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    Theories of Counseling:

    Cognitive Behavior Therapy

    PowerPoint produced by Melinda Haley, M.S., New Mexico State University.

    This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of an image over a network;

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    Cognitive Behavior Therapy

    Basic Tenets

    The main theories are Cognitive Behavior Therapy, Rational EmotiveBehavior Therapy and Cognitive Behavior Modification.

    The way individuals structure and interpret experiences, determines theirmoods and behaviors.

    Changing conceptualizations lies at the heart of cognitive behavioraltherapy.

    Combines both cognitive and behavioral approaches.

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    Cognitive Behavior Therapy

    Basic Tenets

    Cognitive therapy rests upon the belief that what one thinks determineshow one feels.

    The therapist is supportive and empathic and uses experiments andempirical processes along with a collaborative alliance with the client, toexplore thinking and alternatives.

    Cognitive therapy has been used with a variety of disorders and problems(e.g. anxiety, phobias, depression).

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    What do

    I think

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    Cognitive Behavior Therapy

    Theory of Personality

    Personality includes both genetic endowment and social influence.

    It reflects the individuals cognitive organization and structure.

    Emotions and behaviors are based on perceptions, interpretations, andassumptions.

    Schemas have an important impact on how one operates cognitively.

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    Cognitive Behavior Therapy

    Theory of Personality

    Schemas: A persons core beliefs and basic assumptions.

    Schemas can either be functional or dysfunctional and more than oneschema can compete with another.

    Cognitive Vulnerability: When a persons beliefs and assumptions

    predispose him or her to psychological distress.

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    Cognitive Behavior Therapy

    Nature of Maladjustment.

    Maladjustment stems from irrational beliefs and distorted cognitions.

    Maladaptive cognitions come from:

    Selective attention

    Misperception

    Maladaptive focusing

    Maladaptive self-arousal

    Repertory deficiencies

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    Cognitive Behavior Therapy

    Nature of Maladjustment.

    Maladaptive cognitions lead to maladaptive, self-defeating behaviors.

    Adaptive, self-enhancing behaviors come from a clients self-enhancingthoughts and this can be taught.

    Clients can be taught to shift from self-defeating thoughts to self-

    enhancing thoughts.

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    Cognitive Behavior Therapy

    The Counseling Process

    Cognitive therapy and cognitive behavior modification uses a variety oftechniques or procedures to assist clients in changing negative, selfdefeating responses.

    The therapist might range from directive to unconditionally accepting, fromscientific to empathic, from systemic to open or from suggestive toinstructive.

    It is highly eclectic and utilizes resources and techniques that fit with theclients thought processes.

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    Cognitive Behavior Therapy

    The Counseling Process

    Both cognitive and behavioral strategies might be used.

    Client and therapist work together:

    to help the client gain cognitive and behavioral control over his or herproblem.

    to look at different ways of behaving.

    to analyze thoughts and emotions.

    to practice new cognitive and behavioral patterns.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Becks cognitive psychotherapy

    The goals are to correct faulty information processing and help clientsmodify their assumptions that maintain their maladaptive behaviors andemotions.

    Collaborative Empiricism: Therapist and client are co-

    investigators.

    Guided Discovery: Guided by the therapist, the client engages inexperiments that result in more adaptive ways of thinking.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Relaxation Training and Relaxation Therapy

    A person cannot be in a state of complete physical relaxation while at thesame time be emotionally anxious.

    Works well for stress, anxiety, physiological problems, workplacepressures, and coping with modern lifestyles.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Mental and Emotive Imagery

    Mental Imagery is a process through which a person focuses on vividmental pictures of experiences or eventspast, present or future.

    Emotive Imagery: It is a procedure where the client imagines theemotional sensations and feelings of an actual situation or behavior.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Cognitive Modeling: Identification of what maladaptive or bad thoughts or

    emotions the client wishes to be rid of and then the therapist models withself-talk that the client will incorporate.

    Covert Modeling: A client imagines engaging in the desired behaviors heor she wants to learn or adopt.

    Thought Stopping: Interruption of unwanted thoughts when they occur byshouting stop whenever the unwanted thought pops into consciousness.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Cognitive Restructuring: Replacement of negative, maladaptive thoughts

    with positive, adaptive ones.

    Reframing: To modify or restructure a persons view or perceptionregarding a problem or behavior.

    Stress Inoculation: A process of teaching clients both cognitive and

    physical skills for autonomously coping with future stressful anddistressing situations.

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Meditation and Relaxation: Helps the client concentrate on some internal

    or external stimulus that serves to focus the clients attention away fromaversive stimuli.

    Biofeedback: Uses technology to communicate to a client what his or herown body is doing and then allows that person to use mental processes tocontrol bodily functions.

    Neurolinguistic programming: Using the clients sensory language to fullyexperience the clients inner world (e.g. I see that (visual); I feel that(kinesthetic) ; I hear that auditory).

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    Cognitive Behavior TherapyStrategies for Helping Clients

    Eye Movement Desensitization Reprocessing (EMDR):

    Used primarily to treat traumatic memories.

    The client imagines the scene, is aware of the negative statementregarding that scene (along with noxious feelings), and then followsthe therapists finger with his or her eyes.

    Then the client erases the image from his or her mind.

    This is continued over a series of steps until hopefully the painfulimage and noxious feelings and memories are removed.

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    Cognitive Behavior TherapyAdvantages of Cognitive Behavior Therapy

    It has established human thought processes as data or events that can be

    studied.

    It validated a number of relaxation techniques.

    It has enhanced the rational therapies such as Rational Emotive BehaviorTherapy.

    Uses the systematic scientist-practitioner model.

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    Cognitive Behavior TherapyDisadvantages of Cognitive Behavior Therapy

    It has been harshly judged by feminists, multiculturalists and ecologists

    because it mirrors masculine and Euro-American worldviews and doesnot adequately take culture into consideration.

    It requires a lot of training and skill.

    The therapist needs to not only understand cognitive techniques but also

    have a vast understanding of behavioral and learning theories.

    The therapist needs to have strong discipline and there is less tolerancefor error.

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    Cognitive Behavior TherapyCognitive Behavior Therapy with Diverse Populations

    It matches problems to treatments without regard for race or cultural

    considerations.

    It can be used effectively if culture and the clients worldview is take intoconsideration.

    Therapy is a collaboration and depends upon trust between counselor

    and client and this can work well with culturally diverse clients.

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    Resources

    Ivey, A. E., DAndrea, M., Ivey, M. B. and Morgan, L. S. (2002). Theories of counseling

    and psychotherapy: A multicultural perspective, 5thed. Boston, MA.: Allyn &Bacon.

    James, R. K. & Gilliland, B. E. (2003). Theories and strategies in counseling and

    psychotherapy, 5thed. Boston, MA: Allyn & Bacon.

    Kottler, J. A. (2002). Theories in counseling and therapy: An experiential approach.

    Boston, MA: Allyn & Bacon.

    Copyright Allyn & Bacon 2004