Slide 1

Slide 2 Introductory Training Slide 3 Behavioral Therapy Behavioral Therapy helps you weaken the connections between troublesome situations and your habitual reactions to them. Reactions such as fear, depression or rage, and self- defeating or self-damaging behavior. Cognitive therapy Cognitive therapy teaches you how certain thinking patterns are causing your symptoms distorted picture of what's going on in your life, and making you feel anxious, depressed or angry for no good reason, or provoking you into ill-chosen actions. Slide 4 Therapist and client collaborate to understand the clients behavior in the context of: situational factors thoughts feelings expected outcomes Client learns and applies new coping skills to replace maladaptive thoughts & behaviors and improve outcomes. Slide 5 The therapy with the most research support Hundreds of studies by research psychologists and psychiatrists make it clear why CBT has become the preferred treatment Slide 6 Symptoms for which CBT has demonstrated its effectiveness include: Problems with relationships, family, work, & school Insomnia, & other sleep disorders Self-esteem/Self-image. Preferred treatment for: social issues, panic attacks, phobias, post-traumatic stress, eating disorders, loneliness, headaches Slide 7 The thing that upsets people is not what happens but what they think it means People - and I mean all people, not just therapy clients - routinely distress themselves and others with arbitrary interpretations of what is going on. People also react differently depending on the overriding current emotion Our behaviors reinforce the maladaptive thoughts and feelings Slide 8 THOUGHTS FEELINGSBEHAVIOR Slide 9 Friend is late for dinner What you thinkHow you feelWhat you do She Might have been hurt on her way here Worried or anxiousCall hospital ERs to find out if she's there "She didn't bother to let me know she was delayed. Annoyed or angry Chew her out, or act chilly, when she does show up "It doesn't matter to me whether people are on time." IndifferentNothing in particular "I needed the time to fix the house up anyway." RelievedRelax and enjoy yourself Slide 10 Virtually the only means of access to our moods and emotions are the cognitive and behavioral routes. In order to voluntarily change how we feel, we have to go about it indirectly, not directly. There is no direct way to influence our feelings and moods. Slide 11 The two most powerful levers of constructive change 1.Altering ways of thinking a person's thoughts, beliefs, ideas, attitudes, assumptions, mental imagery, and ways of directing his or her attention for the better. 2.Helping a person greet the challenges and opportunities in his or her life with a clear and calm mind and then taking actions that are likely to have desirable results. Slide 12 Focuses on the training of interpersonal and self- management skills Primary Goal = Mastery of skills needed to maintain long-term abstinence from substance abuse Identify high risk situations, both external circumstances and internal thoughts & feelings Develop skills to cope with high risk situations Practice, with feedback See Monti et al, 1989 Slide 13 In CBT the therapist takes an active part in helping to explore solutions to the clients problems. education, coaching or tutoring CBT provides clear structure and focus to treatment CBT focuses on finding out just what needs to be changed and what doesn't and then works for those targeted changes. Slide 14 Substance use is a learned behavior in which use becomes triggered by environmental stimuli, thoughts and feelings and is maintained by reinforcing effects. Individuals who wish to stop or reduce substance use need skills to cope with these triggers, as an alternative to drug and alcohol use. Effective learning of these new coping skills requires repetition and practice with feedback. Slide 15 Reinforce small steps in the recovery process Therapists help the adolescent realize that long term drug use is incompatible with other short and long term goals Work to increase alternative positive, non-drug related social/recreation activities, while teaching social skills (e.g. problem solving, drug refusal, etc) Helps the adolescent maximize family/peer/community resources and activities to reward non-drug using behavior. Slide 16 Functional Analysis Training in identification of triggers CBT substance addiction treatment includes recognizing and coping with craving, managing thoughts about substance use, problem solving, planning for emergencies, recognizing seemingly irrelevant decisions, and refusal skills. Skills Training In session skills practicing Out of Session skills practicing