1. Cognitive Behavior Therapy

2. Rational Emotive Behavior Therapy
Started by Albert Ellis in 1955-Grandfather of Cognitive Behavior Therapy
Combination of Humanistic & Behavioral Therapy to help deal with issues from past
Ellis had chronic renal problems since 9 and diabetes by 40
Exaggerated fear of public speaking
Shy around women

3. Rational Emotive Behavioral Therapy (REBT)
Stresses thinking, judging, deciding, analyzing, and doing
Assumes that cognitions, emotions, and behaviors interact and have a reciprocal cause-and-effect relationship
Is highly didactic, very directive, and concerned as much with thinking as with feeling
Teaches that our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations

4. Assumptions of REBT
People contribute to their own psychological problems & symptoms by way they interpret events & situations
Reorganization of one’s self-statements will result in reorganization of one’s behaviors
Operant conditioning, modeling & behavioral rehearsal applied to thinking & internal dialogue

5. Commonalities between all Cognitive Behavior Approaches
Collaborative relationship between therapist & client
Premise psychological distress is largely function of disturbance in cognitive processes
Focus on changing cognitions to produce desired changes in affect & behavior
Generally time-limited & educational treatment focusing on specific & structured target problems

6. Roots of REBT
Epictetus-Greek Stoic Philosopher-1st century A.D.-”People are disturbed not by things, by the view which they take of them.”
Horney’s (1950) “Tyranny of the shoulds”
Adler-our emotional reactions & lifestyle are associated with our basic beliefs & therefore cognitively created
role of social interest in determining psychological health
Importance of goals, purposes, values & meaning in human existence
Focus on active teaching
Use of persuasive methods
Giving of live demonstrations in audiences

7. The Therapeutic Process
Therapy is seen as an educational process
Clients learn:
To identify and dispute irrational beliefs that are maintained by self-indoctrination
To replace ineffective ways of thinking with effective and rational cognitions
To stop absolutistic thinking, blaming, and repeating false beliefs

8. View of Human Nature
We are born with a potential for both rational and irrational thinking
We have the biological and cultural tendency to think crookedly and to needlessly disturb ourselves
Humans are self-talking, self-evaluating & self-sustaining
We develop emotional & behavioral problems when we mistake simple preferences (love, approval, success) for dire needs
We learn and invent disturbing beliefs and keep ourselves disturbed through our self-talk
We have the capacity to change our cognitive, emotive, and behavioral processes

9. Emotional Disturbance
Through autosuggestion & self-repetition we install & maintain self-defeating beliefs-irrational dogmas & superstitions self-created plus irrational beliefs from significant others
Blame is core of emotional disturbance-so to recover stop blaming self & others
We escalate desires & preferences into dogmatic & absolutist “shoulds, musts, oughts, demands, commands-which are irrational beliefs which need to be changed

10. Irrational Ideas Irrational ideas lead to self-defeating behavior
Some examples:
“I must have love or approval from all the significant people in my life.”
“I must perform important tasks competently and perfectly.”
“If I don’t get what I want, it’s terrible, and I can’t stand it.”

11. A-B-C Theory of Personality
A = existence of fact, event, behavior, attitude of individual
B = person’s belief
C = emotional & behavioral consequence or reaction of individual
D = disputing intervention-challenge beliefs
E = effective philosophy after disputing
F = new set of feelings
Human beings are largely responsible for creating their own emotional reactions & disturbances
Goal: show people how to change irrational beliefs that directly “cause” disturbed emotional consequences

12. The A-B-C theory

13. D = disputing intervention
Challenges irrational beliefs
Use principles of logic-destroy unrealistic, unverifiable hypotheses
Detect~detect the “shoulds”, “I musts” “awfulizing” “self-downing”
Debate~learn to logically & empirically question beliefs-to argue self out of them
Discriminate~irrational-self-defeating from rational-self-helping beliefs

14. Steps to Change Dysfunctional Living
Acknowledge we are responsible for creating own emotional problems
Accepting we have ability to change disturbances significantly
Recognize emotional problems stem from irrational beliefs
Clearly perceive these beliefs
Seeing value of disputing self-defeating beliefs
Accepting fact to change we must work hard in emotive & behavioral ways to counteract irrational beliefs & dysfunctional feelings and behaviors
Use the REBT methods rest of our lives

15. Steps in REBT Therapeutic Process
Show client incorporated irrational beliefs-teach how to separate irrational from the rational beliefs-engage in activities which are not self-defeating
Demonstrate to client keeping emotional disturbance active by illogical thinking
Help client to modify thinking-recognize vicious cycle of self-blaming
Challenge clients to develop rational philosophy of life-dispute core irrational thinking-teach how to replace with rational beliefs

16. Methods used in REBT Disputing irrational beliefs
Doing cognitive homework
Changing one’s language
Using humor
Rational emotive imagery
Role playing
Shame-attacking exercices
Use of force & vigor
Desensitization
Skills training
Assertiveness training

17. Aaron Beck’s Cognitive Therapy (CT)
Insight-focused therapy
Emphasizes changing negative thoughts and maladaptive beliefs
Theoretical Assumptions
People’s internal communication is accessible to introspection
Clients’ beliefs have highly personal meanings
These meanings can be discovered by the client rather than being taught or interpreted by the therapist

18. Cognitive Distortions identified in CT
Arbitrary references-catastrophizing
Selective abstraction-total context missed
Overgeneralization-extreme belief based on single episode
Magnification & minimization
Personalization-relate external event to self
Labeling & mislabeling-identity based on imperfections or mistakes in the past
Polarized thinking-all or nothing at all thinking

19. Theory, Goals & Principles of CT
Basic theory:
To understand the nature of an emotional episode or disturbance it is essential to focus on the cognitive content of an individual’s reaction to the upsetting event or stream of thoughts
Goals:
To change the way clients think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructuring
Principles:
Automatic thoughts: personalized notions that are triggered by particular stimuli that lead to emotional responses

20. CT’s Cognitive Triad Pattern that triggers depression:
1. Client holds negative view of themselves
2. Selective abstraction: Client has tendency to interpret experiences in a negative manner
3. Client has a gloomy vision and projections about the future

21. Donald Meichenbaum’s Cognitive Behavior Modification (CBM)
Focus:
Client’s self-verbalizations or self-statements
Premise:
As a prerequisite to behavior change, clients must notice how they think,
feel, and behave, and what impact they have on others
Basic assumption:
Distressing emotions are typically the result of maladaptive thoughts

22. Meichenbaum’s CBM Self-instructional therapy focus:
Trains clients to modify the instructions they give to themselves so that they can cope
Emphasis is on acquiring practical coping skills
Cognitive structure:
The organizing aspect of thinking, which seems to monitor and direct the choice of thoughts
The “executive processor,” which “holds the blueprints of thinking” that determine when to continue, interrupt, or change thinking

23. Behavior Change & Coping (CBM)
3 Phases of Behavior Change
1. Self-observation
2. Starting a new internal dialogue
3. Learning new skills
Coping skills programs – Stress inoculation training (3 phase model)
1. The conceptual phase
2. Skills acquisition and rehearsal phase
3. Application and follow-through phase

24. Constructivist Narrative Perspective (CNP)
Focuses on the stories people tell about themselves and others about significant events in their lives
Therapeutic task:
Help clients appreciate how they construct their realities and how they author their own stories