Chapter 9 Cognitive and CognitiveBehavioral Therapy Cognitive and
Chapter 9 Cognitive and Cognitive-Behavioral Therapy
Cognitive and Cognitive. Behavior Therapy ¨ Cognitions – thoughts, beliefs, and internal images that people have about events in their lives. ¨ Cognitive counseling theories focus on mental processes and their influences on mental health. ¨ A common premise is that how people think largely determines how they feel and behave.
Aaron Beck ¨ A Philadelphia psychiatrist who was originally trained as a psychoanalyst. ¨ His approach to mental disorders emphasizes the importance of cognitive thinking, especially dysfunctional thoughts. ¨ Found that cognitive therapy is effective as a short-term treatment for depression and general anxiety.
Donald Meichenbaum ¨ Considered to be one of the founders of Cognitive-Behavior Therapy (CBT). ¨ Born and raised in New York City where he frequently observed people on the street talking to themselves. ¨ Noted for his work with individuals with anger control and aggressive behavior and training adults with post-traumatic stress disorder.
View of Human Nature/Personality ¨ Usually employed with individuals who suffer from: – dysfunctional automatic thoughts - involving content specific to an event. – schemata - general rules about themselves or the world associated with an event. ¨ These individuals often engage is self- statements that affect their behavior.
Cognitive Distortions ¨ “All or Nothing” Thinking ¨ Selective Abstraction ¨ Overgeneralization ¨ Magnification ¨ Minimization ¨ Personalization ¨ Labeling (Mislabeling) ¨ Catastrophizing ¨ Mind-reading ¨ Negative Predictions
Roles of the Counselor ¨ Operate as a collaborator. ¨ Share responsibility with clients to bring about change. ¨ Function as experts on cognitions, behaviors, and emotions. ¨ Allow clients to examine their beliefs functionally. ¨ Diagnoses are used only as a way of working with clients to overcome a disorder.
Goals ¨ Primary goal is to teach clients ways to monitor their negative or automatic thoughts. ¨ Recognize the relationship between thoughts and emotions or behavior. ¨ Compile evidence for and against the distorted automatic thoughts.
Process and Techniques ¨ Specific and goal-directed. ¨ Emphasizes modification of thoughts in order to bring about therapeutic changes. ¨ Thought organization – Cold cognition – descriptive and non-evaluative – Warm cognition – preferences and nonpreferences – Hot cognition – heavily-laden emotionaldemand statements
4 Step Procedure of Implementing Cognitive Strategies (Burns, 1989; Schuyler, 1991) 1. 2. 3. 4. Use standardized guidelines for understanding in a concrete manner the events in people’s lives. Set up a way of recording or reflecting people’s thoughts about those events in order to understand their cognitions in a clear, precise way. Counselors and clients work to find a means to identify and challenge distorted thoughts. Implement new ways of thinking that are realistic and productive.
Prevalent Cognitive Techniques ¨ Specifying automatic thoughts. ¨ Homework. ¨ Cognitive interventions. – Challenging absolutes. – Reattribution. – Labeling of distortions. – Challenging “All or Nothing” thinking. ¨ Cognitive Rehearsals. ¨ Scriptotherapy.
Cognitive-Behavioral Techniques ¨ CBT’s as a group emphasize: – The present – The environment – Learning ¨ Common Interventions of CBT – Self-instruction training – Stress-inoculation training – Thought-stopping – Cognitive restructuring
Multicultural and Gender Sensitive Issues ¨ Cognitive counseling and CBT approaches are applicable to multicultural populations. ¨ Cognitive approaches may also be appropriate for both men and women in dealing with gender-specific concerns. ¨ Drawback: Some women may become too dependent on their counselors to structure sessions and help them examine their beliefs.
Strengths and Contributions ¨ Focused on teaching how to identify and monitor thoughts and behaviors and how to change or modify them. ¨ Proactive in nature. ¨ Demystify the process and techniques that are associated with choice and change. ¨ Generally empowering. ¨ Applicable to a wide range of disorders.
Limitations and Criticisms ¨ For maximum benefit, clients need to have average or above-average intelligence. ¨ Clients can not be psychotic or disabled by present problems. ¨ Clients must be willing and able to complete systematic homework assignments. ¨ Clients must possess a repertoire of behavioral skills and responses or be able to learn them rapidly. ¨ Do not explore past influences including the unconscious or underlying conflicts.
The Case of Linda: Cognitive and Cognitive-Behavioral Therapy ¨ How would you conceptualize this case using cognitive and cognitive-behavior therapy? ¨ What would be your treatment plan for this client using a cognitive or cognitive-behavioral approach?
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