There are a number of cognitive behavioural techniques used in by professional therapists. These approaches are chosen to suit the needs and issues of the client.
Cognitive Behavioural Therapy: an overview
Cognitive behavioural therapy is an approach that looks at both behavioural therapy and cognitive therapy. It looks at why people think and behave the way they do and then provides them knowledge and choice.
In simple terms, (C) cognition is the way we perceive and think, (B) behaviour is the way we react and behave and (T) therapy or change is the method for changing the perception and behaviour.
Common CBT techniques include:
Exploring a client's irrational thoughts and replacing them with rational healthy ones Stopping unhelpful irrational thoughts altogether Gradual exposure to situations and social skills training Assertiveness training
Cognitive behavioural therapy is often the main model and approach for therapists dealing with the following issues with their clients:
Anxiety and panic attacks Depression Eating disorders, predominately bulimia nervosa Phobias
The above areas and issues respond well to CBT as it is widely accepted that perception is the key to lasting change and unnatural or irrational perceptions are the root of these conditions occurring.
Rational Emotive Behaviour Therapy (REBT)
Developed by Albert Ellis in the 1950s, rational emotive behaviour therapy (REBT) is a form of cognitive behavioural therapy. It is a psychotherapy approach that focuses on resolving emotional and behavioural problems and disturbances.
REBT assumes that individuals are hedonistic in that they strive to remain alive and achieve happiness. It also assumes that individuals are also prone to irrational beliefs, thoughts and behaviours that then affect them achieving their wants and goals.
The core belief is that individuals are disturbed by things, but not by the views that we take of them. This means that it is how we feel about something that bothers us, not the "something" itself. Therefore, if the individual can reframe the event, then it is an entirely different emotional effect.
Ellis believes that a client needs to change their belief system in order to deal with and manage an emotional issue or problem. He created the ABC model: this looks at a disputing belief system that questions and challenges the existing belief system.
A - activating event
B - the belief system
C - the consequence, cognitive, emotional or behavioural reaction
For example:
A - person is asked to have a one to one with their boss without any prior warning
B - person is afraid of the manager and person with power, as they believe they are nasty and unfair
C - person panics and acts out of character and behaves irrationally
If the boss is actually a threatening individual who regularly reprimands staff then this consequence could be appropriate. However, if the boss is actually very fair and agreeable then the system has malfunctioned and a faulty belief exists.
The main error is usually generalisation. For example, in this case people such as managers in power are all intimidating and unreasonable. This means that the fault is often the mind over-grouping on the basis on one category.
You can then introduce D - the disputed belief system. This allows choices and reflection in the mind to occur. The disputed belief system will usually take the initial form of questions. So:
D - is my manager actually unfair. Am I perhaps scared because I have had a bed experience with a manager in the past that bullied me?
Cognitive restructuring therapy (CRT)
Cognitive restructuring therapy (CRT) was developed by Aaron Beck in the 1960s. Like Ellis, Beck believed that irrational beliefs were the cause of a problem.
The key philosophy of CRT is that an individual's emotional response to an event or experience is determined by the conscious meaning placed on it. This means that the interpretation of what we perceive is the key to our personal outcome. So, if we see, hear or notice something, then we try and gain an understanding of that thing we have noticed. This means we place a meaning or an interpretation on that thing.
Beck believed that faulty and irrational beliefs spread in a specific manner. He believed that these beliefs could spread threefold and form a triad representative of the entire belief system. The three areas are:
The self The world The future
The self represents how the individual feels about himself or herself. This includes self-esteem, feelings of self-worth and self-image. The world is then the way the individual interacts with the rest of their experiences. So this is when the individual applies their feelings of self to the rest of the world around them. The individual then applies their belief to the future. This means if they have feelings of inadequacies or other such issues, then they portray this into the image of their future.
Beck suggested that these three areas of the triad had negative effects and worsened each other as each one undermines the next in a vicious circle.
For example: an individual may feel they are not good at anything they do. They may think that as they are not perfect at everything, then they are not good at anything. This is their self-belief. They will then believe that world thinks that are not worth or any good at anything. They will portray this image onto the world around them. They will fear their future and believe that nothing will change.
Beck addresses this negative triad by developing adaptive metacognition. This is the process of teaching clients how to think about their feelings. This process teaches clients to notice when their thoughts are distorted and irrational and therefore monitor their negative automatic thoughts and make conscious choices rather than allowing their inappropriate thoughts to dominate.
Cognitive restructuring therapy has developed two major goals as it has matured. These include:
The client learns to spot negative and inappropriate thinking whenever possible. The client will then monitor this and make the choice to substitute this thinking with more realistic and appropriate interpretations of the situation When the pattern or stimulus is too powerful, the client will monitor the impulses and accept their presence but not give in to them. For example, the client suffering from sever depression will accept that they are depressed and that they have little control over that, but will choose to cope the best they can and not give into despair
The first point is most usual, as for many clients their issues are psychological in cause and therefore changes can be made.
The second point is about managing the condition rather that curing it. Monitoring, awareness and self-management are all useful approaches to help the client suffer less.
For both categories, the key point is for the client to learn to identify and alter their negative beliefs that lead to distortion. The therapist will help the client spot his or her own thought patterns. The realisation of this patterns empowers the client to monitor and self-manage their response and behaviour.
There are a number of confronting approaches used in CRT as a practical technique. Some of these include:
Specific Realism of outcome Context
Attributional therapy
Attribution therapy is a recent development in cognitive behavioural therapy and considers the meaning we place on things, specifically what meaning or relevance the individual attributes to an event or situation.
For example: the client experiences a situation when their think they have failed. As a result of this they assume that they are useless in everything they do and that their failure must have happened because of a specific fault, like they are not intelligent enough. Therefore they link the event and situation to their intelligence.
These individuals will also explain success and personal achievement as a fluke or luck, or suggest that the task was so easy anyone could achieve it. This means they continue to reinforce their key belief that they have now formed that they are not intelligent enough.
There are two classic tools used in attributional therapy. These include:
Hand out and log sheets for clients to fill in with their thoughts. This allows them to log the patterns and analyse them Personal journals and diaries for the client to record their thoughts and related subjects. Again this allows the client to analyse and recognise certain patterns.
The self-instructing training (SIT) model
Within the self-instructing training (SIT) model, inoculation works by the client building up immunity to the old stresses and negative reactions and instead applying and favouring new behaviours.
The client will practice using change techniques such as self-hypnosis and visualisation to help them become comfortable changing their old belief into their new positive belief. This will be done in steps to ensure that the client's confidence increases, with each step becoming more and more challenging.
As a client succeeds at each of this stage, then their confidence will increase and their progress will accelerate.
The SIT model is important to our understanding of what techniques are naturally used by CBT therapists as it sets the precedent that change techniques are a natural and appropriate part of a CBT therapist's practice. These change techniques and models include self-hypnosis, visualisation and affirmations.
Cognitive Behavioural Therapy - The Approaches and Techniques Used by Therapists Check For The New Release in Health, Fitness & Dieting Category of Books NOW!
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