Cognitive Therapy

Review outline in notes

• The foundation on which cognitive therapy is established can be identified by the statement, “Men are disturbed not by things but by the views which they take of them.”

Indications for Cognitive Therapy

• Depression• Panic disorder• Generalized anxiety

disorder• Social phobia• Obsessive-compulsive

disorder• Posttraumatic stress

disorder

• Substance abuse• Personality disorders• Schizophrenia• Couple’s problems• Bipolar disorder• Hypochondriasis• Somatoform disorder• Eating disorders

Goals and Principles of Therapy• The goal of cognitive therapy is for clients to learn to

identify and alter the dysfunctional beliefs that predispose them to distort experiences.

• Cognitive therapy is highly structured and short-term, lasting 12 to 16 weeks.

Cognitive therapy– Is based on an ever-evolving formulation of the client and his or her

problems in cognitive terms– Requires a sound therapeutic alliance– Emphasizes collaboration and active participation– Is goal-oriented and problem-focused– Initially emphasizes the present

Basic Concepts

• “The general thrust of cognitive therapy is that emotional responses are largely dependent on cognitive appraisals of the significance of environmental cues.” (Wright, Beck, & Thase, 2003)

Basic Concepts (cont.)

• Automatic thoughts – thoughts that occur rapidly in response to a situation and without rational analysis; sometimes called cognitive errors

• Some examples are:– Arbitrary inference– Overgeneralization– Dichotomous thinking– Selective abstraction– Magnification– Minimization– Catastrophic thinking– Personalization

Basic Concepts

• Schemas (core beliefs) – “Cognitive structures that consist of the individual’s fundamental beliefs and assumptions, which develop early in life from personal experiences and identification with significant others. These concepts are reinforced by further learning experiences and, in turn, influence the formation of other beliefs, values, and attitudes.” (Beck & Weishaar, 2005)

– Schemas may be adaptive or maladaptive, general or specific, and positive or negative.

Techniques of Cognitive TherapyDidactic (Educational) Aspects• Clients must be prepared to become their own therapist.• Therapists provides information about cognitive therapy

and provides assignments to reinforce learning.A full explanation about correlation between distorted

thinking and clients’ mental illness is provided. Cognitive Techniques

• Recognizing automatic thoughts and schemas– Socratic questioning, Imagery, Role play and Thought

recording

Behavioral Interventions (cont.)• Distraction• Relaxation exercises• Assertiveness training• Role modeling• Social skills training• Thought-stopping techniques