COGNITIVE THERAPY

Mark Lawrence Gale

Psychology Department
Adamson University
KEY FIGURES
Aaron Beck Albert Ellis
Donald
Meichenbaum
Albert Ellis
Rational Emotive
Behavior Therapy
View of Human Nature
Human beings are born with the potential for
both rational (straight) thinking and irrational
(crooked) thinking.

Human beings are fallible. We will continue to
make mistakes yet at the same time learn to
live more at peace with ourselves.

Human are self-talking, self-evaluating and
self-sustaining.
View of Human Nature
Human develop emotional and behavioral
difficulties when they mistake simple
preferences (e.g. love, approval, success) for
dire needs.

Humans have an inborn tendency toward
growth and actualization yet they often
sabotage their movement toward growth due
to their inborn tendency toward crooked
thinking and self-defeating behavior.
View of Emotional Disturbance
People do NOT need to be accepted and loved,
even though this may be highly desirable.

Blame is the core of most emotional disturbances.

We need to learn to accept ourselves despite our
imperfections.

We have the strong tendency to escalate our
desires and preferences into dogmatic shoulds,
musts, oughts, demands and commands.
View of Emotional Disturbance
Our hidden dogmatic musts and absolutistic
shoulds create disruptive feelings and
dysfunctional behaviors.

Examples of irrational beliefs:
I must have love or approval from all the significant
people in my life.
I must perform important tasks competently and perfectly
well.
If I dont get what I want, its terrible and I cant stand it.
People should have the same values and standards as
me.
A-B-C Theory of Personality
A
(Activating
Event)
B
(Belief)

C
(Emotional and
Behavioral
Consequences)
D
(Disputing
Intervention)
E
(Effect)

F
(New
Feeling)
Therapeutic Process
Therapeutic Goals
To minimize emotional disturbances and self-
defeating behaviors by acquiring a more realistic
and workable philosophy in life.

To reduce the tendency for blaming oneself or
others for what goes wrong in life and learning
ways to deal with future difficulties.

To induce people to examine and change some of
their most basic values that keeps them disturbed.
Therapeutic Process
Therapists Function and Role
Therapists need show first the clients that they have
incorporated many irrational beliefs. They must
encourage and persuade the clients to engage in
activities that will counter their self-defeating beliefs.

Therapists need demonstrate that clients are keeping
their emotional disturbance active by continuing to think
illogically.

Therapists should act as a teacher and help clients
modify their thinking and abandon their irrational ideas.
Therapeutic Process
Therapists Function and Role
Therapists have to challenge clients to develop a
rational philosophy of life so that in the future they can
avoid becoming the victim of other irrational beliefs.

Therapists have to explain how irrational cognitions
can be replaced with more rational ideas that are
empirically grounded.

Therapists also have to challenge clients in examining
why they are clinging to their old misconceptions
instead of letting them go.
Therapeutic Process
Clients Experience in Therapy
Once clients begin to accept that their beliefs are
the primary cause of their emotions and
behaviors, they are able to participate effective in
the cognitive restructuring process.

The client acts as a learner.

The clients are not encouraged to make
connections between their remote past and
present behavior.

Therapeutic Process
Clients Experience in Therapy
Clients are expected to actively work outside the
therapy sessions.

Homework is carefully designed and agreed on and
is aimed at getting clients to carry out positive
actions that induce emotional and attitudinal change

At the terminal phase of the therapy, clients review
their progress, make plans and identify strategies
for dealing with problems.
Therapeutic Process
Relationship Between Therapist and Client
Just like person-centered approachs unconditional
positive regard, the cognitive approach has the
concept of full acceptance or tolerance.

Therapists refuse to evaluate their clients as
persons while at the same time they are willing to
honestly confront clients nonsensical thinking and
self-destructive behavior.

Therapeutic warmth is deemphasized.

Therapeutic Process
Therapeutic Techniques and Procedures
The cognitive approach is multimodal and integrative in
nature.

It uses cognitive, affective and behavioral techniques to
make sure that the intervention is tailor fit to the needs
of the client.

The techniques are used to address several concerns
anxiety, depression, anger, marital difficulties, poor
interpersonal skills, parenting failures, personality
disorders, eating disorders, psychosomatic disorders,
addictions, etc.

Therapeutic Process
Therapeutic Techniques and Procedures
A. Cognitive Methods

1. Disputing Irrational beliefs
The therapist has to actively dispute the clients irrational
beliefs and teach them how to do this challenging on their
own.

2. Doing cognitive homework
Clients are expected to make lists of their problems, look for
their absolutistic beliefs, and dispute these beliefs.
Doing work outside the therapy sessions can help clients
revise their thinking, feeling and behavior effectively.
Therapeutic Process
Therapeutic Techniques and Procedures
A. Cognitive Methods

3. Changing ones language
Clients who use statements which reflect helplessness and
self-condemnation can learn new and positive statements.

4. Using humor
Emotional disturbances often result from taking oneself too
seriously and losing ones sense of perspective and humor
over the events of life.
Therapists can use humor to counterattack the over-serious
side of individuals.
Therapeutic Process
Therapeutic Techniques and Procedures
B. Emotive Techniques

1. Rational emotive imagery
Clients imagine themselves thinking, feeling and behaving
exactly the way they would like to think, feel and behave in
real life.

2. Role playing
Clients are allowed to rehearse certain behaviors to bring
out what they think and feel in the situation.
The focus is on working through the underlying irrational
beliefs that are related to unpleasant feelings.
Therapeutic Process
Therapeutic Techniques and Procedures
B. Emotive Techniques

3. Shame-attacking exercises
Clients need to work to feel unashamed over certain
behaviors even when others clearly disapprove of them.
Clients are likely to find out that other people are not really
that interested in their behavior.

4. Use of vigor and force
Clients are encouraged to do forceful dialogues with
themselves in which they express their irrational beliefs and
then powerfully dispute them.
Aaron Becks
Cognitive Therapy
Description
Cognitive Therapy is an insight-focused
therapy that emphasizes recognizing and
changing negative thoughts and maladaptive
beliefs.

In order to understand the nature of an
emotional disturbance, it is essential to focus
on the cognitive content of an individuals
reaction to the upsetting event or stream of
thoughts.
Description
Its main goal is to change the way clients think by
using their automatic thoughts to reach the core
schemata and begin to introduce the idea of
schema restructuring.

The clients are encouraged to gather and weigh
the evidence in support of their beliefs.

This is less directive, persuasive and confrontive
compared to Ellis REBT. It also views that the
quality of therapeutic relationship is very
important.
Cognitive Distortions
1. Arbitrary Inference
Making conclusions without supporting and relevant
evidence.
Mind reading: believing someone has a negative opinion
on you without checking it out with him/her.
Fortune telling: predicting things will turn out badly.
Catastrophizing: expecting the worst to happen.

2. Selective abstraction
Forming conclusions based on an isolated detail of an
event
Discounting and filtering: paying lots of attention to
negative events and neglecting positive experiences.
Cognitive Distortions
3. Overgeneralization
Holding extreme beliefs on the basis of a single incident and
applying them inappropriately to dissimilar events or
settings.

4. Magnification and minimization
Perceiving a case or situation in a greater or lesser light
than it truly deserves.

5. Personalization
Tendency for individuals to relate external events to
themselves even when there is no basis for making this
connection.

Cognitive Distortions
6. Externalization or External Blaming
You hold other people responsible for your pain.

7. Labeling and mislabeling
Portraying ones identity on the basis of imperfections and
mistakes made in the past and allowing them to define ones
true identity.

8. Emotional reasoning
Involves basing your judgments, decisions and conclusions
exclusively for your feelings. This is allowing your feelings to
rule your reasoning ability.

Cognitive Distortions
9. Control Fallacy
If you feel externally controlled, you see yourself as a
helpless individual or a victim of fate.
If you have the fallacy of internal control, you see yourself
as responsible for the pain and happiness of everyone.

10. Fallacy of Change
You expect that other people must change for you to be
happy.

11. Entitlement Fallacy
You believe that you are entitled to a problem-free and pain-
free existence. Life is often seen as unfair.

Cognitive Distortions
12. Heavens Reward Fallacy
You expect all your sacrifice and self-denial to pay off as
if there is someone keeping the scores. You feel bitter
when the reward does not come.

13. Polarized Thinking
Involves thinking and interpreting in all-or-nothing terms
or categorizing experiences in either-or extremes.

14. Should Statements
Strict rules which you set for yourself and others. These
work against self-acceptance (guilt) and accepting others
(anger/resentment).
Exercises
What is wrong with the following beliefs?

1. My teacher does not like me. I just know it.
2. Youre just saying that Im good because youre my
friend.
3. I did everything to make him happy, why did he
hurt me this way?
4. I will not adjust to them. They will adjust to me.
5. I just know she would turn me down.
6. Its because of you that I feel bad.
7. Ill be happy only if you will talk to me.
Limitations and Criticisms
Ellis REBT
It does not encourage clients to recount their
long tales of woes.

Personal warmth, empathy, transference and
caring are not considered as essential ingredients
for effective therapy.

Some clients have troubles interacting with a
confrontive therapist and they tend to terminate
the therapy.
Limitations and Criticisms
Ellis REBT
Not enough emphasis is given in encouraging clients to
express and explore their feelings.

Past unfinished businesses and childhood experiences
are ignored.

REBT therapists can misuse their power by imposing
their ideas of what constitutes rational thinking.

Client sometimes see this approach as a process of
persuasion, indoctrination, logic and advice.
Limitations and Criticisms
Becks Cognitive Therapy
Focuses too much on the power of positive thinking.

The approach does not encourage emotional
ventilation or emotionally re-experiencing painful
events.

Focuses only on eliminating symptoms but failing to
explore the underlying causes of difficulties

Ignores the role of unconscious factors.
ANY QUESTIONS?
THANK YOU!