Download Cognitive Behavioural Therapy

Cognitive Behavioural Therapy
The origins of CBT
• Came out of the behavioral psychology
tradition
• Leading proponents were Aaron Beck and
Albert Ellis
• 1960s were the starting point and began with
the treatment of unipolar depression
Definition of CBT
• Focused form of psychotherapy based on a
model suggesting that psychiatric/
psychological disorders involve dysfunctional
thinking
• The way an individual feels and behaves in
influenced by the way s/he structures his
experiences
• Modifying dysfunctional thinking and beliefs
 improvements in symptoms
• Variety of methods/strategies used
The NHS and CBT
• http://www.nhs.uk/Conditions/Cognitivebehavioural-therapy/Pages/Introduction.aspx
Some research evidence
• J H Yost & Giff Weary (1996) compared 58
depressed and 57 non-depressed university
students on a attribution task. The depressed
students had much less of a tendency to
make internal attributions. This, Yost & Weary
suggest, is because depressed persons are
significantly more likely to see people as
victims of circumstance – ie: pretty helpless.
Beck’s cognitive triad
• A - Activating Event (also sometimes
described as a 'Trigger')
• B - Beliefs (for example, the thoughts
that occur to you when the Activating
Event happens)
• C - Consequences - how you feel and
behave when you have those Beliefs
(consequences may be divided into
two parts: your actions and your
emotions)
The ABC
Model
Activating Event
Beliefs
Consequences
Write down the
event or situation
that triggered your
thoughts and
feelings.
Write down the
thoughts that went
through your head
when the activating
event occurred (or
after it)
Actions
How did you act
then?
Emotions
What did you feel
then?
Does it
work?
• Michelson and Marchione: CBT versus
medication as a treatment for Panic Disorder
(reviewed 150 research studies)
100
90
90
87
80
70
60
60
60
50
35
40
30
20
10
10
0
CBT
Anti-depressants
Improvement rate
Anti-anxiety
medication
Relapse rate
Types of CBT
• Stress Inoculation Training
• Rational Emotive Behaviour Therapy (Albert Ellis):
Gloria(!)
• Beck’s Cognitive Therapy – encourages patients to
challenge distorted thoughts
• CBT and Schizophrenia – Hole (1979) encouraged
patients to reality-test their delusions – half reduced
the pervasive nature of their delusions
The Cognitive Element
• Therapist encourages client to become aware
of beliefs that contribute to anxiety or
depression or are associated with general
dysfunction in everyday life. This involves
direct questioning of the client’s thoughts.
• Understand how faulty cognitions can lead to
depression.
‘Wrong’ thinking
•
I need love and approval from those significant to me – and I must avoid
disapproval from any source.
•
To be worthwhile as a person I must achieve, succeed at whatever I do, and make
no mistakes.
•
I shouldn’t have to feel discomfort and pain – I can’t stand them and must avoid
them at all costs.
•
Every problem should have an ideal solution – and it’s intolerable when one can’t
be found.
•
Things must be the way I want them to be, otherwise life will be intolerable.
•
My unhappiness is caused by things that are outside my control – so there is little I
can do to feel any better.
Try it for yourself
• Try doing the homework activities on your
sheet for yourself
• Notice that CBT is an active therapy:
– Cognitive: CBT tries to alter/change
wrong/disabling thoughts
– Behavioural: CBT encourages changes in behaviour
– Experimental: CBT encourages the client to try out
the new behaviour, record their thoughts and the
outcomes
On being a CBT therapist...
• Split into pairs
• One person is the client – the other the therapist
• Situation for the client could be:
– Has got a bad grade at college – thinks he/she is a failure
– Has failed the driving test for the third time, everyone else in
the family passed it first time
– Thinks that all the people in their workplace/job hates them
• The therapist should try to pick on the illogical thoughts –
and offer suggestions/challenges – and then homework!!
• Take 5 minutes – and then swap roles
• This is how counsellors are trained
Applying CBT to Prisons
• Can we reduce aggressive behaviour by e.g. making a
young man see the behaviour of others as less threatening?
• Can we use CBT modelling, role play and rehearsal
techniques to help offenders learn how their thought
patterns lead them to criminal behaviours – and help them
change?
• In your groups of 4 you have two forms of CBT used in US
prisons: Aggression Replacement Therapy and Moral
Reconation Therapy
– Split into pairs and work out what each therapy does – and how
effective it is
– Then tell the other pair about it – and swap over!