Summary
Introduction to cognitive behavioral therapies
Literature:
Farmer & Chapman (2016). Behavioral interventions in cognitive behavior therapy: Practical
guidance for putting theory into action (2nd edition)
- Chapter 1 - Overview
- Chapter 2 - Principles, goals, and structure of initial assessment sessions
- Chapter 3 - Behavioral case formulation and treatment planning
- Chapter 4 - Changing behavior by changing the environment
- Chapter 8 - Behavioral activation
- Chapter 9 - Exposure-based interventions
Beck. J. (2021). Cognitive Behavior Therapy, Basics and Beyond (2nd edition)
- Chapter 1 - Introduction to Cognitive Behavior Therapy
- Chapter 3 - Cognitive Conceptualization
- Chapter 7 - Activity Scheduling
- Chapter 12 - Identifying Automatic Thoughts
- Chapter 13 - Emotions
- Chapter 14 - Evaluating Automatic Thoughts
- Chapter 15 - Responding to Automatic Thoughts
- Chapter 17 - Introduction to Beliefs
- Chapter 18 - Modifying Beliefs
Himle & Franklin (2009). The more you do it, the easier it gets: Exposure and response
prevention for OCD. Cognitive and Behavioral Practice
Craske, Treanor, Conway, Zbozinek & Vervliet (2014). Maximizing exposure therapy: An
inhibitory learning approach. Behavior research and therapy
van den Hout & Engelhard (2012). How does EMDR work? Journal of experimental
Psychopathology
Mankiewicz & Turner (2014). Cognitive restructuring and graded behavioral exposure for
delusional Appraisals of Auditory Hallucinations and Comorbid Anxiety in Paranoid
Schizophrenia. Case reports in Psychiatry
Sivec & Montesano (2012). Cognitive behavioral therapy for psychosis in clinical
practice. Psychotherapy
Jansen, Schyns, Bongers & van den Akker (2016). From lab to clinic: Extinction of cued
cravings to reduce overeating. Physiology and Behavior
Arntz, Drost & van Genderen (2009). Schema Therapy for Borderline Personality Disorder.
(2nd edition)
,Bamelis, Evers, Spinhoven & Arntz (2014). Results of a multicenter randomized controlled
trial of the clinical effectiveness of schema therapy for personality disorders. The American
Journal of Psychiatry
De Klerk, Abma, Bamelis, & Arntz (2016). Schema therapy for personality disorders: a
qualitative study of patients and therapist perspectives. Behavioral and Cognitive
Psychotherapy
Nysæter & Nordahl (2008). Principles and clinical application of schema therapy for patients
with borderline personality disorder. Nordic Psychology
Ostafin, Bauer & Myxter (2012). Mindfulness decouples the relation between automatic
alcohol motivation and heavy drinking. Journal of social and clinical psychology
Salmon, Sephton, Weissbecker, Hoover, Ulmer & Studts, (2004). Mindfulness Meditation in
Clinical Practice. Cognitive and Behavioral Practice
Eifert, Forsyth, Arch, Espejo, Keller & Langer (2009). Acceptance and commitment therapy
for anxiety disorders: Three case studies exemplifying a unified treatment
protocol. Cognitive and Behavioral Practice
, Farmer & Chapman
Chapter 1 - Overview
Cognitive Behavior Therapy (CBT) = therapeutic approaches that emphasize cognitive, behavioral,
emotional, psychological, and environmental factors in relation to psychological disorders.
The emergence of CBT:
- Social learning theory/social cognitive theory (Bandura) = elevated symbolic cognitive
processes to determinants of behavior.
o Reciprocal determinism = behavior, cognitive factors, and environmental influences
reciprocally and continuously interact and influence one another.
o Self-efficacy = an individual’s beliefs about one’s personal efficacy, or ability to
successfully perform coping behavior, were determinants of whether such behavior
will be demonstrated.
Three waves of CBT:
- First wave → behavior therapy to change associations.
o Systematic desensitization, aversive conditioning, reinforcement.
- Second wave → addition of cognitive therapy to change internal mediators (i.e., cognition).
o Thought records.
- Third wave → not changing content but the relation to the content.
o Mindfulness-based interventions (will be explained later on), cognitive defusion.
▪ Mindfulness-based Stress Reduction (MBSR).
• Mindfulness-based Cognitive Therapy (MBCT).
o Mindfulness skills.
o Addition of valued activities.
• Mindfulness-based Relapse Prevention (MBRP).
• Mindfulness-based Eating Awareness Training (MB-EAT).
▪ Acceptance and Commitment Therapy (ACT).
• Decentering = mental content experienced as passing thoughts and
feelings that may or may not have some truth in them.
▪ Dialectical Behavior Therapy (DBT).
Two phases in behavior therapy:
- Understanding behavior → analyzing, hypothesis based.
- Changing behavior → interventions.
The influential cognitive approach of Aaron & Beck:
- Primary assumption → distorted and dysfunctional thinking influences mood and behavior.
Each disorder is defined by a unique set of thought distortions and core beliefs.
- Additional assumption → modification of underlying beliefs, or schemas, is required for
lasting change.
- Implication → promotion of realistic, accurate, and balanced thinking and the modification of
thinking will produce associated changes in mood and behavior.
Models of abnormality within psychology and psychiatry:
- Cognitive therapy → those with psychological disorders are often regarded as having
maladaptive schemas that serve as psychological nuclei of behavioral and emotional
disorders.
- Medical model approach → diseases or dysfunctional biological processes are often
presumed to underlie psychiatric syndromes.
, - Psychodynamic models → the quality, integration, and differentiation of internalized (self)
mental representations and the relative maturity of inner defensive coping mechanism are
etiologically relevant for psychological disorders.
The behavioral perspective about theory and therapy has a different view than the ones above:
- The search for internal causes of behavior is avoided. It is primarily concerned with what one
does and the contexts within which behavior occurs.
- Culture provides the context for referencing which behaviors are acceptable or valued and
which are deviant (abnormal). This also changes over time.
o Example → before 1970, homosexuality was seen as a mental disorder.
Behavioral perspectives → assumptions about the individual, the context within one lives, and the
factors that influence one’s behavior.
- Covert behavior = behavior within the individual.
- Overt behavior = behavior observed by others.
The three-term contingency = the interaction of a person with one’s environment, includes three
elements:
- Antecedents of behavior.
o Discriminative stimuli (Sd) = events that provide information about the likelihood
that the reinforcement or punishment will follow some type of behavior.
▪ Disruptive behavior of children in school is more likely to occur when
classmates reinforce this behavior, the presence of classmates is the Sd.
o Establishing operations (EO) / motivational operations = behavior is influenced by
changing the reinforcing or punishing characteristics of environmental events.
Internal events such as thoughts and hunger are common EOs.
▪ For people who often binge eat, negative thoughts about the self can be EOs
for binge eating behavior.
▪ Someone slapping you might be the EO to show aggressive behavior.
▪ Rule governed behavior = behavior that is influenced by verbal rules.
• Example → a person who is afraid of speaking in public can have a
verbal rule such as: “If I speak in front of a public, I will be evaluated
negatively” and because of this the person will avoid public speaking.
o S-delta = situations or circumstances in which the behavior does not take place.
o Depends on a person’s learning history.
▪ Example → if a certain form of behavior was performed in similar situations
before, and if such behavior resulted in reinforcing outcomes, then the
behavior is more likely to occur in comparable future environments.
- Behavior itself.
o Both covert and overt behavior.
- Consequences that follow behavior.
o The effect that the behavior produces (immediate and delayed).
o Behavior is reinforced if the consequences that follow behavior increase the
likelihood of that behavior to occur again.
Changing behavior with the following changes:
