Cognitive Therapy PDF

Tanta University Faculty of Nursing Psychiatric mental health nursing Cognitive Therapy Under supervision: Dr. Maryam Magdy  ‫‪Prepared by:‬‬ ‫دمحم خالد الديد محمهد احمد‬ ‫دم...

Tanta University Faculty of Nursing Psychiatric mental health nursing Cognitive Therapy Under supervision: Dr. Maryam Magdy  ‫‪Prepared by:‬‬ ‫دمحم خالد الديد محمهد احمد‬ ‫دمحم سعيد عبدالحكيم الحفني‬ ‫دمحم سالمو الدباعي سليمان‬ ‫دمحم عبدالرحمن محمهد محمهد عبدالرحمن دمحم‬ ‫دمحم عبدالكريم سعد الغزالي‬ ‫دمحم فخري عبدالجهاد علي عمر‬ ‫دمحم محمهد فهيم عبدربو قنديل‬ ‫دمحم محمهد مصطفى الرفاعي‬ ‫دمحم يحيى اسماعيل نهاره‬ ‫محمهد احمد على هللا حدوه‬ ‫محمهد رجب عطيو االقهر‬ ‫محمهد صالح منصهر مصلحي صالح‬ ‫محمهد دمحم انهر فرج هللا البديهني‬ ‫محمهد دمحم دمحم دوده‬ ‫ندى دمحم عبد المحدن محمهد‬ ‫ندرين مهسى مهسى جاب هللا‬ ‫نصر دمحم عبدالمحدن لبيب‬  Out Lines 1. Introduction 2. Cognitive theories Aaron beck Albert Ellis_ REBET 3. Cognitive therapy Definition Indications of cognitive therapy Goals of cognitive therapy Techniques of cognitive therapy  Introduction Cognitive therapy is a psychotherapeutic approach that focuses on the role of thoughts in influencing emotions and behaviors. Developed in the 1960s by psychiatrist Aaron T. Beck, it marked a shift in psychological treatment by emphasizing the identification and modification of distorted thinking patterns rather than relying solely on exploring past experiences or unconscious motivations. Cognitive Theories  Aaron Beck Aaron Beck, a psychiatrist, is widely recognized as the founder of Cognitive Therapy and one of the most influential figures in modern psychology. His work revolutionized the understanding of mental health disorders by focusing on the role of thought patterns in emotional and behavioral problems. Key Concepts: 1. Automatic Thoughts: Beck introduced the idea of automatic thoughts, which are spontaneous, often negative thoughts that arise in response to situations. These thoughts are not always based on reality and tend to be distorted, contributing to emotional distress. Example: After failing a test, a person might automatically think, “I‖m a failure,” leading to feelings of hopelessness. 2. Cognitive Distortions: Beck identified specific patterns of distorted thinking that fuel psychological disorders. Common examples include: Catastrophizing: Expecting the worst possible outcome. Overgeneralization: Drawing broad conclusions based on a single event. All-or-Nothing Thinking: Viewing situations in extremes (e.g., success or failure). 3. Cognitive Triad: Beck proposed that depression arises from a negative cognitive triad, which includes: Negative views about the self (e.g., "I am worthless"). Negative views about the world (e.g., "The world is unfair"). Negative views about the future (e.g., "Things will never improve").  Albert Ellis Albert Ellis, a prominent psychologist, developed Rational Emotive Behavior Therapy (REBT) in the 1950s, which is considered one of the earliest forms of cognitive-behavioral therapy. Ellis believed that irrational beliefs were at the core of emotional and behavioral disturbances. His approach aimed to identify, challenge, and replace these beliefs with rational, constructive ones.  Key Concepts of REBT 1. ABC Model: The foundation of REBT is the ABC Model, which explains how beliefs influence emotional outcomes: A: Activating Event – The situation or event that triggers a reaction (e.g., failing a test). B: Belief – The irrational or rational interpretation of the event (e.g., "I must always succeed"). C: Consequence – The emotional or behavioral outcome based on the belief (e.g., feeling worthless or anxious). According to Ellis, the belief (B), not the activating event (A), determines the emotional consequence (C). 2. Irrational Beliefs: Ellis identified common irrational beliefs that lead to emotional distress, such as: "I must be perfect in everything I do." "People must always treat me fairly and kindly." "Life must always go the way I want it to." These beliefs are rigid, unrealistic, and often result in negative emotions like anxiety, guilt, or anger. 3. Disputing Irrational Beliefs: A central part of REBT involves disputing irrational beliefs by challenging their logic and validity. Example: If a person believes, "I must always succeed," the therapist might ask, "Why must you succeed at everything? Is it realistic to expect perfection?" 4. Replacing Beliefs: After disputing irrational beliefs, individuals learn to replace them with rational, flexible alternatives. Example: Replacing "I must succeed" with "I would like to succeed, but failure doesn‖t define my worth."  Techniques Used in REBT: 1. Cognitive Restructuring: Helping individuals identify and challenge their irrational beliefs. 2. Behavioral Techniques: Encouraging individuals to test their beliefs through real-life experiences. Example: A person afraid of public speaking might practice delivering a speech to challenge their fear. 3. Emotive Techniques: Helping individuals develop emotional resilience, self-acceptance, and a more positive outlook. 4. Use of Humor: Ellis believed that humor could help individuals see the absurdity of their irrational beliefs and reduce emotional intensity.   DEFINITION OF COGNITIVE DISTORTION: Cognitive distortions are when our mind puts a ―spin‖ on the events we see and attaches a not-so-objective interpretation to what we experience—it happens all the time. We all have cognitive distortions, which are simply tendencies or patterns of thinking or believing, and they are especially common in people with depression and other mood disorders.  TYPES OF COGNITIVE DISTORTION: 1. All-or-Nothing Thinking This distortion is the culprit when we think in extremes, with no gray areas or middle ground. All-or-nothing thinkers often use words like "always" and "never" when describing things. “I always get stuck in traffic!” “My bosses never listen to me!” This type of thinking can magnify the stressors in our lives, making them seem like bigger problems than they may, in reality, be 2. Overgeneralization Those prone to overgeneralization take isolated events and assume all future events will be the same. For example, an overgeneralizer who faces a rude sales clerk may start believing that all sales clerks are rude and that shopping will always be a stressful experience 3. Mental Filter Those who tend toward mental filtering may gloss over positive events and hold a magnifying glass to the negative. Ten things can go right, but a person operating under the influence of a mental filter may only notice the one thing that goes wrong. (Add a little overgeneralization and all-or-nothing thinking to the equation, and you have a recipe for stress.) 4. Disqualifying the Positive Those who tend toward mental filtering may gloss over positive events and hold a magnifying glass to the negative. Ten things can go right, but a person operating under the influence of a mental filter may only notice the one thing that goes wrong. (Add a little overgeneralization and all-or-nothing thinking to the equation, and you have a recipe for stress.) 5. Magnification and minimization Similar to mental filtering and disqualifying the positive, this cognitive distortion involves emphasizing negative events more strongly and downplaying the positive ones. The customer service representative who only notices customers' complaints and fails to notice positive interactions is a victim of magnification and minimization. 6. Jumping to Conclusions We do this all the time. Rather than letting the evidence bring us to a logical conclusion, we set our sights on a conclusion (often negative) and then look for evidence to back it up, ignoring evidence to the contrary. The kid who decides everyone in his new class will hate him and ―knows‖ that they‖re only acting nice to him to avoid punishment is jumping to conclusions. 7. Emotional Reasoning This one is a close relative of jumping to conclusions because it involves ignoring certain facts when drawing conclusions. Emotional reasoners will consider their emotions about a situation as evidence rather than objectively looking at the facts. “I‖m feeling completely overwhelmed, therefore, my problems must be completely beyond my ability to solve them,” or “I‖m angry with you; therefore, you must be in the wrong here” are both examples of faulty emotional reasoning. 8. Should" Statements Those who rely on ―should statements‖ tend to have rigid rules, set by themselves or others, that always need to be followed — at least in their minds. They don‖t see flexibility in different circumstances and put themselves under considerable stress trying to live up to these self-imposed expectations. If your internal dialogue involves many ―shoulds,‖ you may be influenced by this cognitive distortion. 9. Labeling and mislabeling Those who label or mislabel will habitually place labels that are often inaccurate or negative on themselves and others. “He‖s a whiner.” “She‖s a phony.” “I‖m just a useless worrier.” These labels tend to define people and contribute to a one-dimensional view of them, paving the way for overgeneralizations to move in. Labeling cages people into roles that don‖t always apply and prevents us from seeing people (ourselves included) as we really are. It‖s also a big no-no in relationship conflicts. 10. Personalization Those who personalize their stressors tend to blame themselves or others for things over which they have no control, creating stress where it need not be. Those prone to personalization tend to blame themselves for the actions of others or blame others for their own feelings. If any of these feel a little too familiar, that‖s a good thing: recognizing a cognitive distortion is the first step of moving past it.  Coping With Cognitive Distortions. 1. Become More Aware of Your Thoughts 2. Recognize the Effect of Cognitive Distortions 3. Challenge Your Thoughts 4. Talk to a Professional  Definition of Cognitive Therapy Cognitive therapy is a structured, short-term, and goal-oriented form of psychotherapy that focuses on identifying and changing negative or distorted thought patterns that contribute to emotional distress and maladaptive behaviors. It is based on the idea that our thoughts significantly influence our emotions and behaviors, and by altering unhelpful thoughts, individuals can achieve improved mental health and well-being. Indications of Cognitive Therapy: Cognitive therapy is highly effective in treating a range of psychological issues, particularly those involving emotional and behavioral difficulties driven by negative thought patterns. Below are some of the main conditions and situations where cognitive therapy is indicated: 1. Mood Disorders 2. Anxiety Disorders 3. Post-Traumatic Stress Disorder (PTSD) 4. Obsessive-Compulsive Disorder (OCD) 5. Eating Disorders 6. Stress and Anger Management 7. Substance Use Disorders 8. Chronic Pain and Health Conditions 9. Sleep Disorders 10. Low Self-Esteem 11. Grief and Loss 12. Relationship Problems  Goals of cognitive therapy The main goals of cognitive therapy are focused on fostering healthier thinking, emotional regulation, and coping strategies. Below are the primary goals: 1. Identify Negative or Distorted Thoughts. 2. Challenge and Dispute Negative Thoughts. 3. Reduce Emotional Distress and Maladaptive Behaviors. 4. Improve Problem-Solving and Coping Skills. 5. Prevent Relapse and Foster Long-Term Resilience. 6. Promote Healthier Relationships. 7. Enhance Overall Well-Being and Quality of Life. the key techniques used in cognitive therapy: 1. Cognitive Restructuring (Cognitive Reframing): Purpose: To identify and replace distorted or irrational thoughts with more balanced, realistic ones. How it Works: The therapist helps the individual examine the evidence for and against their negative thoughts, challenges those thoughts, and guides them to adopt healthier, more rational alternatives. Example: A person who thinks, "I will fail the test and disappoint everyone," might reframe it as, "I‖ve studied well and can do my best. Even if I don‖t do perfectly, it‖s not the end of the world." 2. Socratic Questioning: Purpose:To stimulate critical thinking and self-reflection in the patient. How it Works: The therapist uses open-ended, probing questions to help the individual explore the logic and validity of their thoughts. This technique encourages individuals to come to their own conclusions, rather than simply providing them with answers. Example: If someone believes, "I can never succeed," the therapist might ask, "What evidence do you have to support that belief? Can you think of times you‖ve succeeded in the past?" 3. Thought Records (Thought Diaries): Purpose: To increase awareness of automatic negative thoughts and track progress in challenging them. How it Works: Individuals are encouraged to write down their thoughts, identify cognitive distortions, rate the intensity of their emotions, and come up with more balanced alternative thoughts. This process helps individuals see patterns in their thinking and emotional responses over time. Example: An individual might record an event (e.g., "I made a mistake at work"), their automatic thoughts (e.g., "I‖m incompetent") and emotional reactions (e.g., "I feel worthless") before challenging the thought with a more realistic alternative (e.g., "Everyone makes mistakes, and I can learn from this experience") and noting a reduction in distress. 4. Behavioral Experiments: Purpose: To test the validity of beliefs through real-life experiences. How it Works: The therapist designs activities or experiments to help the individual test their distorted beliefs in the real world. This can involve trying new behaviors or experiencing feared situations and observing the outcomes, which often disproves irrational thoughts. Example: A person with social anxiety might be encouraged to attend a social gathering and observe whether people actually judge them negatively, thus challenging their belief that they are always judged harshly. 5. Activity Scheduling and Planning: Purpose: To increase engagement in enjoyable or meaningful activities and improve mood. How it Works: The therapist helps the individual plan and schedule enjoyable, productive, or rewarding activities throughout the week. This is particularly useful for individuals experiencing depression, as it helps them break the cycle of inactivity and negative thinking. Example: A person with depression might schedule small, manageable tasks, such as walking outside, engaging in a hobby, or meeting a friend, to gradually lift their mood. 6. Mindfulness and Acceptance-Based Techniques: Purpose: To enhance awareness of the present moment and reduce emotional distress by changing the relationship with thoughts. How it Works: While not a central feature of traditional cognitive therapy, mindfulness techniques are often incorporated to help individuals observe their thoughts non-judgmentally and accept them without trying to control or change them immediately. This reduces the impact of negative thoughts on emotions and behavior. Example: Practicing deep breathing and observing thoughts without reacting to them can help a person experiencing anxiety avoid getting caught up in the cycle of worry. 7. Graded Exposure: Purpose: To reduce avoidance and anxiety by gradually facing feared situations. How it Works: The individual is gradually exposed to situations or objects they fear in a step-by-step manner. Each step is designed to be manageable and allows the person to build confidence in their ability to handle anxiety-provoking situations. Example: A person with a fear of flying might start by reading about flying, then watching videos, and eventually taking short flights, progressively reducing their anxiety. 8. Challenging Core Beliefs (Schemas): Purpose: To address deeply held, often unconscious beliefs that shape one‖s interpretation of the world. How it Works: Cognitive therapy helps individuals identify and challenge maladaptive core beliefs (schemas), which are often formed in childhood. By addressing these core beliefs, individuals can reduce their influence on their current thinking patterns and emotional responses. Example: Someone with a core belief that they are "unworthy" might work with their therapist to challenge that belief and develop healthier, more balanced self- perceptions. 9. Problem-Solving Training: Purpose: To enhance an individual‖s ability to cope with and manage stressors or challenges. How it Works: The therapist helps the individual break down a problem into smaller, manageable steps, identify potential solutions, and evaluate the pros and cons of each option. This encourages a proactive, solution-focused mindset. Example: If someone feels overwhelmed by work deadlines, they might use problem-solving techniques to prioritize tasks, break them into smaller steps, and develop a realistic schedule. 10. Cognitive Restructuring Through Self-Talk: Purpose: To change the internal dialogue that contributes to negative emotions. How it Works: Individuals are encouraged to become aware of their internal self- talk and replace negative or self-critical statements with more compassionate, constructive messages. Example: A person who constantly criticizes themselves might replace thoughts like "I‖m so stupid" with "I made a mistake, but I can learn from it."  References  Very Well Mind: https://www.verywellmind.com/what-is-cognitive-behavior-therapy-2795747  The Washington Center For Cognitive Therapy: https://washingtoncenterforcognitivetherapy.com/treatment-models/cognitive- therapy/goals-of-cognitive-therapy/  Very Well Mind: https://www.verywellmind.com/what-is-cognitive-behavior-therapy-2795747  Positive Psychology: https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques- worksheets/  Very Well Mind: https://www.verywellmind.com/what-is-cognitive-behavior-therapy-2795747  Very Well Mind: https://www.verywellmind.com/cognitive-distortions-and-stress-3144921