THEORIES OF COUNSELING

Cognitive Behavior Therapy: Albert Ellis / Aaron Beck / Judith Beck / Donald Meichenbaum
INTRODUCTION A – B – C Framework
• Both cognitive therapy and cognitive behavioral
therapies are based on:
✓ Structured psychoeducational model;
✓ Role of homework;
✓ Place responsibility on the client to take active role
✓ Developing a strong therapeutic alliance • A is the existence of a fact, or an activating event, or
an inference about an event, of an individual.
ELLI’S RATIONAL EMOTIVE BEHAVIOR THERAPY • C is the emotional and behavioral consequence or
• People contribute to their own psychological problems reaction of the individual; the reaction can be either
by the rigid and extreme beliefs they hold about healthy or unhealthy.
situations. • A (the activating event) does not cause C (the
emotional consequence).
• Human beings are born with a potential for both rational • B, which is the person’s belief about A, largely creates
or straight thinking and irrational or crooked thinking C, the emotional reaction.

• Cognitions, emotions, and behaviors interact • Sample:

significantly and have a reciprocal cause-and-effect If a person experiences depression after a divorce, it
relationships. may not be the divorce itself that causes the depressive
reaction nor his inference that he has failed, but he
• Basic hypothesis: our emotions stem mainly from our person’s beliefs about his divorce or his feature.
beliefs which influence the evaluations and
interpretations we make to life situations. • How emotional disturbance fostered?
Fed by the self-defeating sentences clients continually
VIEW OF EMOTIONAL DISTURBANCE repeat to themselves like:
• “We learn irrational beliefs from significant others “I am totally to blame for the divorce”
during childhood and then re-create these irrational “I am miserable failure”
beliefs throughout our lifetime”
• D (Disputing)
• How we reinforce self-defeating beliefs? Application of the methods to help clients challenge
Autosuggestion and Self-repetition their irrational beliefs.

• Blame: core of most emotional disturbances 3 Components of Disputing Process:

✓ Detecting
• Major Goal: Detect their irrational beliefs, particularly their
Encourage clients to be less emotionally reactive. absolutist “shoulds” and “musts”, their “awfulizing”
Sample: and their “self-drowning”
By feeling sadness and disappointment about life’s
adversities rather than by anxiety, depression and ✓ Debating
shame. Debate their dysfunctional beliefs by learning how to
logically and empirically question them and to
• 3 Basics Musts that lead to Self – defeat: vigorously argue themselves out of and act against
a) “I must do well and win the approval of others for believing them
my performances or else I am no good.”
✓ Discriminating
b) “Other people must treat me considerately, fairly, Discriminate irrational
kindly, and in exactly the way. I want them to treat
me. If they don’t, they are no good and they • Cognitive Restructuring
deserve to be condemned and punished.” Teaches how to improve themselves by replacing
irrational beliefs with rational beliefs
c) “I must get what I want, when I want it; and I must
not get what I don’t want. If I don’t get what I want, Clients learn to monitor their self-talk, identify
it’s terrible, I can’t stand it, and life is no good for maladaptive self-talk, and substitute adaptive self-talk
depriving me of what I must have.” for their negative self-talk.

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 THEORIES OF COUNSELING
Cognitive Behavior Therapy: Albert Ellis / Aaron Beck / Judith Beck / Donald Meichenbaum
• E (Effective philosophy) • It is important to establish as much as possible an
New effective belief system consists of replacing egalitarian relationship, as opposed to presenting
unhealthy thoughts with healthy ones. yourself as an nondisclosing authority figure.

• F (Feelings) TECHNIQUES AND PROCEDURES

If clients are successful in doing E, new sets of feelings A. Cognitive Methods
take place. • Relies heavily on thinking, disputing, debating,
challenging, interpreting, explaining and teaching.
Instead of feeling seriously anxious and depressed, we • The most efficient way to bring about lasting emotional
feel healthily sorry and disappointed. and behavioral change is to change way of thinking.
THERAPEUTIC GOALS
• Teaching clients how to separate the evaluation of their 1. DISPUTING IRRATIONAL BELIEFS
behavior from the evaluation of themselves Actively disputing clients’ irrational beliefs and teaching
them how to do this challegng on their own.
• Two main goals of REBT:
1. Assist clients in the process of achieving Sample clients learn to tell themselves:
unconditional self-acceptance (USA) and - “Why must people treat me fairly?”
unconditional oter acceptance (UOA) - How do I become a total flop if I don’t succeed at
2. See how USA and UOA are interrelated. tasks I try?”
- “If life doesn’t always go the way I would like it to, it
THERAPIST’S FUNCTION AND ROLE isnt awful, just inconvenient.”
1. Disputes clients’ irrational beliefs and encourages
clients to engage in activites that will counter their self- 2. HOMEWORK
defeating beliefs and to replace their rigid “must” with Clients are encourage to put themselves in risk-taking
preferences. situations that will allow them to challenge their self-
liminting beliefs.
2. Demonstrate how clients are keeping their emotional
disturbances active by continuing to think illogically and Clients self-fulfilling prophecy and actually fail because
unrealistically. they told themselves in advance that they would.

3. Help clients modify their thinking and minimize their Sample:

irrational ideas. A client with a talent for acting who is afraid to act in
front of an audience because of fear of failure may be
4. Challenge clients to develop a rational philiosophy of asked to take a smal part in a stage play.
life so that in the future they can avoid becoming the
victim of other irrational beliefs. 3. BIBLIOTHERAPY
Reading REBT self-help books
CLIENT’S EXPERIENCE IN THERAPY
• Clients are expected to work hard and carry out 4. CHANGING ONE’S LANGUAGE
behavioral homework assignments. Clients learn that “musts” “oughts” and absolute
“shoulds” can be replaced by preferences.
• Homework is carefully designed and agreed upon and
aimed at getting clients to carrry out positive action that Clients who use language patterns that reflect
induce emotional and attitudinal change. helplessness and self-condemnation can learn to
employ new self-statements, which help them think and
RELATIONSHIP BETWEEN THERAPIST AND CLIENT behave differently.
• REBT therapist accept their clients as imperfect beings
5. PSYCHOEDUCATIONAL METHODS
who can be helped through a variety of techniques
Educate clients about the nature of their problems and
how treatment is likely to proceed.
• REBT therapist are often open and direct in closing their
own beliefs and values.
Clients are more likely to cooperate with a treatment
program if they understand how the therapy process
• Some are willing to share their own imperfections as a works and if they understand why particular techniques
way of disputing clients unrealistic notions. are being used.

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 THEORIES OF COUNSELING
Cognitive Behavior Therapy: Albert Ellis / Aaron Beck / Judith Beck / Donald Meichenbaum
B. Emotive Techniques • Automatic Thoughts
1. RATIONAL EMOTIVE IMAGERY Personalized notions that are triggered by particular
Clients are asked to vividly imagine one of the worst stimuli that lead to emotional responses.
things that might happen to them.
• Primary Focus
They imagine themselves in specific situations where Assist clients in examninin and restructuring their core
they experiene disturbing feelings. Then they are beliefs.
shown how to train themselves to develop healthy
emotions in place of disruptive ones. COGNITIVE DISTORTIONS
• Systematic errors in reasoning that lead to faulty
2. USING HUMOR assumptions and misconceptions
Teaches clients to laught not at themselves, but at their
self-defeating ways of thinking 1. Arbitrary Inferences:
Making conclusions without supporting and relevant
3. SHAME – ATTACKING EXERCISES evidence
Develop exercises to help people reduce shame and
anxiety over behaving in certain ways, Includes “catastrophizing” or thinking of the absolute
worst scenario and outcomes.
Refuse to feel ashamed by telling ourselves that it is not
catastrophic if someone thinks we are foolish. Sample:
You might begin your first job as a counselor with the
Carrying out such assignments enable cient to find out conviction that you will not be liked or valued by either
that other people are not really that interested in their your colleagues or clients.
behavior. Thus, work on themselves so that they do not
feel ashamed or humiliated. 2. Selective Abstraction
Forming conclusions based on an isolated detail of an
Sample: event
Clients may wear loud clothers to attract attention;
Ask a silly question at a lecture Events that matter are thoe dealing with failure and
deprivation
C. Behavioral Techniques
• Includes procedures such as: Sample:
- Operant conditioning As a counselor, you might measure your worth by your
- Self-management principles errors and weaknesses, not your successes.
- Systematic desensitization
- Relaxation techniques 3. Overgeneralization
- Modeling Process of holding extreme beliefs on the basis of a
AARON BECK’S COGNITIVE THERAPY single incident and applying them appropriately to
• Beck’s observations of depressed clients revealed that dissimilar events or settings.
they had a negative bias in their interpretation of certain
life events which contributed to their cognitive Sample:
distortions. If you have difficulty working with one adolescent, you
might conclude that you will not be effective counseling
• Cognitive Therapy any adolescents. You might also conclude that you will
Perceives psychological problems as stemming from not be effective working with any clients.
commonplace processes such as faulty thinking,
making incorrect inferences on the basis of inadequate 4. Magnification and Minimization
or incorrect information, and failing to distinguish Perceiving a case or situation in a greater or lesser light
between fantasy and reality than it truly deserves.

• Theoretical assumptions of CT: Sample:

1. People’s internal communication is accessible to Assuming that even minor mistakes in counseling a
introspection client could easily create a crisis for the individual and
2. Client’s belief have highly personal meanings might result in psychological damage
3. Meanings can be discovered by the client rather
than beingtaught or interpreted by therapist.

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 THEORIES OF COUNSELING
Cognitive Behavior Therapy: Albert Ellis / Aaron Beck / Judith Beck / Donald Meichenbaum
5. Personalization THE CLIENT-THERAPIST RELATIONSHIP
Relate external events to themselves even when there • Effective therapists must combine empathy and
is no basis for making this connection sensitivity along with technical competence.

Sample: • Therapeutic alliance is a necessary first step in

If a client does not return for a second counseling cognitive therapy.
session, you might be absolutely convinced that this
absence is due to your terrible perforamnce during the • Therapists must also have a cognitive
initial session. conceptualization of cases, be creative and active, be
able to engage clients through a process of Socratic
6. Labeling and Mislabeling questionning and be knowledgeable and skilled in the
Portraying one’s identity on the basis of imperpections use of cognitive and behavioral strategies aimed at
and mistakes made in the past and allowing them to guiding clients in significant self-discoveries that will
define one’s true identity lead to change.

Sample: DONALD MEICHENBAUM’S COGNITIVE BEHAVIOR

If you are not able to live up to all of a client’s MODIFICATION
expectations, you might say to yourself, “I’m totally • Changing client’s self-verbalizations
worthless and should turn my professional license in
right away” • Self-statements affect a person’s behavior in much the
same way as statements made by another perso
7. Dichotonomous Thinking
Categorizing experiences in either – or – extremes.
• A prerequisite to behavior change, client must notice
Events are labeled in black or white terms.
how they think, feel, and behave and the impact they
have on others.
Sample:
You might view yourself as either being the perfectly
• Helping clients become aware of their selt-talk and the
competent counselor or as a tota flop if your are not fully
stories they tell about themselves.
competent
• Acquring practical coping skills for problematic
• Way to produce lasting change is to modify inaccurate
situations such as impulsive and aggressive behavior,
and dysfunctional thinking.
anxiety in social situations, fear of taking test, eating
problems and fear of public speaking
• Clients are taught to test these automatic thoughts
against reality by examining and weighing the evidence
HOW BEHAVIOR CHANGES
for and against them.
• Behavior changes through interaction of inner speech,
• “What is the evidence for ___?” cognitive structures, and behaivior and their resultant
outcomes.
Testing them by actively engaging in a socratic
dialogue with the therapist, carrying out homework
assignments, doing behavioral experiments, gathering • 3 Phase Process of Change:
data on assumptions they make and forming alternative
interpretations. Phase 1: Self-observation
If depressed clients hope to make constructive
changes, they must first realize that they are not victims
• Socratic Dialogue
of negative thoughts and feelings. Rather, through the
Assisting clients to determine how accurate and helpful
things they tell themselves.
certain thoughts may be
Phase 2: Starting a New Internal Dialogue
DIFFERENCES BETWEEN CT AND REBT
Clients learn to notice their maladaptive behaviors, and
they begin to see opportunties for adapative behavioral
ASPECT REBT CT
alternatives
View of faulty Persuade clients that Views clients’ belief
thinking certain of theirbeliefs are as being more
irrational and nonfuctional inaccurate than Cients learn to change their internal dialogue, which
irrational servses as a guide to new behavior
Role of Models rational thinking Uses Socratic
Therapist and helps clients to dialogue by posing
identify and dispute open-ended
irrational beliefs. questions to clients
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 THEORIES OF COUNSELING
Cognitive Behavior Therapy: Albert Ellis / Aaron Beck / Judith Beck / Donald Meichenbaum
Phase 3: Learning New Skills • Relapse Prevention
Clients more effective coping skills which are practiced Teaching clients to view any lapses that occur as
in real-life situations learning opportunities

Sample: CONSTRUCTIVIST NARRATIVE PERSPECTIVE

Clients who can’t cope with failure may avoid appealing • Focuses on the stories people tell about themselves
activities for fear of not succeesing at them. Cognitive and others regarding significant events in their lives.
restructuring can help them change their negative view,
thus making them more willing to engage in desired • Begins with the assumption that there are multiple
activities realities

STRESS INOCULATION TRAINING • Help clients appreciate how they construct their realities
• Individuals are given opportunities to deal with relatively and how they author their own stories.
mild stress stimuli in successful ways, so that they
gradually develop a tolerance for stronger stimuli.

• We can affect our ability to cope with stress by

modifying our beliefs and self statements about our
performance in stressful situations.

• Phases of Stress Inoculation Training

1. Conceptual – Educational Phase
Creating a working relationship and therapeutic
alliance with clients

Gain a better understanding of the nature of stress

and reconceptualizing it in social interactive terms.

2. Skills Acquisition and Consolidation Phase

Focus is on giving clients a variety of behavioral
and cognitive coping skills to apply to stressful
situations.

Sample of coping statements:

- “How can I prepare for a stressor?” (“What do
I have to do? Can I develop a plan to deal with
the stress?”)

- “How can I confront and deal with what is

stressing me?” (“What are some ways I can
handle a stressor? How can I meet this
challenge?”)

- “How can I cope with feeling overwhelmed?”

(“What can I do right now? How can I keep
my fears in check?”)

- “How can I make reinforcing self-

statements?” (“How can I give myself
credit?”)

3. Appication and Follow – through Phase

Clients practice their new self – statements and
apply their new skills to everyday life

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