CBT Problem Solving Tools Part 1/3

How To Use

Cognitive Behavioural Therapy

Problem Solving Tools Part 1/3

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CBT : An Introduction To The Basic Tools Of Cognitive Behavioural Therapy

Warning & Disclaimer

This material is not intended to replace any advice of any medical

professional whatsoever, including psychological and psychiatric

advice.

This material is offered for interest purposes only as my interpretation

of published material I have purchased in regular High Street shops

and my experience of using a number of the tools in a professional

capacity. The professional capacity within which I use these tools is in

no way connected to the psychological, psychiatric or medical

profession as a whole.

Once again, this material is for interest only and is not intended to

replace the advice of any medical professional.

If you are in any doubt, seek immediate assistance from the relevant authorities.

We will be looking at the following tools in this presentation:

• Defining The Problem

• Brainstorming

• Cause & Effect Diagrams aka Fishbone Diagrams

• The 5 Whys (In Part 2)

• Kipling’s Six Wise Men (In Part 2)

• Data Gathering (In Part 2)

• The 80/20 Rule (In Part 2)

• Selecting Solutions (In Part 3)

• Action Plans (In Part 3)

• Evaluation (In Part 3)

Defining The Problem

Problem Definition is of utmost importance because you will keep referringback to it throughout the rest of the problem solve.

Don’t be afraid to spend half an hour setting this out and write it a fewdifferent ways; take the best from each and come up with a pair ofstatements that truly define the problem.

You’ll notice it’s a pair of statements. The first should define the how thingsstand today. The second statement should define how we want things tolook at a set point in the future.

A tool called SMART helps us to do this.

Red Text = Current StateGreen Text = Desired

State

Defining The Problem Using SMART

• Specific

Be Specific About The Problem. Problems Are A Symptom Of A Cause. We Do Not Know The Cause Yet,So Only Write Down What It Is You Are Unhappy With.

• Measurable

Say How Often This Happens, For How Long It Has Been Going On. How Much It Costs, WhateverYou Can Think Of. This Bit Is Nearly Always About Numbers.

• Achievable

Don’t Set A Goal You Can’t Achieve: That Will Set You Back Further Because You Will Be SettingYourself Up To Fail. Smaller, Achievable Goals Will Keep You Motivated As You Achieve Them.

• Relevant

Your Desired State Should Mean Reaching A Point Where The Problem Has Been Eliminated.If You Define It Incorrectly, You Will Probably Select A Solution That Doesn’t Eliminate The Problem.

• Time Bound

Always, ALWAYS, Put A Deadline In The Problem Statement – The Time By Which You Want To Have Achieved Your Goal.This Should Ideally Be No Longer Than A Month, In Order To Maintain Motivation. If It Is Much Longer Than A Month,You May Want To Consider Whether You Need To Break the Problem Down Into Smaller Chucks.


State

SMART: Practical Examples

1. I am in danger of losing my job due to repeated lateness. I wish to put in place abedtime and morning routine during my week off (next week) and I will use it toensure I improve my attendance from Monday 3rd October 2011.

2. I may lose my flat due to rent arrears. I need to find a way of decreasingmy costs by Monday 10th October 2011.

3. There is always a puddle of water behind my toilet. I want to call a plumberand get it sorted by Monday 17th October 2011.


State

SMART: Tips & Pitfalls

1. When writing the desired state, try not to simply write the opposite of the current state.

2. When writing the desired state, always think about what process can help us, but don’t define thecontent of the process.

In the first example, we have said it is a new routine that we need, but be careful because this isslipping into what is known as “Solution Mode”. If we define what process we need – a newbedtime / morning routine, it should be OK because we haven’t defined what that routine will contain – thatwould prove disastrous as we would have simply bypassed the whole process.

For example, we haven’t simply said that we need to set the alarm earlier. That would be to assume that the time we wake up is the only problem. So we need to leave it open enough for us to be able to explorethe problem with an open mind.

The important thing is not to select a solution before we have investigated the possible causes.This will introduce bias and we may subconsciously dismiss causes that don’t fit with thesolution that we have assumed is correct.

3. In the 3rd example, we have set ourselves up to fail. We have stated that we definitely want a plumber.As the example progresses, you will see why defining a very specific solution is dangerous.For now, to be factual and don’t make assumptions if it can be avoided.

Recommended Reading!

We STRONGLY recommend you read our article on The Hawthorn Effect before continuing. You need to be aware of it if you are intending to progress further with the Problem Solving

Tools.

http://www.dontbeacyb.org/?p=433

Brainstorming – Used To Find Possible Causes

Brainstorming is a very useful tool that is often overlooked because it conjures upimages of management meetings with management speak and blue skies thinking...

1. Get yourself a pack of Post-Its (I’ll explain why Post-Its are useful later)

2. Sit down and start thinking about what could be causing the problem.

3. Write down everything that comes into your head – don’t discard anythingyet because you may miss any emerging themes, or trends, if you do.

4. Find a nice big clean flat surface and stick them on it.

5. Stand back and take 10 minutes to read over them a few times – get to knowthem all – have a cup of coffee and relax – just keep reading them back to yourself.

Brainstorming: Practical Example 1/3

I am in danger of losing my job due to repeated lateness. I wish to put in place abedtime and morning routine during my week off (next week) and I will use it toensure I improve my attendance from Monday 3rd October 2011.


State

Late Nights Don’t

Hear Alarm

Hit Snooze

Too Often

Dawdle in the mornings

Have to make lunch before I

leave.

Insomnia

Iron Shirt

Too many beers

Train was late

My keys are never where I

left them.

Went back to

get glasses

I often have an upset stomach in the morning

There was a queue in

the coffee shop

Shined shoes Forgot

MP3 player

Burned toast

Kitchen flooded


I may lose my flat due to rent arrears. I need to find a way of decreasing mycosts by Monday 10th October 2011.


State

Had other bills

Forget to pay it

Amount seems to

vary!

Council are stroppy. They

get paid when I have it!

I never have the 2nd payment of

the month

I only know I’m skint when the cashpoint stops

giving me money.

I have to live as well

Buying present for my son

Fritter my

money

Just happened to be a lot of

bands I wanted to see

Peer pressure to go out

Don’t know where cash goes

Work lunches are expensive

The PS3 game I have been

waiting for was released


There is always a puddle of water behind my toilet. I want to call a plumberand get it sorted by Monday 17th October 2011.


State

Cistern leakingWater tank

leaking?

Toilet leaking

Something is leaking!

Cause & Effect Diagrams or Fishbone Diagrams

In Here We Write Our Problem

Definition (From the

SMART tool)

On The ‘Bones’ of the Fish, we create categories. On these Category Bones, we group our potential causes (and later on, we cando this with out potential solutions as well). Draw this out on a big sheet of paper and group your Post-It notes (I told you they wereimportant!) . Until you get some experience, try using the suggested categories below. As you learn more about the tool, you canincrease or decrease the number of bones or rename them with more meaningful categories to your particular problem.

Don’t be afraid to experiment!

Category: Thoughts Category: Actions

Category: FeelingsCategory: Feeldback

Budget Note: Why Am I using Post-Its & Big Sheets Of Paper?

The reason is a psychological effect from, visual management. If you have the luxury of the budget and a safe environment in which to display them, they serve as a constant reminder of progress. It is good practice to keep a notebook as well, but notebooks can be left in drawers and forgotten about easily. We need to make it as hard for you to leave this alone as possible, so the visual management element may seem over the top, when in fact it is actually a support mechanism to help you stick with this. If you can’t use this technique, you can still achieve the same results from CBT: as long as your willpower is strong, you will succeed anyway. Read the three red sentences for a summary.

Cause & Effect Diagram (Fishbone Diagram): Example 1/3

Top Tip: How To Use Our Examples

You may have noticed by now, but in case not, our examples are going to run in the same sequence throughout this presentations. We will make them available as 3 separate

downloads, one containing Example 1 all the way through, another containing just Example 2 and the 3rd with just Example 3. This will mean that you have access to 3 complete Problem

Solves to help guide you through your own experience with these tools.

I am in danger of losing my

job due to repeatedlateness. I wish to put

inplace a bedtime andmorning routine during

myweek off (next week)

and Iwill use it to ensure Iimprove my

attendancefrom Monday 3rd

October2011.

Thoughts Actions

FeelingsFeeldback

Late Nights

Don’t Hear Alarm

Hit Snooze Too Often

Dawdle in the mornings

Have to make lunch before I leave.

Insomnia

Iron Shirt

Too many beers

My keys are never where I left them.

Went back to get

glasses

I often have an upset stomach in the morning

Queue inthe coffee

shop

Shined shoes

Forgot MP3 player

Burned toast

Where Are The Missing Causes?

The eagle eyed among you may have noticed there were 2 Post-Its left after we transferredthem from the Brainstorming session to the Cause & Effect (Fishbone) Diagram.

They have been removed for good reason, but with an important exception attached to their removal!

Train was late

Kitchen flooded

These causes are outside our Sphere Of Influence. In other words, we had no control over them and we have low influence over them.

Remember that when we defined our problem using SMART, we said that the desired state had to be achievable. As such, workingwith an unavoidable cause like preventing one of many upstairs neighbours in your tower block from ever leaving the tap on againis not achievable, so we eliminate it here.

Likewise, if you are capable of getting every train in the UK to run on time 100% of the time, we take our hats off to you!

The important exception is that we must have been absolutely honest. If these were just excuses we made up for you boss, then weneed to be honest with ourselves now. Was it the train or was it me? If it was me, why was that? Is it already in my other causes?If yes, then fine, if not – we need to write it down. We cannot resolve a problem if we have chosen to bury it.

Later on, the 80/20 Rule will also help us to eliminate causes at the start.

Example 1/3

What Is this Telling Us?

It is telling us that the root cause of our problem (losing our job)is as a direct result of:

our Actions and the Feedback from those actions.

Why are there no thoughts? Why are there no feelings? We arefaced with losing our job yet the problem does not seemto be anything to do with our thoughts and our feelings.

And therein lies the root cause of the problem.

At this stage I am going to stop saying we.

This example comes from a real Problem Solve that Don’t Be A Cyb.org ran with their Citalopram Diary contributor, Mike.

The use of this tool will see more relevant with a little of Mike’s background.

Mike had his head a sand for a long time about depression and he had come to the conclusion that he needed help becauselosing his job simply wasn’t an option; his reaction was simply a learned behaviour though – I’m ill, I’ll go to the doctor. Therewas very little thought going on at that time.

In these circumstances, it isn’t surprising to see very little going on with thoughts and feelings because Mike hadn’t yetlearned that our thoughts impact directly upon actions and that both of these impact upon our feelings (see our presentationentitled An Introduction To The Basic Model Of CBT for more information on this).

Now that we know this, we can take account of it at each further step in the problem solve.

Example 1/3

Had other bills

Forget to pay it

Amount seems to

vary!




the month






I only know I’m skint when the cashpoint stops

giving me money.Fritter

my money


Work lunches are expensive

The PS3 game I have been

waiting for was released



Eliminating Duplicates

One reason it is such a good idea to standback and really get to know the Post-Its is thatyou will learn to spot things that mean the same.

Keep the one that is most relevant.

Notice that the Post-Its in green could all be related tospending, but have a think about them – a game, my son.bands, peer pressure to go to the pub, other bills ...

They are quite diverse and are likely to play a majorpart in our solution, so we will tweak The Cause &Effect (Fishbone) Diagram to show that instead.

I may lose my flat due to

rent arrears. I need to find a

way of decreasing my costs

by Monday 10th October

2011.

Thoughts Actions

FeelingsFeeldback

other bills

Forget to pay it

Amount seems to

vary!




the month







Work lunches are

expensive

PS3 game

Example 2/3


It is telling us that the root cause of our problem (Mike losing hisFlat) is as a direct result of:

Mike’s Actions and the Feedback from those actions.

On this problem, Mike has had some thoughts and we will look atthose when we start to interrogate causes with The 5 Whys.

For now, we can see that there are still very few feelings and thatthe main causes again seem to be trapped in the Actions andFeedback areas.

Looking at this in conjunction with Mike’s previous example, we are starting to build up a bigger picture. This will not comeinto play yet, but it is important to notice any trends that start developing.

If trends are noticed, it is important to consider them both within the current problem solve and also as the potential source for

a future problem solve.

We will look more at this after we have explored all 3 examples fully.

Example 2/3

There is always a puddle of

water behind my toilet. I

want to call a plumberand get it sorted by

Monday17th October 2011.

Thoughts Actions

FeelingsFeeldback

Cistern leaking

Water tank leaking?

Toilet leaking

Something is leaking!



This is telling us that there is only one potential cause – a leak.

If that is so, then the solution that has been written into theDesired State is correct and we should simply implement thatsolution and stop problem solving.

However, as mentioned earlier, this 3rd example is set up toillustrate a problem solving failure, so we will look at the potentialpitfalls of making assumptions and jumping into solution mode toosoon.

For now, this raises a good question about what types of issues Problem Solving is useful for.

The rule of thumb is that if you cannot confidently state one cause and one cause alone within 10 minutes, then you areprobably unsure of the real root cause. If that is the case, then Problem Solving is appropriate.

If however, following this example, you only identified one cause, then there is no point continuing to the next stages.

The important thing again is complete honesty with yourself.

If there is more than one cause but we are unwilling to admit some of them, then Problem Solving will fail because we wouldbe looking at the wrong problem.

Look to the real root cause – am I really ready to make changes if I cannot be honest with myself?

Example 3/3

Coming Up

That’s all we are going to look at for now.

In the next presentation, we will be looking at interrogating Causes using a tool knownas The 5 Whys.

This will help us move closer to the root causes and away from superficial causes.

We’ll look at Kipling’s Six Wise Men which can throw a whole new light on any problem.

We will also look at data gathering which will allow us to apply the 80/20 rule to ensurethat we get the maximum benefit for our effort.

If you have any questions about using the tools mentioned in this series, pleasefeel free to get in touch with us via our Contact Page.

Keep Thinking & Don’t Be A Cyb.org ☺

Fin

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CBT Problem Solving Tools Part 1/3