Cognitive Behavioural Therapy PDF

Cognitive behavioural therapy Chapter 07 Introductory questions: Revisiting cognitive behavioural basics Behaviour follows cognitions and emotions. As simple as that. Do you agree? Can long-standing habits be unlearned? Can adult counselling be effective without revisiting...

Cognitive behavioural therapy Chapter 07 Introductory questions: Revisiting cognitive behavioural basics Behaviour follows cognitions and emotions. As simple as that. Do you agree? Can long-standing habits be unlearned? Can adult counselling be effective without revisiting early childhood experiences?  Pioneers, context, and history Figure 7.5 Aaron T. Beck Figure 7.2 Albert Ellis Figure 7.7 Arnold Allan Lazarus  Pioneers, context, and history Figure 7.9 Christine Figure 7.8 Donald Padesky Figure 7.10 Kathleen Mooney Meichenbaum Relevant theoretical concepts Self-statements: Things you tell and believe yourself, about yourself Habits: Repeated behaviours about events, things, or situations with little or no conscious intent, that is, you are often unaware of it Schemas: Someone’s mental representation of the relationships of any components of things, events, or situations Beliefs: Declarations that someone makes to themselves at a pre/conscious level which influence conscious thoughts  Cognitive behavioural therapy (CBT) and others Beliefs (cognitions), schemas, and emotive experiences link to behaviours (habits) Rigid or too flexible schemas = psychopathology Social cultural context influences beliefs, actions, and feelings CBT emerged from behavioural therapy CBT includes rational emotive behavioural therapy (REBT) and cognitive therapy (CT) 22 types of CBTs See Figure 7.1 Five (5) leading CBTs Rational emotive behavioural therapy (REBT) Cognitive therapy (CT) Multimodal therapy (MMT) Cognitive behavioural modification (CBM) Strength-based CBT (SB- CBT) Rational emotive behavioural therapy (REBT) Albert Ellis Believed that disturbances originate from beliefs and perceptions and not from objective facts Rational and irrational beliefs (see Figure 7.3) The ABCDEF model (see Figure 7.4) A: Activating event – Something happens or is experienced B: Behavioural belief – Event is evaluated to form a belief C: Consequences – Emotional consequences are experienced because of the belief D: Disputation – Beliefs are disputed E: Effect – A more rational behavioural effect because of the disputation F: Feelings – More positive feelings are experienced  REBT: Cognitions Cold Warm Hot cognition cognition cognitions s s Objective and Preferences Self-imposed non- and wants ‘musts’/’rules’ evaluative facts I will mow the Because I I must law the lawn later prefer the lawn later today garden to today, because I did look neat, I otherwise it a while ago. mow the lawn people will quite often. think I am lazy.  Cognitive therapy (CT) Aaron T Beck Meaning of an experience ►Feelings about self ►Behaviour Cognitive errors lead to faulty thinking/evaluation Arbitrary inferences: “I am sure most people at the party will ignore me”. Selective abstraction: “I got 95% for the test. It is such a shame that I did not know 5% of the work”. Overgeneralisation: “Last time I played hockey I was injured. I would rather not play any sport again”. Magnification/generalisation: “I failed my first test. I will definitely not get this degree”. Personalisation: “The teacher looks upset. I am sure I did something wrong”. (Mis)labelling: “He didn’t say much; he must be embarrassed about something”. Dichotomous thinking: “Only an A is good enough. A B might just as well be a F”. See Table 7.1  Multimodal therapy Arnold Allan Lazarus 7 elements to consider (The BASIC- I.D.) B: Behaviour A: Affect (emotions) S: Sensations I: Imagery C: Cognitions I: Interpersonal functioning D: Drugs and biology Problems are multi-layered Customise treatment to create a BASIC-I.D. profile  Cognitive behavioural modification (CBM) Donald Meichenbaum Combines CBT and BT Self-talk guides behaviour Aim is to change self-talk 3 phases: Self-observation New dialogue/narrative New skills  Strength-based cognitive behavioural therapy Christine Padesky and Kathleen Mooney Identify and discover existing strengths Reflect on success behaviour New ways of thinking and coping strategies that align with personal strengths Stage 1: Explore and find strengths and successes Stage 2: Discover more strategies for success–from specific to general Stage 3: Apply and implement new strategies Stage 4: Practise the use of new strengths in difficult areas Core constructs and assumptions: Cognitive behavioural therapy Beliefs guide behaviour/dysfunctional beliefs/irrational thoughts/cognitive errors/ cognitions, emotions, and behaviour in interactions/people naturally strive towards happiness/information processes to find meaning/everyone has irrational beliefs/it is possible to think differently/ internal locus of control  CBT: Maladjustment/pathology Biological predispositions Social expectations Philosophical (cultural and social identities) Psychological (rules and irrational beliefs) Musturbations: ‘awfulising’/ self- damnation/ ‘I-can’t stand it’  CBT: Goals and Holistic processes Meaning Self- An integrated interest approach to foster self- Indices actualisation Self- for self- Social actualisati Equip clients with skills on actualisati interest on Accepting Scientific uncertaint thinking y Commit externally  CBT: Counselling relationship 10–16 sessions (30–50 minutes each) Empathic understanding and accurate communication Collaborative More directive (teachers/guides) Structured process and position to take CBT: Case conceptualisation Starts with formulating the case ▼ Guided imagery to target belief schemas ▼ Explore the ABCDEF model ▼ Explore ‘musturbations’ (make use of thought records/pie charts/coping card)  CBT: Techniques Cognitive Emotive Behavioural Psychoeducation and Homework bibliography Penalisation Negative imagery Offer new choices and actions Flooding Future imaging Analogy, parable, and metaphor Role play Skills training Paralinguistics Stepping out of character Relaxation training Therapeutic markers Emotionally charged language Reduction of absurdity Visual aids Contradict beliefs (devil’s advocate) Pragmatic disputes Paradoxical intention/humour Semantic precision Application examples: Case studies pp. 214– 215 Table 7.2 Johannes Adams Sipho Gumede Nobuhle Dlamini  Chapter reflection, evaluation, and relevancy Which strengths of cognitive behavioural therapy are especially relevant within an African context? Which limitations of cognitive behavioural therapy are especially relevant within an African context? For which typical ‘problems’/‘disorders’ will cognitive behavioural therapy be indicated?