CBT Presentation (Therapy Techniques).pptx

It shows the CBT therapy in detail.

1. Introduction. Approaches to psychotherapy fall under five broad categories: [email protected]

2. First wave psychotherapy (BT) Behaviour therapy Second wave psychotherapy (CBT) Cognitive (Beckian) therapy Third wave CBT Mindfulness therapies Acceptance & commitment therapy [email protected]

3. Cognitive Behavioural Therapy (CBT) Beck (1960s) “The stronger person is not the one making the most noise but the one who can quietly direct the conversation toward defining and solving problems.” Aaron Temkin Beck. (1921-2021) [email protected]

4. Introduction. I nitially developed in the early 1960s by Dr. Aaron Beck of the University of Pennsylvania. During clients’ cognitive development they learn incorrect habits of processing and interpreting information. Aim is thus to unravel these distortions and help them to learn more different and realistic ways of processing and reality-testing information. [email protected]

5. Basic concepts. ‘ Cognition ’ is defined as that function that involves inferences about one’s experiences and about the occurrence and control of future events . It includes the processes involved in identifying and predicting complex relations among events for the purposes of adaptation . Humans have capacity for both primal/primitive and for higher level cognitive processing. [email protected]

6. Basic concepts. Schemas. Structures that consist of people’s fundamental beliefs and assumptions . They are meaning making cognitive structures . They are relatively stable cognitive patterns that influence through their beliefs, how people select and synthesize incoming information. Developed early in life through personal experiences and identification with significant others and reinforced by further learning experiences. [email protected]

7. Basic concepts. Modes. Networks of cognitive, affective, motivational and behavioural schemas . Modes are fundamental to personality since they interpret and adapt to emerging and ongoing situations. CBT approaches dysfunctional modes by deactivating them, modifying their content and structure and by constructing adaptive modes to neutralize them. [email protected]

8. Basic concepts. Cognitive vulnerability. Refers to humans’ cognitive frailty . Because of their schemas, each person has a set of unique vulnerabilities and sensitivities that predispose them to psychological distress. When they exhibit psychological problems, their dysfunctional schemas and beliefs lead them systematically to bias information in unhelpful ways. [email protected]

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10. Basic concepts. Automatic thoughts . T houghts which occur spontaneously, without effort or choice . In psychological disorders, automatic thoughts are often distorted, extreme , or otherwise inaccurate . Not so deeply buried as beliefs and schemas. People’s self-evaluations and self-instructions appear to be derived from deeper structures- their self-schemas (deeper beliefs and assumptions). [email protected]

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12. Cognitive distortions. Dichotomous thinking By thinking that something has to be either exactly as we want it or it is a failure. “Unless I do extremely well in this exam, I’m a failure.” Selective abstraction Picking out an idea or fact from an event to support their depressed or negative thinking. The boyfriend who becomes jealous at seeing his GF tilt her head towards a man at a noisy event. Mind reading Refers to the idea that we know what another person is thinking about us. Negative prediction When an individual believes that something bad is going to happen, and there is no evidence to support this, this is a negative prediction. Catastrophizing Taking one event that one is concerned about and exaggerating it so that he/she becomes fearful. Stomach pain=cancer. Overgeneralization. Making a rule based on a few negative events, individuals distort their thinking through overgeneralization. A woman concludes after a disappointing date that “All men are alike.” [email protected]

13. Cognitive distortions. Labeling and mislabeling A negative view of oneself is created by self-labeling based on some errors or mistakes. “I faltered while speaking. I’m a horrible speaker.” Magnification or minimization Cognitive distortions can occur when individuals magnify imperfections or minimize good points. They lead to conclusions that support a belief of inferiority and a feeling of depression. Magnification= “If I appear the slightest bit nervous in class, it’ll be a disaster.” Minimization= A man describing his terminally ill mother as having a slight ‘cold.’ Personalization Taking an event that is unrelated to the individual and making it meaningful produces the cognitive distortion of personalization. “I must have done something to offend him.” [email protected]

14. Cognitive model of development of schemas. Individual beliefs begin in early childhood and develop throughout life. Early childhood experiences lead to basic beliefs about oneself and one’s world. These beliefs can be organized into cognitive schemas . Positive experiences of support and love from parents, lead to beliefs such as “I am lovable” and “I am competent,” which in turn lead to positive views/cognitive schemas of themselves in adulthood. [email protected]

15. Cognitive model of development of schemas. Persons who develop psychological dysfunctions, in contrast to those with healthy functioning, have negative experiences that may lead to beliefs such as “I am unlovable” and “I am inadequate .” These developmental experiences, along with critical incidents/traumatic experiences , influence individuals’ belief systems. Negative experiences , such as being ridiculed by someone, may lead to conditional beliefs such as “ If others don’t like what I do, I am not valuable .” Such beliefs may become basic to the individual as negative/maladaptive cognitive schemas . [email protected]

16. Cognitive model of development of schemas. Early maladaptive schemas . Assumed to be true about themselves and their world. Resistant to change Cause difficulties in individual’s lives. Usually activated by a change in one’s world (triggering event), such as a loss of a job. [email protected]

17. Cognitive model of development of schemas. When these conditions occur , individuals often react with strong negative emotions. Are the result of previous dysfunctional childhood interactions with family members. Through these belief systems that children develop, they start to view reality in ways that cause problems in functioning internally or with others. Likely to continue through adolescence and adulthood. [email protected]

18. The cognitive developmental model (for depression). [email protected]

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20. The cognitive model (for GAD). [email protected]

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23. The cognitive developmental model (for social anxiety). [email protected]

24. Cognitive model of development of schemas. Young (1999) identified 18 early maladaptive schemas which he classified into the following 5 domains. Disconnection & rejection Impaired autonomy & performance Impaired limits Over-vigilance & inhibitions Other directedness [email protected]

25. Goals of therapy. Identifying negative automatic thoughts (NATs) and the cognitive schemas that they represent. Changing the dysfunctional cognitive schemas through: [email protected]

26. Goals of therapy. T o remove biases or distortions in thinking so that individuals may function more effectively. NOTE: Generally, when establishing goals, cognitive therapists focus on being specific , prioritizing goals, and working collaboratively with clients. The goals may have affective, behavioral, and cognitive components. [email protected]

27. Assessment in CBT. Careful attention is paid to assessment of client problems and cognitions , both at the beginning of therapy and throughout the entire process, so that the therapist may clearly conceptualize and diagnose the client’s problems. client interviews self-monitoring thought sampling, assessment of beliefs and assumptions s elf-report questionnaires Techniques. [email protected]

28. Therapeutic process. Structured in approach. Initial phase: assessment of the problem d evelopment of collaborative therapeutic relationship Case conceptualization Middle phase: h elping client identify/learn about his inaccurate thinking identifying NATs Guided discovery approach employed; Homework assigned. Termination phase: i nsight developing i mplementing learned strategies m oving towards change. [email protected]

29. Therapeutic interventions. Cognitive Behavioural Eliciting and identifying automatic thoughts. Providing reasons Questioning Encouraging clients to engage in feared activities. Focusing on imagery Self-monitoring of thoughts Reality testing and correcting automatic thoughts Conducting Socrates dialogue Identifying cognitive distortions Decatastrophizing Daily record of rational responses Identifying and modifying underlying beliefs Socrates questioning Hypothesis testing Using imagery Reliving childhood memories Activity scheduling Rating mastery and pleasure Hypothesis testing Rehearsing behaviour and role play Assigning graded tasks Diversion techniques Assigning homework [email protected]

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35. Socratic questioning [email protected]

36. Activity scheduling [email protected]

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38. CBT effective treatment for: Depressive disorders Anxiety disorders Phobias Panic disorder Obsessive compulsive disorder Addictive behaviours Personality disorders E ating disorders [email protected]