Cognitive It can also be used to

 

 

 

 

 

 

 

 

 

 

 

Cognitive
Behavioral Therapy (CBT)

Ashley
Barker

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California
State University, Chico

 

 

 

 

 

 

 

 

Introduction

            The reason that this model was chosen
is because of the variety of mental disorders that it has the ability to
successfully treat.  The techniques used
in this model work for both adults and children.  It focuses on reframing negative thoughts and
replacing them with positive thoughts. 
This is a model that throughout the research indicates a high
probability of success and is one that is of particular interest of many
practicing clinicians.  

History of Development

            Cognitive Behavioral Therapy (CBT)
has been around since the 1960’s.  Stemming
from Albert Ellis’  “Rational Emotive
Behavior Therapy (REBT) is a type cognitive therapy first used by Albert Ellis
which focuses on resolving emotional and behavioral problems” (McLeod
2008).  The goal of REBT is to change
irrational beliefs to more rational ones; and subsequently persuades the person
to challenge these false beliefs through reality testing.  Ellis developed this model in the early 1960’s.  In 1957 Ellis also created “The ABC Model.”  Ellis’ model analyzes the process by which a
person has developed irrational beliefs as A-Activating Event or Object
situation, B-Beliefs, and C- Consequence. (McLeod 2008).  He further believes that (B) their beliefs
help cause the consequences (C) (McLeod 2008). 

            Not long after, a psychiatrist by
the name of Aaron Beck developed CBT or Cognitive Behavioral Therapy.  Beck “formulated
the idea for the therapy after noticing that many of his patients had internal
dialogues that were almost a form of them talking to themselves” (Foundation
Recovery Network 2017) it was at this time that Beck realized the importance of
“The link between thoughts and feelings was very important. He invented the
term automatic thoughts to describe emotion-filled
thoughts that might pop up in the mind” (Martin 2016).  Beck later called his finding CT (cognitive
therapy) because of the importance that it placed on thinking (Martin
2016).  CBT initially focused on people
with depression.  In 1967 Beck identified
“Three mechanisms that he thought were responsible for depression: (1) the
cognitive triad. (2) Negative self-schemas (3) Errors in logic.” (McLeod
2008). 

Population Intended for

            CBT is used to treat a wide variety of mental
health illnesses.  It has been cited that
it is effective in treating depression, anxiety, eating disorders, PTSD,
substance abuse, schizophrenia, along with many other mental illnesses.  It can also be used to treat medical
disorders such as irritable bowel syndrome due to the depression and anxiety
that often can come along with this illness. 
CBT can be used individually, in group settings, and in couple’s
therapy.  There is not one population in
and of itself that it is intended for. 
That is the beauty of this model. 
CBT is able to work with children, young adults, adults, as well as the
elderly.  CBT can be used with any
population regardless of age, ethnicity, or sexual orientation.  CBT can take place in any setting where the
client is comfortable.  This can include
an office setting, however can also include outdoors on a walk, playing a game
at a park, or in the comfort of the clients home.

Strategies
and methods used-(get reference)

            One of
the most common strategies/techniques used in CBT is reframing.  CBT is used by therapists to help people
overcome their negative thinking patters and replace them with healthier, more
positive thoughts.  CBT can often help
reprogram the negative thinking patterns associated with depression, anxiety,
eating disorders, etc. and often give lasting results.  There are seven techniques that Beck designed
for reframing negative thoughts while clients were not in sessions: According
to McGauran “(1) Counteract Negative Thoughts; (2) Brainstorming; (3) Conduct
Thought & Behavior Patterns; (4) Use Visualization, Morning and Night;
(5)Practice Positive Thinking; (6) Scheduling Daily Positive Activities; (7) Re-frame
Disappointment as Normal” (McGauran n.d.).  Beck explained that
“learning to differentiate between direct consequence of one’s own actions and
those that were out of your control you have to let go (Beck 2012). 

            Beck also speaks
about cognitive distortions which are “faulty ways of thinking that convince us
of a reality that simply is not true.” (Beck 2012).  He says there are 15 main cognitive distortions
that can plague even the most balanced thinkers at times:  (1) Filtering; (2) Black and White Thinking;
(3) Overgeneralization; (4) Jumping to Conclusions; (5) Catastrophizing/Magnifying
or Minimizing; (6) Personalization; (7) Control Fallacies; (8) Fallacy of
Fairness; (9) Blaming; (10) Shoulds; (11)Emotional Reasoning; (12) Fallacy of
Change; (13) Global Labeling/Mislabeling; (14) Always Being Right; (15)
Heaven’s Reward Fallacy. (Positive Psychology Program 2015).  These
techniques are most commonly used while with the therapist during the
session. 

What the
practitioner actually does

            CBT is a
typically a structured type of therapy and it is 100% based on how the client
is right now.  Typically, before a
session begins, CBT clinicians have their clients fill out certain forms to
assess their mood which provide them with an objective method of assessing
symptoms.  Then, clinicians will ask in
the client in their own works how they are feeling this week compared to other
weeks.  This is often called “mood
check.” and it helps guide the session for the day.  Next, the clinician
will often ask what types of problems that they’ve had the previous week and if
they see any upcoming the next week which allows the clinician to figure out
the agenda for the day.  The clinician
may bring up last week’s session as well as last week’s homework; also about
anything positive that may have occurred last week.  Together, clinician and client will
prioritize the session, decide which items are most important to cover, and how
they would like to spend their session together.  In the middle of the session, the client and
the clinician will discuss the problems the client put on the agenda.  Usually that is a combination of problem
solving, assessing, and the usefulness of the client’s thoughts and beliefs in
the problematic situation.  The clinician
will teach the client new skills that may involve modifying maladaptive
thinking and behavior.  We may also
record her homework in writing, responding to clients unhelpful or distorted
think and practicing behavioral skills. 
At the end, the clinician may often ask for feedback about how the
session went and give room for thoughts about change for future sessions.

Research
regarding its effectiveness

            In an
article titled “The Efficacy of Cognitive Behavioral Therapy: A Review of
Meta-analyses,” research was done on 106 Meta analytic studies.  Results indicated that despite having weaknesses in some areas, it is clear
that the evidence-base of CBT is enormous. The areas that were studied were:
substance use disorder, schizophrenia and other psychotic disorders, depression
and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders,
eating disorders, insomnia, personality disorders, anger and aggression,
criminal behaviors, general stress, distress due to general medical conditions,
chronic pain and fatigue, distress related to pregnancy complications and female
hormonal conditions. 

             The
research included:  16 quantitative
reviews that included 332 clinical trials covering 16 different disorders or
populations (listed above). To obtain the articles for the review, the
researchers searched various databases to gather information.  Their initial search yielded 116
articles.  They excluded duplicate
articles, only articles from the year 2000 and newer as well as they could only
be quantitative in nature and only focused on CBT.  The final sample included in this review
consisted of 269 meta-analyses. “Out of those, we described a representative
sample of 106 meta-analytic studies. The final sample included in this review
consisted of 269 meta-analyses. Out of those, we described a representative
sample of 106 meta-analytic studies” (Hoffman et. Al. 2012). 

            The
next study researched focused on patients suffering from Irritable Bowel
Syndrome and the medical and mental health symptoms that are present with this
condition.  The study focused on treating
the patients with just medical treatment and with a combination of medical
treatment and CBT.  50 IBS patients were
selected from a Gastro ology Clinic and split into groups of medical treatment
and medical treatment with psychotherapy. 
All 50 patients had no prior mental health diseases and were between the
ages of 18-60.  Two tests were
administered to them by a psychologist: 
ROME-II (IBS symptoms index) and SCL-90-R (evaluates psychological
symptoms) (Mahvi-Shirazi et. Al. 2012).   CBT was conducted for
8 weeks for the case group while they were taking their medications.  The other group only took the
medication.  The two groups were compared
for reduction of IBS syndromes as well as regards the level of mental health
after the 8 weeks.  Both groups were then
re-tested with the ROME-II and the SCL-90-R for pre and post results. In
conclusion, the study shows that decreased anxiety, depression and medical
issues in the 80th percentile were found in the case group.  The other group did not see the same results,
although with medication alone they did see a reduction in symptoms.  Even with CBT and medication, there was not a
reduction in intestinal symptoms. This shows that CBT probably increases organ
sensitivity through changing the cognitive response. 

            The
final study researched the effectiveness of CBT with delusional disorders. 

 

 

 

           

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

25 CBT Techniques and
Worksheets for Cognitive Behavioral Therapy. (2017, October 19).         Retrieved December 08, 2017, from https://positivepsychologyprogram.com/cbt-        cognitive-behavioral-therapy-techniques-worksheets/

Beck, P. J. (2012,
January 26). Structure of a CBT Session. Retrieved December 08, 2017, from             https://www.huffingtonpost.com/judith-s-beck-phd/cognitive-therapy_b_1224375.html

Cognitive behavioural
therapy versus other psychosocial treatments for schizophrenia. (2012,        April 18). Retrieved December 15, 2017,
from             http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008712.pub2/full

Hofmann, S. G., Asnaani,
A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012, October 01). The       Efficacy of Cognitive Behavioral Therapy:
A Review of Meta-analyses. Retrieved        December
08, 2017, from             https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/#R13

Mahvi-Shirazi, M.,
Fathi-Ashtiani, A., Rasoolzade-Tabatabaei, S., & Amini, M. (2012, February   29). Irritable bowel syndrome treatment:
cognitive behavioral therapy versus medical      treatment.
Retrieved December 11, 2017, from      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309448/

Martin, B. (2016, July
17). In-Depth: Cognitive Behavioral Therapy. Retrieved December 08,       2017, from
https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/

McGaraun, D. (n.d.). 7
Cognitive Behavioral Techniques to Help Reframe You’re Thinking.         Retrieved December 08, 2017, from http://www.activebeat.com/your-health/7-cognitive-       behavioral-techniques-to-help-reframe-your-thinking/

McLeod, S. (1970, January
01). Saul McLeod. Retrieved December 08, 2017, from             https://www.simplypsychology.org/cognitive-therapy.html

The Development of
Cognitive Behavioral Therapy. (2017, July 05). Retrieved December 08,       2017, from https://www.foundationsrecoverynetwork.com/development-cognitive-      behavioral-therapy/

 

 

 

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