Theories of Counseling: Cognitive Behavior Therapy PowerPoint produced by Melinda Haley, M.S., New Mexico State University. “This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of an image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.” “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. “Copyright © Allyn & Bacon 2004”

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). “Copyright © Allyn & Bacon 2004”

Cognitive Behavior Therapy Theory of Personality Personality includes both genetic endowment and social influence. It reflects the individual’s cognitive organization and structure. Emotions and behaviors are based on perceptions, interpretations, and assumptions. Schemas have an important impact on how one operates cognitively. “Copyright © Allyn & Bacon 2004”

Cognitive Behavior Therapy Theory of Personality Schemas: A person’s 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 person’s beliefs and assumptions predispose him or her to psychological distress. “Copyright © Allyn & Bacon 2004”

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 “Copyright © Allyn & Bacon 2004”

Cognitive Behavior Therapy Nature of Maladjustment. Maladaptive cognitions lead to maladaptive, self-defeating behaviors. Adaptive, self-enhancing behaviors come from a client’s self-enhancing thoughts and this can be taught. Clients can be taught to shift from self-defeating thoughts to self-enhancing thoughts. “Copyright © Allyn & Bacon 2004”

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 client’s thought processes. “Copyright © Allyn & Bacon 2004” r e s o u r c e s a n d t e c h n i q u e s

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. “Copyright © Allyn & Bacon 2004”

Cognitive Behavior Therapy Strategies for Helping Clients Beck’s 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 co-investigators. Guided Discovery: Guided by the therapist, the client engages in experiments that result in more adaptive ways of thinking. “Copyright © Allyn & Bacon 2004”

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. “Copyright © Allyn & Bacon 2004”

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 events—past, present or future. Emotive Imagery: It is a procedure where the client imagines the emotional sensations and feelings of an actual situation or behavior. “Copyright © Allyn & Bacon 2004”

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. “Copyright © Allyn & Bacon 2004”

Cognitive Behavior Therapy Strategies for Helping Clients Cognitive Restructuring: Replacement of negative, maladaptive thoughts with positive, adaptive ones. Reframing: To modify or restructure a person’s 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. “Copyright © Allyn & Bacon 2004”

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 client’s 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 client’s sensory language to fully experience the client’s inner world (e.g. I see that (visual); I feel that (kinesthetic) ; I hear that auditory). “Copyright © Allyn & Bacon 2004”

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 therapist’s 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. “Copyright © Allyn & Bacon 2004”

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. “Copyright © Allyn & Bacon 2004”

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. “Copyright © Allyn & Bacon 2004”

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 client’s 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., D’Andrea, 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”