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Theme 9:Help Clients Learn Methods To
Cope with Cognitive Distortions
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What are Cognitive Distortions
Faulty beliefs or assumptions arising
from errors in thinking,misinterpretation or faultyperception of reality
Cognitive distortions are associated with awide range of mental health and substanceabuse disorders and have also beenimplicated in relapse to substances
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Examples of Cognitive Distortions
1Once an addict, always
an addict
2Ill never use alcohol ordrugs again
3A drink wont hurt
4Relapse cant happen to me
A 12-steps
reference to
cognitivedistortions that
recovering
persons must
alter to avoidrelapse
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CognitiveDistortions
How do cognitive distortions
contribute to a relapse?
Some of clients
cognitive errors &distortions may
increase the
probability that an
initial relapse mayescalate into a full
relapse
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Types of Cognitive Distortions
1
2
3
4
5
Over generalizing
Selective Abstraction
Excessive Responsibility
Self-Reference
Assuming Temporal Causality
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Types of Cognitive Distortions
6
7
8
9
Catastrophizing
Dichotomous Thinking
Absolute Willpower Breakdown
Body Over mind
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1 OVER GENERALIZING
It is the most common cognitive error that mediates the
escalation from a slip to a full relapse.
The lapse is taken as a sign or symptom of total
relapse, an over-generalization to a total failure from asingle event
A person comes to a general conclusion based on a
single incident or piece of evidence. If something bad
happens once, we expect it to happen over and over
again. A person may see a single unpleasant event as
a never-ending pattern of defeat.
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2 SELECTIVE ABSTRACTION
A single mistake or slip is selectively abstracted as an
indication of total failure
A person picks out from a complex situation only
certain features and ignores that could lead to adifferent conclusion
The only event that matter are failures, deprivations etc. I
should measure myself by errors, weaknesses
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3 EXCESSIVE RESPONSIBILITY
This error is related to the tendency of some people to
attribute the cause of a lapse to personal, internal
failings such as a lack willpower or moral weakness
The person tends to assume total responsibility orpersonal causality making it difficult to resume control
I am responsible for all the bad things, or failures
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4 ASSUMING TEMPORAL CAUSALITY
It is the tendency to generalize over time with the
following erroneous assumption
If it has been true in the past, then it is always going to
be true
Once an addict, always an addict
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5 SELF-REFERRENCE
Describes the perception that a lapse will become the
focus of everyone elses attention
I am the centre of everyones attention, particularly my
failures. I am the cause of misfortunes
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6 CATASTROPHIZING
We expect disaster to strike, no matter what. This is
also referred to as magnifying or minimizing
We hear about a problem and use what if questions
(e.g. What if tragedy strikes? What if it happen to me?)
The only event that matter are failures, deprivations etc. I
should measure myself by errors, weaknesses
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7 DICHOTOMOUS THINKING
This cognitive error is based on the assumption that
everything is either one extreme or another
The lapse is viewed as a sign of dichotomous switch
from the white side of abstinence to the black sideof relapse and failure
There is no grey area. All lapses are relapses;
abstinence once violated, can never be regained
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8 ABSOLUTE WILLPOWER BREAKDOWN
The faulty assumption is Willpower is absolute, once
willpower has failed, loss of control is inevitable
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9 BODY OVER MIND
The faulty assumption : Once the deed is done and
the drug is in my body, physiological addiction or
disease processes take over that I am powerless to
control
This is a powerful belief in a drug-oriented culture.
The belief that a single shot of heroin or alcohol is
sufficient to produce a lifelong overpowering physicaladdiction that cannot be voluntarily overcome.
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Cognitive Treatment Cognitive Restructuring
Title
Client identifies & monitors
Dysfunctional automatic thoughts
Client learns torecognize connections
between thoughts,
emotions and actions
Client evaluates the
reasonableness of the
Automatic thoughts
Client must identifyand alter
dysfunctional
assumptions
Client learns to substitute
more reasonable thoughts
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Abstinence Violation effect describes a type ofreaction by a drug user or drinker to a lapse,
which may influence whether a lapse leads to
relapse
It describes the clients emotional response to
the initial lapse and the causes to which the
person attributes the lapse.
Abstinence Violation Effect
(Marlatt & Gordon)
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