Cognitive therapies

Aim

Changing irrational/inappropriate thoughts that may be having a negative impact on an individual - usually by considering evidence for negative statements

Beck's cognitive restructuring (1)

The act of identifying ineffective patterns in thinking & changing them to be more effective (triggering less negative emotion, seeing things more clearly or enabling more skilful behaviour)

(2)

Builds on your ability to accurately recognise automatic thoughts & feelings

The process

Therapist will ask client questions. Aim is to move them away from negative cognitive processes & towards positive cognition

Questions

1) what is the evidence supporting the conclusion currently held by the client?

2) what is another way of looking at the same situation but reaching another conclusion?

3) what will happen if, indeed, the current conclusion/opinion is correct

rational-emotive behavior therapy (REBT)

Ellis: people aren't disturbed by things but rather by their view of things so he believed people are affected by how they think

The process (reframing)

Challenging negative thoughts by reinterpreting the ABC in a more positive, logical way

Treatment

Often involves 1-2 sessions every 2 weeks for about 15 sessions. Therapists & clients work together to verify reality. Patients become more able to distinguish between fact & fiction & don't perceive things in extreme terms

Cognitive

Cognitive factors addressed after improvement in patient's mood/energy by being taught to identify faulty thinking responsible for low mood & to challenge these thoughts

Behaviour

Addresses behavioural change with behavioural tasks set by therapist between sessions eg testing belief they're incapable of being included in conversations, they'll be tasked with talking to strangers in social situations. To prevent relapse they're provided with 'booster' sessions in the subsequent year

Strengths (1)

Take account of clients 'thinking behaviour' & how they view the world

(2)

Treatment has clear goals - to change maladaptive thinking to more positive

(3)

Teach clients to try to think differently which they can use to recognise & t change their own negative thoughts in the future

(4)

Relatively quick compared to other talking therapies eg psychoanalysis with many clients showing more positive thinking after just a few sessions

(5)

Work well for a range of problems as shown by automatic studies eg have been used successfully to treat general anxiety, depression, EDs & stress

Weaknesses (1)

Only useful for clients who are well enough to have insight & reflect on their own thoughts so those who are very unwell may not benefit from

(2)

Ignore hidden reasons for problems eg unconscious thoughts so don't really get to the root of some problems

(3)

Changing thinking patterns may not be enough to remove some severe problems eg less successful than behavioural techniques for agoraphobia

(4)

Individuals have to be determined to address their problems & for REBT they have to be willing to do 'homework' & practice new behaviours - can require considerable commitment of time & effort