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Cognitive Behavior Therapy

By: Lindsay Blank, Jennifer Kotch, & Jose Amaro
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lindsay blank

on 13 November 2012

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Transcript of Cognitive Behavior Therapy

COGNITIVE BEHAVIOR
THERAPY By: Lindsay Blank, Jennifer Kotch,
& Jose Amaro CBT Techniques Aw Man... It's Homework Time!! Socratic Questioning Albert Ellis - ABC Framework CONTRIBUTIONS Albert Ellis Donald Meichenbaum Judith S. Beck Key Players Born in Pittsburgh
Hospitalized 9 times as child
Founder of approach to psychotherapy known as Rational Emotive Behavioral Therapy (REBT)
Fear of public speaking and rejection of women
Established the Albert Ellis Institute Born in Philadelphia
Second of Four Children
Daughter of Aaron Beck, Father of Cognitive Therapy
Began career teaching children with learning disabilities
Expert in cognitive behavior therapy
President of non-profit, Beck Institute for Cognitive Behavior Therapy in Philadelphia; co-founded with father. Born in New York City
Became a natural "people watcher" to understand human behavior
Interested in how people came to engage in destructive behavior like the Holocaust while other people grew up learning to care for others.
Psychotherapeutic approach of constructivist narrative therapy What do you think? A-activating event

B- belief
C- emotional & behavioral consequence
D- disputing intervention
E-effect
F-new feeling Guide for self discovery
Autonomy
Reduces resistance
Seven types of questions Change in accurate thoughts or beliefs
Self management skills
Schemas Aaron Temkin Beck Born in Providence, Rhode Island
Youngest of five children
Nearly died by age seven
Used personal problems to understand others when developing cognitive theory
Graduate from Brown University and Yale School of Medicine
Developed cognitive theory of depression
Pioneering figure in cognitive therapy Dr.Judith Beck. (2011) Hollon, S. D. (2010). Truscott, D. (2010). Yalom,(2002) Overholser, James C., (1993). Shurick, A.A., Hamilton, J.R., Roy, L.T., Gross, A.K., & Phelps, E.A., (2012). Kazantzis, Nikolaos, Dattilio, Frank M., (2010) Cognitive Restructuring Stress Inoculation Training Decrease anxiety, stress and irrational thinking
Conceptual Education
Application Phase Stop your Thoughts! FREEZE!!! The client will learn to replace the disturbing, irrational thought with a rational cognition or the irrational thought will quickly return Rational Emotive Imagery Most effective if there is a specific situation in which anxiety occurs for the client
5 steps
Goal: to use the same calming thought each time anxious feelings begin CONTRIBUTIONS What is Cognitive Behavior Therapy?


1. Cognitive activity affects behavior
2. Cognitive activity may be monitored and altered
3. Desired behavior change may be effected through cognitive change Three fundamental propositions: Three classes of cognitive behavioral therapy: 1. Coping skills
2. Problem solving
3. Cognitive restructure Cognitive Revolution A- Failing Theories class =
Depression
B- I am stupid!
C- Drop out of graduate school

D- Get tutoring

E- Improves Grades
F- Improve Self confidence EXAMPLES RULES Can you tell Sarah Palin's
Cognitive Distortions? Aaron Beck's Cognitive Therapy Automatic Thoughts:



Intermediate beliefs:


Core Beliefs "If people don’t like me, I’ll never
become president” Dropping out of the presidential race “I’m not good enough” Cognitive behavior modification
Healthy self Talk
Behave our way into thinking Meichenbaum's CBM Some Differences . . . REBT- Teaching centered

CT- Client Centered

CBM- Behavior Focused Sheehy & Horan (2004) Wilde, (2008) Wilde, (2011) Depression
Generalized Anxiety Disorder
Phobias
Schizophrenia
Bulimia Nervosa
Panic Disorder
PTSD
OCD
Bipolar Disorder EFFICACY Significant Improvement Areas of Concern Cognitively impaired
Children
Psychosis
Dementia
Hearing impaired
Culture
Borderline Personality
Sex Offenders There's More Than one way to Skin a Cat . . . Rational Emotive Behavior Therapy: Albert Ellis (ABCDE)
Cognitive Therapy: Aaron Beck & Judith Beck (“Depression”-BDI)
Self- Instructional Training + Stress Inoculation: Donald Miechenbaum (self- talk)
Self- Control Treatments: Marvin Goldfried (Systematic desensitization)
Problem - Solving Therapy: D’Zurilla & Goldried
Structural & Constructivist Psychotherapy: Guidano & Liotti
ACT: Steven Hayes Empirical Evidence I WANT PROOF!! 1. A study was completed on adolescents from a lower socio-economic status who were diagnosed with PTSD. These adolescents were receiving other services (i.e. case management, medication management, etc). The study found that after three months, the adolescents were reporting less PTSD and depression symptoms, however, aggressive behaviors did not change.

2. A study was conducted using forty adolescents from an inpatient psychiatric ward, who had substance abuse problems (alcohol and cannabis abuse). These adolescents and their families received CBT for six months, which included individual, family and parenting sessions. The days of using these substances did not decrease; however, there was a decrease in the amount of intake of each substance. It was also found that with the decrease in the intake of the substance, the suicidal behavior also decreased. Emergency services, hospitalizations, and arrests also decreased after receiving CBT. Dozois & Beck, (2011). Beck, (2011). Dobson, (2010). Clark & Beck, (2011). Beck, (2011). Dobson, (2010). Dozois & Beck, (2011). Beck, (2011). 3. A meta- analysis was conducted to see if cognitive behavioral therapy or pharmacotherapy is more beneficial for depression and anxiety disorders. Electronic databases and references where searched for randomized controlled studies that compared CBT and Pharmacotherapy either with or without a placebo in adults with major depressive or anxiety disorder. The results of the study indicated that there was very little differences between CBT versus pharmacotherapy. The initial hypothesis was that patients with anxiety disorders would show relatively greater effects from CBT compared to medication whereas patients with depression would show the opposite effect was actually disproven in this study. In this study both CBT and medication were effective in treating each disorder with the exception of medication showing slightly more improvement in the case of anxiety.


4. Cognitive behavioral therapy and acceptance and commitment therapy have both been proven to be effective methods in treating patients with anxiety. This study compared cognitive behavioral therapy to acceptance and commitment therapy in order to determine which study would be more efficacious when working with patients that are diagnosed with anxiety. 87 patients diagnosed with this anxiety disorder completed 12 sessions of ACT or CBT and were given a self-report to measure anxiety at baseline, post treatment, and at 6 and 12 month follow up assessments. The study found that CBT showed significantly higher results for individuals with moderate levels of anxiety, and among individuals with no comorbid mood disorders. However ACT showed remarkably higher results for individuals with comorbid mood disorders. 5. A randomized control trial (RCT) was done of cognitive behavioral therapy for people with Parkinson’s disease who are also depressed. The purpose was to examine predictors of treatment response to CBT for depression in Parkinson’s disease (dPD). The sample compromised of 80 depressed people with PD and their caregivers participating in an RCT or CBT versus clinical monitoring with no treatment. Caregiver’s participation in treatment would be an important predictor of response to CBT. It was found that CBT was associated with significant improvements in depression, anxiety, coping, quality of life, and motor disability in people with Parkinson’s disease compared with clinical monitoring over a 14 week time span. Results suggested that caregiver participation my positively influence dPD to CBT. 6. A randomized control trial was conducted to evaluate the effectiveness of a cognitive behavioral therapy manualized program called ‘Thinking + Doing = Daring’ (TDD). The program will be tested with 120 clinically anxious children (8-12) years old. The primary outcome will measure the child’s anxiety symptoms level. Children will be randomly assigned to the experimental (N=60, TDD) or to the control condition (N = 60, treatment as usual). It was found that there was a greater decrease in anxiety symptoms in children that follow the TDD treatment rather than the children that receive treatment as usual. Last But Not Least . . . References Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York, NY US:
Guilford Press.

Drahota, A., Wood J. J., Sze K. M., & Dyke, V. M. (2011). Effects of cognitive
behavioral therapy on daily living skills in children with high- functioning autism and
concurrent anxiety disorders. (451), 257-265. doi: 10.1007/s10803-010-1037-4

Dobson, K. S. (2010) Handbook of cognitive-behavioral therapies (3rd.). New York, NY US:
Guilford Press.

Dozois, D. A., & Beck, A. T. (2011). Cognitive therapy. In J. D. Herbert, E. M. Forman (Eds.),
Acceptance and mindfulness in cognitive behavior therapy: Understanding and applying the
new therapies( pp. 26-56). Hoboken, NJ US: John Wiley & Sons Inc.

Clark, D. A., & Beck, A. T. (2012). The anxiety and worry workbook: The cognitive behavioral
Solution. New York, NY US: Guilford Press.

Myrick, A. (2012). Incorporating play therapy into evidence- based treatment with
children affected by obsessive compulsive disorder. 21(2), 74-86. doi:
10.1037/a0027603

Roshanaei- Moghaddam, B., Pauly, M.C., Atkins, D. C., Baldwin, S. A., Stein, M. B., & Roy- Byrne, P. (2011).
Relative effects of CBT and pharmacotherapy in depression versus anxiety: Is medication somewhat better for depression, and CBT somewhat better for anxiety?.Depression And Anxiety, 28(7), 560-567. Doi:10.1002/da.2082

Wolitzky- Taylor, K. B.b Arch, J. J., Rosenfield, D., & Craske, M. G. (2012). Moderators
non- specific predictors of treatment outcome for anxiety disorders: A comparison of
cognitive behavioral therapy to acceptance and commitment therapy. Journal Of
Consulting And Clinical Psychology, 80(5), 786-799. Doi:10.1037/a0029418 Esposito-Smythers, Christianne, Spirito, Anthony, Kahler, Christopher W. Hunt, Jeffrey & Monti, Peter (2001). Treatment of Co-occurring substance abuse and suicidality among adolescents: a randomized train. Journal of consulting and clinical psychology 79(6) 728-739

Kazantzis, Nikolaos, Dattilio, Frank M. (2010). Definitions of homework, types of homework, and ratings of the importance of homework among psychologists with cognitive behavior therapy and psychoanalytic theoretical orientations. Journal of clinical psychology. 66(7), 758-773.

Mueser, K.T., Rosenberg, S.D. & Rosenberg, H.J. (2009). Cognitive restructuring I:the common style of thinking. Treatment of posttraumatic stress disorder in special populations: a cognitive restructuring program.99-119. Doi: 10.1037/11889-006.

Overholser, James C. (1993) Elements of the Socratic method. Psychotherapy: theory, research, practice and training. 30(1)67-74.

Rosenberg, H.J.& Jankowski, M (2009) Treatment of posttraumatic stress disorder in special populations: a cognitive restructuring program. Adolescents. 255-266. Doi:10.1037/11889-013\

Sheehy, Richard; Horan, John J. (2004) International Journal of stress management. Effects of stress inoculation training for first year law students. US: educational publishing foundation 11(1) 41-55

Shurick, A.A. Hamilton, J.R. L.T. Roy, A.K. Gross & Phelps, E.A. (2012) Durable effects of cognitive restructuring on conditioned fear. Emotion. Doi:10.1037/e0029143.

Wilde, J (2011) Rational emotive imagery (REI). In H.G. Rosenthal (ED). Favorite counseling and therapy techniques (2nd ed) 333-335.

Wilde Jerry. (2008) Journal of cognitive and behavioral psychotherapies. 8(1). 133-141 ISSN: 1584-7101 Dobkin, R.D., Rubino., Allen, L.A., Friedman, J., Gara, M.A., Mark, M.H., & Menza. (2012).
Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson’s disease. Journal OfConsulting And Clinical Psychology, 80(4), 694-699. doi: 10.1037/a0027695

Beck institute for cognitive behavioral therapy. (n.d.). Retrieved from http://www.beckinstitute.org/what-is-cognitive-behavioral-therapy/

Yalom, V. (2002, April). An interview with donald meichenbaum, phd. Retrieved from http://www.psychotherapy.net/interview/donald-meichenbaum

Jansen, M., van Doorn, M. M., Lichtwarck-Aschoff, A., Kuijpers, R. M., Theunissen, H., Korte, M., & ... Granic, I. (2012). Effectiveness of a cognitive-behavioral therapy (CBT) manualized program for clinically anxious children: Study protocol of a randomized controlled trial. BMC Psychiatry, 12doi:10.1186/1471-244X-12-16 THE END
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