CognitiveBehavioral Therapy l Cognition Covert Behavior Private Behavior

Cognitive-Behavioral Therapy ��. ������������

l Cognition – Covert Behavior Private Behavior Knowledge Thinking Believe Attitude Value Attribution Expectation

A B 1 B Cognition Expectation C

Operant Conditioning l B. F. Skinner l B - Behavior (���� ) E – Environment )������ ( A – Antecedents (����� ) C - Consequences (������ ) l l l E

Reinforcement Theory Positive Reinforcement l Positive Reinforcer (C+) l Negative Reinforcement l Negative Reinforcer l Avoidance Behavior l Escape Behavior l

Punishment l Positive Punishment l Negative Punishment l l l Punisher Extinction

Social Cognitive Theory l A. Bandura Social Learning Theory l Acquired l Observational Learning l Model l Live Model l Symbolic Model l

Self-Regulation l Self-Awareness l -Self-Observation l -Judgment Process l -Self-Reaction l l Self-Efficacy

Information Processing Theory Input Sensory Store Selective Attention Rehearsal Short Term Memory Long Term Memory

Attribution 1. Internal vs External Locus of Control 2. Stable vs Unstable 3. Controllable vs Uncontrollable Expectation Motive

Considering factors before using CBT l Will Power l Self-Awareness l Sense of Self l Sense of Will

Two Basic Models of CBT l Cognitive Restructuring Therapy Teaches clients to change distorted and erroneous cognitions that are maintaining their problem behaviors. Used when clients’ problems are maintained by an excess maladaptive thoughts.

Cognitive Restructuring Techniques: Thought Stopping Rational Emotive Behavior Therapy (REBT) – Ellis Cognitive Therapy – Beck

l Cognitive-Behavioral Coping Skills Therapy Teaches clients adaptive responses— Both cognitive and overt behavioral—to deal effectively with difficult situations they encounter. Appropriate for problems that are maintained by a deficit in adaptive cognitions.

Cognitive-Behavioral Coping Skills Therapy Techniques: l Self-Instructional Training l Problem-Solving Therapy

Assessing Cognition l Interview l Self-Recording l Direct Self-Report Inventory l Think-Aloud Procedures

Functional Analysis Why do clients develop abnormal behaviors/mental disorders? l Can not prove by experiment. l Behavioral Psychologists: Learning l Functional relationship among A (Antecedents) B (Behavior) and C (Consequences ( l

l B. F. Skinner: Operant Conditioning Antecedents: crowded store l Consequences: increasing behavior l Positive Reinforcer l decreasing behavior l Punisher l Extinction l

Increasing Avoidance/Escape Behavior l Negative Reinforcer l l Reflex Behavior: Behavior that is elicited by Antecedents

Expansion of the Functional Analysis of Behavior l Added Cognitive factor (Covert Behavior) in Functional Analysis. A - Antecedents l B 1 - Cognition/Affection l B – Behavior l C - Consequences l

l Using information from an interviewing and self-monitoring (self-recording(

l A – Antecedents/Activating Event l ����������������� (A can be internal or external, real or imagined) l (A can be an event in the past, present, or future) l

Cognitive Restructuring Therapy

Thought Stopping l Thought Stopping has been successful in treating: l Anxiety l Compulsive Behavior l Headaches l excessive Masturbation l Physical Aggression l Self-Injurious Behaviors

Rational Emotive Behavior Therapy (REBT) Developed by Albert Ellis l Used to be RET l Early 90’s, Retitled REBT l l Psychological problems-negative emotions and maladaptive behaviors__are maintained by the INTERPRETATIONS people give to events in their lives.

l Epictetus: Greek Stoic Philosopher l People are disturbed not by things but by the views they take of them.

REBT begins with ABC l A: Activating experience l B: Beliefs, especially the IRRATIONAL l C: Consequences, the neurotic symptoms and negative emotions l l Adds D and E l D: Dispute the irrational beliefs l E: Effects of rational beliefs

Irrational Beliefs Absolute Thinking l Overgeneralization l Catastrophizing l Personal Worthlessness l Sense of Duty (Musturbation Habit( l

Disputing Irrational Beliefs Realistic or Empirical Methods l Logical Methods l Practical or Pragmatic Methods l

Created Rational Beliefs Using Rational Coping Self-Statements l Modeling/Positive visualization l Cost-Benefit Analysis l Relaxation l Reframing l Problem-Solving Method l Unconditional Self-Acceptance l

Cognitive Therapy Aaron Beck l University of Pennsylvania l ’ 1960 s l l Assumption: Psychological disorders are maintained by distorted cognition.

Automatic Thoughts l Depression l Anxiety Disorders l Phobias l Obsessive-compulsive Disorder l Panic attack l Personality Disorder l

Cognitive Distortions Arbitrary Inference l Overgeneralization l Selective Abstraction l Personalization l Dichotomous Thinking l Magnification and Minimization l

Process of Cognitive Therapy The goals of cognitive therapy are: 1. to correct clients’ faulty information processing; 2. to modify clients’ dysfunctional beliefs that maintain maladaptive behaviors and emotions; 3. to provide clients with the skills and experiences that create adaptive thinking.

Empathy l Socratic Dialogue l Hypotheses l Test Hypotheses (Collaborative Empiricism) l

Cognitive Interventions Analyze faulty logic l Provide relevant information l Three-Column Technique Situation -Auto. Thoughts -Log. Error l Generating alternative interpretations l Reattribution l Decatastrophizing l

Overt Behavioral Interventions l Activity Schedule l Mastery and Pleasure Rating l Graded Task Assignment

Cognitive-Behavioral Therapy: Coping Skills l Self-Instructional Training -Donald Michenbaum l Problem-Solving Therapy -D’Zurilla & Goldfried

Self-Instructional Training l Developed by D. Meichenbaum University of Waterloo, Canada Used to treat Impulsive Behaviors Stop, Look, and Listen

Self-Instructions serve six different functions: Preparing client to use Self-Instruction l Focusing Attention l Guiding Behavior l Providing Encouragement l Evaluating Performance l Reducing Anxiety l

Five steps of Self-Instructional Training Cognitive Modeling l Cognitive Participant Modeling l Overt Self-Instructions l Fading of Overt Self-Instructions l Covert Self-Instructions l

Impulsive Behaviors l Social Withdrawal l Anxiety l Fear l Anger l Obesity l Bulimia l Problem solving l

Problem-Solving Training Developed by D’Zurilla & Goldfried l Used to treat Stress Depression Agoraphobia Eating Disorders Smoking l

Migraine Headaches Aggressive Behaviors Anger Assertive Behaviors Classroom Behaviors Adjustment

l Problem-Solving Training serves a dual purpose: 1. treating the immediate problems 2. preparing clients to deal on their own with future problems.

Five basic stages of Problem. Solving Training Adopting a problem-solving orientation l Defining the problem and setting goals l Generating alternative solutions l Deciding on the best solution l Implementing the solution and evaluating its effects. l

l Adopting a problem-solving orientation: The client must understand that 1. It is essential to identify problems when they occur. 2. Problems are a normal part of life, and people can learn to cope with them. 3. Effective problem solving involves carefully assessing alternative courses of action.

l Defining the problem and setting goals: Therapist help client A precise definition of the problem is required. The GOALS can focus: 1. on the problem situation 2. on emotional and cognitive reactions to the problem situation 3. on both.

l Situation-Focused l Reaction-Focused

l l l Generating Alternative Solutions: Brainstorming Deciding on the Best Solution: Potential Consequences Implementing the Solution and Evaluating Its Effects:

��������� l l l l Problem-Solving Modeling Technique Behavioral Rehearsal Coaching Group Feedback Reinforcement/Stimulus Control Cognitive Restructuring Relaxation

l l l l Recreation Social Network Enhancement Small Group Methods Discussion Role-Playing Subgrouping Buddy System Group Exercises