Chapter Eight: Cognitive Theory and Therapy

Historical Context  The black box comes open  “Cognitive Types” begin to emerge

Forms of Cognitive Theory and Therapy  Rational-Semantic  Collaborative-Empirical  Philosophical-Constructivist

Theoretical Principles of Cognitive Theory and Therapy  People are disturbed, not by what happens, but by what they think of what happens.

Applied Models of Cognitive Therapy  Rational Emotive Behavior Therapy  Aaron Beck’s Cognitive Therapy  Self-Instructional Training

Theory of Psychopathology  Pathology, or disorders occur because of thinking errors

The Practice of Cognitive Therapy  Preparing yourself  Preparing your client  Assessment Issues and Procedures

Specific Therapy Techniques  Generating Alternative Explanations  Disputing  Thinking in Shades of Grey  Giving up the “should” rule

Extended Case Examples Case of Richard continued Cognitive restructuring Changing habits Continued Behavioral Practices

Therapy Outcomes Research  Similar to Behavioral Therapy—many “proven” interventions.

Multicultural Perspectives  Similar to behavioral interventions, some cultures prefer active, directive strategies  Little actual research conducted with minority cultures

Concluding Comments  Cognitive therapy has strong efficacy findings  Reservations about scientific validation as only source of “proof.”

Student Review Assignments  Critical corner  Reviewing key terms  Review questions

Critical Corner  Some critics, especially humanistic and existential therapists, contend that cognitive therapy is too intellectual. They emphasize that most clients actually need to more deeply feel, experience and understand their emotions, rather than using cognitive tactics to talk themselves out of important emotional states. What are your thoughts on this criticism? Do clients need to be more intellectual or more emotional?

Critical Corner (continued)  The foundation of all cognitive therapies is the same: As an expert, the therapist first demonstrates to the client that he is thinking in a way that is either irrational or maladaptive and then the therapist teaches the client new and better ways to think. When you consider this fact, isn’t it true that all cognitive therapies are a bit presumptuous? Then, when you t consider this presumptuous assumption even further, doesn’t it make you want to become a more sensitive cognitive therapist—perhaps a constructivist who honors the client’s experience and then helps him re-write his personal narrative in a more positive and strength-based manner? It’s no wonder why Mahoney and Meichenbaum have moved on.

Critical Corner (continued)  The fact is that when therapists need therapy, most of them—even cognitive and behavioral therapists—go to psychodynamic or experientially-oriented therapists. Why would that be? One possibility is that engaging in rigid cognitive and behavioral approaches is both demanding and tiresome. How many clients really want to keep detailed cognitive monitoring logs and tediously dispute their maladaptive cognitive distortions? Don’t you think it’s true that insight- oriented therapies are intrinsically more exciting than cognitive and behavioral approaches? Even worse, isn’t it true that insight oriented therapy is, in contrast to cognitive therapy, much more likely to produce the motivation for new learning?

Critical Corner (continued)  Despite the fact that cognitive therapists pride themselves on their empirical foundation, relatively little data is available on the application of cognitive therapy with various cultural groups. Given the complete absence of empirical data on cognitive methods with diverse clients, to stay consistent with their orientation, cognitive therapists should either label their treatment approaches as “experimental” with non-White clients or they should refrain from using their treatment methods with non-White clients. What are your thoughts on this issue? Because of their criticism of humanistic-existential therapists, aren’t cognitive therapists being hypocritical when they apply their techniques on non-White clients.

Review Key Terms  Rational-Semantic Cognitive Therapy  Collaborative-Empirical Cognitive Therapy  Philosophical-Constructivist Therapy  Stimulus-Organism Response (S-O-R) theory  The REBT ABCs  Collaborative empiricism  Automatic thoughts

Key Terms (continued)  Self-schema or core beliefs  Socratic questioning  Cognitive distortions  Arbitrary inference  Selective abstraction  Personalization

Key Terms (continued)  Dichotomous/Polarized thinking  Stress Inoculation Training  Self-instructional training  Collaborative interviewing  Problem list  Thought Record or cognitive self- monitoring

Review Questions  Discuss the relative importance of John Watson and Mary Cover Jones in the development of applied behavior therapy techniques. Which of these researchers amassed a large amount of practical information about counter-conditioning?  Who is the historical figure to which applied behavior analysis can be traced? Do applied behavior analysts believe in using cognitive constructs to understand human behavior?

Review Questions  What are the main differences between Ellis’s REBT and Beck’s Cognitive Therapy?  What are the five bedrock assumptions of Ellis’s REBT?  Meichenbaum’s approach is based on verbal mediational processes. In practical terms, what does he mean by verbal mediational processes?

Review Questions  List and describe four of Beck’s cognitive distortions.  Provide examples of what sorts of self-talk Meichenbaum might teach anxious or angry clients when using Stress Inoculation Training approaches.  List and describe the REBT ABCs (including D, E, and F).

Review Questions  Describe what Beck means by a self- schema.  What are the three steps of Stress Inoculation Training?  What information would you put into a Thought Record?  What is cognitive storytelling and what is the purpose of using it with young clients?