Cognitive Therapies Module 71 Cognitive Therapy Assumes our

Cognitive Therapies Module 71

Cognitive Therapy • Assumes our thinking effects our feelings – Thoughts intervene between events and our emotional reactions – Depression often caused by self-blaming and overgeneralizing explanations of bad events • Therapy focuses on recognition and alteration of unhealthy thinking patterns – Teaches people new, more adaptive ways of thinking and acting

Self-Serving/Defeating Bias • Self-Serving Bias - Tendency to judge oneself favorably – Healthy people tend to do this • Self-Defeating Bias tendency to blame themselves for problems and credit the environment for successes • Severely depressed patients tend to do this

Rational Emotive Behavior Therapy • Developed by Albert Ellis • People’s difficulties are caused by their faulty expectations and irrational beliefs • Goal is to expose and confront the person’s core irrational beliefs • ABCDE model: § Activating Event § Disputing Irrational Beliefs § Beliefs - Irrational § Effective ways of § Consequences thinking & behaving developed • When an Activating event (A) occurs, it is the person’s Beliefs (B) about the event that cause emotional Consequences (C) • Effective in the treatment of depression, social phobia, and certain anxiety disorders, and in helping people overcome selfdefeating behaviors

How REBT Works • Step 1: Identify the core irrational beliefs or self talk that underlie personal distress • Step 2: Vigorously dispute and challenge the irrational beliefs. Therapist acts as a teacher to show patient how to do this. – Stop Irrational Thoughts – Reframe them to be more positive – Dispute irrational beliefs with evidence • Rational-emotive therapists tend to be very direct and even confrontational • From the client’s perspective, rational-emotive therapy requires considerable effort – person must admit her irrational beliefs and accept the fact that those beliefs are irrational and unhealthy – client must radically change her way of interpreting and responding to stressful events

REBT – AN EXAMPLE • PROBLEM: Social Phobic concerned they will be publicly embarrassed when giving a class presentation. • SOLUTION: Therapist questions the likelihood of such embarrassment occurring and impact of it. • Therapist’s goal is to show the client that not only is their failure unlikely, but even if it did happen, it would not be a big deal.

REBT Therapy

Aaron Beck’s Cognitive Therapy • Based on the assumption that thoughts, moods, and behaviors are interrelated • Beck believes that depression and other psychological problems are caused by distorted thinking and catastrophic beliefs • Focuses on changing the client’s unrealistic beliefs • Therapist acts as model and aims for a collaborative therapeutic climate • Therapy includes homework of writing down automatic thoughts or habits • Gentler, less combative approach than Albert Ellis’ REBT

Cognitive Therapy: How it Works • CT therapist encourages the client to empirically test the accuracy of his or her assumptions and beliefs – The client learns to recognize and monitor the automatic thoughts that occur without conscious effort or control – The client learns how to empirically test the reality of the automatic thoughts that are so upsetting • CT is very effective in treating depression, anxiety disorders, eating disorders, PTSD, and relationship problems. It may also help prevent depression from recurring

Ellis’ REBT vs. Beck’s Cognitive Therapy • REBT therapists logically debate • Beck stresses the quality of the and vigorously challenge or dispute therapeutic relationship the irrationality of a client’s beliefs. • Beck places more emphasis on the • Ellis views therapist as a teacher and does not think that a client discovering misconceptions warm personal relationship with a for themselves. client is essential. • The method is based upon the • REBT is often highly directive, particular disorder. persuasive and confrontive. • REBT uses different methods depending on the personality of the client

Cognitive Behavioral Therapy • An integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing inappropriate behaviors) • Based on the assumption that cognitions, behaviors, and emotional responses are interrelated • Cognitive-behavioral therapists challenge maladaptive beliefs and substitute more adaptive cognitions • They use behavior modification, shaping, reinforcement, and modeling to teach problem solving and change unhealthy behavior patterns • Effective for treatment of anxiety, depression & anorexia nervosa

Prevalence of Cognitive Therapy Half of all faculty in accredited clinical psychology doctoral programs now align themselves with a cognitive or cognitivebehavior therapy orientation. (Data from Mayne & others, 1994. Note: Some faculty identify with more than one perspective. )

Family and Group Therapies

Group and Family Therapy • Group therapy—one or more therapists working with several people at the same time. • Family therapy—based on the assumption that the family is a system and treats the family as a unit. • Couple therapy—relationship therapy that helps with difficulty in marriage or other committed relationships

Group Therapy • Having a therapist work with a number of patients at one time • Groups usually consist of 6 to 10 people • Cognitive, behavior, and humanistic therapists all can lead group therapies.

Advantage of Group Therapy • Therapists can help more than one person at a time. • Overall session cost is lower. • Patients interact with others having the same problems as they have. • Builds a sense of community

Self-help groups: Helping yourself by helping others • Self-help groups and support groups are typically organized and led by nonprofessionals • The groups are either free or charge nominal fees to cover the cost of materials. • Typically, members have a common problem and meet for the purpose of exchanging support • The format of such groups varies enormously, but many follow a 12 -step approach • Self-help groups can be as effective as therapy • More research is needed on why self-help groups are effective and on the kinds of people and problems that are most likely to benefit from them

Family Therapy • Therapy that treats the family as a system • Views the patient’s problems as influenced by or directed at family members • Every family has certain unspoken “rules” of interaction and communication. • Issues are explored, and unhealthy patterns of family interaction can be identified and replaced with new “rules” that promote the psychological health of the family • Attempts to guide the family toward positive relationships and improved communication