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Conrad cbt

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Text of Conrad cbt

  • 1.
    • An Theory Integration Presentation by
  • Katherine Ashe, Victoria Adamczyk, Bobby Aiello, and Nick Abdelahad


  • Conrad's brother Buck died in a boating accident and he blames himself for not being able to save Buck. He feels so guilty about it that he tries to kill himself and gets sent to the hospital for a few months to recover. It is recommended that Conrad continue to see a therapist outside the hospital now that he is back home and recovering. His father is more supportive of the idea than his mother is, who refuses to acknowledge anything that happened with Buck or Conrad in the past. Conrad, like Buck, is on the swim team, but doesn't seem to be enjoying it much anymore. He becomes interested in a girl at school, Jeanine, but isn't quite sure how to approach a relationship with her.


  • Mood check
  • Setting the agenda
  • Bridging from last session
  • Today's agenda
  • Homework
  • Summarize the session
  • Feedback from client


  • Goal = teach clients to change dysfunctional/irrational thoughts and behaviors, unconditional self and other acceptance
  • Make connections between irrational beliefs and how they lead to emotional disturbances
  • Teach clients to reframe their negative thoughts into more positive ones
  • Clients need to work actively outside of therapy homework assignments


  • Self defeating behavior
  • Knowingly do things that will cause him to fail or start trouble
  • - Conrad keeps practicing with swim team even though he thinks he's become too slow
  • - starts a fight with a former teammate after a meet


  • Rational emotive behavior therapy
  • Emotions stem from beliefs and reactions to situations
  • Dispute irrational beliefs
  • - believes he's responsible for Buck and Karen's death
  • - needs to be more like Buck, always living in his shadow


  • Self acceptance
  • Needs to be able to accept himself before he can accept others
  • - accept that he cannot change what happened with the accident, wasn't his fault
  • - once he realizes that, he can start having relationships with other people again
  • - accept his mother for who she is doesn't show emotions, or talk about what happened


  • Activating event -> belief -> consequence
  • - Buck dies in boating accident -> Conrad believes he could have saved him -> tries to commit suicide because of his guilt
  • - Karen kills herself -> Conrad blames himself for not seeing warning signs -> becomes depressed and remembers how it felt when Buck died
  • - boys disturb talk with Jeanine -> the date is ruined -> Conrad doesn't open up to her anymore


  • Cognitive homework
  • - create a schedule for the week with events that he enjoys doing
  • - put himself in risk taking situation, trying to talk to mom about not opening up even though he may get blown off
  • Change language
  • re-frame sentences so they're not so negative
  • Role-playing Act 1


  • Rational-emotional imagery
  • - imagine the worst things that could happen
  • - Conrad having to live with just his mother, he could have died in accident too
  • Role playing and Shame attacking exercises
  • - take a risk on something Conrad is afraid to do
  • - asking Jeanine out on a date, talking with mother about why she doesn't seem to love him


  • Role-playing
  • Activity scheduling/monitoring
    • Allows for evaluation of automatic thoughts and/or emotional shifts
    • Can plan for specific events at specific times that can bring pleasure to depressed clients
  • Role-playing Act 2


  • Creator of the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI)
    • Would have Conrad take the BDI after initial session
  • Therapy is insight-focused: want to change the way clients think


  • Therapeutic relationship is necessary, but NOT sufficient
  • Therapist wants to encourage client to take an active role in self-discovery
  • Teach client how to be their own therapist
  • Emphasize how thoughts influence emotions and behaviors


  • Personalized notions that are triggered by particular stimuli that lead to emotional responses
    • CBT therapist wants to identify and challenge automatic thoughts
  • Some of Conrads automatic thoughts:
    • Mom: hates him
    • Buck: guilt/anger
    • Blames himself when others feel negatively about him


  • Personalization
    • Conrads constant blaming of himself
  • Overgeneralization
    • Bucks death sends Conrad spiraling into a world of guilt, blame, and depression
  • Selective Abstraction
    • Janine laughing while on her date with Conrad ruins his entire night


  • Should Statements
    • I should have died
    • I should have saved Karen
    • I should have held on to Buck
    • I should have told my parents I quit the team


  • Correct dysfunctional thinking
    • Bucks death is Conrads responsibility
    • Mothers hatred is Conrads fault
    • Conrad should have saved Karen
    • Conrad is feeling survivor guilt
  • Modify erroneous assumptions
    • If Buck had been stronger and held on he would have lived
    • If I had been with Karen I could have saved her


  • What evidence do you have that supports your claim that your Moms treatment of you is your fault?
  • What do you think you could have done differently to help Buck?
    • to help Karen?
  • How could you look at this situation so you would feel less responsible for Bucks death?
  • Role-playing Act 3


  • Main focus is the internal dialogue of the client
  • Role-playing Act 4


  • Why Conrad would benefit -
  • focus on how we interpret and react to events change the way that he viewed the accident and his relationships with his mother and Jeanine
  • continue with own therapy outside of sessions homework assignments would be helpful to fit in activities he enjoys doing, making a schedule to get things back to normal
  • Why he wouldn't -
  • not much focus on the past he needs to talk about the accident and figure out his feelings behind what happened and why

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