This summary of cognitive behaviour therapy includes: an introduction; Albert Ellis's Rational Emotive Behaviour Therapy; Key Concepts - View of Emotional Disturbance, A-B-C Framework; The Therapeutic Process - Therapeutic Goals, Therapist's Function & Role, Client's Experience in Therapy, Relation...
Cognitive Behaviour Therapy:
Introduction:
Traditional behaviour therapy has broadened & largely moved in the direction of cognitive
behaviour therapy. Several more CB approaches include:
- Albert Ellis’ rational emotive behaviour therapy (REBT)
- Aaron T Beck & Judith Beck’s cognitive therapy (CT)
- Christine Padesky’s strengths-based CBT (SB-CBT)
- Donald Meichenbaum’s cognitive behaviour therapy
- Arnold A Lazarus’s multimodal therapy
All cognitive behaviour approaches share same basic characteristics & assumptions as
traditional therapy (Chap 9). Like:
- 1. Collaborative relationship with client & therapist
- 2. Premise that psychological distress is often maintained by cognitive processes
- 3. Focus on changing cognitions to produced desired changes in affect/behaviour
- 4. Present-centred, time-limited focus
- 5. Active & directive stance by therapist
- 6. Educational treatment focusing on specific & structured target problem
In addition: both cognitive therapy & CBT based on structured psychoeducational model –
make use of homework, place responsibility on client to assume active role both in/outside
sessions, emphasise developing strong therapeutic alliance & use a variety of cognitive &
behavioural strategies to bring about change.
Therapists help clients examine how they understand themselves & their world
Both cognitive therapy & CBT based on assumption: beliefs, behaviours, emotions & physical
reactions linked. Changes in 1 area = changes in other areas. A change in beliefs isn’t only
target of therapy, but enduring changes usually require a change in beliefs.
Albert Ellis’s Rational Emotive Behaviour Therapy:
Introduction
Rational emotive behaviour therapy (REBT): focus on cognition/behaviour as it emphasises
thinking, assessing, deciding, analysing & doing.
Assumes:
- people contribute to their own psychological problems & specific symptoms, by the
rigid & extreme beliefs they hold about events & situations
- cognitions, emotions & behaviours interact & have a mutual cause-and-effect
relationship. REBT emphasises all 3 modalities & their interactions =
holistic/interactive approach
1
,Basic hypothesis: our emotions mainly created from our beliefs. These influence the
evaluations & interpretations we make & fuel the reactions we have to life situations.
Clients taught skills – tools to identify & reject irrational beliefs acquired & self-constructed &
maintained by self-indoctrination. Learn: how to replace detrimental ways of thinking with
effective & rational cognitions = change their emotional experience & their reactions to
situations
Educational process NB – therapist functions like a teacher, collaborating with client on
homework assignments & introducing strategies for constructive thinking. Client (learner)
practices new skills in everyday life.
Key Concepts
View of Emotional Disturbance:
REBT based: we learn irrational belief from significant others during childhood & then re-
create these irrational beliefs throughout our lifetime. We actively reinforce our self-
defeating beliefs through the process: autosuggestion (making suggestions for ourselves) &
self-repetition, then behave in ways that are consistent with these beliefs. Mainly: our own
repetition of early-indoctrinated irrational beliefs – keeps dysfunctional attitudes alive &
functioning within us
Blame: basis of many emotional disturbances. Need to stop blaming ourselves/others & learn
to fully/unconditionally accept ourselves despite our imperfections/
We have strong tendencies: transform our desires/preferences into absolute ‘shoulds’;
‘musts’; ‘oughts’; demands and commands. – these demands create disruptive
feelings/dysfunctional behaviours
3 basic musts (irrational beliefs) that we internalise & always lead to self-defeat:
- 1. ‘I must do well & be loved/approved by others’
- 2. ‘Other people must treat me fairly, kindly & well’
- 3. ‘The world & my living conditions must be comfortable, satisfying and just,
providing me with all that I want in life’
A-B-C Framework:
A-B-C Framework: central to REBT theory/practice.
A: existence of an activating event/adversity, or an inference/conclusion reached about an
individual
B: person’s belief about A
C: emotional & behavioural consequence/reaction of individual. Reaction either
healthy/unhealthy.
A (the activating event) doesn’t cause C (the emotional consequence). Instead, B (the
person’s belief about A) mainly creates C
2
, Example: if a person experiences depression after a divorce, it may not be the divorce itself
that causes depressive reaction, nor his inference that he’s failed, but the person’s belief
about his divorce or about his failure. Ellis believes: beliefs about rejection & failure (point B)
are what mainly cause the depression (point C) – not the actual event of divorce/person’s
inference of failure (point A).
Essence of REBT: believing that human beings are largely responsible for creating their own
emotional reactions & disturbances
After A, B & C comes D (disputing). D involves: methods that help clients challenge heir
irrational beliefs. There are 3 components of disputing process: detecting; debating &
discriminating
- Learn to discriminate between irrational (self-defeating) beliefs & rational (self-
helping) beliefs
- Detect irrational beliefs, absolutist ‘shoulds’ & ‘musts’, ‘awfulising’ & ‘self-drowning’
- Debate dysfunctional beliefs by logically, empirically & pragmatically questioning them
Clients asked: vigorously argue themselves out of believing & acting on irrational beliefs.
Clients encouraged to develop E (new effective philosophy) – has a practical side. A new &
effective belief system consists: replacing unhealthy irrational thoughts with healthy rational
ones. ‘Homework’ – enhance & maintain these therapeutic gains/personal insights
The Therapeutic Process
Therapeutic Goals:
Leads clients – minimise their emotional disturbances/self-defeating behaviours by gaining:
more realistic, workable & compassionate philosophy of life.
Collaborative effort between therapist/client – choose realistic & life-enhancing therapeutic
goals
Therapists’ task: help client differentiate between realistic/unrealistic goals & between self-
defeating/self-enhancing goals
Aim: change dysfunctional emotions/behaviours -> healthy ones. Also: help clients achieve
unconditional self-acceptance (USA); unconditional other-acceptance (UOA) & unconditional
life-acceptance (ULA)
Therapists Function and Role:
Step 1:
- Show clients they have incorporated many irrational absolute ‘shoulds’; ‘oughts’ &
‘musts’ into their thinking.
- Therapist: disputes clients’ irrational beliefs
- Encourage clients to engage in activities that’ll work against their self-defeating
beliefs by replacing their ‘musts’ with preferences
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