Coginitive behaviour therapy

• Cognitive treatment approaches teach people to think in more

adaptive ways by changing their dysfunctional cognitions about the
world and themselves.
• Unlike behavior therapists, who focus on modifying external behavior,
cognitive therapists attempt to change the way people think as well
as their behavior.
• Because they often use basic principles of learning, the methods they
employ are sometimes referred to as the cognitive-behavioral
approach (Beck & Rector, 2005; Butler et al., 2006; Fried-berg, 2006).
• Rational-emotive therapists teach clients how to recognize the
“shoulds,” “oughts,” and “musts” that are controlling their actions
and preventing them from choosing the lives they want.
• They attempt to break through a client’s closed-mindedness by
showing that an emotional reaction that follows some event is really
the effect of unrecognized beliefs about the event.
•
• According to Ellis, when people demand certain
• “musts” (“I must get into graduate school”)
• and “shoulds” (“He should love me”) from themselves and
others, they create emotional distress and behavioral
dysfunction (David, Schnur, & Belloiu, 2002; Ellis, 1997,
2003a, 2003b, 2004).
• In therapy, Ellis often
• argued with clients, cajoling and teasing them, sometimes in very
blunt language.
• Once clients recognize their self defeating thoughts, Ellis begins
working with them on how to behave differently—to test out new
beliefs and to learn better coping skills.
• Reflecting this increased attention to behavioral change, he renamed
his therapy rational-emotive behavior therapy (REBT) (Crosby, 2003)
• In therapy,
• this belief (and others) is openly disputed through rational
confrontation and examination of alter-native reasons for the event,
such as fatigue, alcohol, false notions of sexual performance.
• This confrontation technique is followed by other interventions that
replace dogmatic, irrational thinking with rational, situationally
appropriate ideas.
• Although cognitive treatment approaches take many forms, they all
share the assumption that anxiety, depression, and negative
emotions develop from maladaptive thinking.
• Accordingly, cognitive treatments seek to change the thought
patterns that lead to getting “stuck” in dysfunctional ways of thinking.
• Therapists systematically teach clients to challenge their assumptions
and adopt new approaches to old problems.
• Cognitive therapy is relatively short term and usually lasts a maximum
of 20 sessions.
• Therapy tends to be highly structured and focused on concrete
problems.
• Therapists often begin by teaching the theory behind the approach
and then continue to take an active role throughout the course of
therapy by acting as a combination of teacher, coach, and partner.
RATIONAL EMOTIVE BEHAVIOUR THERAPY
• One good example of cognitive treatment,
• rational-emotive behavior therapy,attempts to restructure a
person’s belief system into a more realistic, rational, and logical set
of views.
• According to psychologist Albert Ellis (2002, 2004), many people lead
unhappy lives and suffer from psychological disorders because they
harbor irrational, unrealistic ideas such as these:
• We need the love or approval of virtually every significant other
person for everything we do.
• We should be thoroughly competent, adequate, and successful in all
possible respects in order to consider ourselves worthwhile.
• It is horrible when things don’t turn out the way we want them to.
• Rational-emotive behavior therapy aims to help clients eliminate
maladaptive thoughts and beliefs and adopt more effective thinking.
• To accomplish this goal,therapists take an active, directive role during
therapy and openly challenge patterns of thought that appear to be
dysfunctional.
• Developed by Albert Ellis (1973, 1995),
• rational-emotive therapy is based on the premise that many
psychological problems stem from how people think about and
interpret events in their lives.
• It is not the actual event that causes the emotional upset,
• but rather the individual’s interpretation of the event that results in
emotional distress.
• Specifically, it identifies the
• client’s faulty or irrational beliefs that lead to self-defeating
behaviors, anxiety, depression, anger, or other psychological
problems.
• Several studies support Ellis’s notion that people
• who think more irrationally evidence more psychological distress
(Solomon, Arnow, Gotlib, & Wind, 2003; Ziegler & Leslie, 2003;Ziegler
& Smith, 2004).
Cognitive therapy assumes

• Cognitive therapy assumes

• that faulty thought processes—beliefs that are irrational,
• overly demanding,
• or that fail to match reality—create problem behaviors
• and emotions(Barlow, 2008; Corey, 2009;Davies, 2008; Ellis, 1996,
2003b,2004; Kellogg & Young, 2008).
• Like psychoanalysts, cognitive therapists believe that exploring
unexamined beliefs can produce insight into the reasons for
disturbed behaviors.
• However, instead of believing that a change in behavior occurs
because of in-sight and catharsis,
• cognitive therapists believe that in-sight into negative self-talk (the
unrealistic things a person tells himself or herself) is most important.
• Through a process called cognitive restructuring, this in-sight allows
clients to challenge their thoughts, change how they interpret events,
and modify maladaptive behaviors.
A-B-C MODEL
• Such irrational beliefs trigger negative emotions, which in turn
support the irrational beliefs and lead to a self-defeating cycle.
• Ellis calls it the A-B-C model in which
• negative activating conditions (A) lead to the activation of an
irrational belief system (B), which in turn leads to emotional
consequences (C).
• For example, if a person experiences the breakup of a close
relationship (A) and holds the irrational belief (B)that “I’ll never be
loved again,” this triggers negative emotions (C) that in turn feed back
into support of the irrational belief
• In addition, whereas psychoanalysts focus primarily on childhood family
relationships,
• cognitive therapist assume that a broad range of events and people—both inside
and outside the family—influence beliefs One of the best-known cognitive
therapists is the late
• Albert Ellis, who developed an approach known rationaemotive therapy (RET)
(1961, 2003a, 2003b, 2004). Ellisboth inside and outside the family—influence
beliefs.
Rational emotive therapy (RET)
• One of the best-known cognitive therapists is the late Albert Ellis,
who developed a approach known as rational emotive therapy (RET)
(1961, 2003a, 2003b, 2004).
• Ellis called RET an A–B–C–D approach, referring to the four steps
involved in creating and dealing with maladaptive thinking:
• an activating event,
• the person’s belief system,
• the emotional and behavioral consequences that the person
experiences,
• and disputing (or challenging) erroneous beliefs .
• Cognitive therapies are highly effective treatments depression,
anxiety disorders, bulimia nervosa anger management, addiction, and
even some symptoms of schizophrenia and insomnia (Beck &
Grant,2008; Dobson, 2008; Ellis, 2003a, 2003b, 2004; Kellogg& Young,
2008; Neenan, 2008; Palmer & Gyllensten,2008).
• However, both Beck and Ellis have been criticized for ignoring or
denying the client’s unconscious dynamics, overemphasizing
rationality, and minimizing the importance of the client’s past
(Hammack,2003).
• Other critics suggest that cognitive therapies aresuccessful because
they employ behavior techniques,not because they change the
underlying cognitivestructure (Bandura, 1969, 1997, 2006, 2008;
Laidlaw &Thompson, 2008; Wright & Beck, 1999). Imagine that you
sought treatment for depression and learned to construct events
more positively and to curb your all-ornothing thinking. Imagine that
your therapist alsohelped you identify activities and behaviors that
wouldpromote greater fulfillment. If you found your depres-sion
lessening, would you attribute the improvement toyour changing
thought patterns or to changes in yourovert behavior?