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Transcript of Cognitive Therapy
Jamie Alam 1913-2007; founder of Institute for Rational Emotive Therapy in New York http:///www.brainyquote.com/quotes/authors/a/alber_ellis.html Rational-Emotive Behavior Therapy Albert Ellis REBT is a highly didactic, cognitive, action-oriented model of therapy that stresses the role of thinking and belief systems as the root of personal problems
More than 40 years old, REBT has undergone some development, but the basic premise--emotions and behavior can best be modified by changing the client's thinking Theory of Personality Easy as ABC's
Activating events (such as rejection)
Beliefs (way individuals process activating events
Consequences (emotional and behavior experiences of what just occurred)
"Individuals make themselves emotionally healthy or emotionally upset by the way they think, not the environment" (Prochaska, 298) REBT Theory Psychopathology Psychopathology of everyday life can be explained by the "ABC" model of human functioning.
Activating events are identified as either rational beliefs (rB) or irrational beliefs (iB).
Irrational beliefs include words such as should, ought, and must and include immediate demands.
There beliefs are typically absolutes and tend to be evaluative, judgemental, and bring about unhealthy consequences. Striking similarities to REBT
Making clients aware of maladaptive cognitions
Replacing with appropriate/adaptive thought patterns
Homework is an essential piece of cognitive therapy
Time-limited Cognitive Therapy Maladaptive cognitions, dysfunctional attitudes, depressogenic (depression-causing) assumptions
dichotomous thinking Cognitive therapy Individual schemas
Content specificity hypotheses
(1) events are interpreted negatively
(2) depressed individuals dislike themselves
(3) the future is appraised negatively
Thinking is to absolute, too broad, or too arbitrary Cognitive Therapies REBT Therapeutic Processes Once the ABC's of psychotherapy are understood, the proper route to change disturbing consequences is not through examining A's (activating) or venting C's (consequences); instead the B's (belief) must be modified.
The ABC model is followed by D--the disputing of irrational beliefs when they act or feel in a self-defeating way.
Leads to E--effective new philosophy--a sound and rational set of preferred beliefs Consciousness Raising Client's Work
Clients are expected to assume considerable responsibility for planning and implementing their treatment. They are also encouraged to accept responsibility for their difficulties.
One hour a week in therapy
complete homework--reading books, listening to logic-driven tapes Consciousness Raising Therapist's Work:
Teach client about rational and irrational thinking
Identify, dispute, and modify irrational beliefs
Facilitate efforts to develop a more rational outlook on life
Problem solving and beyond to help people to establish more balanced, logical and rewarding lives
Use persuasion, praise, humor, anecdotes from own life to enable clients to think more rationally and make positive changes
Highly active and directive in their style REBT Therapeutic Content
Intrapersonal Conflicts According to REBT therapists, psychological problems are intrapersonal in origin. These emotional problems are produced by irrational beliefs. Some examples of intrapersonal conflicts are:
Anxiety and defense mechanisms
Intimacy and sexuality
Impulse control Therapeutic Relationship Unconditional support to clients
Do not evaluate the client as a person, but evaluate the client's beliefs and behaviors
REBT therapists behave in a genuine and open manner sharing their own ideas, beliefs, and philosophy of life
Clients reports feeling understood not because the therapist is empathizing (emoting) with them, but because the therapist is bringing into awareness the cause of the client's problems In conclusion... By challenging the patients irrational ideas caused issues with the straight-to-the-point approach
Sarcasm and inflated tone disagreeing with patients irrational beliefs may bring adverse feelings on REBT
Ellis maintains vigorous debating style is a must especially with defiant clients Aaron Beck (1921-Present) Cognitive therapy consists of all of the approaches that alleviate psychological distress through the medium of correcting faulty conceptions and self-signals."
Beck, A.T. (1976). Cognitive therapy and emotional disorder. New York: International Universities Press. Cognitive Therapy Therapeutic Processes Stages
Become aware of automatic thoughts
Recognize maladaptive cognitions
Feedback on changes
Based on empirical evident and beliefs are treated as hypotheses
disattribution technique Therapeutic Relationship Socratic dialogue (collaborative empiricism)
Empathic and war, but believe empathy alone insufficient
Therapist directs the course of treatment but the client must take an active role in therapy
Therapist tries to provide symptom relief
Teach relapse prevention strategies The Therapist Genuine and accurate
Creative and active
Cognitive conceptualization of cases
Knowledgeable about cognitive and behavioral strategies
Acts as a catalyst and guide The Client Takes an active role in therapy
Brings up topics to discuss
Identifies distortions in their thinking
Summarizes session points
Collaboratively design homework
Client learns to become his own therapist Practicalities of Cognitive Therapy Most effective with mildly disturbed individuals or with single major symptoms
Patients wither greater inborn tendencies to irrational thinking require longer therapy
Endorse brief and structured treatment
Group therapy is used to apply problems
Proven successful with children, adolescents, adults, and organizations
Amenable to medication Mindfulness/Acceptance Therapy Third wave of cognitive therapy
Eastern or Buddhist twist
Train clients to be mindful and accept their beliefs
Meditation and breathing
Acceptance skill training
Acceptance and Commitment Therapy Effectiveness of Cognitive Therapies REBT-significant results across age groups and with multiple disorders
Cognitive therapy- for depression significant results were found for adolescents, adults, and older adults; significant results were found across age groups for other disorders including social phobias Criticisms Behavioral- Ellis did not provide enough testing and data to accompany his theories; Beck did not provide a causal relationship between beliefs and disorder; applaud behavioral techniques
Psychoanalytic- believe that cognitive therapy confuses patients into believing what the therapist wants them to believe Criticisms Humanistic- thoughts and emotions should not be thought of as irrational but used to fuel change
Cultural- therapy is geared towards the thinking of predominantly white males and challenging beliefs may not be acceptable to all cultures
Integrative- cognitive therapies overgeneralize beliefs and devalue the emotional side of humans Future directions Ellis
declining in popularity
eclectic in methodology Beck
on the rise
commitment to psychotherapy integration
dedication to empirical evaluation