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7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
1/22
2003 John Winston Bush, PhD. All rights reserved.
Orientation to CBT(Cognitive behavior therapy)
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
In the beginning There was psychoanalysis (in various flavors)
And there was client-centered (Rogerian) therapy
And very little else
Note: Nearly all of it was based on clinical
experience, personal hunch, and intuition notmuch science behind it
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
But then...
About 50 years ago, psychologists andpsychiatrists began looking to scientific
studies of human behavior for ideas abouthow to do therapy
The result today: Cognitive behavior therapy
(CBT) has become the preferred treatment formost emotional and behavioral problems
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Basic CBT strategies(in order of appearance)
Behavior therapy (1950s)
Desensitization
Behavior modification
Behavioral activation
Cognitive therapy (1960s)
Rational-emotive therapy
Becks cognitive therapy Newer approaches (1990s)
Mindfulness meditation
Acceptance and commitment therapy
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Examples
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Desensitization
Typical goal: To reduce feelings of anxiety,
anger or other emotion that is causingneedless trouble
Typical method: Elicit the feeling while in a
relaxed state
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Behavior modification
Typical goal: To replace a habitual,
unwanted behavior with a more desirable one
Typical method: Identify eliciting cues;specify new behavior; then reward progress
toward goal without waiting to fully achieve it
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Behavioral activation
Typical goal: To overcome depression byrestoring contact with the normal rewards of
the everyday world
Typical method: Identify activities withpotential for pleasure or mastery; initiate or
increase participation in them
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Rational-emotive therapy
Typical goal: To think and act more
rationally
Typical method: Identify irrationalbeliefs and assumptions that arecausing or maintaining a problem, andwork towards correcting them
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Becks cognitive therapy
Typical goal: Same as in rational-
emotive therapy
Typical method: Identify particular
types of cognitive errors and work oncorrecting them
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Mindfulness meditation
Typical goal: To be less disturbed by events,thoughts, memories, mental images,
fantasies and bodily sensations
Typical method: Develop knack of justobserving thoughts, memories, images,
fantasies and sensations as they occur,without clinging to them or rejecting them(acceptance)
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Acceptance and
commitment therapy
Typical goal: Same as in mindfulnessmeditation, but in context of commitment topersonal values
Typical method: Identify personal values; usevarious tactics to reduce domination of thoughts,
memories, mental images and emotions thatrestrict contact with ongoing experience andinterfere with living by those values
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Diagnosis in CBT
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Orthodox (medicalized) diagnosis:
Assign person or problem to one or morebroad categories based on symptoms andcomplaints
CBT (behavior-analytic) diagnosis:
Identify exactly what events, thoughts,emotions, moods and actions are causingtrouble
Find out under what specific circumstancesthey occur, and what the consequences are(both immediate and delayed)
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Not hard to see how this
makes therapy morefocused and effective, is it?
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
How to begin
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
First: Tell your story in
whatever way is natural toyou
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Next: Review with therapistwhat seem to be the main
problems, using thisframework....
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Context 1 (obvious): When does it
happen? Where? With whom (ifanyone)? With what consequences?
Context 2 (not so obvious): Howdoes it relate to your ideas about howthings are or ought to be?
Content: What happens? When it
happens, what do you think,remember, imagine, feel, or do?
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Then what?
Work with therapist on identifying things youcan do that are likely to diminish the problem
either by changing the situation oraccepting it
Try your best to do the agreed things
Keep track of how well (or badly) they seemto be working
If necessary, revise plan and try again
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Feeling better already?
Good.
7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)
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2003 John Winston Bush, PhD. All rights reserved.
Now begins the hard work.
And the adventure.
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