Cognitive Behavior Therapy, Self-Directed Coping Methods, and ACT Chapter 27 Copyright © 2011 Pearson Education, Inc. All rights reserved.

Cognitive Behavior Therapy Cognition Belief, thought, expectancy, attitude, or perception Cognitive Behavior Modification / Cognitive Behavior Therapy Helping clients through behavior modification methods and through focusing on debilitating thoughts and beliefs Copyright © 2011 Pearson Education, Inc. All rights reserved.

Cognitive Restructuring Methods Assumptions: Individuals interpret and react to events in terms of their perceived significance Cognitive deficiencies can cause emotional disorders Focus of therapy: Cognitive restructuring Changing faulty thinking patterns Approaches include behavior modification components Copyright © 2011 Pearson Education, Inc. All rights reserved.

Cognitive Restructuring Methods Rational-Emotive Behavior Therapy (REBT) Developed to help individuals change irrational thought Utilizes in vivo behavioral homework assignments Procedure: Identify irrational thoughts Challenge thoughts Teaching client (through modeling and homework) to replace the irrational self-statements with statements based on “rational” beliefs Copyright © 2011 Pearson Education, Inc. All rights reserved.

Copyright © 2011 Pearson Education, Inc. All rights reserved. Effectiveness of REBT More effective than no treatment More effective than various other treatments in decreasing client’s irrational self-talk More effective than other treatments in reducing emotional distress No effect on behavioral measures (approaching feared object) Copyright © 2011 Pearson Education, Inc. All rights reserved.

Cognitive Restructuring Methods Beck’s Cognitive Therapy Faulty and negativistic, though patterns lead to behavioral and emotional problems Procedure: Identification of dysfunctional thoughts Use various methods to counteract the dysfunctional thoughts EX: Hypothesis testing Use of homework assignments that utilize behavior modification procedures to develop desirable daily activities Gentler, less confrontational approach than REBT Copyright © 2011 Pearson Education, Inc. All rights reserved.

Beck’s Distorted Thought Patterns Dichotomous thinking – all-or-none evaluations Overgeneralization – rule or belief applied too broadly Arbitrary inference – drawing inaccurate conclusions based on insufficient, ambiguous, or contrary evidence Magnification – exaggeration of the meaning or impact of an event Copyright © 2011 Pearson Education, Inc. All rights reserved.

Effectiveness of Cognitive Therapy Effective in treating depression Most research has focused on treatment of depression More research needed to evaluate this treatment for other disorders Copyright © 2011 Pearson Education, Inc. All rights reserved.

Self-Directed Coping Methods Self-Instructional Training Five steps: Adult demonstration of self-instructing Child performs while adult verbalizes Child performs the task and verbalizes out loud Fading of overt self-instructions Task performance with covert self-instructions Copyright © 2011 Pearson Education, Inc. All rights reserved.

Self-Directed Coping Methods Meichenbaum’s Stress Inoculation Training Teaches cognitive skills that allow clients to deal with stressful events Three Phases: Reinterpretation phase It is not the stressor that is the cause of the stress reaction, but it is the way the client views the event Coping training phase Clients learn coping strategies Relaxation, self-instruction, and self-reinforcement Application phase Clients practice skills in stressful situations Copyright © 2011 Pearson Education, Inc. All rights reserved.

Effectiveness of Stress Inoculation Many of the components (relaxation, modeling, desensitization) have been validated when applied independently Evidence suggests that this method is as effective as its component procedures Copyright © 2011 Pearson Education, Inc. All rights reserved.

Self-Directed Coping Methods Problem Solving Training Teaches people how to proceed through logical reasoning to satisfactory solutions to personal problems Steps in personal problem solving: General orientation Problem definition Generation of alternatives Decision making Implementation Verification Evaluation of problem solving methods Adults and children can rapidly learn skills, but do not often apply them appropriately Copyright © 2011 Pearson Education, Inc. All rights reserved.

Mindfulness and Acceptance Awareness, observation, and description of one’s overt and covert behaviors, as they occur, in a nonjudgmental way Acceptance Also called experiential acceptance Set of behaviors in reaction to mindfulness Refraining from judging one’s sensations, feelings, and behaviors Thoughts are viewed as just responses, just passing events Copyright © 2011 Pearson Education, Inc. All rights reserved.

Mindfulness and Acceptance Acceptance and Commitment Therapy (ACT) Three phases: Learning that past attempts to control troublesome thoughts and emotions have not only been unsuccessful, but increased the frequency of these thoughts Learning to experience thoughts and emotions in a nonjudgmental way Done through use of mindfulness training and acceptance exercises Identifying values in various life domains and then translating these values into goals and actions Evaluation Early studies find positive results Equivalent to systematic desensitization for treatment of math anxiety Effective in reducing stress in the workplace Relatively new approach and more research needed Copyright © 2011 Pearson Education, Inc. All rights reserved.