10 - Cognitive Therapy.ppt

8/11/2019 10 - Cognitive Therapy.ppt

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COGNITIVE THERAPY

Mark Lawrence Gale

Psychology Department

Adamson University


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KEY FIGURES

Aaron Beck Albert Ellis Donald

Meichenbaum


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Albert Ellis

Rational Emotive

Behavior Therapy


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View of Human Nature

Human beings are born with the potential forboth rational (straight) thinking and irrational

(crooked) thinking.

Human beings are fallible. We will continue to

make mistakes yet at the same time learn to

live more at peace with ourselves.

Human are self-talking, self-evaluating and

self-sustaining.


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View of Human Nature

Human develop emotional and behavioraldifficulties when they mistake simple

preferences (e.g. love, approval, success) for

dire needs.

Humans have an inborn tendency toward

growth and actualization yet they often

sabotage their movement toward growth due

to their inborn tendency toward crooked

thinking and self-defeating behavior.


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View of Emotional Disturbance

People do NOT need to be accepted and loved,even though this may be highly desirable.

Blame is the core of most emotional disturbances.

We need to learn to accept ourselves despite our

imperfections.

We have the strong tendency to escalate our

desires and preferences into dogmatic shoulds,

musts, oughts, demands and commands.


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View of Emotional Disturbance

Our hidden dogmatic musts and absolutisticshoulds create disruptive feelings and

dysfunctional behaviors.

Examples of irrational beliefs:

I must have love or approval from all the significant

people in my life.

I must perform important tasks competently and perfectly

well.

If I dont get what I want, its terrible and I cant stand it.

People should have the same values and standards as

me.


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A-B-C Theory of Personality

A(Activating

Event)

B(Belief)

C(Emotional and

Behavioral

Consequences)

D(DisputingIntervention)

E(Effect) F(NewFeeling)


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Therapeutic Process

Therapeutic Goals To minimize emotional disturbances and self-

defeating behaviors by acquiring a more realistic

and workable philosophy in life.

To reduce the tendency for blaming oneself or

others for what goes wrong in life and learning

ways to deal with future difficulties.

To induce people to examine and change some of

their most basic values that keeps them disturbed.


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Therapeutic Process

Therapists Function and Role Therapists need show first the clients that they have

incorporated many irrational beliefs. They must

encourage and persuade the clients to engage in

activities that will counter their self-defeating beliefs.

Therapists need demonstrate that clients are keeping

their emotional disturbance active by continuing to think

illogically.

Therapists should act as a teacher and help clients

modify their thinking and abandon their irrational ideas.


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Therapeutic Process

Therapists Function and Role Therapists have to challenge clients to develop a

rational philosophy of life so that in the future they can

avoid becoming the victim of other irrational beliefs.

Therapists have to explain how irrational cognitions

can be replaced with more rational ideas that are

empirically grounded.

Therapists also have to challenge clients in examining

why they are clinging to their old misconceptions

instead of letting them go.


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Therapeutic Process

Clients Experience in Therapy Once clients begin to accept that their beliefs are

the primary cause of their emotions and

behaviors, they are able to participate effective in

the cognitive restructuring process.

The client acts as a learner.

The clients are not encouraged to make

connections between their remote past and

present behavior.


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Therapeutic Process

Clients Experience in Therapy Clients are expected to actively work outside the

therapy sessions.

Homework is carefully designed and agreed on and

is aimed at getting clients to carry out positive

actions that induce emotional and attitudinal change

At the terminal phase of the therapy, clients review

their progress, make plans and identify strategies

for dealing with problems.


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Therapeutic Process

Relationship Between Therapist and Client Just like person-centered approachs unconditional

positive regard, the cognitive approach has the

concept of full acceptance or tolerance.

Therapists refuse to evaluate their clients as

persons while at the same time they are willing to

honestly confront clients nonsensical thinking and

self-destructive behavior.

Therapeutic warmth is deemphasized.


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Therapeutic Process

Therapeutic Techniques and Procedures The cognitive approach is multimodal and integrative in

nature.

It uses cognitive, affective and behavioral techniques to

make sure that the intervention is tailor fit to the needs

of the client.

The techniques are used to address several concerns

anxiety, depression, anger, marital difficulties, poor

interpersonal skills, parenting failures, personality

disorders, eating disorders, psychosomatic disorders,

addictions, etc.


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Therapeutic Process

Therapeutic Techniques and Procedures

A. Cognitive Methods

1. Disputing Irrational beliefs

The therapist has to actively dispute the clients irrationalbeliefs and teach them how to do this challenging on their

own.

2. Doing cognitive homework

Clients are expected to make lists of their problems, look for

their absolutistic beliefs, and dispute these beliefs.

Doing work outside the therapy sessions can help clients

revise their thinking, feeling and behavior effectively.


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Therapeutic Process


A. Cognitive Methods

3. Changing ones language

Clients who use statements which reflect helplessness andself-condemnation can learn new and positive statements.

4. Using humor

Emotional disturbances often result from taking oneself too

seriously and losing ones sense of perspective and humor

over the events of life.

Therapists can use humor to counterattack the over-serious

side of individuals.


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Therapeutic Process


B. Emotive Techniques

1. Rational emotive imagery

Clients imagine themselves thinking, feeling and behavingexactly the way they would like to think, feel and behave in

real life.

2. Role playing

Clients are allowed to rehearse certain behaviors to bring

out what they think and feel in the situation.

The focus is on working through the underlying irrational

beliefs that are related to unpleasant feelings.


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Therapeutic Process


B. Emotive Techniques

3. Shame-attacking exercises

Clients need to work to feel unashamed over certainbehaviors even when others clearly disapprove of them.

Clients are likely to find out that other people are not really

that interested in their behavior.

4. Use of vigor and force Clients are encouraged to do forceful dialogues with

themselves in which they express their irrational beliefs and

then powerfully dispute them.


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Aaron BecksCognitive Therapy


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Description

Its main goal is 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.

The clients are encouraged to gather and weigh

the evidence in support of their beliefs.

This is less directive, persuasive and confrontive

compared to Ellis REBT. It also views that the

quality of therapeutic relationship is very

important.


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Cognitive Distortions

1. Arbitrary Inference

Making conclusions without supporting and relevant

evidence.

Mind reading: believing someone has a negative opinion

on you without checking it out with him/her.

Fortune telling: predicting things will turn out badly.

Catastrophizing: expecting the worst to happen.

2. Selective abstraction

Forming conclusions based on an isolated detail of an

event

Discounting and filtering: paying lots of attention to

negative events and neglecting positive experiences.


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3. Overgeneralization Holding extreme beliefs on the basis of a single incident and

applying them inappropriately to dissimilar events or

settings.

4. Magnification and minimization Perceiving a case or situation in a greater or lesser light

than it truly deserves.

5. Personalization Tendency for individuals to relate external events to

themselves even when there is no basis for making this

connection.


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6. Externalization or External Blaming You hold other people responsible for your pain.

7. Labeling and mislabeling

Portraying ones identity on the basis of imperfections andmistakes made in the past and allowing them to define ones

true identity.

8. Emotional reasoning Involves basing your judgments, decisions and conclusions

exclusively for your feelings. This is allowing your feelings to

rule your reasoning ability.


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9. Control Fallacy If you feel externally controlled, you see yourself as a

helpless individual or a victim of fate.

If you have the fallacy of internal control, you see yourself

as responsible for the pain and happiness of everyone.

10. Fallacy of Change You expect that other people must change for you to be

happy.

11. Entitlement Fallacy You believe that you are entitled to a problem-free and pain-

free existence. Life is often seen as unfair.


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12. Heavens Reward Fallacy

You expect all your sacrifice and self-denial to pay off as

if there is someone keeping the scores. You feel bitter

when the reward does not come.

13. Polarized Thinking

Involves thinking and interpreting in all-or-nothing terms

or categorizing experiences in either-or extremes.

14. Should Statements

Strict rules which you set for yourself and others. These

work against self-acceptance (guilt) and accepting others

(anger/resentment).


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Exercises What is wrong with the following beliefs?

1. My teacher does not like me. I just know it.

2. Youre just saying that Im good because youre my

friend.3. I did everything to make him happy, why did he

hurt me this way?

4. I will not adjust to them. They will adjust to me.

5. I just know she would turn me down.

6. Its because of you that I feel bad.

7. Ill be happy only if you will talk to me.


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Limitations and Criticisms

Ellis REBT It does not encourage clients to recount their

long tales of woes.

Personal warmth, empathy, transference and

caring are not considered as essential ingredients

for effective therapy.

Some clients have troubles interacting with a

confrontive therapist and they tend to terminate

the therapy.


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Ellis REBT Not enough emphasis is given in encouraging clients to

express and explore their feelings.

Past unfinished businesses and childhood experiencesare ignored.

REBT therapists can misuse their power by imposing

their ideas of what constitutes rational thinking.

Client sometimes see this approach as a process of

persuasion, indoctrination, logic and advice.


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Becks Cognitive Therapy Focuses too much on the power of positive thinking.

The approach does not encourage emotional

ventilation or emotionally re-experiencing painful

events.

Focuses only on eliminating symptoms but failing to

explore the underlying causes of difficulties

Ignores the role of unconscious factors.


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ANY QUESTIONS?

THANK YOU!

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10 - Cognitive Therapy.ppt