Aaron Beck is the founder of CBT which he originaly created to treat depssion. He had the belief that cognitions are at the root of suffering. So, by modifying our ways of htinking we can mitigate our suffering.
Beck was critical of 'irrational' the Ellis used in REBT, so he used 'maladaptive' to describe unhelpful thoughts
Key Concepts:
Cogntive Model: the way a person perceives a sutation is more closely connection to their reaction than the situation itself
Stress-Vulnerability Model: as more stress occurs the more automatic thoughts are at the mercy of underlying dysfunctional beliefs
"Psychologically healthy people are aware of their cognitions and can replace them with healthier thoughts and behaviors"
Automatic Thoughts: stream of cognitions that are constantly flowing through our minds. Internal conversion and self talk are normal to the human experience but tend to be negative, faulty, and biased
They mediate between a situation and an emotion
Intermediate beliefs: connect core beliefs to automatic thoughts and often are reflective of extremes and absolutes
Core beliefs: central ideas about ourselves, other people, the world, and our future. These underlie our automatic thoughts and are reflected in our intermediate thoughts
Typically stem from childhood experiences, not always true, and are modifiable
More categorized as helpless core beliefs or unlovable core beliefs
Schemas: mental structures that organize information around core beliefs. Think of them as information processing filters that interpret, integrate, store, and ascribe meaning to our lived experiences
Rules that govern our information processing and thus behavior
We are more likely to recall observations that are relevant to our schema either supporting or challenging it.
Misremembering tends to align with our schema and confirm our beliefs despite not being true
The Therapeutic Process
Interventions that target all 3 areas of functioning: thinking, feeling, behavior
5 steps in a typical session
Structure the session and set an agenda w/ client
Review previously learned content, skills, and process the weekly homework
Introduce new material, psychoed, and practices skills
Collaborative processing and feedback of session
Assign homework appropriately
Therapeutic Goals
Help people recognize and correct errors in their information processing systems
Teach people to recognize, identify, and respond to dysfunctional thoughts, emotions, and behaviors
Exploring evidence to support or counter negative cognitions
Challenge maladaptive thoughts and behaviors
Develop more plausible and self-enhancing ways of being
CBT uses changes in thinking to bring about changes in doing and feeling
Therapeutic Techniques & Procedures
Cognitive Restructuring
cognitive rehearsal
self-talk
affirmations
letter writing
cost benefit analysis
role playing
bibliotherapy
Mindfulness
Behavioral Experiments
Activity Scheduling
Josh has developed a great relationship with Mia and after living together for 2 years, they have decided to get married, at Mias suggestion
Automatic thoughts: I can’t be the sort of husband Mia wants and our marriage will end.
Intermediate beliefs: A good husband must be willing to sacrifice his own needs for those of his wife and children. Marriage is a difficult endeavor at which few succeed
Core belief: I am not able to love another person and have little to offer in my relationships.
Schema: I am inadequate and am destined to fail, no matter how hard I try. This makes me feel discouraged about my upcoming marriage; I feel disaster and shame hanging over my head. What’s the point of trying if I know I will fail at whatever I do.
Application of CBT
Depression: modify dysfunctional thoughts that maintain hopelessness and low self esteem. Behavioral modifications can be made to target specific behaviors
Anxiety: Specificallly helpful for panic disorder when used with exposure therapy. Identifies and modifys ideas related to panic attacks. In social anxiety, thoughts about performances and being in social settings can be targeted in conjunction with relaxation
OCD: Has long been considered one of the most effective treatments to modify intrusive thoughts and compulsive behaviors
PTSD & Trauma Disorders: Cognitive restructuring and processcingtherapy is helpful to address symptoms. TF-CBT (trauma focused CBT) is an approach used with children that incorporates psychoeducation for parents, relaxation, cognitive coping skills, processing, family sessions, and creating safety plans.
Eating Disoders: Has the strongest empirical evidence for treating bulimia
Group Counseling: reinforcement and modeling by other members in a group setting is well suited for CBT because it allows experimentation of new observed behaviors
Personality disorders, pain management, insomnia, substance use, couples therapy
Multicultural populations: CBT explores and considers the core beliefs of each client. The techniques used are tailored for each client making it applicable to those of all identities and backgrounds.
Limitations
Somewhat based on a medical model that relies on a diagnosis
Not all individuals will like or benefit from the direct and structure approach
Relatively brief structure might not fit the needs of all clients
Counselors can view CBT as a rapid solution and miss out on building rapport or downplay the therapeutic relationship
Additional interventions might be needed in addition to CBT techniques
Counselors must be organized, direct, and have a knowledge base of many theories to apply a range of interventions