Cognitive therapy

Cognitive therapy

1. AARON TEMKIN BECK (b. 1921) was born in Providence, Rhode Island. His childhood was characterized by adversity . Beck used his personal problems as a basis for understanding others and developing his theory . A graduate of Brown University and Yale School of Medicine , Beck initially practiced as a neurologist, but he switched to psychiatry during his residency . Beck is the pioneering figure in cognitive therapy, one of the most influential and empirically validated approaches to psychotherapy. His conceptual and empirical contributions are considered to be among the most significant in the field of psychiatry and psychotherapy BIOGRAPHY OF AARON T. BECK

2. Beck joined the Department of Psychiatry of the University of Pennsylvania in 1954, where he currently holds the position of Professor (Emeritus) of Psychiatry. Beck’s pioneering research established the efficacy of cognitive therapy for depression. He has successfully applied cognitive therapy to depression, generalized anxiety and panic disorders, suicide, alcoholism and drug abuse, eating disorders, marital and relationship problems, psychotic disorders, and personality disorders. He has developed assessment scales for depression, suicide risk, anxiety, self-concept, and personality.

3. COGNITIVE THERAPY

4. Aaron T. Beck developed an approach known as cognitive therapy (CT) as a result of his research on depression SIMILARITIES OF COGNITIVE THERAPY, BEHAVIOR THERAPY AND REBT ACTIVE STRUCTURED DIRECTIVE EMPIRICAL TIME-LIMITED MAKE USE OF HOMEWORK PRESENT- CENTERED COLLABORATIVE REQUIRE EXPLICIT IDENTIFICATION OF PROBLEMS AND THE SITUATIONS IN WHICH THEY OCCUR.

5. Cognitive therapy perceives psychological problems as stemming from commonplace processes such as faulty thinking, making incorrect inferences on the basis of inadequate or incorrect information, and failing to distinguish between fantasy and reality. THEORETICAL ASSUMPTIONS OF COGNITIVE THERAPY people’s internal communication is accessible to introspection clients ’ beliefs have highly personal meanings , and that these meanings can be discovered by the client rather than being taught or interpreted by the therapist

6. The goal is to change the way clients think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructuring . This is done by encouraging clients to gather and weigh the evidence in support of their beliefs. AUTOMATIC THOUGHTS- personalized notions that are triggered by particular stimuli that lead to emotional responses.

7. COGNITIVE DISTORTIONS ARBITRARY INFERENCES- refer to making conclusions without supporting and relevant evidence. This includes “catastrophizing,” or thinking of the absolute worst scenario and outcomes for most situations. 2. SELECTIVE ABSTRACTION consists of forming conclusions based on an isolated detail of an event. In this process other information is ignored, and the significance of the total context is missed. The assumption is that the events that matter are those dealing with failure and deprivation.

8. OVERGENERALIZATION is a process of holding extreme beliefs on the basis of a single incident and applying them inappropriately to dissimilar events or settings . MAGNIFICATION AND MINIMIZATION consist of perceiving a case or situation in a greater or lesser light than it truly deserves. PERSONALIZATION is a tendency for individuals to relate external events to themselves , even when there is no basis for making this connection.

9. LABELLING AND MISLABELLING involve portraying one’s identity on the basis of imperfections and mistakes made in the past and allowing them to define one’s true identity. DICHOTOMOUS THINKING involves categorizing experiences in either-or extremes.

10. In cognitive therapy , clients learn to engage in more realistic thinking, especially if they consistently notice times when they tend to get caught up in catastrophic thinking. After they have gained insight into how their unrealistically negative thoughts are affecting them, clients are trained to test these automatic thoughts against reality by examining and weighing the evidence for and against them. This process of critically examining their core beliefs involves empirically testing them by actively engaging in a Socratic dialogue with the therapist, carrying out homework assignments, gathering data on assumptions they make, keeping a record of activities, and forming alternative interpretations

11. Cognitive therapy is focused on present problems, regardless of a client’s diagnosis . The past may be brought into therapy when the therapist considers it essential to understand how and when certain core dysfunctional beliefs originated and how these ideas have a current impact on the client’s specific schema The goals of this brief therapy include providing symptom relief , assisting clients in resolving their most pressing problems, and teaching clients relapse prevention strategies.

12. SOME DIFFERENCES BETWEEN CT AND REBT REBT CT REBT is often highly directive, persuasive, and confrontational ; it also focuses on the teaching role of the therapist . The therapist models rational thinking and helps clients to identify and dispute irrational beliefs. CT uses a Socratic dialogue by posing open-ended questions to clients with the aim of getting clients to reflect on personal issues and arrive at their own conclusions. CT places more emphasis on helping clients discover and identify their misconceptions for themselves than does REBT Through a process of rational disputation, Ellis works to persuade clients that certain of their beliefs are irrational and non-functional. Cognitive therapists view dysfunctional beliefs as being problematic because they interfere with normal cognitive processing, not because they are irrational

13. The Client–Therapist Relationship Macy (2007) states that effective cognitive therapists strive to create “ warm, empathic relationships with clients while at the same time effectively using cognitive therapy techniques that will enable clients to create change in their thinking, feeling, and behaving” The therapist functions as a catalyst and a guide who helps clients understand how their beliefs and attitudes influence the way they feel and act. Clients are expected to identify the distortions in their thinking, summarize important points in the session , and collaboratively devise homework assignments that they agree to carry out

14. Cognitive therapists emphasize the client’s role in self-discovery . The assumption is that lasting changes in the client’s thinking and behaviour will be most likely to occur with the client’s initiative, understanding, awareness, and effort. Cognitive therapists aim to teach clients how to be their own therapist

15. Applications of Cognitive Therapy Cognitive therapy initially gained recognition as an approach to treating depression , but extensive research has also been devoted to the study and treatment of anxiety disorders Cognitive therapy has been successfully used in a wide variety of other disorders and clinical areas, some of which include treating phobias, psychosomatic disorders , eating disorders, anger, panic disorders, and generalized anxiety Disorders, posttraumatic stress disorder, suicidal behaviour, borderline personality disorders , narcissistic personality disorders, and schizophrenic disorders, personality disorders; substance abuse , chronic pain ,medical illness, crisis intervention , couples and families therapy, child abusers, divorce counseling , skills training, and stress management.

16. TREATMENT OF DEPRESSION

17. Depression-prone people often set rigid, perfectionist goals for themselves that are impossible to attain. Their negative expectations are so strong that even if they experience success in specific tasks they anticipate failure the next time . They screen out successful experiences that are not consistent with their negative self-concept. The thought content of depressed individuals centers on a sense of irreversible loss that results in emotional states of sadness, disappointment, and apathy Beck’s therapeutic approach to treating depressed clients focuses on specific problem areas and the reasons clients give for their symptoms.

18. APPLICATION TO FAMILY THERAPY Some cognitive behavior therapists place a strong emphasis on examining cognitions among individual family members as well as on what may be termed the “ family schemata”. These are jointly held beliefs about the family that have formed as a result of years of integrated interaction among members of the family unit. It is the experiences and perceptions from the family of origin that shape the schema about both the immediate family and families in general. These schemata have a major impact on how the individual thinks , feels, and behaves in the family system