Cognitive Behavior Therapy

Founded By:

Albert Ellis (1913-2007)



Aaron T. Beck (b.1921)



Judith S. Beck (b.1954)



Donald Meichenbaum (b.1940)

Key Concepts:

*Rational emotive behavior therapy- Developed by Albert Ellis; "The basic assumption of REBT is that people contribute to their own psychological problems, as well as to specific symptoms, by the rigid and extreme beliefs they hold about events and situations" (Corey p. 291).  People learn irrational beliefs during childhood and re-create them throughout their lives. 
 
*People are born with potential for both rational/straight thinking and irrational/crooked thinking.
*"People have predispositions for self-preservation, happiness, thinking and verbalizing, loving, communion with others, and growth and self-actualization. They also have propensities for self-destruction, avoidance of thought, procrastination, endless repetition of mistakes, superstition, intolerance, perfectionism and self-blame, and avoidance of actualizing growth potentials" (Corey p. 292). 
*A-B-C Framework- A=(Activating event) B=(Belief) C=(Emotional and behavioral consequence) D=(Disputing intervention) E=(Effect) and F=(New feeling).
*Cognitive restructuring- Teaches people how to replace irrational with rational beliefs.
*Cognitive therapy- "Beck developed cognitive therapy about the same time that Ellis was developing REBT, yet they appear to have created their approaches independently" (Corey p. 302); Cognitive therapy, rational emotive behavior therapy, and behavior therapy share alot of similarities "All of these therapies are active, directive, time-limited, present-centered, problem-oriented, collaborative, structured, and empirical" (Corey p. 302).
*Automatic thoughts- Thoughts triggered by certain stimuli that cause emotional responses.
*Cognitive distortions- Errors in reasoning that lead to faulty assumptions and misconceptions.
*Cognitive distortions:
     *Arbitrary inferences- Making conclusions without supporting evidence.
     *Selective abstraction- Forming conclusions on an isolated detail of an event.
     *Overgeneralization- Holding extreme beliefs based on a single incident and applying those
     beliefs to dissimilar events of settings.
     *Magnification and minimization- Perceiving a case or situation in a greater or lesser light.
     *Personalization- Client tends to relate external events to themself when their is no basis for this
     connection.
     *Labeling and mislabeling- Portraying identity on basis of imperfections and mistakes from past
     and allowing those to define true identity.
     *Dichotomous thinking- Categorizing experiences in either-or extremes.
*Cognitive behavior modification- "Another major alternative to rational emotive behavior therapy..." (Corey p. 310); developed by Donald Meichenbaum; combines elements of both behavior  and cognitive therapies.  
*"Meichenbaum has developed his approach by incorporating the constructivist narrative perspective (CNP), which focuses on the stories people tell about themselves and others regarding significant events in their lives" (Corey p. 315).

Therapeutic Goals:

*"... teaching clients how to separate the evaluation of their behaviors from the evaluation of themselves-their essence and their totality-and how to accept themselves in spite of their imperfections" (Corey p. 295).
*Clients minimize emotional disturbances and self-defeating behaviors.
*Clients acquire a workable life philosophy.
*Client achieves unconditional self-acceptance and unconditional other acceptance.
* Homework- Assignments are checked in later sessions; "...aimed at getting clients to carry out positive actions that induce emotional and attitudinal change" (Corey p. 296); clients learn to dispute self-defeating thinking by practicing new skills outside of therapy.

Techniques:

*Rational Emotive Behavior Therapy- "REBT generally starts with clients' disturbed feelings and intensely explores these feelings in connection with thoughts and behaviors" (Corey p. 297).
*Cognitive Methods:
     *Disputing irrational beliefs- Therapist actively disputes clients' irrational beliefs and teaches the
     client how to do this on their own.
     *Doing cognitive homework- Clients make lists of problems, look for their beliefs, and dispute
     their beliefs.
     *Bibliotherapy- Clients are encouraged to read self-help books.
     *Changing one's language- "REBT rests on the premise that imprecise language is one of the
     causes of distorted thinking processes"(Corey p. 299). 
     *Psychoeducational methods- Clients are introduced to educational materials that reveal how the
      therapy process works and why certain techniques are used. 
*Emotive Techniques:
     *Rational emotive imagery- Clients are asked to imagine one of the worst things that could happen
     to them. 
     *Using humor- Emotional disturbances come from being too serious so humor is used to put life
     in perspective. 
     *Role playing- Therapist interrupts to show clients what they telling themselves; clients rehearse
     their behaviors to bring their feelings to light. 
     *Shame-attacking exercises- Exercises that are aimed at teaching the client that most of their
     shameful feelings is just them attacking themselves. 
*Behavioral Techniques:
     *Operant conditioning
     *Self-management principles
     *Systematic desensitization
     *Relaxation techniques
     *Modeling
*Collaborative empiricism- Therapist attempts to collaborate with client in testing the validity of the client's cognitions. Uses a reflective questioning process.
*3 phase process of change in cognitive behavior modification-
      *Phase 1= Self-observation- Client learns to observe their own behavior.
      *Phase 2= Starting a new internal dialogue- Clients learn to notice their maladaptive behavior and
      see opportunities for adaptive behavior alternatives.
      *Phase 3= Learning new skills- Client learns to interrupt the downward spiral of thinking, feeling,
      and behaving and learns to cope. 
*Stress inoculation training- "Stress inoculation training consists of a combination of information giving, Socratic discovery-oriented inquiry, cognitive restructuring, problem solving, relaxation training, behavioral rehearsals, self-monitoring, self-instruction, self-reinforcement, and modifying environmental situations" (Corey p. 312).
*Relapse prevention- Procedures for dealing with inevitable setbacks; clients are taught to view them  as "learning opportunities" instead of "catastrophic failures".

References

Corey, G. (2013). Theory and practice of counseling and psychotherapy. Belmont, CA: Brooks/Cole.

eitrainingcompany.com "Albert Ellis"

anxietycounselingsolutions.com "Aaron Beck"

beckinstituteblog.org "Judith Beck"

nacbt.org "Donald Meichenbaum"

thecwcnj.com "REBT model"