Cognitive Behavior Therapy in Psychology

COGNITIVE BEHAVIOR THERAPY
(CBT)
Course: Family Counseling
Presented by Safa Qasim

VIEW OF HUMAN NATURE
 The view of behavioral therapies does not rest on a
deterministic assumption that humans are mere
product of their socio- cultural conditioning. Rather,
the current view is that the person is the producer
and the product of his/ her environment (Badura,
1974)
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INTRODUCTION TO CBT
 Developed by Aaron Beck.
 An insight therapy.
 Emphasizes recognizing and changing negative thoughts
and maladaptive beliefs.
 CBT usually takes place over a limited number of sessions
(typically five to 20).
 Dysfunctional thinking is common to all psychological
disturbances.
 Rationale: The way people feel and behave is determined
by how they structure their experience.
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 Assumption: Cognitions are the major determinants
of how we feel and act.
 The goal is to change the way the client thinks.
 According to Beck, in order to understand the
nature of an emotional episode or disturbance, it is
essential to focus on the cognitive content of an
individual’s reaction to the upsetting event or
stream of thoughts.
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COGNITIVE CONCEPTUALIZATION
 Cornerstone of CBT
 Formulation to understand client’s presenting
problems
 Also, can include strengths, positive qualities and
resources
 Starts with basic Cognitive Model:
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COGNITIVE DISTORTIONS
 For Beck, the most direct route to changing
dysfunctional emotions and behaviors is by
modifying inaccurate and dysfunctional thinking.
 The following common distortions in processing
information have been identified as leading to faulty
assumptions and misconceptions:
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1. Arbitrary Inference:
 Refers to reaching conclusions without sufficient and relevant
evidence.
 “Catastrophizing”, fortune telling or thinking the absolute worst
scenario for a situation.
 • E.g.: “He didn’t call me back, he is trying to ignore me”
2. Selective Abstraction:
 Consists of forming conclusions based on an isolated detail of an event
and thus, missing the significance of the overall context.
 E.g.: Everyone talked to me, but X didn’t say hello to me in the party a
“My whole evening is spoilt”
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3. Over Generalization:
 A process of holding extreme beliefs on the basis of a single
incident and applying them inappropriately to dissimilar
events or settings.
 E.g.: Failing one test a “I am going to fail all the exams”
4. Magnification and Exaggeration:
 Consists of overestimating the significance of negative
events.
 E.g.: “Anyone could have passed that Math competition
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5. Personalization:
 A tendency for people to relate external events to themselves,
even when there is no basis for making this connection.
 E.g.: “My parents are fighting because I am did not score well
in Math.”
6. Imperatives/ Shoulds Or Musts:
 Having a precise, fixed idea of how one should behave, and you
overestimate how bad it is that these expectations are not met.
 E.g.: “I should not be anxious.”
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7. Polarized Thinking:
 Involves thinking and interpreting in all- or- nothing terms,
or categorizing experiences in either/ or extremes.
 E.g.: My father scolded me yesterday : “He doesn’t love me
at all”
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Step 1: Ask client to note down what they actually do and rate
each activity in terms of:
 Pleasure (sense of enjoyment) – 0-10
 Mastery (sense of achievement) – 0-10
Step 2: Using their:
 Values (what is important to them - e.g., get involved in
community, spend time with family)
 Aspirations (How they want life to be - e.g., gain knowledge)
and
 Goals (what they want to accomplish through therapy - e.g.,
lose 2 Kgs in 1 month) create an activity schedule for them.
Step 3: Either fill activity chart or make a to-do list
BEHAVIORAL STRATEGIES– Activity
Scheduling
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 Go slow.
 Negotiate between patient’s pace and what you
think needs to be done
 Include reinforcements
 Remove possible obstacles (e.g., patient may
feel disheartened that they are able to do bare
minimum: psycho-educate them)
 If possible, include a co-therapist (from
caregivers) who can push patient to do certain
activities
Troubleshooting
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 One strategy - Various names
1 Dysfunctional Thought Record
2 Thought Diary
3 A-B-C charting
4 Situational Analysis
Identification of Automatic Thoughts
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 Identification:
1 Of automatic thoughts
2 Dysfunctional assumptions
3 Core beliefs
4 Cognitive restructuring
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 The “Thinking Error” Question
Am I making a thinking error?
 “Advantage/Disadvantage” Question
What would be the advantage or disadvantage
of thinking like this?
COGNITIVE RESTRUCTURING– Socratic
Questioning
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 The “De-catastrophizing” Question
What is the worst that could happen?
What is the best that could happen?
What is a more realistic outcome?
 “Distancing” Question
If _____ (friend’s name) was in this situation &
had this thought, what would I tell him/her?
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 The “Alternative Thinking” Question
Is there another way to look at the situation?
 What would be more balanced way of
thinking/rational thought?
(Balanced thinking is about looking for new
information that you might otherwise overlook).
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 The “Alternative Thinking” Question
Is there another way to look at the situation?
 What would be more balanced way of
thinking/rational thought?
(Balanced thinking is about looking for new
information that you might otherwise overlook).
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 “Thought errors” are biases in the way people
think. They can include: Catastrophizing, “all or
nothing” thinking, over- generalization,
magnification, etc.
 They may feel these beliefs are facts, but closer
interrogation can reveal they have little
evidence to support them.
Preventing thought errors
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 Emotional reasoning is when a person
concludes that, because they feel something,
their thoughts must be true.
 Cognitive restructuring encourages people to
take a pause and question what the evidence is
for this belief. Learning to discern realistic and
unrealistic thoughts may help reduce anxiety.
Addressing emotional reasoning
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CBT: Improving Family Dynamics
 Helps improve communication and resolve conflict
among family members.
 Most popular therapy for family and marriage.
 Focuses on thoughts and behaviors and how they affect
other family members.
 Addresses the family’s unfavorable thought patterns and
behaviors.
 It highlights how cognition shapes emotions and behavior
and attempts to support family members in becoming
more adaptable thinkers and communicators.
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 Improved Communication: Better understanding and
empathy can result from family members’ improved
communication abilities, which CBFT can facilitate. In
addition to learning to listen and respect other people’s
viewpoints, family members may also learn to
communicate their needs and feelings more effectively.
 Enhanced ability to solve problems: CBFT can assist families
in acquiring problem-solving techniques that they can use
in various contexts. Family members can develop their
ability to recognize issues, come up with several solutions,
and weigh the advantages and disadvantages of each.
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 Decreased conflict: CBFT can lessen the volume and
severity of conflict in the family by enhancing
communication and imparting conflict resolution
techniques. A more tranquil and harmonious
household atmosphere may result from this.
 Reduced signs of mental health disorders: Cognitive
behavioral therapy (CBFT) is useful in lessening the
signs of anxiety, depression, and other mental health
conditions. CBFT helps improve mental health
outcomes for families by addressing the underlying
beliefs, feelings, and behaviors that fuel these
symptoms.
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 Enhanced coping abilities: It can assist family members in
acquiring coping mechanisms to handle stress, worry, and
other difficulties. This can involve mindfulness practices,
relaxation techniques, and other methods for handling
challenging emotions.
 Enhanced family cohesion: It can assist in forging closer ties
and a more cohesive unit within the family. Family members
may strengthen their sense of camaraderie and support for
one another by cooperating to overcome obstacles and
accomplish goals.
 Better connections between parents and children: It can
assist parents in creating more constructive and successful
parenting techniques, which can result in better relationships
with their kids. This might involve establishing proper limits,
implementing consistent punishment, and offering emotional
support.
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Advantages of CBT
 Time- limited;
 Helps us become more aware of your emotions,
thoughts and behaviors;
 Directive;
 Structured approach;
 Can be applied in treating depression, general anxiety,
social anxiety, test anxiety, phobias, psychosomatic
disorders, eating disorders, anger, and chronic pain
problems.
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Thank you for your attention!
The END

Cognitive Behavior Therapy in Psychology

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