Cognitive Behavioral Therapy

Today's Points 01 Theory

02 Proponents

03 Key Concepts

04 Therapeutic Process

05 Application

06 Contributions of the Approach

07 Limitations & Criticisms

08 Supplementary Resources
 Cognitive Behavioral Therapy
(CBT)
• is a talking therapy that can help the
client to manage the problems by
changing the way they think and
behave.
CBT is based on the concept that ...

THOUGHTS FEELINGS BEHAVIOR

INTERCONNECTED
CBT deals with the client’s current
problems, rather than focusing on
issues from your past.
 Cognitive behavioral therapy (CBT) is a common type of talk therapy
(psychotherapy). You work with a mental health counselor (psychotherapist or
therapist) in a structured way, attending a limited number of sessions.
CBT is useful in
addressing emotional
challenges/mental health
disorders such as but not
limited to:
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Proponent

Aaron Temkin Beck, MD

Father of Cognitive Behavioral
Therapy

• Born on 28 July 1921 in Providence, Rhode Island

• Youngest of 5 children
• Graduated from Brown University in 1942 - English & Political Science
• Earned his MD from Yale University in 1946
• Married Phyllis Beck; 4 children and one of which became an influential
cognitive-behavior therapist - Judith Beck - President of the Beck Institue of
CBT.
 In the 1950s and 1960s, American
psychiatrist Aaron T. Beck noticed patterns
with his depressed clients. They seemed to
hold negative views of self, others and their
future, and no matter how much exploration
of their past occurred, these negative views
did not shift.

“cognitive distortions”

Published: Cognitive Therapy for Depression

The Cognitive Model

Automatic
Thoughts
Cognitive
Distortions
Underlying beliefs or schemas
 Automatic Thoughts

An individual’s immediate, unpremeditated

interpretations of events are referred to as automatic
thoughts. Automatic thoughts shape both the
individual’s emotions and their actions in response to
events.
 Cognitive
Distortions
Errors in logic are quite prevalent in patients with psychological disorders. They lead
individuals to erroneous conclusions. Below are some cognitive distortions that are
commonly seen in individuals with psychopathology:

• Dichotomous thinking
• Overgeneralization
• Selective abstraction
• Mind reading
• Fortune Telling
• Emotional reasoning
 Underlying Beliefs

Underlying beliefs shape the perception and interpretation of events. Belief systems or
schemas take shape as we go through life experiences. They are defined as templates or rules
for information processing that underlie the most superficial layer of automatic thoughts.
Beliefs are understood at two levels in CBT:

Core Beliefs Intermediate

• The central ideas about self and the world. • Consists Beliefs
of assumptions, attitudes, and rules.
• The most fundamental level of belief. • Influenced in their development by the core
• They are global, rigid, and overgeneralized. beliefs.

• Examples of dysfunctional core • Examples of dysfunctional intermediate beliefs:

beliefs: • “To be accepted, I should always please others.”
• “I am unlovable.” • “I should be excellent at everything I do to be considered
• “I am inadequate.” adequate.”
• “The world is hostile and dangerous.”
 Albert Ellis

Remote Emotive Behavior Therapy

An off-shoot of CBT
CBT is based on several core principles, including:

• Psychological problems are based, in part, on faulty or unhelpful ways of

thinking.
• Psychological problems are based, in part, on learned patterns of
unhelpful behavior.
• People suffering from psychological problems can learn better ways of
coping with them, thereby relieving their symptoms and becoming more
effective in their lives.
CBT treatment usually involves efforts to change thinking patterns. These
strategies might include:

• Learning to recognize one’s distortions in thinking that are creating

problems, and then to reevaluate them in light of reality.
• Gaining a better understanding of the behavior and motivation of
others.
• Using problem-solving skills to cope with difficult situations.
• Learning to develop a greater sense of confidence in one’s own abilities.
CBT treatment also usually involves efforts to change behavioral patterns.
These strategies might include:

• Facing one’s fears instead of avoiding them.

• Using role playing to prepare for potentially problematic interactions
with others.
• Learning to calm one’s mind and relax one’s body.
 The psychologist and patient/client work together, in a collaborative
fashion, to develop an understanding of the problem and to develop a
treatment strategy.

CBT places an emphasis on helping individuals learn to be their own

therapists.
The Therapeutic
Process

• Gain an Understanding of the issue

2. Ask a Series of questions
3. Recognize problematic thoughts and
behaviors
4. Work to adjust thoughts and behaviors.
Some activities involved in the course of CBT:
• regular one-on-one or group sessions, or a combination of both
• gets frequent feedback
• does role-playing activities
• learns ways to calm the mind and body
• has gradually increased exposure to the things they fear
• does homework assignments
• keeps a cognitive behavioral diary
• practices skills to promote positive behavioral change and
growth
 CBT=REBT, CT …

CBT
Cognitive
behavioral therapy

Albert Ellis, Aaron Beck …

 CBT=REBT, CT …

❑ Application ( Procedures and techniques )

❑ Role of the therapist
❑ Advantages and limitations
❑ Supplementary Ressources ( short video)

CBT
 CBT=REBT, CT …

Application
01 Techniques and procedures
 CBT=REBT, CT …

✓ Relationship ( Client and therapist )

✓ Use of the ABCDE model
✓ Assesment
✓ Cognitive technique
✓ Behavioral technique
✓ Emotive technique
✓ Imagery technique
✓ The process of therapeutic change
✓ The conclusion and constructive
thoughts

Application ( technique and procedures )

 CBT=REBT, CT …

Relationship ( Client and therapist )

The relationship in REBT is usually based upon certain
core therapeutic conditions advanced by Carl Rogers.
These core conditions are empathy (understanding the
client’s viewpoint accurately), warmth, respect,
genuineness (the therapist acting in a natural and open
way), and unconditional positive regard (the client is
accepted without any reservations; REBT calls this
unconditional acceptance). REBT agrees that these
conditions are necessary for the development of a
relationship that will help the client to achieve his/her
goals for change.

Application ( technique and procedures

 CBT=REBT, CT …

The
ABCDE model

Application ( technique and procedures )

 CBT=REBT, CT …

The process that seeks to understand the

client’s presenting problems and their
Assesment degree of severity. REBT therapists seek
clear and specific information (where
possible) from clients in the first session in
order to place their problems within the
ABC framework.

Application ( technique and procedures )

 CBT=REBT, CT …

Logic Usefulness

Cognitive technique

Realism

Application ( technique and procedures )

 CBT=REBT, CT …

Behavioral techniques
These are negotiated with the client
on the basis of being challenging,
but not overwhelming, that is, tasks
that are sufficiently stimulating to
promote therapeutic change

Application ( technique and procedures )

 CBT=REBT, CT …

involve fully engaging clients’ emotions while they

forcefully dispute their irrational beliefs. Among these
techniques are shame-attacking exercises whereby
clients act in a ‘shameful’ way in real life in order to
attract public ridicule or disapproval ( taking an
imaginary dog for a walk, and at the same vigorously
striving for self-acceptance with rational statements
such as ‘Just because I’m acting foolishly doesn’t make
me a fool.’ Clients can learn from these exercises not to
damn or rate themselves on the basis of their behaviour
or the reactions of others.)

Emotive techniques Application ( technique and procedures )

 CBT=REBT, CT …

In this technique the client is encouraged to feel

anxious by imagining giving an incompetent
presentation to her colleagues and then, without
altering any details of this mental picture, to change
her emotion to one of concern. This emotional shift is
brought about by the client replacing her underlying
irrational belief with a rational belief.

Imagery technique
Application ( technique and procedures )
 CBT=REBT, CT …

The process of therapeutic

change
❑ That individuals largely (but not totally) create their
own emotional disturb- ances about life events through
their irrational thinking about these events.
❑ That individuals have the capacity to minimize or
remove these disturbances by identifying, challenging
and changing their rigid patterns of thinking.
❑ In order to acquire a rational or flexible pattern of
thinking, individuals need to think, feel and act against
their irrational beliefs, usually on a lifelong basis.

Application ( technique and procedures )

 CBT=REBT, CT …

The conclusion and

constructive ways
1. Anti-awfulizing – negative events are judged on a scale of
badness that lies within human understanding (e.g. ‘These
things are happening to me and they are very bad but not
awful’).
2. High frustration tolerance – the ability to tolerate or withstand
a great deal of difficulty or discomfort in one’s life (There is a
lot of pressure at work but I can stand it without liking it’).
3. Acceptance of self and others – human beings are seen as
fallible (imperfect) and in a state of continuous change,
therefore it is futile to label them in any way (see D in
ABCDE model).

Application ( technique and procedures )

 CBT=REBT, CT …

Role of the therapist

02

Role of the therapist

CBT=REBT, CT …
 CBT=REBT, CT …

Focuses on behavior change

and its connection to thoughts.
Utilizes behavioral strategies
such as self-monitoring and
reinforcement to modify
specific behaviors.

Role of the therapist

 CBT=REBT, CT …

Takes an active and

confrontational stance.
Challenges clients' irrational
beliefs, encourages them to
face their fears, and guides
them in restructuring their
thoughts.
Acts as a collaborator, facilitating
the client's exploration of
automatic thoughts and cognitive
distortions. Socratic questioning
helps clients gain insight and
modify thought patterns.

Role of the therapist

 CBT=REBT, CT …

Advantages and limitations

03
 CBT=REBT, CT …

Advantages
• CBT approaches are evidence-based and
effective in treating various psychological
issues.
• Techniques are practical, goal-oriented, and
can be adapted to diverse populations.
• Clients gain skills for long-term self-
management of thoughts and behaviors.
 CBT=REBT, CT …

Advantages
Clients make changes that minimize
stressors, increase personal strengths
and supports, and establish skills for
dealing more effectively with their
physical and social (cultural)
environments.
 CBT=REBT, CT …

• Some individuals might struggle with

the structured nature of CBT.
• Overemphasis on cognition may
overlook the impact of external factors
on emotions and behaviors.

limitations
 CBT=REBT, CT …

In CBT the focus is on the present,

which can result in the therapist
failing to recognize the role of the
past in a client’s development.

limitations
 CBT=REBT, CT …

Supplementary ressource
04 Video on the power of CBT
 CBT=REBT, CT …

References:
❖ Corey, G. (2013b). Student manual for Theory and Practice of
Counseling and Psychotherapy (9th ed.). Belmont, CA: Brooks/Cole,
Cengage Learning.
❖ Claringbull, N (2010) Counseling and Psychotherapy practice –
what is counseling and Psychotherapy? www.learningmatters.co.uk
❖ Palmer, S. (2000. Introduction to Counselling and Psychotherapy,
the essential guide. British Library Cataloguing in Publication data/
The Cromwell Press Ltd, Trowbridge, Wiltshire

Supplementary ressource
 CBT=REBT, CT …

Short video ( using CBT for social anxiety ) (see the link)

1.https://www.youtube.com/watch?v=W3hMmZQAdhw
2.TRAILS Short Film Series - Psychoeducation on CBT B9g

Supplementary ressource