Pom ch 15 ppt

Chapter 15: Cognitive Psychotherapy

Introduction to Cognitive Psychotherapy

• Cognitive therapy has gained popularity over the past decades.

• More clinical psychologists endorse cognitive therapy than any other single-school approach.

• It is a reaction to both behavioral and psychodynamic therapies.

Goals of Cognitive Therapy

• Aim is to increase logical thinking and fix faulty thinking.

• Emphasizes that the way we interpret events influences our emotional responses.

Importance of Cognition

• Cognition can also be referred to as thought, belief, or interpretation.

• Our feelings, although attributed to events, are actually mediated by our cognitions.

  • Events happen > We interpret them > Our interpretations influence our feelings.

Revising Cognitions

• Since cognitions determine emotions, revising illogical thoughts can lead to healthier emotional reactions.

• Extreme cognitions can provoke unwanted feelings.

• Three Steps to Revising Cognitions:

  1. Identify illogical cognitions (automatic thoughts).

  2. Challenge those cognitions.

  3. Replace with more logical cognitions.

• Cultural considerations: Are certain beliefs too sacred to challenge?

Teaching as a Therapy Tool

• Cognitive therapists often act as educators:

  • Teach clients about the cognitive model.

  • Use various tools: handouts, lectures, readings, written assignments.

• The goal is to empower clients to teach themselves rather than depend on the therapist.

Homework in Cognitive Therapy

• Homework is commonly assigned to clients between sessions:

  • Written tasks include keeping a record of events, interpretations, and feelings.

  • Behavioral tasks might involve performing specific actions to examine the validity of their cognitions.

Structure of Cognitive Therapy

• Cognitive therapy is:

  • Brief: Often limited to 15 sessions or fewer.

  • Structured and planned: Sessions have specific goals set at the beginning.

  • Focused: Not as free-flowing as some other therapeutic approaches.

Approaches to Cognitive Therapy

Albert Ellis

• Developed Rational Emotive Behavior Therapy (REBT).

• Emphasizes the connection between rational thinking and emotions.

• ABCDE Model:

  • Activating Event

  • Belief

  • Consequence (Emotional)

  • Dispute

  • Effective New Belief

• Provides a framework for clients to understand and record their experiences.

ABCDE Model Example

• A: Activating Event - Studying for the CPA exam.

• B: Belief - "I absolutely have to pass... or my career is doomed."

• C: Emotional Consequence - Anxiety.

• D: Dispute - Challenge the belief about needing to pass first time.

• E: Effective New Belief - Passing later is acceptable; happiness doesn't solely depend on this outcome.

Aaron Beck

• His approach is commonly referred to as cognitive therapy.

• Uses Dysfunctional Thought Record instead of ABCDE.

• Identifies Common Thought Distortions:

  • All-or-nothing thinking.

  • Catastrophizing.

  • Magnification/minimization.

  • Personalization.

  • Overgeneralization.

  • Mental filtering.

  • Mind reading.

• Treats beliefs as hypotheses that need testing rather than proven facts.

Recent Applications of Cognitive Therapy

Mindfulness and Acceptance-Based Therapies

• Known as “third wave” therapies.

• Involves awareness of present moments without judgment.

• Encourages engagement with mental processes rather than avoidance.

• Derives from Buddhist traditions.

Specific Third Wave Therapies

• Acceptance and Commitment Therapy (ACT).

• Dialectical Behavior Therapy (DBT).

• Metacognitive Therapy.

Acceptance and Commitment Therapy (ACT)

• Developed by Steven C. Hayes.

• Focuses on accepting internal experiences and committing to personal values.

• Aims to transition from FEAR (Fusion, Evaluation, Avoidance, Reason-giving) to ACT (Accept, Commit, Take action).

Dialectical Behavior Therapy (DBT)

• Developed by Marsha Linehan, primarily for borderline personality disorder (BPD).

• Focuses on emotional regulation.

• Key practices include problem solving and validation.

• Skills training includes:

  • Emotion regulation.

  • Distress tolerance.

  • Interpersonal effectiveness.

  • Mindfulness skills.

Metacognitive Therapy

• Focuses on thinking about thinking (metacognition).

• Identifies the cognition itself as the activating event leading to unhappiness.

• Aims to directly address thoughts about thoughts as the focal point of therapy.

Cognitive Therapy for Medical Problems

• Cognitive therapy can assist patients in dealing with injuries or illnesses by addressing irrational thought patterns.

• Enhancing logical reasoning can improve both mental and physical health outcomes.

Efficacy of Cognitive Therapy

• Supported by a robust body of empirical evidence showing effectiveness for various disorders:

  • Depression.

  • Anxiety disorders.

  • Bulimia.

  • PTSD.

  • Others.

• Cognitive therapists often structure therapies to facilitate empirical study.