Cognitive Behaviour Therapy (CBT) Gerhard Ohrband - ULIM University, Moldova 1 st lecture Introduction

Course Structure 1. Introduction: What is CBT? What are differences and similarities with other therapy schools? 2. Diagnostics in CBT 3. Classification of Psychological Disorders (ICD- 10, DSM-IV), Clinical Psychology (Etiology, prevalence, comorbidity and symptoms) 4. Etiological concepts in CBT: learning theories (classical and operant conditioning, vicarious learning, Mowrer’s Two-factor theory) 5. Systematic desensitization: in-vivo exposure and imaginatory 6. Aversion training: overt and covert

Course Structure 7. Response prevention: treating obsessive-compulsive disorder (OCD), behaviour modification 8. Social skills training: anger management, assertiveness training 9. Rational-emotive Therapy (RET) 10. Beck’s Cognitive Therapy for depression 11. Marital and Sex Therapy 12. Trauma Therapy: Expressive writing, work with affirmations, visualizations; working with victims of crimes, accidents and other difficult life-events 13. Relaxation techniques: yoga, meditation, Alexander technique, Feldenkrais 14. CBT at school: helping children with autism, hyperactivity, social phobia, social adjustment problems, learning difficulties and antisocial behaviour. 15. CBT in treating addiction and substance abuse

Content What is CBT? historical perspectives differences and similarities with other therapy schools

What is CBT? Cognitive Behaviour Therapy focus on unlearning disfunctional or learning new functional behaviour and cognitions focus on the “here and now” instead of digging in a client’s past application of findings in experimental psychology (learning theories)

What is CBT? focus on accurate diagnostics and therapy evaluation (constant and final) tailoring a therapy plan according to an individual’s specific needs eclectic approach (using that which works) typically, highly structured and relatively short therapies (approx sessions)

History 1950s Joseph Wolpe: Behavioural Therapy 1970s Cognitive Behaviour Therapy

Who is who?

Structure of a CBT Therapy first encounter – formulating first hypotheses as to the nature of the problem diagnostics and classification establishing therapy goals and making a therapy contract constant evaluation of therapy progress if necessary, strategy change final evaluation: have previously set goals been met? preparing client for time after therapy

CBT and Psychoanalysis CBTPsychoanalysis diagnosticsvery important for differentiated treatment less important, one-for- all treatment knowing about the causes not so important, focusing on the “here and now” very important etiologylearning, defective cognitions childhood traumas, defense mechanisms therapy durationshortlong scientific basisbased on experimental psychology based on case studies and introspection

Techniques in CBT systematic desensitization (Wolpe) – fear and phobia aversion therapy – drinking, smoking, transvestism, overeating behaviour modification – schizophrenia, mental retardation reinforcement of adaptive behaviours token economies modeling social skills training cognitive behaviour therapy

Discussion Criticisms: focus on the symptoms of a psychological problem to the exclusion of its root causes symptom substitution Evidence: symptom substitution does not appear to occur (Baker, 1969)

Literature Baker, B.L. (1969). Symptom treatment and symptom substitution in enuresis. Journal of Abnormal Psychology, 74, Ellis, A. (1973). Rational-emotive therapy. In R. Corsini (ed.), Current Psychotherapies, Itasca, IL: Peacock. Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press.

Journals American Journal of Psychiatry Annals of Psychiatry Archives of General Psychiatry Behaviour Research and Therapy British Journal of Clinical Psychology British Journal of Psychiatry Clinical Psychology and Psychotherapy Cognitive Neuropsychiatry Current Opinion in Psychiatry Journal of Abnormal Psychology Journal of Clinical Psychology Journal of Psychotherapy Practice and Research Psychotherapy

Internet resources REBT-CBT NET The Internet Guide to Rational Emotive Behavior Therapy and Cognitive Behavior Therapy The National Association of Cognitive-Behavioral Therapists (NACBT) The NACBT promotes and supports the practice of cognitive-behavioral therapy. The NACBT Website provides the latest information on CBT, including credentials they offer. A National Referral Database is also a feature of this site! Student and professional memberships are available.

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