Cognitive Behavioral Therapy

Wayne State University - SW 7070

Melissa Gibbons, Brittany Sherman,
Danielle Wray, Lilly Pearce, Mary Corbeill
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is one of the leading evidence-based practice
treatment methodologies.

2 Original Cognitive Interventions

1962 1976
Rational-Emotional Cognitive Therapy
Behavior Therapy (CT)
(REBT) A.T. Beck
Albert Ellis
History of Cognitive Behavioral Therapy
The First Wave (1940s)

Behavioral Therapy as a short

term therapy for anxiety and
depression after WWII vets
returned.

Challenged psychoanalytic
Freudian therapy
History of Cognitive Behavioral Therapy
The Second Wave (1960s)

Cognitive Revolution

Social Psychology

Understanding ways individuals interact and think about each other

Development of Computer Science and Programming

Understanding how computers think

A combo of these disciplines helped create CBT by looking at human cognition in

the same way as computer cognition
History of Cognitive Behavioral Therapy
The Third Wave (2006)
Focus on control and emotional
avoidance
Controlling thoughts
Solution or problem?
Adaptive Behavior and controlling
internal experiences
Major Third Wave Therapies
Acceptance and Commitment
Therapy (ACT)
Mindfulness Based Cognitive
Therapy (MBCT)
Dialectical Behavior Therapy
(DBT)
Behavioral Activation (BA)
Functional Analytic
Psychotherapy (FAP)
Cognitive Behavioral Analysis
System of Psychotherapy
(CBASP)
Integrative Couple Therapy (ICT)
 Distinguishing Features of CBT
10 Distinguishing Features
- Active Approach
mentioned by Granvold (2010). - *Can anyone think of benefits of
assigning clients homework?*
- Idiosyncratic Subjective - Educational Model
Experience - Socratic Methods
- Collaborative Effort - Empirical Focus
- Time-Limited Treatment
- * Can anyone think of what issues - Relapse Prevention
a client might have that impedes
on their motivation to change?*

- Unconditional Regard for Self (Granvold, 2010).

and Others
Overview of CBT
CBT aims to change thought patterns and behaviors

Short term and goal orientated

Changes clients attitude and behavior by focusing on thoughts, beliefs and

attitudes that are held and relates to behavior

One person changes the behavior of another by changing the world in which he
lives. In doing so, he no doubt changes what the other person feels or
introspectively observes". -B.F. Skinner (1974, p. 181)
Behavioral Theory is one of the oldest and most extensive theories applied to
clinical social work.
Overview of CBT
-In the 1930s, 40s, and 50s, Behavioral Theory was overshadowed by Psychodynamic
theorizing in clinical social work but reappeared in the 1960s, along with cognitive-
behavioral theories and therapies.

-Strom (1994) surveyed a random sample of practicing clinical social workers. The
study found that 67% used cognitive-behavioral orientation in their work and 32%
used it along with another theoretical orientation.

-Carey and Foster (2013), stated "there is perhaps a case to be made that
behaviorism has provided a pragmatic and common sense foundation upon which so
much social work practice has been applied" (p. 254).
Overview of CBT
-A behavioral approach to clinical social work rests on a conceptual foundation known
as Social Learning Theory (SLT), used to understand behavior.

-Behaviorism is a philosophy of science that contains certain assumptions and

positions regarding ontology, epistemology, ethics, determinism, language, etc.
Social Learning Theory
Social Learning Theory is used to explain social behaviors

Human behavior is what we do

Most human behavior is learned by experience

Fundamental learning occurs

Involves interpersonal behavior

There are different ways of learning

A basic assumption is that human behavior is the product of the interactions

between the individual and the environment.
Social Learning Theory
Respondent Learning

Operant Learning

Positive Reinforcement

Negative Reinforcement

Positive Punishment

Negative Punishment

Observational Learning
Respondent Learning (Classical Conditioning)

Desired Stimulus + Neutral Stimulus = Response

Soon, Neutral Stimulus = Response

Example: Pavlovs Dog

Operant Learning
Uses positive or negative
reinforcement or punishment

Positive = Gain
Negative = Loss
Reinforcement = increase
behavior
Punishment = decrease Positive Reinforcement
behavior Negative Reinforcement

Positive Punishment

Negative Punishment
Operant Learning - Positive Reinforcement
Rewarding

Increase in a behavior due to a gain.

Ex. A child volunteers to answer in

class and is praised by her teacher for
answering. Volunteering is
strengthened. Here, praise and social
approbation are functioning as a
reinforcing consequence.
(Thyer & Meyers, 2014, p. 25)
Operant Learning - Negative Reinforcement
Relief

Increase in behavior due to loss.

Ex. You step out into the bright

sunlight and your eyes hurt. Putting
on sunglasses alleviates the pain.
In the future, you are more likely to
put on your sunglasses in bright
light.
(Thyer & Meyers, 2014, p. 26)
 Operant Learning - Positive Punishment
Decrease in behavior due to gain.

Ex. A child uses a curse word in front

of a parent and is slapped hard across
the mouth. In the future, the child uses
that curse word less often in front of
that parent.
(Thyer & Meyers, 2014, p. 26)
Operant Learning - Negative Punishment
Decrease in behavior due to loss.

Ex. A child acts out and a parent

takes away their favorite toy. The
child is less likely to act out in the
future.
Observational Learning
Modeling behavior.

Learning by watching others.

Ex. Youtube tutorials.

 Cognitive Theory
Cognitive Theory involves understanding an individuals thought processes

Piaget (1936): Origins of thinking

Ellis (1977) vs. Beck (1985)

Major Interventions in Cognitive Therapy:

- Changing misconceptions

- Modifying irrational statements

- Enhancing problem-solving

- Enhancing self-control

(Thyer & Myers, 2014)

 Cognitive Theory (cont.)
Ellis believed that irrational beliefs were the main source of cognitive disorders

Examples of Irrational Cognitions (from Ellis)

- Competence

- Must be treated kindly

- Things should not be difficult

*Can anyone think of a real-life example of one of these irrational cognitions?

*Can anyone think of an environment that might foster one of these irrational
cognitions?
 Cognitive Theory (Cont.)
Becks contributions to Cognitive Theory:

- Originally focused on severely depressed individuals

- Is now applied to Diagnostic Statistical Manual (DSM)

- Focuses more on emotions than Ellis (McLeod, 2015)

- Emphasis on helping relationship

Both Ellis and Becks Cognitive Theories aim to educate clients

(Thyer & Myers, 2014)

 Relationship Between Social Learning and Cognitive Theories
Cognitive therapists acknowledge the importance of respondent, operant, and
observational learning.

Cognitive theory = expansion of Social learning theory

Therapists argue that more factors must be considered in understanding and

treating clients:

- People respond to cognitive representations of events

- Some cognition can be monitored and altered

- Altering cognition can change patterns of emotion and behavior

 Cognitive Targets of Assessment
o Cognitive Content
o Cognitive Process
o Schemas

(Corsini & Wedding 2013)

 Major CBT Approaches
o Cognitive Restructuring
o Rational Emotive Behavior Therapy: Rationality and
Irrationality; ABCs of REBT; Derivatives of Irrational Beliefs;
Unconditional Regard for Self and Others; Detecting and Disputing
Irrational Beliefs; Cognitive Homework; Emotive Techniques;
Behavioral Techniques
Major CBT Approaches continued
Cognitive Therapy and thinking
errors:
Dichotomous Thinking;
Overgeneralization;
Selective Abstraction;
Arbitrary Inference;
Magnification and
minimization;
Personalization
Main Uses of CBT
Problem solving

Individual therapy

Addictions

Depression and anxiety

Trauma
Effectiveness of CBT
Evidence based practice

Most frequently used intervention

Effective across backgrounds

 References
Corsini, R. J., & Wedding, D. (2013). Current Psychotherapies. Retrieved from
https://books.google.com/books?hl=en&lr=&id=67yuMhJ5ieQC&oi=fnd&pg=PA196&dq=rational%2Bemotional%2Bbehavior
%2Btherapy&ots=9wN1UWceYc&sig=cxswrmcs4w29PVVJa7n469_Iytk#v=onepage&q=rational%20emotional%20behavior
%20therapy&f=false

Granvold, D.K. (2010). Cognitive-behavioral therapy with adults. In J. R. Brandell (Ed.), Social Work Practice with Micro, Mezzo, and
Macro Systems Custom Edition (pp. 108-142). Thousand Oaks, CA: SAGE Publications, Inc.

McLeod, S. A. (2015). Cognitive Behavioral Therapy. Retrieved from www.simplypsychology.org/cognitive-therapy.html

Thyer, B.A. & Myers, L.L. (2014). Behavioral and cognitive theories. In J. R. Brandell (Ed.), Social Work Practice with Micro, Mezzo,
and Macro Systems Custom Edition (pp. 19-39). Thousand Oaks, CA: SAGE Publications, Inc.

Suffolk Cognitive Therapy. (2014). History of CBT. Retrieved from http://suffolkcognitivetherapy.com/web/specialties/history-of-cbt/

Walsh, F. (2014). Family Therapy. In J. R. Brandell (Ed.)Social Work Practice with Micro, Mezzo, and Macro Systems Custom Edition
(pp. 82- 107). Thousand Oaks, CA: SAGEPublications, Inc.