Download Ch. 19 S. 4 Cognitive Therapy and Behavior Therapy

Ch. 19 S. 4 : Cognitive Therapy
and Behavior Therapy
Obj: Describe how cognitive and
behavior therapists try to help
people.
Cognitive therapy and behavior therapy are
considered together because both
methods share the same goal – to help
clients develop new ways of thinking and
behaving.
Both cognitive and behavior therapists
encourage the clients to focus on their
thoughts and actions.
Advocates of these two theories contend
that only by modifying self-defeating
thoughts and behavior patterns will the
client truly be able to solve his or her own
problems.
Cognitive Therapy
The aim of cognitive
therapy is to help
people learn to think
about their problems in
more productive ways.
Cognitive psychologists
focus on the beliefs,
attitudes, and thought
processes that create
and compound their
clients’ problems.
They believe that some people develop
ways of thinking that are illogical or based
on faulty assumptions. Such ways of
thinking can lead to emotional and
behavioral problems for these people.
Cognitive therapists help people change
their ways of thinking.
The two most widely used cognitive therapy
methods are rational-emotive therapy and
psychiatrist Aaron Beck’s model of
therapy, sometimes called cognitive
restructuring therapy.
Rational-Emotive Behavior Therapy
First developed by
psychologist Albert
Ellis in the 1950s,
rational-emotive
behavior therapy
(REBT) is based on
Ellis’s belief that
people are basically
logical in their thinking
and actions.
However, the assumptions upon which they base
their thinking or actions are sometimes incorrect.
According to Ellis, people may develop emotional
problems when they base their behavior on
these faulty assumptions.
An example of a commonly held false assumption
that leads to emotional problems is “I must do
everything perfectly.” People who believe they
must do everything perfectly in order to be
happy must also believe that if they are
unhappy, it is because they did something
imperfectly. Thus, their unhappiness is their own
fault.
People are often unaware of their false
assumptions even though the assumptions
influence their conscious thoughts and
actions. The role of the therapist in REBT
is first to identify and then to challenge the
false assumptions. To teach individuals to
think more realistically, REBT therapists
use techniques such as role-playing and
modeling.
Beck’s Cognitive Therapy
Another form of cognitive
therapy was introduced
in the 1960s by
psychiatrist Aaron
Beck. In contrast to
REBT’s focus on faulty
assumptions, the focus
of Beck’s cognitive
therapy is on
restructuring illogical
thought processes.
Beck has noted several types of illogical
thought processes that may lead to
emotional problems, particularly
depression. Some of these include the
following:
• Arbitrary inference, or drawing conclusions
for which there is no evidence. For
example, when a teacher passes a
student in the hall and does not smile, the
student may arbitrarily conclude that the
teacher is planning to fail her.
• Selective abstraction, or drawing
conclusions about a situation or event on
the basis of a single detail and
misinterpreting or ignoring other details
that would lead to a different conclusion.
For example, a person may look at his
reflection in a mirror, but instead of feeling
happy about his good features – say, a
handsome smile and a muscular build – all
he notices is the small blemish on his chin.
• Overgeneralization, or drawing a general
conclusion from a single experience. For
example, a person may conclude that she
is worthless because she failed one test.
Using Beck’s approach gently guides clients
in testing the logic of their own thought
processes and developing more logical
ways of thinking.
Evaluation of Cognitive therapy - Cognitive
therapy tends to be a short term method,
making it a realistic option for more people
than traditional psychoanalysis.
Studies of this therapy show that modifying
irrational beliefs helps people with anxiety
and depression.
One reason for this is that cognitive therapy
provides coping skills that reduce the risk of
recurrence of depression once treatment
ends. A combination of cognitive therapy
and antidepressant medication may be
superior to either treatment alone in the
case of people with persistent depression.
Behavior Therapy
The goal of behavior
therapy, which is also
called behavior
modification, is to help
people develop more
adaptive behavior. Some
people seek behavior
therapy to acquire
desirable behaviors, such
as the skills needed to
develop healthy social
relationships or confront
phobias.
Many behavioral techniques fall into two
categories: counter conditioning, which
helps people to unlearn undesirable
behaviors, and operant conditioning, which
helps in the learning of desirable
behaviors. The choice of behavioral
techniques for an individual client depends
largely on the nature of the individual’s
psychological disorder.
Counter conditioning
If undesirable behaviors
are conditioned, or
learned through
reinforcement, then
presumably they can
be unlearned, or
counter conditioned.
Counter conditioning
pairs the stimulus that
triggers an unwanted
behavior with a new,
more desirable
behavior.
These techniques include systematic
desensitization, modeling, and aversive
conditioning.
• Systematic desensitization – a person cannot
feel anxious and relaxed at the same time. The
therapist therefore trains the client to relax in the
presence of an anxiety-producing situation.
This is done in a systematic way. First, the
therapist teaches the client how to relax
completely. Once this has been accomplished,
the therapist gradually exposes the client to the
object or situation that causes the phobic
response.
Systematic desensitization may be
combined with other counter conditioning
measures, such as modeling and aversive
conditioning.
• Modeling - involves observational learning.
The client observes and then imitates the
therapist or another person coping with the
feared object or situation.
• Aversive conditioning – is essentially, the
opposite of systematic desensitization. In
aversive conditioning, the therapist
replaces a positive response to a stimulus
with a negative response. (stop smoking)
People who learn more desirable behaviors
through counter conditioning often
experience a boost in their self-esteem,
because they will lead less restrictive lives.
Operant Conditioning
The behavioral technique of operant conditioning is based
on the assumption that behavior that is reinforced tends
to be repeated, whereas behavior that is not reinforced
tends to be extinguished.
Behavioral therapists reinforce desirable behaviors with
rewards and at the same time withhold reinforcement for
undesirable behaviors.
Operant conditioning has sometimes proved
effective in more severe cases, such as
schizophrenia and childhood autism, that
were previously resistant to other types of
treatment. Operant conditioning is often
used in institutional settings, such as
mental hospitals.
Sometimes people find it difficult to adopt a
new behavior all at once, finding it easier
to change their behavior gradually.
Another method of operant conditioning,
called successive approximations, is
useful in such situations. The term
successive approximations refers to a
series of behaviors that gradually become
more similar to a target behavior. Through
reinforcement of behaviors at each stage,
the target behavior is finally achieved.
Evaluation of behavior therapy – it tends to
be somewhat more effective overall than
psychoanalysis or person-centered
therapy. It is also a short-term therapy,
sometimes bringing about lasting results in
just a few months.
BT is especially effective for well-defined
problems such as phobias, PTSD, and
compulsions.
It has also helped people overcome
depression, social problems and problems
with self-control (like smoking)