Cognitive

1
Cognitive Behavioral Approaches to Counseling

• Intro. Counseling Human Services
• KEAN UNIVERSITY
• Dr. Mascari

2
Behavior therapy (Modification)

• Origins of behaviorist movement in 1950s
  1960s (anti-psychoanalytic)
• Widespread use in schools (token economy)
• Relaxation training techniques emerge
• Assertiveness training
• Exposure therapies (flooding)
• fight or flight
• Trauma
• EMDR new approaches

3
(No Transcript)
4
Criticisms of Behavior Therapies

• Changes behavior, not feelings
• Ignores the relationship with clients
• Provides clients no insight (understanding)
• Treats symptoms, not causes
• Involves control manipulation by the counselor
• Bandura (1960s) - social learning theory makes
  cognition a legitimate focus of behavior therapy

5
Cognitive Behavior Therapy

• A. Ellis - Rational Emotive Behavior Therapy
  (REBT)
• D. Michenbaum - Cognitive Behavior Therapy (CBT)
• A. Beck - Cognitive Therapy (CT)
• Glasser - Reality Therapy (Existential core?)
• Lazarus - Multimodal Therapy (BASIC-I.D.)
• All share the following principles
• Collaborative relationship with client
• Psychological distress cognitive disturbance
• Change cognitions to change affect behavior
• Time limited educational focus on targeted
  goals

6
REBT Overview

• Irrational beliefs learned in childhood
  reinforced
• A (activating event)
• B (irrational belief)
• C (consequence - emotional or behavioral)
• D (disputing beliefs - detect debate)
• E (new effective belief system)
• F (new feeling)

7
VIEW ELLIS VIDEO

• What is Ellis case conceptualization of Glorias
  complaint?
• Identify the use of A-B-C
• What general approach or other techniques did you
  see?
• From REBT
• From other approaches

8
REBT Techniques

• Therapeutic stance unconditional acceptance/
  teach client to accept others/ honestly confront
  faulty beliefs/self-disclosure/confront
  transference as a need for approval
• Disputing irrational beliefs (counselor or
  client)
• Doing cognitive homework (in risk taking)
• Changing language (shoulds/musterbation)
• Use humor (counselor client)
• Shame attacking exercises

9
Irrational beliefs small group activity

• Core of REBT are the 11 irrational beliefs (p.
  304-305) - Which are yours?
• Using the model of Sera Nick (P. 306), develop
  your own A-B-C situation.
• Develop D
• List possible resulting E F
• Report back to the class

10
Becks Cognitive Therapy

• Insight oriented approach aimed at changing
  clients negative thoughts beliefs (cognitive
  distortions - depression)
• Counselor is highly interactive with client
  disputing
• Automatic thoughts from cognitive distortions
• Arbitrary inference (lack of evidence/isolated
  incidents)
• Selective abstraction (detail out of context)
• Min/Magnification (errors in significance/magnitud
  e)
• Personalization (apply external events to self)
• Polarized thinking (extreme views of self -
  Gloria)

11
VIDEO Cognitive Behavior treatment in practice

• What did you like about what the counselor did?
  What didnt you like?
• What techniques (CBT/REBT) were used by the
  counselor?
• What irrational beliefs affected the student?
• Where would you go from here with the client
  based on REBT or CT?

12
C-B effectiveness research

• EVT CBT-Panic disorders, generalized anxiety
  disorder, social phobia, agoraphobia, chronic
  pain, bulimia CT-depression, geriatric patients.
  Crits-Cristoph, P. (1998)
• REBT studies have shown effectiveness in 1-12
  sessions (criticism - studies flawed)
• Many REBT practitioners are technical
  eclectics, using other techniques borrowed
  at-will.

13
REBT vs. Others

• METHOD CONSIDERABLE DISTINCT LITTLE
• IMPROVEMENT IMP.
  NO IMP.
• Psychoanalysis 13 37 50
• Psychodynamic18 45 37
• REBT 44 46 10