(psychology, self-help) introduction to cbt (cognitive behavior therapy)

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  • 7/30/2019 (Psychology, Self-help) Introduction to CBT (Cognitive Behavior Therapy)

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    2003 John Winston Bush, PhD. All rights reserved.

    Orientation to CBT(Cognitive behavior therapy)

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    2003 John Winston Bush, PhD. All rights reserved.

    In the beginning There was psychoanalysis (in various flavors)

    And there was client-centered (Rogerian) therapy

    And very little else

    Note: Nearly all of it was based on clinical

    experience, personal hunch, and intuition notmuch science behind it

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    2003 John Winston Bush, PhD. All rights reserved.

    But then...

    About 50 years ago, psychologists andpsychiatrists began looking to scientific

    studies of human behavior for ideas abouthow to do therapy

    The result today: Cognitive behavior therapy

    (CBT) has become the preferred treatment formost emotional and behavioral problems

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    2003 John Winston Bush, PhD. All rights reserved.

    Basic CBT strategies(in order of appearance)

    Behavior therapy (1950s)

    Desensitization

    Behavior modification

    Behavioral activation

    Cognitive therapy (1960s)

    Rational-emotive therapy

    Becks cognitive therapy Newer approaches (1990s)

    Mindfulness meditation

    Acceptance and commitment therapy

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    2003 John Winston Bush, PhD. All rights reserved.

    Examples

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    2003 John Winston Bush, PhD. All rights reserved.

    Desensitization

    Typical goal: To reduce feelings of anxiety,

    anger or other emotion that is causingneedless trouble

    Typical method: Elicit the feeling while in a

    relaxed state

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    2003 John Winston Bush, PhD. All rights reserved.

    Behavior modification

    Typical goal: To replace a habitual,

    unwanted behavior with a more desirable one

    Typical method: Identify eliciting cues;specify new behavior; then reward progress

    toward goal without waiting to fully achieve it

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    2003 John Winston Bush, PhD. All rights reserved.

    Behavioral activation

    Typical goal: To overcome depression byrestoring contact with the normal rewards of

    the everyday world

    Typical method: Identify activities withpotential for pleasure or mastery; initiate or

    increase participation in them

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    2003 John Winston Bush, PhD. All rights reserved.

    Rational-emotive therapy

    Typical goal: To think and act more

    rationally

    Typical method: Identify irrationalbeliefs and assumptions that arecausing or maintaining a problem, andwork towards correcting them

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    2003 John Winston Bush, PhD. All rights reserved.

    Becks cognitive therapy

    Typical goal: Same as in rational-

    emotive therapy

    Typical method: Identify particular

    types of cognitive errors and work oncorrecting them

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    2003 John Winston Bush, PhD. All rights reserved.

    Mindfulness meditation

    Typical goal: To be less disturbed by events,thoughts, memories, mental images,

    fantasies and bodily sensations

    Typical method: Develop knack of justobserving thoughts, memories, images,

    fantasies and sensations as they occur,without clinging to them or rejecting them(acceptance)

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    2003 John Winston Bush, PhD. All rights reserved.

    Acceptance and

    commitment therapy

    Typical goal: Same as in mindfulnessmeditation, but in context of commitment topersonal values

    Typical method: Identify personal values; usevarious tactics to reduce domination of thoughts,

    memories, mental images and emotions thatrestrict contact with ongoing experience andinterfere with living by those values

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    2003 John Winston Bush, PhD. All rights reserved.

    Diagnosis in CBT

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    2003 John Winston Bush, PhD. All rights reserved.

    Orthodox (medicalized) diagnosis:

    Assign person or problem to one or morebroad categories based on symptoms andcomplaints

    CBT (behavior-analytic) diagnosis:

    Identify exactly what events, thoughts,emotions, moods and actions are causingtrouble

    Find out under what specific circumstancesthey occur, and what the consequences are(both immediate and delayed)

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    2003 John Winston Bush, PhD. All rights reserved.

    Not hard to see how this

    makes therapy morefocused and effective, is it?

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    2003 John Winston Bush, PhD. All rights reserved.

    How to begin

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    2003 John Winston Bush, PhD. All rights reserved.

    First: Tell your story in

    whatever way is natural toyou

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    2003 John Winston Bush, PhD. All rights reserved.

    Next: Review with therapistwhat seem to be the main

    problems, using thisframework....

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    2003 John Winston Bush, PhD. All rights reserved.

    Context 1 (obvious): When does it

    happen? Where? With whom (ifanyone)? With what consequences?

    Context 2 (not so obvious): Howdoes it relate to your ideas about howthings are or ought to be?

    Content: What happens? When it

    happens, what do you think,remember, imagine, feel, or do?

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    2003 John Winston Bush, PhD. All rights reserved.

    Then what?

    Work with therapist on identifying things youcan do that are likely to diminish the problem

    either by changing the situation oraccepting it

    Try your best to do the agreed things

    Keep track of how well (or badly) they seemto be working

    If necessary, revise plan and try again

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    2003 John Winston Bush, PhD. All rights reserved.

    Feeling better already?

    Good.

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    2003 John Winston Bush, PhD. All rights reserved.

    Now begins the hard work.

    And the adventure.