Aaron Beck - Cognitive Behavioral Therapy (CBT)

core tenets

1. A collaborative relationship between the client and therapist
2. Psychological distress is a function of disturbance in cognitive processes
3. Focus on changing cognitions to produce changes in affect and behavior
4. Emphasis on psychoeducation

short-term approach

Present-centered
Active and directive therapist
Specific and structured target problems

ABC Model of REBT

activating event → beliefs → consequences

belief change in ABC Model

disputing intervention → effective philosophy → new feeling

cognitive therapy

values insight in order to change negative thoughts and maladaptive beliefs

distorted beliefs

the result of cognitive errors

psychological problems

an exaggeration of adaptive responses resulting from commonplace cognitive distortions

cognitive therapy assumptions

1. Internal communication is accessible to introspection
2. Clients' beliefs have highly personal meanings
3. These meanings can be discovered by the client rather than being taught or interpreted by the therapist

collaborative empiricism

Relies on Socratic dialogue/reflective questioning for clients to test the validity and usefulness of their cognitions

how does change occur?

reevaluating faulty beliefs based on contradictory evidence that clients have gathered

Beck Triad of Depression

Negative view of self, the world, and the future

application of cognitive therapy

length and course varies greatly and is partially determined by diagnosis and specific protocol

depression

16-20 sessions, behavioral activation

panic disorder

6-12 sessions, catastrophic beliefs

strengths-based CBT (Kathleen Mooney)

Variation of Beck's approach
Focus on identifying and integrating client strengths throughout each phase

goal of strengths-based CBT

to prompt more active participation throughout

cognitive behavior modification (Donald Meichenbaum)

Focuses on self-statements and self-talk
Precursory to change, clients must notice how they think, feel, and behave, and what impact they have on others

assumption of cognitive behavior modification

Distressing emotions are typically the result of maladaptive thoughts

self-instruction

Train clients to modify instructions they give themselves so they can cope more effectively

luxury coping skills

Skills that require additional materials and can't be practiced at any given moment

cognitive structure

Organizing aspect of thinking which monitors and directs the choice of thoughts

cognitive narrative approach to CBT

Focuses on plots, characters, and themes in stories people tell themselves and others

CBT multicultural strengths

Relies on the client's belief system and worldview as part of the process of self-exploration

Emphasis on cognition and action may appeal to many cultures

CBT and multicultural therapy approaches shares common assumptons, making integration possible

CBT contributions

Demystified the therapy process

Emphasizes practicing skills in and out of therapy sessions and relies heavily on homework as part of the change and learning process

criticisms of CBT

May be seen as too methodical or manualized

Therapists may misuse clinical power by imposing ideas of what rational and irrational thinking are

REBT confrontational approach may be overwhelming to many clients

Does not value exploration of the past