Counseling and Psychotherapy Chapter 9 and 10 Test review.

Ellis believed events in our lives that causes us to experience them in a certain way and states like depression and anxiety are a result of

self-defeating beliefs and irrational ideas.

Ellis believes therapists functions as... hint: what approach does he have

teacher/psychoeducational

CBM is a component to relapse prevention please define it

teaching clients to see relapses as learning opportunities rather than as catastrophic failures.

behavior thearpy

the way we learn and unlearn behaviors

Beck Depression Inventory is used

to assess severity of depressive symptoms. *Highly reliable and valid.*

Behavioral Assessment Interview

used to identify particular antecedents and consequences that influence behavior.

Mindfulness

based stress reduction (MBSR) This program applies mindfulness techniques to coping with stress and promoting physical and psychological health.

Mindfulness

being aware of our experiences in a receptive way and engaging in activities in a nonjudgmental way. Intentional focus on the present.

Self-directed behavior

A basic assumption is that people are capable of self-directed behavior change and the person is the agent of change.

Coping skills program

A behavioral procedure for helping clients deal effectively with stressful situations by learning to modify their thinking patterns.

Self-instructional therapy

An approach to therapy based on the assumption that what people say to themselves directly influences the things they do. Training consists of learning new self-talk aimed at coping with problems.

Dialectical behavior therapy (DBT)

A blend of behavioral and psychoanalytic techniques aimed at treating borderline personality disorders; primarily developed by Marsha Linehan.

Eye movement desensitization and reprocessing (EMDR)

An exposure-based therapy that involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders and fearful memories of clients.

Self-efficacy

An individual's belief or expectation that he or she can master a situation and bring about desired change.

Irrational belief

An unreasonable conviction that leads to emotional and behavioral problems.

Emotional Techniques in REBT

1. Rational emotive imagery - imagine the worst thing that can happen. Try to develop healthy emotions in place of maladaptive ones. 2. Using humor - not taking oneself too seriously 3. Role playing 4. Shame-attacking exercises

Evidence-based treatments

Therapeutic interventions that have empirical evidence to support their use.

Self-talk

What people "say" to themselves when they are thinking. The internal dialogue that goes on within an individual in stressful situations.

Define the functional assessment or Behavioral analysis- ABC model

A = Antecedents - what came before the behavior - antecedent events cue or elicit a certain behavior B = Behavior - the behavior itself - something client wants to increase or decrease (or start or stop completely) C = Consequences - what came after the behavior - increase or decrease the behavior.

Define multimodal therapy and who is associated with it

(Arnold Lazarus) Basically this is Cognitive Behavior Therapy. *Multimodal therapists try to determine precisely what treatment strategies will work best with each client and under what circumstances.* Tend to be very active during therapy sessions - act as trainers, educators, role models and coaches. They provide information, instruction, feedback and model assertive behaviors, offering suggestions and positive reinforcements. Basic I.D. Assessment Process - See page 267 and 268 for chart with specific questions therapist can ask Areas include behavior, affect, sensation, imagery (how we picture ourselves), cognition, interpersonal relationships, drugs/biology. *Basic premise of multimodal therapy is that breadth is more important than depth.*

Please list the main names in CBT and define what they are known for. Hint there are 4 names.

*Albert Ellis* - Rational Emotive Behavior Therapy *Aaron Beck* - Cognitive Behavior Therapy *Judith Beck* - Cognitive Behavior Therapy *Donald Meichenbaum*- CBM cognitive behavior modification

Name and define the 4 major areas of development in Behavioral Thearpy

*Classical Conditioning * (also called Respondent Conditioning): Ivan Pavlov - experiments with dogs Dogs salivate (unconditioned response) when meat is placed in front of them (unconditioned stimulus). However, when a bell (conditioned stimulus) is paired with the meat, dogs salivate in response to the bell alone (conditioned response). It is believed that much learning is a result of classical conditioning. Especially true for phobias. *Operant Conditioning* - Behaviors that are reinforced are more likely to recur. Reinforcer must be reinforcing for the individual. Positive vs. negative reinforcement, punishment, extinction can all be applied to therapy. *Social Learning Theory*- consists of modeling and also of the belief that people are capable of self-directed behavior change, and that the person is the agent of change. Self-efficacy is the belief that a person can master a situation and bring about desired change. *Cognitive behavior therapy *- CBT - assumption that what people believe influences how they act and feel.. Became very popular in the 1970's and replaced Behavior therapy by itself. Most therapists integrate at least some CBT into practice. *View of Human Nature*- the person is both the product and the producer of his or her environment. More recent behavioral approaches give more control to clients.

Who did Ellis give credit to for his therapeutic motives?

*Ellis gave credit to Adler and Horney* ("tyranny of the shoulds" "People disturb themselves by the rigid and extreme beliefs they hold about events." *Clients hold irrational beliefs which influence our emotions and the reactions we hold to life's situations.*

List and define Vivo Exposure and Flooding (both are types of *exposure therapy*).

*In Vivo Exposure*- Live exposure, again typically in a graduated sequence from least to most threatening. Sometimes therapist accompanies the client. *Flooding* - intense and prolonged exposure to the feared stimulus. Can be done imagined at first, but is usually done in vivo. This will significantly raise anxiety as a means to ultimately reducing it. Needs very clear and full informed consent.

List and define the therapeutic techniques for operant conditioning

*Positive reinforcement* (Said to be effective) Involves the ADDITION of something of value to the individual (praise, attention, money, food, etc.) as a consequence of certain behavior. *negative reinforcement* (said to be effective/ supported) TEXTBOOK DEFINITION: An aversive stimulus is removed following the behavior to decrease the frequency of the behavior. SIMPLIFIED: (PROACTIVE) something negative can encourage somebody to do a behavior to avoid something NEGATIVE. Adding something negative until behavior is demolished and then removing it. For example: Car seat belt: the beeping is reinforcing you because it is adding something that is negative. Next time you get in the car you are likely to put on your seat belt to avoid the stimulus before it even starts. MORE examples: if a parent keeps annoying their child by asking them to clean their room they are more likely to do it to avoid the nagging. Giving a pass to the car behind to avoid its honking. Getting up from the bed to avoid the noisy alarm. Taking an antacid before having a spicy meal. Applying sunscreen before heading to the beach to avoid getting sunburned. Leaving early from the house to avoid traffic jams. *Extinction*: Gradually removing the reinforcer for a previously reinforced behavior. Eventually the behavior will die (e.g. if you previously gave attention to a child throwing a temper tantrum in the supermarket or gave in and bought the candy, then stopping it and letting the child cry, eventually the child will stop the tantrums because they are not reinforced. Tantrums will be extinguished. Note that sometimes unwanted behaviors increase first before decreasing. *Positive punishment* - an aversive stimulus is added (e.g. time out) to decrease the frequency of a behavior. EXAMPLES:Yelling at a child for bad behavior. Forcing them to do an unpleasant task when they misbehave. Adding chores and responsibilities when he fails to follow the rules. Assigning students who forget to turn in their assignment extra work. Adding extra sensitivity training to employees who offend or harass someone at work. Implementing more rules and restrictions when a teen misses curfew. *Negative punishment* - a reinforcing stimulus is removed (e.g. withholding allowance). *Note that Skinner was not an advocate of punishment. He much preferred reinforcement* (carrot vs. stick or "you can catch more flies with honey than with vinegar). Most practitioners recommend using the lease aversive stimulus possible to bring about behavior change, and positive reinforcement is the most positive and powerful agent of change.

Define exposure therapy

*imagined or real exposure* to feared stimulus, typically in a graduated sequence from least to most threatening. reworded: aims to extinguish behaviors by repeated exposure to (increasing in magnitude) stimulus

Explain the role of the therapist from a behavioral approach

- Therapist tries to understand how certain behaviors started and how they were maintained. -Therapist uses techniques that have been shown through research to work. -Evaluation of the success or treatment interventions throughout the duration of treatment. -Baseline measures are collected at the beginning of treatment, and then changes are monitored as a function of interventions. Follow-up assessments are made to see if interventions last over time. Clients must be motivated to change, and homework is given between therapy sessions. Transfer of what happens in and during therapy must be made to everyday life for therapy to be considered successful.

Shame

-attacking exercises A strategy used in REBT therapy that encourages people to do things despite a fear of feeling foolish or embarrassed. The aim of the exercise is to teach people that they can function effectively even if they might be perceived as doing foolish acts.

Self-Management Programs and Self-Directed Behavior. List the five aspects and explain what they can be effective for.

1. Selecting goals - measurable, attainable, positive and realistic 2. Translating goals into target behaviors - anticipating obstacles to change 3. Self-monitoring - observing your own behavior, keeping a behavioral diary 4. Working out a plan for change - *action plan* 5. Evaluating an action plan *Useful for* a wide variety of health problems (e.g. asthma, cancer, arthritis, heart disease, substance abuse, diabetes, headaches, nutrition, self-care) as well as a wide variety of emotional problems (e.g. panic attacks, fears, increasing productivity, anxiety, exercise, smoking control, depression.

According to CBM list the 3 phases to behavior change

1. Self-observation - observing one's own cognitions (mostly negative cognitions) 2. Starting a new internal dialogue - telling oneself more constructive thoughts 3. Learning new skills - teaching more adaptive ways of coping

Ellis said we have three basic musts or irrational beliefs - they are:

1. *I must do well and win the approval of others* for my performances or else I am no good 2. *Other people must treat me considerately, fairly and kindly.* If they don't they deserve to be condemned and punished. *I must get what I want, when I want it.* I must not get what I don't want. If that happens, it's terrible, I can't stand it, and life is no good.

Cognitive Restructuring involves....

1. Acknowledging that we are fully responsible for creating our own emotional problems, 2. Accepting the notion that we have the ability to change these disturbances (to a large degree) 3. Recognizing that our emotional problems largely stem from irrational beliefs 4. Clearly seeing those beliefs 5. Seeing the value of disputing those beliefs 6. Accepting that we need to work hard to counteract irrational beliefs 7. Understanding the rational alternative to the irrational beliefs 8. Practicing healthy alternatives for the rest of our life

Limitations of Behavior Therapy (hint there are 4)

1. Behavior therapy does not change feelings, only behaviors. In practice, some clinicians do deal with feelings and how they affect thoughts and behavior. 2. Behavior therapy does not provide insight. Behavior therapists do not see insight as necessary for behavior change. 3. Behavior therapy treats symptoms, not causes, and therefore, other symptoms may be likely to emerge that will take the place of the old ones that have been changed. There is no evidence that symptom substitution occurs. 4. Behavior therapy involves control and social influence by the therapist. However, behavior therapists typically engage clients as partners in the change process, and thereby give them much control over the therapeutic process.

List the Cognitive Techniques in REBT hint- there is 5

1. Disputing irrational beliefs 2. Doing cognitive homework 3. Bibliotherapy (reading educational materials on REBT) 4. Using more precise language (self-statements that are not so negative or absolute). 5. Psychoeducation

CBM Procedures in Stress Innoculation training: Hint 5

1. Expose clients to anxiety-provoking situations by role-playing and imagery 2. Have clients evaluate their anxiety level 3. Teach clients to become aware of anxiety-provoking cognitions 4. Help clients re-evaluate self-statements (are they valid? Do they always apply?) 5. Have clients evaluate their anxiety level after re-evaluating self-statements

Ct relies on the principles that hint there are 3

1. People's internal dialogue is accessible to themselves 2. These beliefs have highly personal meanings 3. These meanings can be discovered by the client

Define the applications of group therapy (hint there are 3 written in the notes)

1. social skills training groups 2. psychoeducational groups with a specific focus, stress management groups 3. multimodal group therapy, mindfulness and acceptance based behavior therapy in groups.

List and define the *4 newer approaches to mindfulness and acceptance based CBT*

1.Dialectical Behavior Therapy (DBT) - Marsha Linehan - combines behavioral and psychoanalytic techniques. Highly structured approach which incorporates 4 modules - mindfulness, interpersonal effectiveness (to cope with interpersonal conflicts), emotion regulation and distress tolerance. Used especially for borderline personality disorder. Therapists need special training in DBT 2.Mindfulness based stress reduction (MBSR) - The idea is that much of our stress comes from wanting things to be different than they are. MBSR teaches people to live more fully in the present. Not based on changing cognitions, but rather on accepting them through meditation, yoga. 3. Mindfulness based cognitive therapy - primarily for depression - 8 week very specific program where clients are taught how to respond to their own negative automatic thoughts. Sessions are spelled out on page 272. Includes experiential learning, practice in session and for homework. 4.Acceptance and Commitment therapy (ACT) - encouraging clients to accept, rather than change or control unpleasant thoughts and situations. Active, non-judgmental embracing of experiences in the here and now. Helping clients to understand that they have bad or negative thoughts and feelings, and that these can be accepted and don't necessarily need to be changed (radical departure from traditional Cognitive Behavior Therapy). Clients learn to accept and then distance themselves from their thoughts and feelings. The Commitment piece is a commitment to action, helping the client to live a more meaningful life. Useful for substance abuse disorders, depression, phobias, panic disorder, and PTSD.

Behavioral therapy started in years-

1950's and 1960's., and gained tremendous acceptance during the 1970's and 1980's.

Selective abstraction

A cognitive distortion that involves forming conclusions based on an isolated detail of an event.

Dichotomous thinking

A cognitive error that involves categorizing experiences in either-or extremes.

Mindfulness-based cognitive therapy (MBCT)

A comprehensive integration of the principles and skills of mindfulness applied to the treatment of depression.

Stress inoculation training (SIT)

A form of cognitive behavior modification developed by Donald Meichenbaum that is a combination of information giving, Socratic discussion, cognitive restructuring, problem solving, relaxation training, behavioral rehearsals, self-monitoring, self-instruction, self-reinforcement, and modifying environmental situations.

Arbitrary inferences

A form of cognitive distortion that refers to making conclusions without supporting and relevant evidence.

Positive reinforcement

A form of conditioning whereby the individual receives something desirable as a consequence of his or her behavior; a reward that increases the probability of its recurrence.

Acceptance and commitment therapy (ACT)

A mindfulness-based program that encourages clients to accept, rather than attempt to control or change, unpleasant sensations.

Multimodal therapy

A model endorsing technical eclecticism; uses procedures drawn from various sources without necessarily subscribing to the theories behind these techniques; developed by Arnold Lazarus.

Cognitive triad

A pattern that triggers depression.

Social learning approach

A perspective holding that behavior is best understood by taking into consideration the social conditions under which learning occurs; developed primarily by Albert Bandura.

Systematic desensitization

A procedure based on the principles of classical conditioning in which the client is taught to relax while imagining a graded series of progressively anxiety-arousing situations. Eventually, the client reaches a point at which the anxiety-producing stimulus no longer brings about the anxious response.

Acceptance

A process involving receiving our present experience without judgment or preference, but with curiosity and gentleness, and striving for full awareness of the present moment.

Cognitive restructuring

A process of actively altering maladaptive thought patterns and replacing them with constructive and adaptive thoughts and beliefs.

Overgeneralization

A process of holding extreme beliefs on the basis of a single incident and applying them inappropriately to dissimilar events or settings.

Socratic dialogue

A process that cognitive therapists use in helping clients empirically test their core beliefs. Clients form hypotheses about their behavior through observation and monitoring.

CBM: Stress Innoculation Training

Helping clients to cope with small stresses so that they will be better equipped to cope with larger stresses. Coping skills are designed to address both present problems and future difficulties. This also helps prevents relapse.

socratic dialogue

A process that cognitive therapists use in helping clients empirically test their core beliefs. Clients form hypotheses about their behavior through observation and monitoring. some examples: What would be lost by trying a specific activity? Will you feel worse if you are passive? How do you know it is pointless to try?

Mindfulness

A process that involves becoming increasingly observant and aware of external and internal stimuli in the present moment and adopting an open attitude toward accepting what is, rather than judging the current situation.

Therapeutic collaboration

A process whereby the therapist strives to engage the client's active participation in all phases of therapy.

anxiety hierarchy

A rank-ordered list of what the client fears, starting with the least frightening (bottom of the triangle) and ending with the most frightening. (top of triangle). *USED WITH SYSTEMATIC DESENSITIZATION*

Constructivist approach

A recent development in cognitive therapy that emphasizes the subjective framework and interpretations of the client rather than looking to the objective bases of faulty beliefs.

Behavioral assessment

A set of procedures used to get information that will guide the development of a tailor-made treatment plan for each client and help measure the effectiveness of treatment.

Assertion training

A set of techniques that involves behavioral rehearsal, coaching, and learning more effective social skills; specific skills training procedures used to teach people ways to express both positive and negative feelings openly and directly.

Anger management training

A social skills program designed for individuals who have trouble with aggressive behavior.

Define the therapeutic technique: Progressive Muscle Relaxation

A specific method by which clients can be trained to relax through tensing and relaxing muscles one by one. Has been used with surgery patients, chronic pain, migraines, surgery, headaches, insomnia, hypertension, asthma, panic disorder, irritable bowel syndrome.

Reinforcement

A specified event that strengthens the tendency for a response to be repeated. It involves some kind of reward or the removal of an aversive stimulus following a response.

Behavior rehearsal

A technique consisting of trying out in therapy new behaviors (performing target behaviors) that are to be used in everyday situations.

Personalization

A tendency for people to relate external events to themselves, even when there is no basis for making this connection.

Musturbation

A term coined by Ellis to refer to behavior that is absolutist and rigid. We tell ourselves that we must, should, or ought to do or be something.

Rational emotive behavior therapy (REBT)

A theory that is based on the assumption that cognitions, emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship.

Behavior modification

A therapeutic approach that deals with analyzing and modifying human behavior.

Cognitive behavior modification (CBM)

A therapeutic approach that focuses on changing the client's self-verbalizations.

Cognitive behavior therapy (CBT)

A treatment approach that aims at changing cognitions that are leading to psychological problems.

Operant conditioning

A type of learning in which behaviors are influenced mainly by the consequences that follow them.

Applied behavior analysis

Another term for behavior modification; this approach seeks to understand the causes of behavior and address these causes by changing antecedents and consequences.

In vivo desensitization

Brief and graduated exposure to an actual fear situation or event.

Cognitive therapy (CT)

An approach and set of procedures that attempts to change feelings and behavior by modifying faulty thinking and believing.

Cognitive behavior therapy (CBT)

An approach that blends both cognitive and behavioral methods to bring about change. (The term CBT has largely replaced the term "behavior therapy," due to the increasing emphasis on the interaction among affective, behavioral, and cognitive dimensions).

Constructivist narrative perspective

An approach that focuses on the stories that people tell about them themselves and others regarding significant events in their lives.

evience based practice

All therapies need to be proven to be effective. ( MUST HAVE EVIDENCE)

Classical conditioning

Also known as Pavlovian conditioning and respondent conditioning. A form of learning in which a neutral stimulus is repeatedly paired with a stimulus that naturally elicits a particular response. The result is that eventually the neutral stimulus alone elicits the response.

Assume acronym means

Ass out of you and me. helping clients to realize there fears or beliefs may be assumptions/ jumping to conclusions can help them to reroute and catch their thought processes while it is happening

Basic Characteristics and Assumptions:

Behavior Therapy is based on scientific research evidence. Therapy goals are agreed to by client and therapist, and problems and interventions are assessed repeatedly for effectiveness. Behavior includes mental processes, cognitions and beliefs. Deals with the current problems and the factors that maintain them. Clients are expected to be active in terms of doing something to bring about change. Role-playing new behaviors may occur during therapy sessions, and practice occurs between sessions. Action-oriented plan to replace old, maladaptive behaviors with newer more adaptive ones. The assumption is that change can take place without delving into early experiences or understanding the origins of a problem. Assessment is ongoing and involves self-monitoring. Continual assessment and evaluation of treatment interventions to see if they are working and what changes may need to be made if they are not working. An individual plan of treatment interventions for each individual client.

B.F. Skinner

Behaviorist that developed the theory of *operant conditioning* by training pigeons and rats. Known as Father of Behaviorism and has a scientific approach to behavior and behavior change

Homework

Carefully designed and agreed upon assignments aimed at getting clients to carry out positive actions that induce emotional and attitudinal change. These assignments are checked in later sessions, and clients learn effective ways to dispute self-defeating thinking.

Donald Meichenbaum was known for

Cognitive Behavior Modification (CBM)

Irrational beliefs, shoulds, musts, awfulizing, self-downing - all must be disputed by

Cognitive restructuring

Arron Beck is known for

Cognitive therapy Also often called Cognitive Behavior Therapy) Beck developed CT at around the same time Ellis developed REBT. Much in common with REBT and behavior therapy - time limited, directive, active, present-centered, collaborative, structured and empirical. Homework is utilized. Aimed at changing maladaptive beliefs.

Schema

Core beliefs that are centrally related to dysfunctional behaviors. The process of cognitive therapy involves restructuring distorted core beliefs (or schema).

Distortion of reality

Erroneous thinking that disrupts one's life; can be contradicted by the client's objective appraisal of the situation.

Consequences

Events that take place as a result of a specific behavior being performed.

Ellis was extremely kind and gentle while approaching his clients/therapy. T or F

F Ellis' relationship between Client and Therapist explained- A warm relationship *not required*. Ellis was not warm with clients. *quite harsh* very blunt., rude, etc *However, there is a collaborative process between therapist and client.*

assertive and agressive is the same T or F

F Agressive-violence, assertive standing up for youself

Beck is known for INCREASING maladaptive behaviors. T or F

F. Aimed at *changing* maladaptive beliefs.

Phobias can be a classically conditioned response and it *must*take multiple times to form a reaction or phobia. T or F

F. It can take only one time to create a fear to a conditioned response, but it does TEND to be multiple exposures.

the past is NOT AT ALL brought into CBT. T or F

F. Past is brought in to the extent that it may be relevant in terms of how the distortions got started and how they have been maintained, *affecting functioning today.*

CT works very well for ONLY depression. T or F

F. YES there are Very clear evidence that CT works very well for depression. HOWEVER, Also works for phobias, anxiety disorders, eating disorders, anger, panic disorders, post-traumatic stress disorder, suicidal behavior, borderline personality disorder, narcissistic personality disorder, substance abuse, psychosomatic disorders, chronic pain, crisis intervention, couples and family therapy, divorce counseling, stress management (many, many applications!).

Extinction

When a previously reinforced behavior is no longer followed by the reinforcing consequences, the result is a decrease in the frequency of the behavior in the future.

Behavioral analysis

Identifying the maintaining conditions by systematically gathering information about situational antecedents, the dimensions of the problem behavior, and the consequences of the problem.

Cognitive distortions

In cognitive therapy, the client's misconceptions and faulty assumptions. Examples include arbitrary inference, selective abstraction, overgeneralization, magnification and minimizations, labeling and mislabeling, dichotomous thinking, and personalization.

Stress inoculation

Individuals are given opportunities to deal with relatively mild stress stimuli in successful ways, so that they gradually develop a tolerance for stronger stimuli.

In vivo flooding

Intense and prolonged exposure to the actual anxiety-producing stimuli.

Cognitive processes

Internal events such as thoughts, beliefs, perceptions, and self-statements.

In vivo exposure

Involves client exposure to actual anxiety-evoking events rather than merely imagining these situations.

Progressive muscle relaxation

It is a method of teaching people to cope with the stresses produced by daily living. It is aimed at achieving muscle and mental relaxation and is easily learned.

Modeling

Learning through observation and imitation. (think of social learning theory- Banduera)

Automatic thoughts

Maladaptive thoughts that appear to arise reflexively, without conscious deliberation.

Define Antecedent events

Ones that cue or elicit a certain behavior.

What is differentiation between skinners two aspects of operant conditioning: POSITIVE PUNISHMENT and NEGATIVE REINFORCEMENT

Positive punishment decreases the target behavior by adding something aversive (bad). Negative reinforcement increases the target behavior by taking away something aversive

Constructivist Narrative Perspective (CNP)

Precursor to Narrative therapy. Meichenbaum talks about how people construct stories about their lives - they essentially see it from their own reality. Less structured and more discovery-oriented than standard cognitive therapy. focuses on the stories people tell about themselves and others regarding significant events in their lives

Relapse prevention

Procedure for promoting long-term maintenance that involves identifying situations in which clients are likely to regress to old patterns and to develop coping skills in such situations.

Cognitive behavioral coping skills therapy

Procedures aimed at teaching clients specific skills to deal effectively with problematic situations.

Assessment interview

Questioning that enables the therapist to identify the particular antecedent and consequent events that influence or are functionally related to an individual's behavior.

please list some MAIN DIFFERENCES between REBT and CT

REBT - more confrontational (this was Ellis's style), directive, persuasive, teaching role of the therapist. CT - Socratic dialogue - posing open-ended questions to clients and getting them to arrive at their own conclusions. More emphasis on having the client come up with the reasons for the cognitive distortions. IMPORTANT/ MAJOR TAKE AWAY *Beck views faulty cognitions as being inaccurate rather than irrational. Beck emphasized the quality of the therapeutic relationship as key, believing therapists need to be sensitive and empathic. Beck says without a working alliance, it is very difficult (or impossible) to reach clients. Ellis did not think the therapeutic relationship was important.*

What therapy was Albert Ellis known for? What did he believe?

Rational Emotive Behavior Therapy (REBT) Clients hold irrational beliefs which influence our emotions and the reactions we hold to life's situations. *the first CBT* He determined we have 3 basic ones: *this will be repeated in a seperate card, but just to preface* Ellis said we have three basic musts or irrational beliefs - they are: 1. *I must do well and win the approval of others* for my performances or else I am no good 2. *Other people must treat me considerately, fairly and kindly.* If they don't they deserve to be condemned and punished. *I must get what I want, when I want it.* I must not get what I don't want. If that happens, it's terrible, I can't stand it, and life is no good.

Schemas

Schemas - core beliefs - if dysfunctional, can be worked on in therapy to try to change them. If depressed person feels it won't get better, ask if there was any time in the past week (even month) when they felt even a little bit better.

Assessment

Self monitoring- can be done using scales/written or verbal. helps to assess how severe behavior is. can be general such as : how much anxiety did you experience today or extremely specific/targeted: how many times you locked your door before you could leave the house (OCD)

Albert Bandura

Social learning theory also known as Social Cognitive theory. 1) Based on modeling. 2) Ways in which people influence their own motivation and behavior through choice 3) importance of Self-Efficacy and resilience 4) Studies how stress reactions and depressions are caused

Define the basis of the therapeutic process in behavior therapy

Specific treatment goals are identified by client and therapist - must be clear and concrete. A plan of action to work towards these goals is put in place, usually involving subgoals.

Eye Movement Desensitization and Reprocessing (EMDR)

Specifically useful for PTSD (Post-Traumatic Stress Disorder) Involves 3 phases - assessment and preparation, imaginal flooding and cognitive restructuring. Requires very specific training for the therapist. Much research shows it is better than no treatment for trauma, but some other treatments can work just as well. Another explanation off of the internet "A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories."

Self-management

Strategies in self-management programs include self-monitoring, self-reward, self-contracting, and stimulus control.

REBT is It is typically brief. There is an emphasis on education and prevention. T or F

T

Basic Principles of CT: Clients have automatic thoughts. T or F

T. Beck found that these automatic negative thoughts persist even in the face of evidence to the contrary.

Assertion (or Assertiveness) Training

Teaches people that they can choose whether to behave assertively in certain situations. Teaches people how to express themselves in ways that reflect sensitivity to the feelings and rights of others. Focuses on clients' negative self-defeating beliefs and faulty thinking, which can lead to passive behavior (clients feel they do not have the right to behave assertively). Often done in groups. Works for Western cultures - may not work for some cultures that place more value on harmony and collectivism.

A-B-C model of personality

Temporal sequence of antecedents, behavior, and consequences. The theory that people's problems do not stem from activating events but, rather, from their beliefs about such events. Thus, the best route to changing problematic emotions is to change one's beliefs about situations.

Self-efficacy is

The belief that a person can master a situation and bring about desired change.

Imprtant information to note: Cognitive Therapists have clients help devise the homework and begin it during the therapy session. Things are framed as testable hypotheses to be tested by the client. Specific measurable goals. Ultimately teaches clients to be their own therapists by having them learn to identify and change maladaptive thoughts.

The key is that these goals are TARGETED, ATTAINABLE, AND ACHIEVABLE according to client.

Punishment

The process in which a behavior is followed by a consequence that results in a decrease in the future probability of a behavior.

Self-monitoring

The process of observing one's own behavior patterns as well as one's interactions in various social situations.

Functional assessment

The process of systematically generating information on the events preceding and following the behavior in an attempt to determine which antecedents and consequences are associated with the occurrence of the behavior.

Rationality

The quality of thinking, feeling, and acting in ways that will help us attain our goals. Irrationality consists of thinking, feeling, and acting in ways that are self-defeating and that thwart our goals.

Internal dialogue

The sentences that people tell themselves and the debate that often goes on "inside their head"; a form of self-talk, or inner speech.

Negative reinforcement

The termination or withdrawal of an unpleasant stimulus as a result of performing some desired behavior.

define counter transference

The unconscious transfer of feelings onto the patient that are related to things/ people in their past. Your own processes to what the client is telling you. referred to as your buttons. YOU ALMOST ALWAYS EXPERIENCE THIS IN EVERY SESSION.

explain the therapeutic process

Therapeutic Goals - to help the client distinguish between realistic and unrealistic goals and self-defeating and self-enhancing goals. Therapist helps client choose more realistic and self-enhancing goals. Helping clients accept themselves and others unconditionally. Therapist's Function and Role - to help client see how they have many irrational "shoulds," "oughts" and "musts" in their lives, and to help them change the irrational thoughts to more rational ones. Client's Experience in Therapy - learning to realize that life doesn't always work out the way you expect or want it to. Focus is on present experiences, not past. Homework is regularly assigned (agreed to by client) to carry out positive actions to create emotional and attitudinal change. Relationship between Client and Therapist - warm relationship not required. Ellis was not warm with clients. However, there is a collaborative process between therapist and client.

Define the therapeutic technique: Systematic Desensitization:

Therapist assesses what is causing the anxiety - under what circumstances is the client becoming anxious, etc. Then a process of relaxation training, development of a graduated anxiety hierarchy (list of things that makes the client most anxious and next most anxious, etc.) and systematic desensitization occurs (with client in a relaxed state), moving progressively up the anxiety hierarchy. Very supported by research. Also works with anger, asthma, insomnia, motion sickness, nightmares and sleepwalking.

Behavior therapy

This approach refers to the application of diverse techniques and procedures, which are supported by empirical evidence.

Please list define the THREE phases associated with Stress Inoculation training

This is done in 3 phases: Conceptual-educational phase - to build a working therapeutic relationship with the client. Training includes teaching clients to become aware of their own role in creating their stress and their life stories. Skills acquisition and consolidation phase - giving clients a variety of behavioral and coping skills to apply to stressful situations. Includes relaxation training, learning how to prepare for a stressor, how to confront a stressor, coping with feeling overwhelmed, making self-reinforcing statements. Application and follow-through phase - imagery and behavior rehearsal, role-playing, modeling, slowly moving to in vivo exposure.

ABC model

This model of behavior posits that behavior (B) is influenced by some particular events that precede it, called antecedents (A), and by certain events that follow it called consequences (C).

Social skills training

This training involves a broad category that deals with an individual's ability to interact effectively with others in various social situations. A treatment package used to teach clients skills that include modeling, behavior rehearsal, and reinforcement.

Exposure therapies

Treatment for fears and other negative emotional responses by carefully exposing clients to situations or events contributing to such problems.

Does the behavioral approach to therapy emphasize a collaborative relationship between client and therapist? T or F

True

Strengths of Cognitive Approach from a Diversity Perspective:

Uniquely tailored to client's individual needs and strengths. Clients learn specific skills to carry out in everyday life. Strategies to minimize stressors are learned, as well as increasing personal strengths and supports.

Shortcomings of Cognitive Approach from a Diversity Perspective:

Value is on independence. Other cultures value interdependence and see that as a key to good mental health. Such clients would not likely respond favorably to CBT.

Define transference

When the client displaces emotions felt toward other people such as counselor

Social Skills Training

a therapy approach that helps people learn or improve social skills and assertiveness through role playing and rehearsing of desirable behaviors. Reworded: broad training to help people learn to communicate in ways that are appropriate and effective. Entails psychoeducation, modeling, role-playing and feedback. Training can be specificallytailored to the individual needs of the client. Useful in alcohol/substance abuse, ADHD, bullying, social anxiety, couples therapy, depression, emotional and behavioral problems in children. One popular type of social skills training is anger management training.

Collectivism

a worldview in which social behavior is guided largely by goals that are shared by a collective. ex. familial relationships- parents take care of children and eventually children will contribute and care for them as they get older.

token economy

an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats common in classrooms- receiving stickers as rewards for good behavior

distinguish assertive vs. agressive

assertive- asking boss for a raise. (healthy, not violent, good training/ skill to have) aggressive- punching your boss in the face (violent, not a strong and effective way of making changes in your life)

CBM focuses on....

changing the client's self-verbalization. Meichenbaum says self-statements affect our behavior the same as if the statement came from another person. *Combines Behavior therapy and Cognitive Therapy.*

List: Strengths and Contributions of Behavior Therapy

clear plans are put into action. Specific techniques are used - role-playing, relaxation, coaching, practice, modeling, feedback, learning in stages, mindfulness skills, homework. Clients DO instead of talking about the problems. Much assessment of effectiveness of interventions. *Use what works, change interventions that don't work.* The most empirical research has been done with behavior therapy (also CBT). Clients have control over what the goals should be.

Arnold Lazarus

clinical behavior therapy - basically a cognitive behavioral approach, empirically supported. Called Multimodal therapy. Recognized as an authority on brief, efficient and effective therapy.

cognitive restructuring

cognitive restructuring teaches people how to replace irrational (self-defeating) beliefs with more rational (helpful) ones. Beliefs that are harmful get disputed in therapy. Doing so will help create more positive feelings. reworded a therapeutic approach that teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs

Today, behavior therapy includes...

cognitive therapy, social skills training, relaxation training and mindfulness strategies.Since 2000, additional behavioral techniques include Dialectical Behavior Therapy (DBT), which is especially useful for personality disorders, Mindfulness-based stress reduction (MBSR) and Acceptance and Commitment therapy (ACT). Behavioral techniques have received much empirical support and are now widely used by most therapists in one way or another.

Flooding Prolonged and intensive in vivo or imaginal exposure to high anxiety/how does it work?-

evoking stimuli without the opportunity to avoid or escape from them.

define cognitive distortions

faulty assumptions and misconceptions

Self-instructional training

focuses on helping clients become more aware of their self-talk. Meichenbaum says it is or may be more effective to behave ourselves into a way of thinking than thinking ourselves into a way of behaving (Social Psych studies have confirmed that this is true). Also, Meichenbaum points out that how we feel affects our thinking, just as our thinking affects how we feel. (When we are sad or depressed, it colors our thinking, not just the other way around)

What is the goal of Ellis' REBT?

for clients to be less emotionally reactive. Ok to feel sadness and disappointment, but these should not be turned into anxiety, depression and shame.

Behavioral technique in REBT (hint there is one)

homework

As a counselor using a self monitoring scale can also help understand/communicate the need for acceptance. please elaborate on this.

if a persons anxiety ranges from 5-10 on a scale. Accepting that they may never be at a 1 is important. It is important they understand everybody is different and the goal is to find a happy and attainable way of life for the client, and it is unrealistic FOR ANYBODY to never have any anxiety especially if they are at an 8 most days.

Awfulizing

mental exaggeration of setbacks or inconveniences (must be disputed by cognitive reconstructing)

REBT is applied in what types of settings

schools, couples, family and group therapy

Emperical

scientific research based

negative triad

negative views of the self, the world, and the future Negative triad that triggers depression - negative view of oneself, one's experiences and the future.

The behavioral approach was radically different from

psychoanalytic/psychodynamic approach

Define some cognitive distortions in CBT

recap: cognitive distortions- faulty assumptions and misconceptions 1. Arbitrary inferences - making conclusions without supporting evidence; catastrophizing 2. Selective abstraction - forming conclusions based on one isolated detail of an event, ignoring other information and the total picture 3. Overgeneralization - holding extreme beliefs on the basis of a single incident then generalizing to other situations 4. Magnification and minimization - Magnifying or minimizing an event 5. Personalization - relating external events to the self when they really don't apply 6. Labeling and mislabeling - defining oneself on the basis of past mistakes 7. Dichotomous thinking - black or white thinking; extreme all or none thinking

Acceptance

receiving one's own present experience without judgment. Integration of spirituality into the counseling process.