Counselling Theories

Week 12

Cognitive Behavioural Therapies/Counselling

You will be invited to:• Check in with yourself and the group – objects? • Describe the origins and key contributors to Cognitive

Behavioural Therapy• Name and describe some of the key concepts,

theories and practices involved in CBT and CB Counselling.

• Participate in some brief experiential exercises, illustrating elements of CBT.

• Compare and contrast CB theory and practices with other counselling approaches.

• Consider the requirements for the second assignment - write a plan/outline for discussion in the session next week.

A Range of CB Therapies

• Cognitive Behaviour Therapy

• Rational Emotive Behaviour Therapy

• Rational Behaviour Therapy

• Rational Living Therapy

• Cognitive Therapy

• Dialectic Behaviour Therapy

• Brief Solution Focussed Therapy? 

The origins of CBT are in Cognitive and Behavioural Psychology – Some key

contributors include:

• Ivan Pavlov• J B Watson• E L Thorndike• B F Skinner• Albert Bandura• Joseph Wolpe

• Hans J Eysenck• Aaron Beck• Albert Ellis• Milton Erickson• Steve de Shazer• Arnold A Lazarus

Epictetus However…the theoretical origins of cognitive

behaviour therapy can be traced back to the Stoic Philosopher Epictetus, who in the first century AD noted that:

“People are disturbed not so much by events as by the views which people take of them”.

The Big Idea

Peoples’ problems are caused not by things which happen to them but by how they think about or process things which happen to them.

The role of CBT, therefore, is to relieve emotional disturbance by helping people to change their maladaptive/irrational beliefs and behaviours.

Some Irrational Beliefs

• I should always be loved and approved of by everyone

• In order to be a worth while person, I need to be good at everything

• Bad people, including myself, should be severely punished.

• If things are not the way I want them to be, then it’s a disaster.

A.B.C (Ellis’ model)

• A = Activating event (something happens)

• B = Beliefs about what happened (rational or irrational)

• C = Consequences (emotional and behavioural responses.

ABC, an example

Sue invites her friend to the cinema.

A – Activating EventSue’s friend says that she wants to spend some time alone

with her sister and her sister’s family.B – Belief and InferenceSue thinks, ‘she’s not really the friend I thought she was –

she has rejected my offer. This always happens to me. I am not likeable.

C - Emotional and Behavioural ConsequencesSue becomes depressed and avoids her friend.

ABC, an example continued

Sue invites her friend to the cinema:

A – Activating Event

Sue’s friend says that she wants to spend some time alone with her sister and her sister’s family.

B – Beliefs and Inference

Sue thinks: “I would really like to see the film with Jane and spend lots of time together, but what Jane says is reasonable, she has her family to think of too”

C – Emotional and Behavioural Consequences

Sue suggests that she and Jane see the film together later in the week and uses her free evening to catch up with college work and to spend time with her mum. Sue feels good.

Making and Maintaining Changes

• CB therapists use various techniques to help clients to challenge and change irrational thoughts and behaviours. For example:

• Thought stopping• Rehearsing• Experimenting• Systematic de-sensitisation• Scaling fears

CBT: A Structured Approach

1. Establishing rapport and creating a working alliance between counsellor and client. Explaining the rational for treatment.

2. Assessing the problem. Identifying and quantifying the frequency, intensity and appropriateness of problem behaviours and cognitions.

3. Setting goals or targets for change. These should be selected by the client, and be clear, specific and attainable.

4. Application of cognitive and behavioural techniques.5. Monitoring progress, using on-going assessment of

target behaviours.6. Termination and planned follow-up to reinforce

generalization of gains. Find out what the problem is – ask questions.

Review and Discussion

• What have you learned about CBT’s?

• What do you think might be the strengths and limitations of this approach?

• What are the differences between CBT’s and Psychodynamic Counselling and Person-centred Counselling?

• Are you ready to write your assignment?

Assignment 2?

Refer to your course handbook

Ascentis Counselling Level Two – the Second Assessment

Describe and evaluate the use of CBT’s in counselling practise.

Include:

a) a brief description of the origins and ideas which influence CBT’s

b) a description of some of the key features of CBT’s, including examples

c) an evaluation of CBT’s, focussing on their strengths and limitations.

CBT Assignment

• Please bring your draft to the next session.

• Have a good break!