Cognitive Behavior Therapy (CBT)

INTRODUCTION

CBT is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. CBT combines the Cognitive Therapy developed by Aron Beck and Behavior Therapy techniques. Thoughts cause Feelings and Behaviors Emphasis placed on current behavior. CBT is a collaborative effort between the therapist and the client. o Client role - define goals, express concerns, learn & implement learning o Therapist role - help client define goals, listen, teach, encourage. Based on "rational thought." - Fact not assumptions. CBT is structured and directive. Based on notion that maladaptive behaviors are the result of skill deficits. Homework is a central feature of CBT. Cognitive therapies do not appear to work as well with those who are cognitively impaired.

DEFINITION

Focused form of psychotherapy based on a model suggesting that psychiatric/psychological disorders involve dysfunctional thinking The way an individual feels and behaves in influenced by the way s/he structures his experiences. Modifying dysfunctional thinking provides improvements in symptoms and modifying dysfunctional beliefs that underlie dysfunctional thinking leads to more durable improvement

INDICATIONS Cognitive therapy was originally developed for use in the treatment of depression.
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Personality disorders Seasonal affective disorders Generalized anxiety disorders obsessive-compulsive disorders Mood disorders-depression

MAJOR CONCEPTS & PROCEDURE The General Cognitive Model

The Cognitive Triad

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Negative view of the self (e.g., Im unlovable, ineffective) Negative view of the future (e.g., nothing will work out) Negative view of the world (e.g., world is hostile)

Automatic Thoughts
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Negative thoughts about yourself, your world, or your future Examples of automatic thoughts Catastrophizing - extreme consequences of events All or nothing - seeing things in black and white - no grey areas Emotional reasoning - if I feel it, it must be true

Self-defeating (irrational) beliefs as per Ellis Ellis suggested that a small number of core beliefs underlie most unhelpful emotions and behaviors. Core beliefs are underlying rules that guide how people react to the events and circumstances in their lives. Here is a sample list of such of these: I need love and approval from those around to me. I must avoid disapproval from any source. To be worthwhile as a person I must achieve success at whatever I do. I cannot allow myself to make mistakes. People should always do the right thing. When they behave obnoxiously, unfairly or selfishly, they must be blamed and punished. 6. Things must be the way I want them to be. 7. My unhappiness is caused by things that are outside my control so there is nothing I can do to feel any better.
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I must worry about things that could be dangerous, unpleasant or frightening otherwise they might happen. I must avoid lifes difficulties, unpleasantness, and responsibilities. Everyone needs to depend on someone stronger than themselves. Events in my past are the cause of my problems and they continue to influence my feelings and behaviors now. I should become upset when other people have problems, and feel unhappy when theyre sad. I shouldnt have to feel discomfort and pain.

11. Every problem should have an ideal solution. Helplessness

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I am inadequate, ineffective, incompetent, cant cope I am powerless, out of control, trapped I am vulnerable, likely to be hurt, weak, needy I am inferior, a failure, a lower, not good enough, defective, dont measure up.

Hopelessness
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I am unlikable, unwanted, will be rejected or abandoned, always be alone I am undesirable, unattractive, ugly, boring, have nothing to offer I am different, defective, not good enough to be loved by other, a nerd

The Cognitive Model

The Basic Goals of CBT

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To challenge the thoughts about a particular situation by identifying the cognitive traps To help the patient to identify less threatening alternatives To test out these alternatives in the real world
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To challenge the assumptions that lead to the automatic thoughts

The Basic Tenets of CBT

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Cognitive specificity Socratic dialogue Collaborative empiricism

Conclusion
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Cognitive behavioral therapy (CBT) is an established treatment for a number of psychiatric disorders. The CBTs are the best-studied psychological treatments of major depressive, panic, generalized anxiety, and obsessive-compulsive disorders. (Friedman, Thase & Wright, 2008) The CBTs have become one of the standard psychosocial treatment approaches for mental disorders.