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Assessment

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Colin Doucette

on 4 November 2013

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Transcript of Assessment

Cognitive Behavioral Family Therapy
Historical & Theoretical Influences
Cognitive Behavioral Family Therapy

Reciprocal interactions of family members.
The family as a system.
Assessing a family.
The fundamental procedures of CBFT (a modular approach).
Self – Monitoring, Self – Instruction, Rational Analysis, and Behavioural Enactment.
(Friedberg, 2010)
Background Information
Goals of Cognitive Behavioral Assessment
Therapist Role
Identifying connections between thoughts, moods and behaviors of family members.
Question and evaluate negative automatic thoughts.
Identify and correct cognitive distortions.
Recording your thoughts.
Target assumptions and beliefs
Behavioral experiments.
(Rector, 2010)

Therapist Role.. Con't..
Identify strengths and presenting problems within the individual's family and environment.

Place individual & family functioning in the context of developmental stages.

Identify cognitive, emotional, behavioral aspects of family interaction that might be targeted for intervention (Nichols, 2013).

Assessment Tools
Unstructured observations in the initial interview.
Identification of the presenting problem.
Therapist observation of family interaction patterns in relation to the presenting problem. Focus is placed upon the reciprocal nature of family members' cognitions and behavior.

Colin Doucette, Jessica McCarthy, Julie Osmond,& Angela Smith
Assessment
Therapist awareness of distorted thinking patterns
All-or-nothing (black-and-white) thinking
Disqualifying the positive:
Overgeneralization
Mental filter
Catastrophizing
Mind reading
Personalization


(Rector, 2010)
Automatic thoughts

Streams of thoughts that spontaneously arise from a perceived experience triggered by a situation or circumstance
eg. Window breaking
Functional/Dysfunctional Families
Functional Families
Dysfunctional Families
Structure
Session Structure
Techniques
Frequency & Setting
Goals of CBT with Families
Analysis
Weaknesses
Strengths
Cognitive Tools Video
Role Play Description
Genogram
(1) Mood Check In
(2) Homework Review
(3) Agenda Setting
(4) Processing Session
Content
(5) Homework Assignment
(6) Feedback

(Friedberg, 2006)
(1) Self monitoring
(2) Self Instruction
(3) Rational analysis
(4) Behavioral Enactment

CBT is time limited.
Treatment for emotional disorders such as depression and anxiety usually take 12-20 sessions.
Hospital based programs generally last 12-15 sessions.
Clients may require as little as 4-6 treatments.
CBT starts out on a weekly basis; spaced further apart as treatment progresses (every two weeks, every month...
Booster sessions available following therapy to prevent relapse.
Setting is nonspecific, wherever therapist can meet client.
•Systemic perspective & reciprocity of family relationships.
• Transparent and observable.
• Collaborative relationship between the family and therapist.
• Effective regardless of demographics.
•"Booster” sessions.
• Create space for alternative discourse about a problem.


• Problem-oriented.
• Difficulty identifying thoughts and emotions.
• Struggle with tolerating heightened emotions.
• Incomplete client homework assignments.
• Financial constraints.
• Low motivation or optimism toward improving
family problems.
• Family members avoiding treatment sessions.

Therapeutic Goals
Process
(Rector, 2010)
(Rector, 2010)
Historical Perspective of CBFT
CBT: Albert Ellis (1950's) & Aaron Beck (1960's)
CBFT: Baucom, Epstein, Dattilio (1980's)
Theoretical Influences on CBFT
Reinforcement, extinction
Theory of Social Exchange (Thibaut * Kelley, 1959)
Automatic thoughts, schemas
Behavior Exchange Theory (Thibaut & Kelley, 1959)
Marital Satisfaction
Communication Skills
Conflict Resolution
Dimensions of Dysfunctional
Families
• Ambiguous & Limited.
• Modifying specific behavior patterns to alleviate the presenting problem (or symptoms).
• Elimination of undesirable behavior.
Increase positive behavior as defined by the family.
• Identification of clients personal goals.
• Increase rate of rewarding interactions by fostering positive behavior change (ex. Marital Therapy).

(Rector, 2010)
Gathering client/family view of problem.
Awareness of subjective meanings.
Not only to alleviate symptoms but to teach skills that foster understanding so families can solve their own problems.
Concerned with prevention rather than with curing problems.
Dysfunctional families
Characteristics
Contributors
Results
CBFT with dysfunctional families
(Friedberg, 2006)
The therapist collaboratively works with family members to instill problem solving techniques.
By the end of therapy, client's should be aware of the negative patterns that maintain family problems.
Emphasis on therapist language.
ABC's of CBT
ctivating event

elief

onsequence


A

B

C
(Friedberg, 2006)
(Rector, 2010)
• Are interested in learning useful skills that help manage day-to-day emotional difficulties.
• Are willing and motivated to practice change strategies (e.g., homework) between sessions in order to improve problems within the family (Rector, 2010).

CBT is NOT for families that…
• Primarily want to focus on past issues.
• Expect supportive counseling.
• Are not willing to complete homework in between sessions.

CBT is for families that…
(Rector, 2010)
Clients may associate CBT with mental health treatment.
Medication may affect client outcome.
(Mungo, 2009; Nichols, 2013)
(Mid Ohio Psychological Services, 2012; Nichols, 2013)
(Friedberg, 2006; Rector, 2010)
(Friedberg, 2006)
(ABC Model of Cognitive Behavioral Therapy, 2012)
(Friedberg, 2006; Rector, 2010)
Gladys is a sixty-nine year old woman who lives in her own home in St. John’s. Her twenty-three year old daughter Julie and her daughter’s partner Jessica live in Gladys’ home rent-free while they both attend university. Gladys and Julie have been getting into arguments lately because Gladys believes Julie needs to help her out more while she lives in her home. Jessica is stuck in the middle, and doesn’t know what to say when Gladys or Julie get into confrontations.
Project Overview
1) Historical & Theoretical Influences
2) Functional & Dysfunctional Families
3) Assessment
4) Therapists Role
5) Cognitive Tools Video
6) ABC's Of CBT
7) Structure
8) Goals of CBT
9) Analysis
10) Role Play Description
11) Genogram
12) Questions

Now....
1) Can you identify any techniques used within the role play which were discussed throughout the presentation?
2) Did you notice how mood check in, homework review, agenda setting, processing session content, homework assignments, and feedback were utilized within the video? Was it effective?

3) Do you have any questions for us?
Full transcript