Boek 2: COGNITIVE BEHAVIOUR THERAPY
Chapter 1: Introduction to Cognitive Behavior Therapy
Dr. Beck was trying to prove that psychoanalysis worked, but instead he found
out that he had to search for another explanations for depression. This way, he
identified distorted, negative cognitions (thoughts) were the primary feature of
depression.
Early 60’s ‘cognitive therapy’ was developed by Beck. The rest of the book
uses the term Cognitive Behavior Therapy (CBT) as a synonym of cognitive
therapy.
It is a structured, short-term, present oriented form of therapy, solving current
problems of the client and modifying dysfunctional thoughts.
The theory underlying CBT:
The Cognitive Model
The cognitive model proposes that dysfunctional thinking is common to all
psychological disturbances. By evaluating thinking in a more realistic way,
someone will subsequently improve in his or her emotional state.
Automatic thoughts emotions
behavior
CBT is used to target the first component: automatic thoughts. This is done by
modifying deeper beliefs and assumptions about the self, others and the world,
which are thought to make a more lasting change. By doing this, the automatic
thoughts (which are a product of these deeper beliefs and assumptions) will be
modified indirectly.
Basic principles of treatment:
Although tailored to the individual, CBT knows some general principles:
1. CBT is based on an ever evolving formulation of the patient’s problems &
an individual conceptualization of each patient (in cognitive terms). This
conceptualization involves:
Current thinking
Precipitating factors
Key developmental events & enduring patterns of interpreting these
events
2. CBT requires a sound therapeutic alliance, involving warmth, empathy,
competence and genuine regard
3. CBT emphasizes collaboration & active participation (team-work)
4. CBT is goal oriented and present focused
5. CBT initially emphasizes the present, the only time attention shifts to the
past is when
Patient has a strong preference to do so
Patient gets stuck in their dysfunctional thinking patterns and
understanding of childhood could help this
6. CBT is educative, teaching the patient to be her own therapist &
emphasizes relapse prevention
7. CBT aims to be time limited (approximately 14 sessions)
8. CBT sessions are structured, maximizing efficiency and effectiveness
9. CBT teaches patients to identify, evaluate and respond to their
dysfunctional thoughts, using guided discovery (or: Socratic
Questioning) to evaluate thinking and behavioral experiments to test
their thinking (a collaborative exploration of evidence)
, 10.CBT uses a variety of techniques to change thinking, mood and behavior.
The technique you choose depends on your conceptualization of the
patient and the specific problem.
A therapy session…
- … begins with checking the patient’s mood, symptoms and experiences
from the past week and reviewing homework assignments
- … discusses a specific problem that the client had put on the agenda,
collaboratively plans a strategy for this problem and linking homework
assignments to this
- … ends with reviewing the important points of the session and feedback
of the client
Developing as a cognitive behavior therapist:
Stage 1 learning basic skills of conceptualizing, based on the intake evaluation
& data collection in
session. Learning to structure the sessions and planning treatment.
Helping the patient solving their dysfunctional thoughts. Learning basic
cognitive and behavioral techniques
Stage 2 Integrating your knowledge of techniques in the conceptualization.
More easily identifying
goals of the treatment. Expanding repertoire of techniques.
Stage 3 Varying in techniques, being able to treat patients with personality
disorders.
Chapter 1: Introduction to Cognitive Behavior Therapy
Dr. Beck was trying to prove that psychoanalysis worked, but instead he found
out that he had to search for another explanations for depression. This way, he
identified distorted, negative cognitions (thoughts) were the primary feature of
depression.
Early 60’s ‘cognitive therapy’ was developed by Beck. The rest of the book
uses the term Cognitive Behavior Therapy (CBT) as a synonym of cognitive
therapy.
It is a structured, short-term, present oriented form of therapy, solving current
problems of the client and modifying dysfunctional thoughts.
The theory underlying CBT:
The Cognitive Model
The cognitive model proposes that dysfunctional thinking is common to all
psychological disturbances. By evaluating thinking in a more realistic way,
someone will subsequently improve in his or her emotional state.
Automatic thoughts emotions
behavior
CBT is used to target the first component: automatic thoughts. This is done by
modifying deeper beliefs and assumptions about the self, others and the world,
which are thought to make a more lasting change. By doing this, the automatic
thoughts (which are a product of these deeper beliefs and assumptions) will be
modified indirectly.
Basic principles of treatment:
Although tailored to the individual, CBT knows some general principles:
1. CBT is based on an ever evolving formulation of the patient’s problems &
an individual conceptualization of each patient (in cognitive terms). This
conceptualization involves:
Current thinking
Precipitating factors
Key developmental events & enduring patterns of interpreting these
events
2. CBT requires a sound therapeutic alliance, involving warmth, empathy,
competence and genuine regard
3. CBT emphasizes collaboration & active participation (team-work)
4. CBT is goal oriented and present focused
5. CBT initially emphasizes the present, the only time attention shifts to the
past is when
Patient has a strong preference to do so
Patient gets stuck in their dysfunctional thinking patterns and
understanding of childhood could help this
6. CBT is educative, teaching the patient to be her own therapist &
emphasizes relapse prevention
7. CBT aims to be time limited (approximately 14 sessions)
8. CBT sessions are structured, maximizing efficiency and effectiveness
9. CBT teaches patients to identify, evaluate and respond to their
dysfunctional thoughts, using guided discovery (or: Socratic
Questioning) to evaluate thinking and behavioral experiments to test
their thinking (a collaborative exploration of evidence)
, 10.CBT uses a variety of techniques to change thinking, mood and behavior.
The technique you choose depends on your conceptualization of the
patient and the specific problem.
A therapy session…
- … begins with checking the patient’s mood, symptoms and experiences
from the past week and reviewing homework assignments
- … discusses a specific problem that the client had put on the agenda,
collaboratively plans a strategy for this problem and linking homework
assignments to this
- … ends with reviewing the important points of the session and feedback
of the client
Developing as a cognitive behavior therapist:
Stage 1 learning basic skills of conceptualizing, based on the intake evaluation
& data collection in
session. Learning to structure the sessions and planning treatment.
Helping the patient solving their dysfunctional thoughts. Learning basic
cognitive and behavioral techniques
Stage 2 Integrating your knowledge of techniques in the conceptualization.
More easily identifying
goals of the treatment. Expanding repertoire of techniques.
Stage 3 Varying in techniques, being able to treat patients with personality
disorders.
