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CBT

Cognitive Behavioral Therapy (CBT)

Introduction

  • CBT stands for Cognitive Behavior Therapy.

  • Focuses on changing negative thought patterns to influence emotions and behaviors.

  • Coined in the 1960s by Aaron Beck.

  • A structured, goal-oriented therapeutic approach.

Core Principles of CBT

  • Change in Thinking: Changing how one thinks can alter feelings and behaviors.

  • Cognitive Model: Explains the interplay between thoughts, feelings, and behaviors.

Understanding the Cognitive Model

Components of the Model

  • Thoughts, feelings, and behaviors are interconnected.

  • Everyday psychological challenges result from negative self-construction.

  • Negative construction of self, experiences, and worldview.

Negative Perspectives

Types of Negative Views

  1. About the World:

    • Example: "Everyone is against me because I'm worthless."

  2. About the Future:

    • Example: "I'll NEVER be good at anything."

  3. About Oneself:

    • Example: "I'm worthless and inadequate."

Cognitive Triad

  • Negative views about:

    • The world: "The world is a cruel and unforgiving place."

    • Oneself: "I'm a failure at everything I do."

    • The future: "Things will never get better, so why bother trying?"

Automatic Thoughts

Characteristics

  • Spontaneous Thoughts: Arise swiftly in response to events.

  • Often negative, distorted, and rooted in past experiences.

  • Influence emotions and behaviors.

    • Example: "I’m going to fail this presentation" → Leads to anxiety and avoidance.

Core Beliefs

Understanding Core Beliefs

  • Deep, rigid beliefs about self, others, and the world.

  • Formed early in life, influencing interpretation of experiences.

  • Negative core beliefs fuel automatic thoughts.

    • Example: "I’m not good enough" (core belief) leads to thoughts like "I always mess up" (automatic thought).

Examples of Negative Core Beliefs

  • "I don’t deserve love."

  • "I am worthless."

  • "I am not lovable."

  • "I am stupid."

  • "I deserve only bad things."

Connecting Core Beliefs and Automatic Thoughts

  • Core beliefs dictate interpretation of situations.

  • Automatic thoughts reflect interpretations influenced by these core beliefs.

  • CBT focuses on challenging and reframing negative thoughts and beliefs.

Cognitive Schemas

Definition

  • Deep frameworks for organizing and interpreting information.

  • Build on past experiences and shape expectations and behaviors.

  • Example: A person with an “I am unlovable” schema misinterprets neutral social cues as rejection.

Relation to Core Beliefs

  • Schemas reinforce and perpetuate core beliefs.

Goals of CBT

  • Primary Goal: Improve the patient’s mood during sessions and promote functional behavior.

  • Action Plan: Help maintain cognitive and behavioral changes outside therapy through homework assignments.

Structure of CBT Session

  • Structured sessions designed to facilitate skill acquisition and therapy application.

Skills and Interventions for CBT

Behavioral-Level Interventions

  • Activity Scheduling

  • Grading task assignments

  • Exposure

  • Contingency management

  • Behavioral Activation

Cognitive-Level Interventions

  • Identifying Automatic Thoughts

  • Evaluating and Responding to Automatic Thoughts

  • Identifying and Modifying Beliefs

Emotion-Level Interventions

  • Emotion Regulation/Modulation

  • Distress Tolerance

  • Integrating Mindfulness

  • Using Imagery

Case Examples

Example 1: Maria

  • Background: 25-year-old graduate student avoiding job applications due to self-doubt.

  • Automatic Thought: "I’m useless. No one will ever want to hire me."

  • Discussion Questions:

  1. What is Maria’s automatic thought?

  2. What underlying core belief influences her thoughts?

  3. What cognitive schema does this align with?

Example 2: Jordan

  • Background: 30-year-old teacher struggling with relationship insecurities.

  • Automatic Thought: "They must be losing interest in me."

  • Discussion Questions:

  1. What is Jordan’s automatic thought?

  2. What core belief drives this reaction?

  3. What cognitive schema does this reflect?

Example 3: Sam

  • Background: 19-year-old college student anxious about speaking in class.

  • Automatic Thought: "Everyone thinks I’m stupid."

  • Discussion Questions:

  1. What is Sam’s automatic thought?

  2. What core belief shapes her self-perception?

  3. What cognitive schema fits this situation?