SOCI221 SN07 Lecture StrategicTherapies CBT S1 2017 · • understand the principles of CBT ... 10...

SOCI221

www.endeavour.edu.au

Session 7

Strategic Therapies:

Cognitive Behavioural Therapy

Department of Social Sciences

© Endeavour College of Natural Health www.endeavour.edu.au 2

Session Aim

o The aim of this session is to provide an

overview to:

• understand the historical background and

importance of Cognitive Behavioural Therapy (CBT)

• understand the principles of CBT

• employ skills and therapeutic techniques of CBT

• analyse and understand the limitations and other

considerations of CBT

© Endeavour College of Natural Health endeavour.edu.au 3

Historical Background



o The term ‘cognitive’ means using thoughts,

and as such, a cognitive therapy can be

described as one that assists in identifying and

changing the way we think

o Cognitive Behavioural Therapy (CBT) was

created in the 1960s and early 1970s, and was

only really adopted as a model for treating

problems of a psychological nature over the

past 30 years



o Perhaps the two most influential pioneers in

CBT’s development were psychiatrist Aaron

Beck and psychologist Albert Ellis


Principles


Principles

o Ellis began to pay attention to the role beliefs

and thoughts played in causing psychological

issues, in the 1960s. He believed that when

people thought irrationally they became upset,

and therefore if people were taught to think in

a more rational way, a lot of psychological

problems could be resolved


Principles

o Beck made the observation that depressed

people have distorted or faulty thinking

patterns, which he believed stemmed from

‘schemas’

o Schemas are core beliefs that subsequently

create a bias on the way we interpret and

perceive our experience


Principles

o Ellis and Beck both asserted that therapy

should aim to assist people with recognising,

and thus changing, their patterns of faulty

thinking and behaviour that is self-defeating

o CBT uses the terms ‘irrational beliefs’,

‘negative thinking’, ‘unrealistic thoughts’, ‘self-

defeating cognitions’, ‘faulty thinking’, and

‘unhelpful cognitions’ to describe cognitions

that result in emotions that are upsetting


Principles

o CBT has been found effective in managing a

number of disorders and problems of a

psychological nature, such as:

• anxiety and phobias

• depression and post-traumatic stress disorder

• sleep difficulties

• relationship problems

• mood swings

• eating disorders

• substance abuse


Principles

o CBT has also been used and found to be

helpful in assisting with both common day-to-

day issues and major challenges, such as

running late for appointments and losing one’s

job


Skills, Strategies, and

Therapeutic Techniques


The ‘ABC’ Model

o CBT uses the ‘ABC’ model to help us identify

that it is our cognitions (thoughts) that actually

determine how we are feeling at any point in

time, rather than assuming it is the people or

events that make us feel good or bad (these

are just seen as providing the stimulus)


The ‘ABC’ Model

o The acronym ‘ABC’ stands for:

A = antecedent (or activating event) – this

situation triggers our response

B = beliefs (our cognitions or thoughts about

the situation)

C = consequences (the way we behave and

feel)


The ‘ABC’ Model

o While we generally tend to put the blame on

the antecedent or activating event (‘A’) for the

consequences we are experiencing (‘C’), it is

in fact our beliefs (‘B’) that result in us feeling

the way we do

o As an example:

A = running late for a job interview

C = anxiety, irritability, dangerous driving


The ‘ABC’ Model

o In this example, you are not feeling irritable

and anxious (C) because you are late for your

interview (A), but rather due to your beliefs (B)

regarding being punctual, and the negative

consequences from running late

o Likewise, some general thoughts people

experience when they feel anxious in these

circumstances include:


The ‘ABC’ Model

“I must never be late. I will be disliked by others if I do

not arrive on time. It would be terrible if people didn’t

like me or I didn’t have their approval all the time.”

o To describe the process of how we challenge

the way we think about situations and

circumstances, Ellis used the term “dispute”

o The next step in the ABC model is to dispute

our beliefs and thoughts which are making us

feel bad, once we have been able to identify

what those thoughts and beliefs are


The ‘ABC’ Model

o Disputing our beliefs in this process assists us

in being able to experience more appropriate

emotions (such as feeling some concern

instead of intense anxiety) and also helps us to

behave in a more appropriate way – so in the

above example, this would be to avoid driving

dangerously


The ‘ABC’ Model

o As an example, in the previous scenario,

rather than listening and responding to the

unhelpful thoughts and beliefs, we could tell

ourselves something like:

“in the past I have found I usually either get there on time,

or just a few minutes after, even when I am running late.

Even if that happens, it is quite unlikely to have severe

consequences. While I prefer to be on time, and normally,

are, it is not the end of the world if I am a little late on this

occasion”


The ‘ABC’ Model

o The process of disputing unhelpful beliefs and

thoughts is the most important part of CBT

o The key to releasing and avoiding lots of

emotions that are upsetting is to learn to

dispute, and ultimately change, the thoughts

(cognitions) that make us feel bad


The ‘ABC’ Model

o Before being able to do this effectively, it is

important to be able to recognise the patterns

of thinking and beliefs that create emotions we

find upsetting in our day-to-day experiences

o These include recognising faulty thinking such

as:

• irrational beliefs (thinking that goes against our

desire for survival and happiness)

• the ‘tyranny of the shoulds’ (beliefs or rules we

have about how things must be)


The ‘ABC’ Model

• ‘awfulising’ (the tendency to exaggerate and

catastrophise the negative consequences of the

situations in our life

• black-and-white thinking (everything is either all-

or-nothing, good-or-bad, without considering the

middle ground)

• overgeneralisation (despite limited evidence,

drawing negative conclusions about others and

ourselves)

• personalisation (assuming the responses of others

are directed at us, or feeling responsible for things

that are not even our fault)


The ‘ABC’ Model

• mental filters (only focusing on one particular point

in a situation, and ignoring all other factors)

• jumping to negative conclusions (assuming the

worst)

• blaming (putting the blame on, and condemning

others, for their faults)

• labelling (where we place labels on ourselves, like

‘ugly’, ‘failure’, ‘idiot’, ‘useless’ etc.

• predicting catastrophe (focusing on all the

negative possibilities)


Disputing Negative And Unhelpful

Cognitions

o One of the most helpful ways of disputing

negative and unhelpful cognitions is to use

Socratic questioning

o This method was created by the ancient Greek

philosopher Socrates, who utilised a number of

questions that were provocative, in order to

challenge the underlying assumptions people

held



Cognitions

o The purpose of Socratic questioning is to

assist us in identifying and recognising the lack

of logic in the way we think. Some examples

include:

• why do I (he/they/she) have to …..?

• would it be disastrous if …..?

• where is the evidence that .….?

• just because I have a preference for this, how is it

that they must …..?



Cognitions

o To change the way we think, simply asking

questions is not enough and we need to create

and formulate more helpful and rational ways

in which to perceive our situation



Cognitions

o This means we need to identify statements

that will directly challenge the negative and/or

irrational parts of our thinking. For example:

“I must be pretty and slim to be successful and liked by

everyone” (belief)

vs

“why must I be pretty and slim to be successful, and

why must I be liked by everyone? Why must it be so?”

(dispute via Socratic questioning)


Limitations and Considerations


Limitations

o As mentioned in session six, like most

psychological interventions, there is no ‘one

size fits all’ strategy that suits everyone

o Similarly, the client must want to change and do

something about their situation, otherwise the

strategies will not be effective and will leave

them in the same, or worse, situation


Limitations And Considerations

o While many people readily adapt to using CBT,

others may not. Therefore having a ‘toolbox’ of

resources and strategies for your clients is

recommended

© Endeavour College of Natural Health endeavour.edu.au 31© Endeavour College of Natural Health www.endeavour.edu.au 31

Activity

oDiscuss the nature of CBT and how it is different

to other models

oForm pairs or groups and apply strategies

based on these concepts

oTake a moment to write down examples of how

you could use Socratic questioning for some

common beliefs you or others hold

© Endeavour College of Natural Health endeavour.edu.au 32© Endeavour College of Natural Health www.endeavour.edu.au 32

Reference List

Edelman, S. (2004). Change your thinking. Victoria: ABC Books

SOCI221 SN07 Lecture StrategicTherapies CBT S1 2017 · • understand the principles of CBT ... 10...

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