COGNITIVE BEHAVIORAL THERAPY

Manlongat, Oflunra Abby A.

Emotive Techniques

• REBT practitioners use a variety of emotive procedures, including unconditional acceptance, rational emotive role playing, modeling, rational emotive imagery, and shame attacking exercises.

• Clients are taught the value of unconditional self-acceptance.

• Even though their behavior may be difficult to accept, they can decide to see themselves as worthwhile persons.

• Clients are taught how destructive it is to engage in “putting oneself down” for perceived deficiencies.

Emotive Techniques

• Although REBT employs a variety of emotive techniques, which tend to be vivid and evocative in nature, the main purpose is to dispute clients’ irrational beliefs (Dryden, 2002)

Emotive Techniques

Rational emotive imagery. • This technique is a form of intense mental practice designed to

establish new emotional patterns. • Clients imagine themselves thinking, feeling, and behaving exactly

the way they would like to think, feel, and behave in real life (Maultsby, 1984)

Using humor. • REBT contends that emotional disturbances often result from taking

oneself too seriously. One appealing aspects of REBT is that it fosters the development of a better sense of humor and helps put life into perspective (Wolfe, 2007).

• Humor has both cognitive and emotional benefits in bringing about change.

Emotive Techniques

• Role playing. Role playing has emotive, cognitive, and behavioral components, and the therapist often interrupts to show clients what they are telling themselves to create their disturbances and what they can do to change their unhealthy feelings to healthy ones. Clients can rehearse certain behaviors to bring out what they feel in a situation.

• Shame-attacking exercises. Ellis developed exercises to help people reduce shame over behaving in certain ways. He thinks that we can stubbornly refuse to feel ashamed by telling ourselves that it is not catastrophic if someone thinks we are foolish. The main point of these exercises, which typically involve both emotive and behavioral components, is that clients work to feel unashamed even when others clearly disapprove of them.

Emotive Techniques

• Use of force and vigor.

Ellis has suggested the use of force and energy as a way to help clients go from intellectual to emotional insight. Clients are also shown how to conduct forceful dialogues with themselves in which they express their unsubstantiated beliefs and then powerfully dispute

Behavioral Techniques

• REBT practitioners use most of the standard behavior therapy procedures, especially operant conditioning, self-management principles, systematic desensitization, relaxation techniques, and modeling.

• Behavioral homework assignments to be carried out in real-life situations are particularly important. These assignments are done systematically and are recorded and analyzed on a form.

• Homework gives clients opportunities to practice new skills outside of the therapy session, which may be even more valuable for clients than work done during the therapy hour (Ledley et al., 2005)

Research Efforts

• If a particular technique does not seem to be producing results, the REBT therapist is likely to switch to another. This therapeutic flexibility makes controlled research difficult.

• As enthusiastic as he is about cognitive behavior therapy, Ellis admits that practically all therapy outcome studies are flawed.

• According to him, these studies mainly test how people feel better but not how they have made a profound philosophical-behavioral change and thereby get better (Ellis, 1999, 2001a).

Applications of REBT to ClientPopulations

• REBT has been widely applied to the treatment of anxiety, hostility, character disorders, psychotic disorders, and depression; to problems of sex, love, and marriage (Ellis & Blau, 1998); to child rearing and adolescence (Ellis & Wilde, 2001); and to social skills training and self-management (Ellis, 2001b; Ellis et al., 1997).

• With its clear structure (A-B-C framework), REBT is applicable to a wide range of settings and populations, including elementary and secondary schools.

Applications of REBT to Client

• REBT can be applied to couples counseling and family therapy.

• In working with couples, the partners are taught the principles of REBT so that they can work out their differences or at least become less disturbed about them.

• In family therapy, individual family members are encouraged to consider letting go of the demand that others in the family behave in ways they would like them to.

• Instead, REBT teaches family members that they are primarily responsible for their own actions and for changing their own reactions to the family situation.

REBT as a Brief Therapy

• REBT is well suited as a brief form of therapy, whether it is applied to individuals, groups, couples, or families.

• Ellis originally developed REBT to try to make psychotherapy shorter and more efficient than most other systems of therapy, and it is often used as a brief therapy.

• Ellis has always maintained that the best therapy is efficient, quickly teaching clients how to tackle practical problems of living.

REBT as a Brief Therapy

• The A-B-C approach to changing basic disturbance-creating attitudes can be learned in 1 to 10 sessions and then practiced at home. Ellis has used REBT successfully in 1-and 2-day marathons and in 9-hour REBT intensives.

Application to Group Counseling

• Cognitive behavior therapy (CBT) groups are among the most popular in clinics and community agency settings. Two of the most common CBT group approaches are based on the principles and techniques of REBT and cognitive therapy (CT).

Application to Group Counseling

• Ellis recommends that most clients experience group therapy as well as individual therapy at some point.

• This form of group therapy focuses on specific techniques for changing a client’s self-defeating thoughts in various concrete situation.

• This approach helps group members see how their beliefs influence what they feel and what they do.

Application to Group Counseling

• CBT groups have targeted problems ranging from anxiety and depression to parent education and relationship enhancement

• Cognitive behavioral group therapy has been demonstrated to have beneficial applications for some of the following specific problems: depression, anxiety, panic and phobia, obesity, eating disorders, dual diagnoses, dissociative disorders, and adult attention deficit disorders (see White & Freeman, 2000).

Aaron Beck

• Developed an approach known as Cognitive Therapy (CT) as a result of his research on depression.

• Cognitive therapy is based on the theoretical rationale that the way people feel and behave is determined by how they perceive and structure their experience.

• Cognitive therapy perceives psychological problems as stemming from commonplace processes such as faulty thinking, making incorrect inferences on the basis of inadequate or incorrect information, and failing to distinguish between fantasy and reality.

Similarities of REBT and CT

• Active• Directive• Time-limited• Present-centered• Problem-oriented• Collaborative• Structured• Empirical• Make use of Homework

DIFFERENCES BETWEEN CT AND REBT

REBT• is often highly directive, persuasive, and confrontational.• It also focuses on the teaching role of the therapist.• The therapist models rational thinking and helps clients to

identify and dispute irrational beliefs. CT• Uses a Socratic dialogue by posing open-ended questions

to clients with the aim of getting clients to reflect on personal issues and arrive at their own conclusions.

• CT places more emphasis on helping clients discover and identify their misconceptions for themselves than does REBT.