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?