Cognitive Behavioral Therapy/Techniques

2 Central Tenets

"cognitions have a controlling influence on our emotions and behavior" "how we act or behave can strongly affect our thought patterns and emotions"

Treatment Strategies: Learning new behavior

-Modeling -Shaping -Token economy -Social skills training -Aversive therapy -Contingency contracting

Treatment Strategies: Cognitive Restructuring

-Monitoring thoughts and feelings -Questioning the evidence -Examining alternatives -Decatastrophizing -Reframing -Thought stopping

Cognitive Distortions: 10 General Categories

1. All or Nothing (dichotomous) Thinking -all good or all bad 2. Overgeneralization- never ending in nature 3. Mental filtering- awfulizing the situation 4. Disqualifying the positive- rejecting the positive 5. Jumping to conclusions- mind reading expected 6. Magnification- exaggerating the outcome 7. Emotional reasoning- assuming feelings reflect the truth about the situation or person. 8. Should statements- monkey on the back 9. Labeling -name calling 10. Personalization- blaming oneself inappropriately for the situation or the event.

CBT Process Steps

1. Awareness 2. Automatic Thoughts 3. Cognitive Distortions/errors 4. Choosing Effective Coping

Interacting Systems in Human Behavior

Affective (feelings) Behavioral (actions) Cognitive (thoughts)

Automatic Thoughts

Automatic thoughts occur in response to a situation Common characteristics of AT include: -Knee-jerk responses to perceived stressor. -Usually negative in content -Quick, fleeting, a kind of shorthand is involved -Usually these thoughts are not in our conscious awareness -Often these thoughts are unrealistic, illogical, & distorted.

Relationships Between Thoughts & Emotions

Cognitive restructuring (CR) allows the person to become aware of the emotions & automatic thoughts related to a particular emotion & its connection to stress. When the person focuses on the underlying themes it allows them to reflect on the meaning and choose how they want to respond. Through CR the person can learn to reduce the intensity, frequency & length of time these distortions are experienced. The goal is to help the person become aware of the relationship between emotional themes to stress triggers & cognitive distortions. Journal keeping that reflects on the thoughts & feelings related to stressful events is a valuable way to identify automatic thoughts & underlying emotions.

The Process of CBT

Cognitive restructuring to help people experience a range of feelings when they are stuck in powerful negative mood states. The health care provider acts as a guide in the process. The client performs the intervention on themselves.

Aims of CBT

Increasing a desired activity Reducing unwanted behavior Increasing pleasure Enhancing social skills

Treatment Strategies: Anxiety reduction

Relaxation training Biofeedback Desensitization

Automatic Thoughts: What do you do?

Stop, take a breath & Reflect. Ask: What is going on? How do I feel? What are my automatic thoughts? Do they contain "shoulds, always, oughts, and nevers?

Identifying Emotions

The way we feel is very important. Positive feelings promote health while negative feelings contribute to ill health. Family & cultural influences determine how we deal with & express emotions. Exaggerated emotions interfere with good problem solving & can require the need of someone to assist in processing these emotions to attain a good outcome.

Treatment Strategies

When a person develops a large number of positive coping skills, their perspective of a stressful situation shifts to viewing the event as a challenge rather than a stressor. This sense of control diminishes the effects of stressful situations or persons.

Cognitive behavioral therapy (CBT)

a therapeutic approach that addresses the relationship among thoughts, feelings, behaviors, & physiology

Cognitive distortions

inaccurate, irrational thoughts

Cognitive restructuring

the examination & reframing of one's interpretation of the meaning of an event