Cognitive Therapy
Aaron Beck is the creator of cognitive therapy. Cognitive therapy believes that changes in thinking lead to changes in acting. It is a short term therapy that is problem focused and goal oriented. "Cognitive theorists focus primarily on thoughts, but also take a holistic view of people and believe that learning about and understanding their feelings and behaviors [is also] important" (Seligman & Reichenberg, 2014, p. 295).
Goals
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Concepts
Cognitive Distortions
- Cognitive distortions develop for many reasons including: biology and genetic predispositions, life experiences, and a person's accumulation of knowledge and learning. Cognitive therapists believe they begin in childhood are reflected in a person's fundamental beliefs.
- Cognitive distortions develop for many reasons including: biology and genetic predispositions, life experiences, and a person's accumulation of knowledge and learning. Cognitive therapists believe they begin in childhood are reflected in a person's fundamental beliefs.
Levels of Cognition
- Automatic Thoughts
"The stream of cognitions that constantly flow through our minds" (Seligman & Reichenberg, 2014, p. 296). These thoughts mediate between a situation and an emotion.
Example: Situation: Amanda learns that her friends went out and did not invite her. Automatic thought: They do not like me Emotion: Sadness & Hurt The emotion is not necessarily caused by the situation, but the automatic thought. |
- Intermediate Beliefs
These beliefs "often reflect extreme and absolute rules and attitudes that shape people's automatic thoughts" (Seligman & Reichenberg, 2014, p. 296).
Example: Amanda believes that friends should always invite you out when they go out. |
- Core Beliefs
"Central ideas about ourselves that underlie many of our automatic cognitions and usually are reflected in our intermediate beliefs...[they] typically stem from childhood experiences, are not necessarily true and can be identified and modified" (Seligman & Reichenberg, 2014, p. 296).
In this example Amanda seems to have unlovable core beliefs |
- Schemas
'"Hypothesized mental structure that organizes information' that encompass the core beliefs" (Seligman & Reichenberg, 2014, p. 296). These include thoughts, emotions and actions. They lead us to have expectations about experiences, events, and roles and affect the way we see reality.
Example: Amanda's schema would be: My friends do not want my company, I guess I am not a good friend or person. |
Treatment
The initial session follows these 10 procedures
Therapeutic Alliance
- Requires a sound therapeutic alliance in which the therapist is active, collaborative, goal oriented, and problem focused - Use Socratic questioning to lead clients through (also known as guided discovery) - "Socratic questioning to elicit the client's concerns - Active listening for clarification, inconsistencies, and emotional reactions - Summarization to provide feedback and enhance clarification - Synthesis or analytical questions that pull all of the information together, along with the client's original concern, and pose an analytical question" (Seligman & Reichenberg, 2014, p. 299). Case Formulation Before a therapist can move forward with interventions it is important that they have a full understanding of the client
Eliciting and Rating Cognitions - Beck would ask his client "what were you thinking just then?" and the client would tell their thought and then one thought would lead to the next. Beck used a dysfunction thought record in order to identify and modify each thought. Determining the Validity of Cognitions - Once the cognitions have been rated and placed into context they are assessed for validity. The counselor will ask the client a bunch of questions to figure out why they think that way. Another method is to develop experiments to test the client's hypothesis, or negative thought. The third approach is the three-question technique: "(1) What evidence is there for the belief? (2) How else could the situation be interpreted? (3) If it is true, what would the implications be?" (Seligman & Reichenberg, 2014, p. 301) Labeling the Distortion - Labeling the distorted thought can assist in in evaluating it Assessment of Mood - Assessing the clients mood can help lead the way to the distorted cognitions |
Techniques/StrategiesChallenging absolute statements - Counselor allows client to retract absolute statement and clarify the behavior more clearly
Activity Scheduling - Encourages people to plan and try new behaviors Reattributing Blame - Help client to see the blame is not entirely theirs or theirs at all Cognitive Rehearsal - Clients mentally rehearse a new behavior and create a cognitive model of themselves successfully performing that behavior Diversions or Distractions - Reduces negative thinking Self-talk - Clients repeat to themselves positive statements Affirmations - Positive slogan Keeping Diaries - Allows client to be aware of distorted thoughts Letter Writing - Gets the emotions and thoughts out without having to say it to the other person Systematic Assessment of the Alternatives - Cost/Benefit analysis of decisions Relabeling - Re label things to something more positive Role-playing - Helps clients actualize some of the new thoughts they have about themselves Distancing -Look into the future to put a problem into perspective Bibliotherapy - Read books about others who have had similar experiences Graded Task Assignments - Start with easy assignments that guarantee success and increase to harder ones to help feel a sense of mastery and accomplishment |
Example
Cognitive Therapy for Depression Cognitive therapists believe that depression is maintained by constant negative thoughts, known as automatic thoughts. Automatic Thoughts: "I am a failure." "Nothing is worth it." Cognitive therapy says that most problems have several parts:
Cognitive therapy will disassemble the problems into parts, thereby making them easier to manage. "[Clients] make small changes in their thinking and behavior every day. Then over time, these small changes lead to lasting improvement in mood and outlook." (Hoffman, 2014) |
Information provided by:
Hoffman, Matthew. 2014. Cognitive therapy for depression. Retrieved from http://www.webmd.com/depression/features/cognitive-therapy
Seligman, L. & Reichenberg, L. (2014). Theories of counseling and psychotherapy: Systems, strategies, and skills. (4th ed). Upper Saddle River, NJ: Pearson.
Hoffman, Matthew. 2014. Cognitive therapy for depression. Retrieved from http://www.webmd.com/depression/features/cognitive-therapy
Seligman, L. & Reichenberg, L. (2014). Theories of counseling and psychotherapy: Systems, strategies, and skills. (4th ed). Upper Saddle River, NJ: Pearson.