Behavioral Therapy

• Emphasis on what can be seen, observed or measured
• Behavior is something that can be operationally defined- it includes overt actions as well as internal processes such as cognitions, images, beliefs and emotions.

 

CBT

• Distinction is very fine between CBT and BT
• CBT is the most widely used type of psychological practice- particularly in Australia.
• It’s brief, cost-effective, evidence-based, collaborative, overt, accessible
• Extremely high face validity
• Helps a person to change unhelpful or unhealthy thinking habits and behaviors
• The reason why CBT is called CBT is because it deals with cognition, emotions and behaviours.
• Good for children.

  

Positive thinking vs. helpful thinking

• Positive thinking can be inaccurate and delusional
• Positive thinking can be a form of denial and sometimes lead to bad outcomes
• Helpful thinking is likely to be true and allow us to feel and behave in a way we want to.

 

Albert Elli’s Rational Emotive Behaviour Therapy

 

Features	•  Founder: Albert Ellis •  Basic assumption is that people contribute to their own psychological problems by the riding and extreme beliefs they hold about events and situations. •  Based on the assumption that cognitions, emotions and behaviours interact significantly and have a reciprocal causeand-effect relationship. •  Our emotions stem mainly from our beliefs, which influence our evaluations and interpretations we make about life situations. •  We learn how to replace such ineffective ways of thinking with effective and rational cognitions. •  The focus is on working with thinking and acting rather than primarily with expressing feelings •  Therapy is seen as an educational process.
View of human nature	•  We are born with a potential for both irrational and rational thinking •  We have the biological and cultural tendency to think crookedly and needlessly disturb ourselves •  We learn and invent disturbing beliefs that keep are maintained through our self talk •  We have the capacity to change our cognitive, emotive and behavioural processes
View of emotional disturbance	•  We learn irrational beliefs from significant others during childhood. •  We actively reinforce our self-defeating beliefs through the processes of autosuggestion and self-repetition, and then we behave in ways consistent to these beliefs. •  Ellis insists that blame is at the core of most emotional disturbances.
An educational process	•  Teach clients to be their own therapists •  Clients learn how to: •  Identify the interplay of their thoughts, feelings and behaviours •  To identify and dispute irrational beliefs that are maintained by self talk •  To replace ineffective ways of thinking with effective and rational cognitions •  To stop absolutistic thinking, blaming and repeating false beliefs

 

 

Therapeutic process of REBT 

Goals	•  To be less emotional reactive •  How to accept themselves in spite of their imperfections •  How to separate the evaluation of their behaviours from the evaluation of themselves •  Differentiate between realistic and unrealistic goals and also self-defeating and self-
	enhancing goals. •  How to change their dysfunctional emotions and behaviours into healthy ones. •  As clients become more able to accept themselves, they are more likely to unconditionally accept others
Therapeutic relationship	•  Therapists strive to unconditionally accept all clients and to teach them to unconditionally accept others and themselves. •  Ellis believes that too much warmth and understanding can be counterproductive and foster a sense of dependence for approval.

 

 

Techniques

• Rational emotive imagery
• Humour
• Role playing
• Shame-attacking exercises: perform a challenging/embarrassing activity to realise that the world goes on and people don’t really care about your behaviour.
• Standard behaviour therapy techniques
• Encourage self-acceptance despite mistakes

 

Cognitive therapy

Theoretical assumptions	•  That our interaction communications are accessible to introspection. •  That our beliefs are highly personal meanings •  These meanings can be discovered by the client and not taught by the therapist
Principles	•  Automatic thoughts •  Emphasised core beliefs about self, world and future •  Cognitive distortions or errors- arbitrary inferences: conclusions without support or evidence •  Overgeneralisation •  Magnification and minimisation •  Personalisation •  Labelling and mislabelling •  Dichotomous thinking- black and white thinking
Cognitive Triad	Patterns that trigger depression •  Clients hold negative views of themselves •  Selective abstraction- interpreting life events through a negative filter •  Clients hold a gloomy vision of the future
Goal	• 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

  

Differences between CT and REBT

• REBT is highly directive, persuasive confrontational, focuses on therapists as the teacher. Views the faulty thinking as irrational.
• CT viewed client’s beliefs as inaccurate not necessarily irrational. Gentler Socratic dialogue, open-ended questions, getting clients to come to their own conclusions.

 

CBM (cognitive behaviour modification)

• Focuses on changing clients self-verbalisations/self statements
• Assume: distressing emotion result from maladaptive thoughts
• Premise: to change behaviour, clients must notice how they think, feel and behave and what impact they have on others.
• Self-instructional therapy focus: emphasis on acquiring practical coping skills, trains clients to modify the instructions they give themselves so they can cope, clients need to become aware of their self-talk.
• Similarities with REBT and CT: assume distressing emotions are the result of maladaptive thoughts

 

Stress inoculation training

• An application of a coping skills program is teaching clients stress management techniques by way of a strategy known as stress inoculation training.
• Individuals are given opportunities to deal with relatively mild stress stimuli in successful ways, so that they gradually develop a tolerance for strong stimuli
• Three stages:
• Conceptual-educational phase
• Skills acquisition and skills consolidation phase
• Application and follow-through phase

 

ACT (Acceptance and Commitment therapy)

• Involves fully accepting the present experience and mindfully letting go of obstacles.
• There is little emphasis on changing the content of a client’s thought.
• The emphasis on acceptance (non-judgmental awareness) of cognitions.
• Goal: to increase psychological flexibility
• Accept what is out of your personal control and commit to action that will improve your quality of life.
• CBT- if you’re feeling bad the thoughts must be wrong
• ACT- accept these thoughts “though is just a thought it is not real”

 

Mindfulness within ACT

• Mindfulness is integral to ACT paying attention with openness, curiosity and flexibility
• At the core of mindfulness and therefore ACT is contact with the present moment
• Start with a distressed client- drop your anchor in the middle of an emotional storm
• Also an emphasis on flexible perspective taking, which has been also coined selfas-context
• It can include interventions based around empathy, comparison and defusion from the conceptualized self
• ACT is about reducing the connection between our thoughts and feelings through distancing ourselves from thoughts
• CBT is about changing our thoughts to improve our emotions
• ACT breaks mindfulness skills into three categories:
  1. Defusion: distracting from, and letting go of, unhelpful thoughts, beliefs, and memories
  2. Acceptance: making room for painful feelings, urges and sensations, and allowing them to come and go without a struggle
  3. Contact with the present moment: engaging fully with you’re here-and-now experience, with an attitude of openness and curiosity.

 

Strengths and Weaknesses (multicultural perspective)

 

Strengths

Weaknesses

•  Uses individual’s belief system as part of their method of world exploration •  Client’s from diverse backgrounds appreciate emphasis on cognition and action

•  Negative view of dependency •  Ellis’ rapid fire approach may alienate those who value being reflective •  Therapists who rely on jargon may come across as incentive to clients, especially those who feel marginalised •  Emphasis on assertiveness, independence, rationality- may limits its use in culture that hold different values •  Therapist may overemphasise cognitive restructure to the neglect of environmental interactions.