Cognitive-Behavioral Theory: Foundations and Practice
Cognitive-Behavioral Theory: Foundations and Practice
Cognitive-Behavioral Theory: Foundations and Practice
Theory:
Foundations and Practice
A general category of theories or a set of
related theories that reflect the importance
of both behavioral and cognitive
approaches to counseling.
Quote:
“ The best years of your life are the
ones in which your problems are
your own. You do not blame them
on your mother, the ecology, or
the president. You realize that you
control your own destiny.”
Albert Ellis
Cognitive-Behavioral Theories:
Commonalities
A general category of theories or a set of related
theories that reflect the importance of both behavioral
and cognitive approaches to counseling.
Four common tenets across cognitive-behavioral
theories
Collaborative Relationship Between Therapist and
Client
Psychological distress is a function of disturbance in
cognitive processes
Focus on changing cognitions to change affect and
behavior
Treatment is educational and time-limited and focused
on specific and structured target problems
Cognitive Behavioral Theorists
Albert Ellis (1913-2007)
Rational-Emotive Behavior Therapy
(REBT)
Aaron Beck (1921- ) pic at left
Cognitive Therapy
Donald Meichenbaum
Cognitive Behavior Modification
Stress Innoculation Training and Self-
Click pic to watch
Instruction Training video of Ellis
More than 20 different theories labeled interview.
cognitive or cognitive-behavioral
Rational Emotive Behavior
Therapy (REBT)
Considered the parent of the CB approaches
Developed by psychologist Albert Ellis in 1955
Roots in Greek philosopher Epictetus
“People are disturbed not by things, but by the view
which they take of them”
Credits Adler with emphasis on teaching and
persuasive methodology
People should accept themselves, even if
they make mistakes yet at the same time
learn to live more at peace with others!
Ellis believed…..
the empathic,
therapeutic relationship
may be “undesirable”
because the temporary
mood elevation brought
on by empathy may
prevent the client from
doing “necessary work”
to get better.
Goals of Therapy
Assist client in identifying and confronting
rules they live by that might be too absolute,
broad or extreme
Therapeutic Relationship…
Warm personal relationship is essential,
though not sufficient for therapeutic change
Labeling behavior that has meaning for
someone as irrational sends up defenses
Role of the Counselor
Functions to guide the client toward personal
discovery and skill development through
deliberative corrective experiences (rather
than direct teaching)
Use of Socratic questioning rather than
disputing
Cognitive Therapy Process
Provide client with a cognitive rationale for
counseling
Have client monitor thoughts that are
distressful
Implement cognitive & behavioral techniques
Identify & challenge cognition that may be
problematic
Examine beliefs and assumptions through
reality testing
Teach clients coping skills to prevent relapse
Cognitive Therapy Techniques
Cognitive Strategies:
Collaborative
Empiricism
Socratic dialogue
Behavioral Strategies:
Relaxation Therapy
Cognitive Modeling
Meichenbaum’s Cognitive
Behavior Modification
Self-talk is at the heart of the way that a person
functions.
Goal of therapy is cognitive restructuring (modify self-
talk and cope more effectively)
Process includes:
Self-observation
Starting a new internal dialogue
Learning new skills
Meichenbaum’s theories
Self-instructional Stress inoculation
training (Cognitive training: consists of
Behavior Modification): three phases---
clients learn to keep 1. Conceptualization
track of self-statements 2. Skills acquisition &
and to substitute more rehearsal
adaptive statements
through homework & 3. Application & follow-
rehearsal) through
Cognitive-Behavioral View of
Human Nature:
Behavior is learned Development is based
Behavior is developed upon each person’s
and maintained by learning history, unique
external cues, experiences, and
reinforcers, or internal cognitive understanding
processes, such as of the world.
cognition.
Past problems are
Here-and-now
orientation to problems considered only as
relating to present.
Important constructs:
The Importance of Cognitions: Emphasis on
the importance of cognitive workings; all
cognitive interventions attempt to produce
change by influencing thinking
The Importance of Learning: Asserts that
abnormal behavior is learned and developed
the same as normal behavior and can be
changed through cognitive-behavioral
approaches.
Important constructs (cont.)
The Importance of Operational Definitions:
Problems are viewed operationally; problems
are functionally related to internal and
external antecedents and consequences
The Importance of Therapeutic Empathy:
Some feel the techniques are more important
than the relationship (like Ellis) Others feel
here is a necessity for an empathic
relationship.
4 Questions to Establish
Counseling Goals:
1. What are the problems that need to be
addressed (presenting problems)?
2. How can progress in counseling be
measured and monitored?
3. What are the environmental contingencies
maintaining the behavior?
4. Which interventions are more likely to be
effective (cognitive, behavioral, or both)?
REBT & Treatment
REBT has been applied to treatment of
anxiety, depression, OCD, panic disorder,
and agoraphobia.
There is some concern that the notion of
“How you feel is based on what you think”
may send a message to clients that they are
responsible for their mental illness.
CBT Strengths
Empowerment of the client to create change
Clarity of models
Emphasis on teaching
Technical eclecticism
Beck has brought the “private experience back into
the realm of scientific inquiry”
Demystification of the therapy process
Focus on self-help
Multicultural Issues & REBT
Therapist must listen carefully for cultural
values and issues of client.
REBT emphasizes self-sufficiency as
opposed to dependency on the support of
others; many cultures promote
interdependence rather than independence
Active nature of REBT techniques sometimes
conflict with passive nature of some cultures
Gender & REBT
May be more appropriate for work with
women because women are subject to more
gender-role socialization messages that
promote irrational beliefs.
Can be applicable to both genders because
counselors can examine the irrational beliefs
of any client, regardless of gender
Limitations of CBT
De-emphasis on client-counselor relationship
Rejection of transference
Rejection of unconscious realm
REBT: Power of the therapist to manipulate
and judge a client
Limitations of CBT
Over simplistic with regard to
psychopathology: based on the power of
positive thinking
De-emphasis on the past
Underplaying the role of emotions as a direct
agent for change
Limitations
Lack of attention to
unconscious or internal
factors which may affect
behavior
Not very attentive to
feelings
Insight and emphasis
on the past are not
emphasized.
Contributions/Advantages
Brief and time-limited
Action oriented
Puts newly acquired insights into action
Teaches clients to carry on their own “therap
y” without counselor
Eclectic techniques that can be applied to
individual client needs
Research and REBT
Perhaps one of the biggest limitations of REBT has been the negative influences of Ellis himself. In his opinion, professionals may oppose
or slight REBT because they don’t like him. He admitted that his public manner and use of four-letter words is controversial and
unconventional and that his use of the term rational may be aversive to empirically minded psychologists. Because it is irrational to
demand that Ellis change his style, professionals must recognize that they can adhere to the basic principles of the theory without
emulating Ellis’ less-than-nurturing style.