Class Book: Title: Theories of Psychotherapy & Counseling: Concepts and CasesAuthor: Richard SharfPublisher: Cengage LearningEdition: 6thISBN Code: 9781305087323ISBN Code 2: 9781305087323In cognitive therapy, changing an individual’s negative thought patterns is seen as key to alleviating psychological distress and improving mental health. Discuss how this approach can impact an individual’s perception and solution strategies for their problems, and under what circumstances might this method face challenges?
Theories of Psychotherapy and
Counseling: Concepts
and Cases
6th Edition
Richard S. Sharf
Chapter 9
Rational Emotive Behavior Therapy
© 2016 Cengage Learning. All rights reserved.
© 2016 Cengage Learning.
All rights reserved.
Evolution of Rational Emotive
Behavior Therapy
Rational therapy (1956)
Rational emotive therapy (1959)
Rational emotive behavior therapy (1992)
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Philosophy of REBT
Responsible hedonism –
Seeking pleasure and avoiding pain
Humanism
– Human interests more important than
those of deities
Rationality
– Be flexible and logical in achieving
goals
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Ellis’s View of Factors that
Affect the Potential for
Therapeutic Change
Biological tendencies to make things worse
Social institutions may have values that interfere with
functioning
Vulnerability to disturbance
– Individuals vary as to the
degree to which they hold
irrational beliefs
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A-B-C Theory of Personality
(REBT)
A –
Activating events support or interfere with goals
B Beliefs of individuals are in response to Activating
events
C Consequences (emotional or behavioral) are
experienced in response to the Activating event
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REBT Theory of Personality:
Irrational Beliefs
Individuals may respond irrationally to an unpleasant
activating event
Individuals may be
disturbed about disturbances.
upset by their “musts” – “I must do well.”
disturbed because they have low frustration
tolerance.
anxious (discomfort or ego).
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REBT Goals of Therapy
Minimize emotional
disturbances
Feel more appropriately
Act more effectively
Decrease self-defeating
behaviors
Become more selfactualized
Think more rationally
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Deal more effectively with
negative feelings and beliefs
Learn the A-B-C philosophy
to prevent new symptoms
from emerging
REBT Therapeutic Approach:
A-B-C-D-E
A
–
Activating
Event
–
Separate what happened from what
was perceived to have happened
B
–
Beliefs
–
Irrational beliefs are the focus of
therapy
C
–
Consequences
–
Important to discriminate between
beliefs and consequences
D
–
Disputing
irrational beliefs
by
–
Detecting
Discriminating
Debating
E
–
Effect
–
Having disputed their irrational beliefs,
clients develop an effective philosophy
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REBT Therapeutic Techniques
Cognitive approaches
DISPUTING
Psychoeducational methods
Coping self-statements
Teaching others
Cost-benefit analysis
Problem solving
Emotive techniques
Behavioral techniques
Imagery
Activity homework
Role playing
Reinforcement and penalties
Shame-attacking exercises
Skill training
Forceful self-statements
Forceful self-dialogue
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Psychological Disorders:
Examples of REBT Approaches
Disorder
Therapist
Client
Anxiety
Ellis
Ted
Depression
Joyce
Penny
Obsessive-compulsive Ellis
Woman afraid that
her infant was
switched
Substance abuse
__________
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Ellis
Current Trends in REBT
REBT increasing in complexity
Incorporation of new techniques into REBT
REBT seen as having constructivist aspects
Self-Management and Rational Training
(SMART)
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Gender Issues and REBT
Irrational beliefs are often gender-related due to gender
role socialization
Types of groups formed to deal with women’s irrational
beliefs:
Assertiveness
Sexuality
Life-cycle change
Career issues
Weight issues
Mother-daughter relationships
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Multicultural Issues and
REBT
Respectful of cultural values
Disputing done after an understanding of cultural values
Emphasis on self-sufficiency may conflict with cultural
values
Active REBT teaching approach may be submissively
accepted by passive clients
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Theories of Psychotherapy and
Counseling: Concepts
and Cases
6th Edition
Richard S. Sharf
Chapter 10
Cognitive Therapy
© 2016 Cengage Learning. All rights reserved.
© 2016 Cengage Learning.
All rights reserved.
Influences on Beck’s
Development of Cognitive Therapy
Sigmund Freud
–
unconscious thoughts
anger can be internalized into
depression
Alfred Adler
–
cognitive nature of individuals
active therapeutic approach
Albert Ellis
–
focus of belief systems
challenging inaccurate
assumptions
George Kelly
–
dichotomous personal constructs
Jean Piaget
–
cognitive development
Cognitive science
–
models of mental functioning
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Important Constructs in the
Cognitive Theory of Personality
Childhood development of beliefs- Long standing views of self
and world develop
Automatic thoughts- Ideas or thoughts that occur without
effort or choice and may lead to emotional responses
Cognitive schemas- Ways of thinking that comprise a set of
core beliefs and assumptions about self and the world
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Ways in Which Individuals
Distort Their Thinking
•All-or-nothing thinking- black or
white thinking
•Selective abstraction- selecting
one fact and ignoring others
•Mind reading- belief that we
know what another person is
thinking
•Negative prediction- belief that
something bad may happen
•Catastrophizing- exaggerating
possible consequences of an
event
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•Overgeneralization- applying
rules broadly
•Labeling and mislabelingnegative view based on errors
one has made
•Magnification- An
imperfection is exaggerated
•Minimization- A positive
event becomes less important
•Personalization- An event is
related to oneself when there
is no relationship
Goals of Cognitive Therapy
Remove biases and distortions in thinking to produce more
effective functioning
Produce positive feelings, behavior, and thinking
Specify goals clearly and concretely
Prioritize goals and develop them in collaboration with the
client
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Assessment in
Cognitive Therapy
Assessment is specific and continues throughout therapy
Interviews – frequent questions
Self-monitoring of thoughts, feelings, and behavior outside the
office
Use of the Dysfunctional Thought Record
Thought sampling
Scales and questionnaires – such as
Beck Depression Inventory
Scale for Suicide Ideation
Dysfunctional Attitude Scale
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Process of Making Therapeutic
Changes in Cognitive Therapy
•
Guided discovery (Socratic dialogue)
•
Three-question technique
1. What is the evidence for the belief?
2. How else can you interpret the situation?
3. If it is true, what are the implications?
•
Specifying automatic thoughts
•
Assigning homework
•
Termination and relapse issues
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Methods for Changing Cognitive
Distortions
•
•
•
•
•
•
•
•
Understanding idiosyncratic meaning- Understand words clients
use as related to their automatic thoughts and cognitive schemas
Challenging absolutes- Point out exaggerations such as
“everyone”, “always”, and “never” to client
Reattribution- Help clients place responsibility appropriately for an
event
Labeling of distortions- Point out when client is distorting a thought
or event
Decatastrophizing- “What if” technique is used to point out actual
rather than feared events
Challenging all-or-nothing thinking- Use scaling to turn a dichotomy
into a continuum
Listing advantages and disadvantages- Write down advantages and
disadvantages
Cognitive rehearsal- Use constructive imagination for new events
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Types of Cognitive Distortions
and Strategies to Change Them
Distortions
Change Strategies
All-or-nothing thinking
Challenging all-or-nothing thinking
Selective abstraction
Mind reading
Negative prediction
Catastrophizing
Decatastrophizing
Labeling and mislabeling
Labeling of distortions
Magnification
Minimization
Personalization
Understanding idiosyncratic meaning
Reattribuiton
Varied distortions
Challenging absolutes
Listing advantages and disadvantages
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Cognitive rehearsal
Cognitive Therapy Concepts Used
in Treating Depression
Cognitive triad – a depressed person’s negative
view of
oneself
the world
one’s future
resulting in a variety of cognitive distortions
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Psychological Disorders:
Examples of Cognitive Therapy
Disorders
Therapist
Patient
Depression
Liese & Larson (1994)
Paul
Anxiety
Freeman et al. (1990)
Amy
Obsessive
Wells (1997)
Electrician
Substance abuse
Beck et al. (1993)
Bill
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Cognitive Methods Used in
Treating Case Examples
Disorder
Patient
Methods
Depression
Paul
Socratic, three question,
DTR
Anxiety
Amy
Socratic, decatstrophizing
Obsessive
Electrician
Socratic, defusing thoughts
from actions
Substance
Abuse
Bill
Socratic, three questions
Practicing control beliefs
Slide 11 Chapter 10
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Current Trends in
Cognitive Therapy :
Mindfulness based stress reduction: Group program
Schema-focused cognitive therapy for individuals with
personality disorders. Typical schemas:
Abandonment/Instability
Mistrust/Abuse
Emotional deprivation
Defensiveness/Shame
Social isolation/Shame
Developing treatment manuals to work with a wide variety
of disorders such as personality disorders and
schizophrenia
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Gender Issues and
Cognitive Therapy
Bem’s gender schema view
Issues with depressed women
Collaboration – encourage woman’s power
Support client beliefs and values as well as challenge
distorted beliefs
Issues with gay men
Learn about sexual orientation
Challenge assumptions about sexuality and sexual roles
Counter misinformation about being gay
Role play “coming out”
Deal with shame issues
Slide 13 Chapter 10
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Multicultural Issues and
Cognitive Therapy
Cultural schemas – cultural beliefs and values
Cognitive therapy’s practical and active approach
may help to counteract negative stereotypes about
therapy.
Educational focus of therapy may have wide appeal.
Application to African-Americans, Latinas, Latinos,
and Native Americans
Slide 14 Chapter 10
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