Transcript Theory and Practice of Counseling and Psychotherapy

Aaron Beck’s Cognitive Therapy
Key concepts
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Cognitive Model of Development
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Automatic Thoughts
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Early childhood experiences lead to basic
beliefs about oneself and one’s world
Automatic thought is a significant role in
perceived distress.
Cognitive Schemas
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How individuals think about their world
Schemas develop early in life from personal
experience and interaction with others.
Key concepts—cognitive Distortions
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All or nothing thinking
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Negative prediction
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Unless I get A, I have failed.
Form conclusions without any supporting
evidence
A person has done well on exams, but predicts
that he/she will fail an exam
Selective abstraction
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Form conclusions based on just one event
Key concepts—cognitive Distortions
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Mind reading
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Catastrophizing
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We think that we know what another person
thinks of us
Exaggerate our concerns
Overgeneralization
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Based on one single event and applying it to
future events
Because I did poorly on my first math exam, I
can’t do math.
Key concepts—cognitive Distortions
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Magnification and minimization
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Personalization
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Magnify imperfections or minimize good points
Relate external events to themselves even
when there is no basis for the connection.
Labeling and mislabeling
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A negative view of oneself is based on
imperfections or mistakes made in the past
The goals of Therapy
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Observe automatic thoughts, identify
cognitive distortions, and ask for evidences
for reality testing the cognitive distortions
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Use automatic thoughts to reach the core
schema and introduce the idea of schema
restructuring
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Focus on specific goals
The Therapeutic Relationship
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Therapeutic relationship is necessary, but
not sufficient for therapeutic effect
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Educate clients about how thoughts
influence their emotions and behaviors
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Teach client how to be their own therapist
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Use homework to test their beliefs in dailylife situations
Therapeutic Techniques
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The three-question techniques
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What is the evidence for the belief?
How else can you interpret the situation?
If it is true, what are the implications?
Specifying automatic thoughts
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Situation Automatic Emotions Alternative
Thoughts
Response
Outcome
Therapeutic Techniques
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Understanding idiosyncratic meaning
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What does it mean to be a loser?
What-if technique (good for overreact clients)
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If…..what would happen?
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Listing advantages and disadvantages
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Challenging absolutes (everyone, always, never….)
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Everyone at work is smarter than me.
Therapeutic Techniques
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Reattribution
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Cognitive Rehearsal
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Use of imagination in dealing with un-coming events
Challenging all or nothing thinking
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attribute responsibility to the situations and not
persons
Scaling: from a dichotomy to a continuum
Labeling of distortion
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Labeling distortion to increase awareness
Cognitive Triad:
Pattern that triggers depression
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Clients hold negative view of themselves and
blames themselves
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Client has a tendency to interpret experiences in
a negative manner
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What is the evidence for the belief?
How else can you interpret the situation?
Client has a gloomy projections about the future
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If it is true, what are the implications?
Research on cognitive therapy (CT)
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More research on depression, followed by
generalized anxiety (GA), OCD, and other
psychological disorder.
Meta-analyses indicate that CT for dealing with
depression and GA is superior to wait list or
control groups
CT works better for those who are less depressed
than for those who are more depressed
CT works better than behavior therapy for GA
From a multicultural perspective
---Contributions
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Diverse populations appreciate the
emphasis on cognition and actions
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Some studies on CBT approach with
minority groups
From a multicultural perspective
--limitations
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Exploring core beliefs is important in CBT
needs to be sensitive to cultural
background and context
 Value “working hard”feel ashamed for
not living up to the expectations
 divorcebring shame to her family
Summary and Evaluation
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contributions:
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research support that CT is a empirically
validated treatment
Limitations
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denying the past
being too technique-oriented
failing to use the therapeutic relationship
working only to reduce symptoms
failing to explore the underlying causes of
difficulties
ignoring unconscious factors and emotions