Cognitive Behavioural Therapy

The origins of CBT Came out of the behavioral psychology tradition Leading proponents were Aaron Beck and Albert Ellis 1960s were the starting point and began with the treatment of unipolar depression

Definition of CBT Focused form of psychotherapy based on a model suggesting that psychiatric/ psychological disorders involve dysfunctional thinking The way an individual feels and behaves in influenced by the way s/he structures his experiences Modifying dysfunctional thinking and beliefs  improvements in symptoms Variety of methods/strategies used

The NHS and CBT behavioural-therapy/Pages/Introduction.aspx behavioural-therapy/Pages/Introduction.aspx

Some research evidence J H Yost & Giff Weary (1996) compared 58 depressed and 57 non-depressed university students on a attribution task. The depressed students had much less of a tendency to make internal attributions. This, Yost & Weary suggest, is because depressed persons are significantly more likely to see people as victims of circumstance – ie: pretty helpless.

Beck’s cognitive triad

The ABC Model A - Activating Event (also sometimes described as a 'Trigger') B - Beliefs (for example, the thoughts that occur to you when the Activating Event happens) C - Consequences - how you feel and behave when you have those Beliefs (consequences may be divided into two parts: your actions and your emotions) Activating EventBeliefsConsequences Write down the event or situation that triggered your thoughts and feelings. Write down the thoughts that went through your head when the activating event occurred (or after it) Actions How did you act then? Emotions What did you feel then?

Does it work? Michelson and Marchione: CBT versus medication as a treatment for Panic Disorder (reviewed 150 research studies)

Types of CBT Stress Inoculation Training Rational Emotive Behaviour Therapy (Albert Ellis): Gloria(!) Gloria(!) Beck’s Cognitive Therapy – encourages patients to challenge distorted thoughts CBT and Schizophrenia – Hole (1979) encouraged patients to reality-test their delusions – half reduced the pervasive nature of their delusions

The Cognitive Element Therapist encourages client to become aware of beliefs that contribute to anxiety or depression or are associated with general dysfunction in everyday life. This involves direct questioning of the client’s thoughts. Understand how faulty cognitions can lead to depression.

‘Wrong’ thinking I need love and approval from those significant to me – and I must avoid disapproval from any source. To be worthwhile as a person I must achieve, succeed at whatever I do, and make no mistakes. I shouldn’t have to feel discomfort and pain – I can’t stand them and must avoid them at all costs. Every problem should have an ideal solution – and it’s intolerable when one can’t be found. Things must be the way I want them to be, otherwise life will be intolerable. My unhappiness is caused by things that are outside my control – so there is little I can do to feel any better.

Try it for yourself Try doing the homework activities on your sheet for yourself Notice that CBT is an active therapy: – Cognitive: CBT tries to alter/change wrong/disabling thoughts – Behavioural: CBT encourages changes in behaviour – Experimental: CBT encourages the client to try out the new behaviour, record their thoughts and the outcomes

On being a CBT therapist... Split into pairs One person is the client – the other the therapist Situation for the client could be: – Has got a bad grade at college – thinks he/she is a failure – Has failed the driving test for the third time, everyone else in the family passed it first time – Thinks that all the people in their workplace/job hates them The therapist should try to pick on the illogical thoughts – and offer suggestions/challenges – and then homework!! Take 5 minutes – and then swap roles This is how counsellors are trained

Applying CBT to Prisons Can we reduce aggressive behaviour by e.g. making a young man see the behaviour of others as less threatening? Can we use CBT modelling, role play and rehearsal techniques to help offenders learn how their thought patterns lead them to criminal behaviours – and help them change? In your groups of 4 you have two forms of CBT used in US prisons: Aggression Replacement Therapy and Moral Reconation Therapy – Split into pairs and work out what each therapy does – and how effective it is – Then tell the other pair about it – and swap over!