Brief Health Focused Culturally Responsive CBT

Brief Health Focused CBT Transforming suffering to strengths

CBT Simple OverviewSimple overview

CBT is a time limited, collaborative, here and now focused treatment aimed at helping patients through developing more accurate healthy thoughts, increased coping skills, behavioral activation and emotional regulation skills.

Aaron Beck CBT in 6 Min

Therapeutic Relationship The CBT relationship is based on collaborative empiricism The Patient and the Therapist collaborate to discover facts and truth grounded in reality.

Good CBT Requires: Warmth, Empathy, Consideration, Exploration and Curiosity, Ability to Give Feedback and Solid Doubt or show me the facts mentality.

The CBT therapist brings expertise in therapy and skills but expects the patient to be experts in themselves and bring that expertise into the treatment.

Three Key Parts of Health Focused CBTFunctional Assessment: Looks at the real life way that mental and physical health challenges arise. Not simple that some one is depressed but what is that depression in this persons life.

Skills Training: Is active and focused on helping enhance the ability to change thoughts, improve emotions and take effective actions.

Changing Thoughts: Negative thoughts are a core part of how CBT conceptualizes mental suffering. Clinicians help patients gain skills to challenge their thoughts, recognize distorted thinking, find more accurate and helpful thoughts and cope cognitively.

The Core Levers of Change

What Creates Change?

In CBT the core of human suffering is developed by any one of the core components. These are thoughts, feelings and behaviors.

If a patient changes how they act it will change their thoughts and if they change their thoughts they can change how they act.

Principles of CBTCBT is Time LimitedCBT is BiopsychosocialCBT is Focused on Present CBT is Person Centered CBT uses the Collaborative SetCBT uses Regular Homework CBT takes Active StanceCBT therapists help Challenge/Change Thoughts

CBT Formulation

Thought Skills Challenging Thoughts: Many times inaccurate thoughts go unchallenged. They can be like a Trojan Horse we believe them because they are inside our mind. Examining thoughts can lead to changing thoughts. Accepting Thoughts: We can simply accept thoughts as they are. Not fixing them but not in the words of ACT fusing with them.

Thought Stopping: We can use various skills to stop thoughts. The most simple of these is to simply using our inner voice to say stop to an unhelpful thoughts.

Distraction: Focusing on something other then a thought can allow the thoughts to stop and reduce their impact.

Thought Replacement: We can replace a negative unhelpful thought with a more true and more helpful thought.

Role Play Developing Thought Skills

The Cognitive Triad

The Cognitive Triad

Cognitive Distortions Cognitive distortions are common and habitual ways that people can misinterpret situations, events, others, and expectations about the future.

Changing Thought Habits

Automatic Thoughts

Automatic Thoughts Lead to Behaviors

Core CognitionsCore Cognitions are the central thoughts that a person believes and guide thinking, actions and feelings. These tend to be deeply held beliefs that were formed in difficult moments and never examined.

The way we work with core cognitions is to identify them, develop evidence to counter them and come up with more accurate core beliefs. Core cognitions lead to automatic thoughts.

Automatic Thoughts Lead to Core Cognitions

CBT Session OverviewThe first 1/3 or 20 min: Is focused on assessing where a patient is, their concerns about tx and reviewing homework.

The second 1/3 20 min: Is focused on introducing session topic and relating topic to patients life and symptoms.

The third 1/3 20 min: Is focused on exploring patients understanding and reaction to interventions, developing home work and reviewing and addressing risk and challenges they may face in HW or in the week.