O thers? 5. Does this thinking help me reach my G oals

Cognitive \ Behavioural Advantages of Cognitive Restructuring Over B Mod If the child’s behaviour is motivate by a strong belief modifying the behaviour will be difficult without addressing the belief Client often has more control over their beliefs than they do over external events such as antecedents and consequences If beliefs change there is a greater change of generalization You are teaching the client a skill as well as changing the behaviour. A skill that can be applied to other situations

Cognitive \ Behavioural Rational Emotive Behavioural Therapy - Summary Basic Premise Man’s problems are based on behaviours which are directed by irrational cognitive structures which produce false beliefs about life events and ideas Treatment Approach Cognitive Restructuring

Cognitive \ Behavioural Behavioural Change with REBT Altered Cognitive Structures Changes Internal Dialogue Changes Behaviour

Cognitive \ Behavioural Aaron Beck – Cognitive Behavioural Therapy Maladaptive behaviours are a result of the client’s particular thinking process Faulty Thinking Styles Arbitrary Inference – drawing conclusions without evidence Magnification – exaggeration of the meaning of an event Cognitive Deficiency – disregard for an important aspect of a life situation

Cognitive \ Behavioural Faulty Thinking Styles – cont. Dichotomous Reasoning – oversimplification and rigid perception of an event Overgeneralization – single instance generalized to universal significance

Cognitive \ Behavioural Steps in Behavioural Change 1. Client recognizes and monitors his cognitions and the relationship between these cognitions and behaviour 2. Client realizes that his interpretations of daily experience is unrealistic. Use of instance identification 3. Client generates alternative cognitions based on appropriate thinking

Cognitive \ Behavioural Behavioural Change with Cognitive Behavioural Altered Thinking Processes Changes Internal Dialogue Changes Behaviour

Cognitive \ Behavioural D. Meichenbaum – Cognitive Behaviour Modification Self statements or client’s self verbalizations affect a person’s behaviour much the same as statements made by another person. For change to occur clients need to interrupt the scripted nature of their behaviour Phases of Behaviour Change Phase 1 – self observation Phase 2 – Initiating new dialogue Phase 3 – Learning new skills

Cognitive \ Behavioural Self Observation Recognition of maladaptive behaviour Initiation of New Dialogue Recognition of maladaptive behaviour must come to elicit inner speech that is different in content from that engaged in prior to change Learning Skills The altered speech must trigger coping behaviours

Cognitive \ Behavioural Cognitive Behavioural Modification Cognitive Structure The organizational aspect of thinking that seems to monitor and direct the strategy route and choice of thoughts The source of the scripts from which all dialogue is borrowed

Cognitive \ Behavioural Steps in Self instruction Cognitive Modeling An external individual performs the task while talking to themselves out loud Overt External Guidance Client performs same task under supervision Overt Self Guidance Client performs the task while instructing themselves out loud Faded overt Self Guidance Client performs the task while whispering the instructions to themselves Covert Self Instruction Client performs the task while guiding their performance with inner speech

Cognitive \ Behavioural Value of Self Instruction 1. Increased distinctiveness of stimulus attribution 2. Direct client’s attention to relevant dimensions of the situation 3. Assist in formulation of hypothesis 4. Structured way to maintain information in short term memory

Cognitive \ Behavioural Other Cognitive Techniques Verbal Mediation Problem Solving

Cognitive \ Behavioural Verbal Mediation Overt or covert attempts to mediate between the antecedent situation and potentially maladaptive behaviour Mediating Questions What was I planning to do? Why shouldn’t I do it? What should I be doing instead? Why should I do that?

Cognitive \ Behavioural Problem Solving Skills A behavioural process which makes available a variety of potentially effective response alternatives for dealing with the problematic situation and increases the probability of selecting the most effective response from among these alternatives Recognize a problem Define the problem and goal Generate alternative solutions Evaluate the solutions Design a plan