Transcript Introduction to Cognitive Behavioral Therapy Lecture

Introductory Training

Behavioral Therapy helps you weaken the
connections between troublesome situations and
your habitual reactions to them.
◦ Reactions such as fear, depression or rage, and selfdefeating or self-damaging behavior.

Cognitive therapy teaches you how certain
thinking patterns are causing your symptoms
◦ distorted picture of what's going on in your life, and
making you feel anxious, depressed or angry for no
good reason, or provoking you into ill-chosen actions.

Therapist and client collaborate to
understand the client’s behavior in the
context of:





situational factors
thoughts
feelings
expected outcomes
Client learns and applies new coping skills to
replace maladaptive thoughts & behaviors
and improve outcomes.


The therapy with the most research
support
Hundreds of studies by research
psychologists and psychiatrists make it
clear why CBT has become the preferred
treatment

Symptoms for which CBT has demonstrated its
effectiveness include:
◦ Problems with relationships, family, work, & school
◦ Insomnia, & other sleep disorders
◦ Self-esteem/Self-image.

Preferred treatment for:
◦
◦
◦
◦
◦
social issues, panic attacks, phobias,
post-traumatic stress,
eating disorders,
loneliness,
headaches

The thing that upsets people is not what happens
but what they think it means

People - and I mean all people, not just therapy
clients - routinely distress themselves and others with
arbitrary interpretations of what is going on.

People also react differently depending on the
overriding current emotion

Our behaviors reinforce the maladaptive thoughts
and feelings
THOUGHTS
FEELINGS
BEHAVIOR
What you think
“ She Might have
been hurt on her
way here”
Friend is late
for dinner
"She didn't bother to
let me know she
was delayed.”
"It doesn't matter to
me whether
people are on
time."
"I needed the time to
fix the house up
anyway."
How you feel
What you do
Worried or anxious
Call hospital ERs to
find out if she's
there
Annoyed or angry
Indifferent
Relieved
Chew her out, or act
chilly, when she
does show up
Nothing in
particular
Relax and enjoy
yourself

Virtually the only means of access to our moods and
emotions are the cognitive and behavioral routes.

In order to voluntarily change how we feel, we have to
go about it indirectly, not directly. There is no direct
way to influence our feelings and moods.
The two most powerful levers of constructive change
1.
Altering ways of thinking — a person's thoughts, beliefs,
ideas, attitudes, assumptions, mental imagery, and ways of
directing his or her attention — for the better.
2.
Helping a person greet the challenges and opportunities in his
or her life with a clear and calm mind — and then taking
actions that are likely to have desirable results.

Focuses on the training of interpersonal and selfmanagement skills

Primary Goal = Mastery of skills needed to maintain
long-term abstinence from substance abuse
 Identify high risk situations, both external circumstances and
internal thoughts & feelings
 Develop skills to cope with high risk situations
 Practice, with feedback

See Monti et al, 1989

In CBT the therapist takes an active part in helping to
explore solutions to the clients problems.
◦ education, coaching or tutoring

CBT provides clear structure and focus to treatment

CBT focuses on finding out just what needs to be
changed and what doesn't — and then works for
those targeted changes.

Substance use is a learned behavior in which use
becomes triggered by environmental stimuli,
thoughts and feelings and is maintained by
reinforcing effects.

Individuals who wish to stop or reduce substance
use need skills to cope with these triggers, as an
alternative to drug and alcohol use.

Effective learning of these new coping skills
requires repetition and practice with feedback.




Reinforce small steps in the recovery process
Therapists help the adolescent realize that long term
drug use is incompatible with other short and long
term goals
Work to increase alternative positive, non-drug
related social/recreation activities, while teaching
social skills (e.g. problem solving, drug refusal, etc)
Helps the adolescent maximize
family/peer/community resources and activities to
reward non-drug using behavior.

Functional Analysis

Training in identification of triggers
 CBT substance addiction treatment includes recognizing
and coping with craving, managing thoughts about
substance use, problem solving, planning for
emergencies, recognizing seemingly irrelevant decisions,
and refusal skills.

Skills Training

In session skills practicing

Out of Session skills practicing