Cognitive Theory/ CBT/ REBT

Central ideas related to human nature

Information processing and stimuli is why we are who we are and why we respond to things the way we do. Based on schemas.

What people believe influences how they feel.

Scientific view of human nature/ behavior.

Central ideas related to maladaptive functioning

Normal emotions and behaviors are disproportionate to life events.

Central ideas related to change

Changing the thought changes the behavior. Changes in beliefs lead to changes in behavior and emotions. People are capable of self-directed change and people are the agents of change.

Recognize Founders

o   B.F. Skinner

o   Albert Bandura

o   Marsha M. Linehan

o   Aaron Beck

o   Pavlov

Recognize Techniques and their purpose

Progressive muscle relaxation: cope with stress.

Systematic desensitization: desensitizes to anxiety inducing stimuli.

Social skills training: helps people interact with others/ interpersonal confidence.

Mindfulness based therapies: facilitate acceptance. Examples:

• MBSR

• ACT

• DBT

• Exposure-based therapies

• EMDR

Four-Step Model to Build Resilience

1. Search for activities that clients already do regularly.

2. Construct: Define obstacles and determine how to overcome them.

3. Apply: Determine how to apply any changes to current living.

4. Practice: Conduct a series of experiments while practicing maintaining a focus on resilience. 

ABC Framework

A: Activating event

C: the emotional or behavioral Consequence or reaction of an individual. A does NOT cause C.

B: the person’s Belief about the activating event largely created the consequence. A causes a B which creates a C.

Be familiar with Strengths Based CBT

Variant of Aaron Beck’s cognitive theory.

Active incorporation of client strengths encourages clients to engage more fully in therapy and provides more avenues for change.

Construct new positive ways of interacting in the world.

Be familiar with Cognitive Behavior Modification

Donald Meichenbaum’s cognitive behavior modification (CBM).

Awareness of how we feel, think, and behave affects change. Distressing emotions come from maladaptive thoughts. Clients create self-statements and cognitive restructuring is central.

Phase 1: Self-Observation;

Phase 2: Starting a new internal dialogue;

Phase 3: Learning New Skills.

Cognitive Distortions

1. Arbitrary inferences

2. Selective abstraction

3. Overgeneralization

4. Magnification/ minimization

5. Personalization

6. Labeling/ mislabeling

7. Dichotomous thinking

Behavior therapy

Focus on directly observable behavior, current determinants of behavior, learning experiences that promote change, tailoring treatment strategies to individual clients, and rigorous assessment and evaluation.

Classical conditioning (respondent conditioning)

A learning process in which a neutral stimulus becomes associated with a meaningful stimulus, eliciting a conditioned response. It demonstrates how behaviors can be learned through association.

What happens prior to learning that creates a response through pairing.

Think Pavlov and his dogs

Operant conditioning

Behavior is controlled by consequences, such as rewards or punishments, shaping future actions based on past experiences.

A type of learning in which behaviors are influenced mainly by the consequences that follow them.

Social learning approach (or the social-cognitive approach)

Developed by Albert Bandura and Richard Walters.

The environmental events on behavior are mainly determined by cognitive processes governing how environmental influences are perceived by an individual and how these events are interpreted.

A basic assumption is that people are capable of self-directed behavior change and that the person is the agent of change.

In doing a behavioral assessment interview,

the therapist’s task is to identify the particular antecedent and consequent events that influence, or are functionally related to, an individual’s behavior.

Reinforcement

A process that strengthens a behavior by providing a consequence an individual finds rewarding or punishing therefore increasing or decreasing the likelihood of that behavior recurring.

Positive reinforcement

Involves the addition of something of value to the individual (such as praise, attention, money, or food) as a consequence of certain behavior. The stimulus that follows the behavior is the positive reinforcer.

Negative reinforcement

Involves the escape from or the avoidance of aversive (unpleasant) stimuli. The individual is motivated to exhibit a desired behavior to avoid the unpleasant condition.

Extinction

Withholding reinforcement from a previously reinforced response.

STOP responding to a meltdown rather than giving in and reinforcing the meltdown. The meltdowns/ negative behavior might temporarily increase before stopping.

Positive punishment

An aversive stimulus is added after the behavior to decrease the frequency of a behavior (such as a time-out procedure with a child who is displaying misbehavior).

Negative punishment

A reinforcing stimulus is removed following the behavior to decrease the frequency of a target behavior (such as deducting money from a worker’s salary for missing time at work or taking television time away from a child for misbehavior).

In educational, community-based, and home-based settings, applied behavioral analysis (ABA) therapy is used for the treatment of

autism spectrum disorder

Progressive muscle relaxation

A structured technique designed to reduce physical and mental stress by systematically tensing and relaxing muscle groups.

Systematic Desensitization

A classical-conditioning–based behavioral technique developed by Joseph Wolpe to reduce maladaptive anxiety by pairing relaxation with gradual exposure to feared stimuli.

Desensitizes to anxiety-provoking stimuli.

Exposure therapy

Helps individuals confront their fears and anxieties by gradually exposing them to the feared object or context in a controlled manner.

In vivo and flooding exposure therapy

Involves client exposure to the actual anxiety-evoking events rather than simply imagining these situations.

Flooding is either in vivo or imaginal exposure to anxiety-evoking stimuli for a prolonged period of time.

Eye movement desensitization and reprocessing (EMDR)

A form of exposure therapy that entails assessment and preparation, imaginal flooding, and cognitive restructuring in the treatment of individuals with traumatic memories.

Social skills training

A broad category that deals with an individual’s ability to interact effectively with others in various social situations; it is used to help clients develop and achieve skills in interpersonal competence.

Think modeling and behavior rehearsal, and ager management training.

Multimodal therapy

A comprehensive, systematic, holistic approach to behavior therapy developed by the late Arnold Lazarus. Grounded in social-cognitive learning theory.

Mindfulness and Acceptance

New wave of behavior therapy emphasizes considerations such as mindfulness, acceptance, the therapeutic relationship, spirituality, values, meditation, being in the present moment, and emotional expression.

Mindfulness-Based Stress Reduction (MBSR)

About 8 weeks designed to reduce stress, pain, and suffering and to help people take responsibility for their own well-being.

Teaches living in the present moment rather than ruminating on the past or worrying about the future.

Mindfulness-Based Cognitive Therapy (MBCT)

An 8-week group program integrating mindfulness practices with cognitive-behavioral skills to prevent depression relapse and change how clients relate to negative thoughts.

A big goal is to build self-compassion

Dialectical Behavior Therapy (DBT)

A comprehensive, evidence-based treatment for chronically suicidal individuals and those with borderline personality disorder; now used for many disorders involving emotion dysregulation.

Help clients build a life worth living by replacing maladaptive behaviors with skillful, effective behaviors.

Interpersonal effectiveness skills help people be effective in their relationships with others.

Acceptance and Commitment Therapy (ACT)

An empirically supported behavioral intervention that combines mindfulness, acceptance, values, and behavior change strategies to increase psychological flexibility.

The main goal is not symptom reduction, but helping clients live a meaningful, values-driven life while opening up to thoughts and feelings rather than avoiding them.

CBT

A structured, evidence-based approach combining cognitive and behavioral strategies to change unhelpful thoughts, emotions, and behaviors.

Uses psychoeducation, cognitive restructuring, behavioral experiments, and skills training to promote change.

Rational emotive behavior therapy (REBT

The first major cognitive-behavioral therapy, developed by Albert Ellis; emphasizes thinking, evaluating, deciding, and doing to change emotional and behavioral outcomes.

• Focus on identifying and replacing irrational beliefs with rational, helpful beliefs.

• Emphasizes unconditional self-acceptance, other-acceptance, and life-acceptance.

REBT is based on the premise that we learn ___    from significant others during childhood and then re-create these irrational beliefs throughout our lifetime.

Irrational beliefs

After A, B, and C comes ___

Following that, clients are encouraged to develop ___

D (disputing).

D encompasses methods that help clients challenge their irrational beliefs. There are three components of this disputing process: detecting, debating, and discriminating.

Then there is E, a new effective philosophy (new rational beliefs), which also has a practical side.

 

REBT practitioners use a variety of emotive procedures like rational emotive imagery and shame-attacking exercises which are…

A form of intense mental practice designed to establish new emotional patterns in place of disruptive ones by thinking in healthy ways and exercises to help people reduce shame and anxiety over behaving in certain ways.

Aaron Beck’s Cognitive Therapy

Highly effective for depression and widely evidence-supported for disorders such as anxiety disorders, PTSD, phobias, schizophrenia, health anxiety, body dysmorphic disorder, etc.

Beck found that depressed clients show cognitive distortions and a negative cognitive triad.

Unlike Ellis, Beck did not claim thoughts are the sole cause of depression—genetic, biological, and environmental factors also contribute. It resembles REBT. 

Cognitive Triad: 

• Negative view of self (self-criticism)

• Negative view of the world (pessimism)

• Negative view of the future (hopelessness)

Cognitive theory emphasizes  ____, elsewhere defined as core beliefs, as a key aspect of the therapeutic process.

schema

Strengths-based cognitive behavior therapy (SB-CBT)

A variant of Aaron Beck’s cognitive therapy developed by Christine Padesky and her colleague Kathleen Mooney.

Empirically based. Major focus on strengths of the client.

A particular application of a coping skills program is teaching clients stress management techniques by way of a strategy known as:

Stress inoculation training (SIT).