copyright © 2011 pearson education, inc. all rights reserved. cognitive behavior therapy,...
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Copyright © 2011 Pearson Education, Inc. All rights reserved.
Cognitive Behavior Therapy, Self-Directed Coping Methods, and ACT
Chapter 27
Copyright © 2011 Pearson Education, Inc. All rights reserved.
Cognitive Behavior Therapy
• Cognition– Belief, thought, expectancy, attitude, or perception
• Cognitive Behavior Modification / Cognitive Behavior Therapy– Helping clients through behavior modification methods and through focusing on debilitating thoughts and beliefs
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Cognitive Restructuring Methods
• Assumptions:– Individuals interpret and react to events in terms of their perceived significance
– Cognitive deficiencies can cause emotional disorders
• Focus of therapy: Cognitive restructuring– Changing faulty thinking patterns
• Approaches include behavior modification components
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Cognitive Restructuring Methods
• Rational-Emotive Behavior Therapy (REBT)– Developed to help individuals change irrational thought
– Utilizes in vivo behavioral homework assignments
– Procedure:• Identify irrational thoughts• Challenge thoughts• Teaching client (through modeling and homework) to replace the irrational self-statements with statements based on “rational” beliefs
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Effectiveness of REBT
• More effective than no treatment• More effective than various other treatments in decreasing client’s irrational self-talk
• More effective than other treatments in reducing emotional distress
• No effect on behavioral measures (approaching feared object)
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Cognitive Restructuring Methods
• Beck’s Cognitive Therapy– Faulty and negativistic, though patterns lead to behavioral and emotional problems
• Procedure:– Identification of dysfunctional thoughts– Use various methods to counteract the dysfunctional thoughts• EX: Hypothesis testing
– Use of homework assignments that utilize behavior modification procedures to develop desirable daily activities
• Gentler, less confrontational approach than REBT
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Beck’s Distorted Thought Patterns
• Dichotomous thinking – all-or-none evaluations
• Overgeneralization – rule or belief applied too broadly
• Arbitrary inference – drawing inaccurate conclusions based on insufficient, ambiguous, or contrary evidence
• Magnification – exaggeration of the meaning or impact of an event
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Effectiveness of Cognitive Therapy
• Effective in treating depression
• Most research has focused on treatment of depression
• More research needed to evaluate this treatment for other disorders
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Self-Directed Coping Methods
• Self-Instructional Training– Five steps:
•Adult demonstration of self-instructing
•Child performs while adult verbalizes•Child performs the task and verbalizes out loud
•Fading of overt self-instructions•Task performance with covert self-instructions
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Self-Directed Coping Methods
• Meichenbaum’s Stress Inoculation Training– Teaches cognitive skills that allow clients to deal with stressful events
• Three Phases:– Reinterpretation phase
• It is not the stressor that is the cause of the stress reaction, but it is the way the client views the event
– Coping training phase• Clients learn coping strategies
– Relaxation, self-instruction, and self-reinforcement
– Application phase• Clients practice skills in stressful situations
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Effectiveness of Stress Inoculation
• Many of the components (relaxation, modeling, desensitization) have been validated when applied independently
• Evidence suggests that this method is as effective as its component procedures
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Self-Directed Coping Methods
• Problem Solving Training– Teaches people how to proceed through logical reasoning to satisfactory solutions to personal problems
– Steps in personal problem solving:• General orientation• Problem definition• Generation of alternatives• Decision making• Implementation• Verification
• Evaluation of problem solving methods– Adults and children can rapidly learn skills, but do not often apply them appropriately
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Mindfulness and Acceptance
• Mindfulness– Awareness, observation, and description of one’s overt and covert behaviors, as they occur, in a nonjudgmental way
• Acceptance– Also called experiential acceptance– Set of behaviors in reaction to mindfulness•Refraining from judging one’s sensations, feelings, and behaviors
•Thoughts are viewed as just responses, just passing events
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Mindfulness and Acceptance
• Acceptance and Commitment Therapy (ACT)– Three phases:
• Learning that past attempts to control troublesome thoughts and emotions have not only been unsuccessful, but increased the frequency of these thoughts
• Learning to experience thoughts and emotions in a nonjudgmental way– Done through use of mindfulness training and acceptance exercises
• Identifying values in various life domains and then translating these values into goals and actions
– Evaluation• Early studies find positive results
– Equivalent to systematic desensitization for treatment of math anxiety
– Effective in reducing stress in the workplace• Relatively new approach and more research needed