1. Chapter 1
The CBT Model

2. Brief History

3. Brief History Aaron T. Beck
Trained in psychoanalysis but had concerns about:
Effectiveness
Found psychoanalytic approach for depression to be conceptually inaccurate and did not reduce client distress
Focusing too much on the past and long-term nature
Resulted in clients thinking that they would always need professional help for their life stressors and problems
Inhibits generalization and maintenance of change
i.e., clients unable to develop their own independent problem-solving skills and manage future life stressors

4. Brief History Aaron T. Beck (late 1950s to 1960s)
Found that his depressed clients had very quick and brief negative self-evaluative thoughts associated with their distressing emotions
Negative Automatic Thoughts – modification of such thoughts improved depressed mood
Developed a short-term and present-oriented form of therapy for depression that focused on modifying negative automatic thoughts and using problem-solving skills
Conceptualization of depression – client distress due to a negative thinking pattern across three domains: self, world, and future

5. Brief History
During this time (1950s-1970s), behavioral therapists were employing the work of experimental behaviorists
Pavlov - classical conditioning
Skinner – operant conditioning
Watson – behavior = stimulus-response association
Eyseneck and Wolpe – systematic desensitization, reciprocal inhibition, relaxation training
Effective treatment for some anxiety disorders with minimal focus on cognitive processes

6. Brief History
Simultaneously other theorists were also developing treatment programs that incorporated cognitive and behavioral components
Meichenbaum – internal dialogue and self-instructional training
Ellis and Harper – irrational thinking and rational emotive behavior therapy
Bandura – social cognitive theory and reciprocal determinism
Acknowledged the importance of internal events (i.e., thoughts) and their influence on emotions and behaviors, including the social environment

7. Brief History
“Cognitive Therapy of Depression” (Beck, Rush, Shaw, & Emery, 1979)
Research soon moved beyond depression to include other distressing mental health problems, especially anxiety-related disorders, with a more explicit integration of cognitive and behavioral methods
CBT is now the most well-established theoretical approach for the most mental health problems
More effective than other theoretical approach for treating anxiety and depressive disorders

8. CBT Model

9. CBT Model Figure 1.1 – Reciprocal Cognitive-Behavioral Model
Visual depiction of how thoughts (including mental images), emotions (including physiological arousal), and behaviors are related and interact with the environment (including social interactions)
Emotions and behaviors are influenced by how situations are perceived
Thoughts act as a mediator between the situation and resulting emotions and behaviors, which then interact with the environment
This interaction with the environment and its outcomes then reciprocally influence our thoughts and emotions
For maladaptively functioning individuals, the reciprocal interaction of thoughts, emotions, and behaviors can negatively feed into each other

10. CBT Model

11. CBT Model
Activity 1.1: Examples of Adaptive and Maladaptive Functioning (p. 4)
See Figure 1.2 – Reciprocal Cognitive-Behavioral Model—Maladaptive Functioning Individual
See Figure 1.3 – Reciprocal Cognitive-Behavioral Model—Adaptive Functioning Individual
Discussion Questions 1.1 (p. 6)
Activity 1.2: Develop Examples of Adaptive and Maladaptive Functioning (p. 6)
Discussion Questions 1.2 (p. 7)

12. CBT Model

13. CBT Model

14. CBT Model General cognitive model (Beck & Haigh, 2014)
The difference between adaptive and maladaptive functioning is largely quantitative, not qualitative
All individuals have negative biases (or thoughts) and positive biases
Maladaptive functioning individuals:
Have negative biases that are extreme and amplify perceived threats
Reduce positive positive biases and minimize rewards or gains
Such biases tend to get exaggerated and eventually activated after experiencing stressors

15. CBT Model
Primary goal of CBT is to help clients identify, evaluate, and modify their negative automatic thoughts and corresponding behaviors
Metacognition – “think about thinking”
Understand how thoughts, emotions (including physiological arousal), and behaviors are interrelated within themselves and between the environment

16. CBT Model
Successful therapy = clients are able to independently make modifications to their thoughts and behaviors while developing effective coping and problem-solving skills
Long-term generalization and maintenance of skills across multiple facets of life – Clients become their “own therapists”

17. CBT Model
Important: CBT is not positive thinking! (e.g., “Don’t worry, be happy!”)
CBT is about helping clients think more rationally
Sometimes rational thoughts are negative and may require acceptance
Emotionally distressed clients tent to have many thoughts that are negative and irrational
Such thoughts are the ones that receive focus for modification
*Although it is helpful to focus on the positive aspects of our lives, it can be detrimental to our well-being to ignore the reality of the negative aspects