CBT

• The therapist encouraging the client to continue imagining until:
• 1.) The client imagines getting through the cisis and feel better OR
• 2.) The client imagines an ultimate catastrophe, such as death. The therapist questions the client to determine the special significance of the catastrophe

The therapist helps the client imagine him or herself at some point in the near future when they are past the obstacle or distressing event.

Guiding the client to imagine that he or she is coping with a difficult situation

Teaching the client to reimagine the image, changing the ending. This helps the client imagine what might be possible, and th client and therapist could work to try to realize these possibilities

treating the image like a verbal automatic thoughts using standard Socratic questioning

Helpful when the client is imagining an exaggerated, though not catastrophic, outcome.

not as changeable as automatic thoughts, but are still more changeable than core beliefs

If-then statements

broad negative evaluations

rigid imperatives usually containing a "must" or "should"

• behaviors the client developed to cope with the painful core belief
• "If I do [compensatory strategy], then [core belief] may NOT come true."

Avoid negative emotion, try to be perfect, be overly responsible, avoide intimacy, seek recognition, avoid confrontation, purposely appear incompetent, avoid responsibility

• 1.) Therapist identifies key automatic thought
• 2.) Therapist asks the client for the meaning of this thought
• 3.) Therapist continues this until one or more important beliefs are uncovered
• 4.) Asking what thought means TO the client often uncovers intermediate belief
• 5.) Asking what thought means ABOUT the client often uncovers a core belief

when the client shows a negative shift in affect or begins to state the belief in the same or similar words

• Charts the relationship between core beliefs, intermediate beliefs and the automatic thoughts
• A cognitive map of the client's psychopathology
• Helps organized the data the client presents

• Arguing between parents or other family members
• Divorce
• Negative interactions with parents, siblings, peers or teachers where the child felt blamed or devalued
• Illness
• Death
• Abuse

Therapist helps client evaluate the belief in the context of specific situations. The questions are more persuasive and leading

Socratic questions, behavioral experiments, cognitive continuum, rational-emotional role play

Correcting polarized thinking, helping the client see that there is a middle ground

• Unlovability
• Incompetence
• Helplessness
• Dangerous environment or other people
• Hopeless future

in childhood as a person interacts with significant others and encounters a series of situations

• Unlovable: unworthy, undesirable, defective
• Incompetent: failure, inferior, not good enough, loser, disrespected

Personally helpless - powerless, vulnerable, trapped, out of control, weak, needy

• Downward arrow technique
• Watching for central themes in the client's automatic thoughts
• watching core beliefs expressed as automatic thoughts

encourages the client to look for evidence that supports a new belief, and to reframe evidence that seemed to support the old belief

helps the client reframe developmental history

helps the client restructure the meaning of an earlier event related to the current distressing situation

people's emotions and behaviors are influenced by their perception of events, not by the event directly

rules, attitudes, and assumptions where the person applies their core beliefs to the demands of everyday life

consistent logical errors in thinking

quick, evaluative situation-specific thoughts that come from deeper beliefs; not deliberative

attend to shift in affect and ask, "What went through your mind just then?"

• Extra-therapeutic factors (40%): larger culture, SES, career, events, family, social support
• Common factors (30%): core conditions of therapy, therapeutic alliance
• Expectancy factors (15%): therapists's social influence on client, placebo effect.
• Specific therapy techniques (15%): CBT

The development and maintenance of the therapeutic relationship.

• Empathic Understanding
• Positive Regard
• Congruence
• Therapeutic Alliance

the degree to which the therapist is successful in communicating personal comprehension of the client's experience

the extent to which the therapist communicates non-evaluative caring and respect

the extent to which the therapist is non-defensive, real, and "non-phony"

• typically easy to form with Axis I disorders and hard with Axis II
• Involves goals that both the client and the therapist endorse
• Collaborative tasks and behaviors and processes within the therapy session that constitute the actual work of therapy
• The positive interpersonal attachment between therapist and client of mutual trust, confidence, and acceptance (bonds)

face the client squarely, provide and open posture, at times lean toward the client, maintain eye contact, and relax

Minimal encouragers and restatements of client's behavior, cognition, and affect?

using silence in a counseling session. It demonstrates the therapist's concern unwillingness to let the client assume control of their part in the therapeutic process.

Expertise, attractiveness

visible evidence such as diplomas; professional dress; reputation of yourself or your institution; acting like you have experience, education and training; having confidence in your theoretical model

the client's perception of your similarity and compatibility with them, an dhow much they like you.

• Dysfunctional thinking is common to all psychopathology
• A change in thinking improves mood and behavior
• Long-lasting improvement comes from changing underlying dysfunctional beliefs

• 1. Based on an evolving formulation of clients and their problems in cognitive terms
• 2. Requires a good therapeutic alliance
• 3. Emphasizes collaboration and active participation
• 4. Goal oriented and problem focused
• 5. Initially emphasizes the present
• 6. Teaches clients to be their own therapists
• 7. Tries to be time-limited
• 8. Sessions are structured
• 9. Teach patients to identify evaluate and respond to their dysfunctional thoughts and beliefs
• 10. Uses a variety of techniques to change thinking, mood, and behavior

• ATs exist with the general stream of consciousness, and are not based on reflection or deliberation
• May be verbal, visual, or both
• Are usually brief and the client more aware of the resulting emotion, which is logically connected to the AT
• ATs are fairly predictable once the clients underlying beliefs are identified

• Often distort reality
• Emotionally distressing
• Interfere with clients' ability to reach their goals

• ATs that arise in the therapy session
• Associated with a change in emotion
• May be about the client, the therapist, or the topic of discussion
• The most important ATs to work with

Marked distress

• When it hinders a client from:
• Thinking clearly
• solving problems
• act effectively
• Gain satisfaction

polarized; viewing a situation in only two categories instead of on a continuum, which is usually more realistic

evaluating a problem as being awful, horrible, unbearable, and uncontrollable rather than something manageable

disqualifying the positive: unreasonably telling yourself that positive experiences, deeds, or qualities do not count

thinking something must be tru because you"feel" believe it so strongly, ignoring or discounting evidence to the contrary

predicting the future negatively without considering other, equally (or more) likely outcomes

putting a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less disastrous conclusion

Evaluating yourself, another person, or situation, and unreasonably magnifying the negative and/or minimizing the positive

• (selective abstraction)
• Paying undue attention to one negative detail instead of seeing the whole picture

believing you know what others are thinking, failing to consider other, more likely possibilities

making sweeping negative conclusions that go far beyond the current situation

believing others are behaving negatively because of you, without considering more plausible explanations for their behavior

having a precise, fixed idea of how you or others should behave and overestimating how bad it is when these expectations are not met

Only seeing the negative aspects of the situation

• Establish trust and rapport
• Assess suicidality
• Socialize the client into cognitive therapy
• Educate the client about his/her disorder/diagnosis
• Normalize the client's difficulties and instill hope
• Make sure the client has realistic expectations for therapy
• Gather information about the client's difficulties
• Use this information to develop a list of goals

the social context of intervention research that has been applied to behavior modification

judgments by laypersons, clients, and others of whether treatment procedures are appropriate, fair, and reasonable for the problem that is to be treated

guides the use of interventions that might be aversive. In some situations restrictions might be required, for example to protect children from seriously injuring themselves

to develop prosocial and adaptive behaviors

an increase in the probability or likelihood of a response following the presentation of a positive reinforcer

verbal praise, attention, physical contact, and facial expressions

• High probability behaviors;
• of any pair of response or activities in which an individual engages, the more frequent one can reinforce the less frequent one.

• the knowledge of results of one's performance;
• does not necessarily include additional events that may be reinforcing in their own right.

tokens function in the same way that money does in national economies, they are earned and then used to purchase more primary reinforcers such as food and other consumables, activities, and privileges.

a behavior is increased or strengthened when it results in escape from or avoidance of an aversive event

the presentation or removal of events that reduces the possibility or likelihood of the response in the future.

inherently aversive events, unlearned

stimuli that acquire their aversive properties by being paired with events that are already of aversive

reprimands, warnings, disapproval, saying "no" and threats

rarely used, and restricted to persons who engage in behaviors dangerous to themselves or to others and who have not responded to other procedures

the removal of a positive reinforcer for certain period of time as a punishment procedure.

the loss of a positive reinforcer, typically a penalty that comes after a behavior

the penalty for engaging in an undesirable behavior, performing some other behaviors in this situation

correcting the environmental effects of the inappropriate behavior

repeatedly practicing the appropriate behavior

• Delay
• Schedule
• Social Reinforcement
• Variation

withholding reinforcement from a previously reinforced response

an increase in responding at the beginning of the extinction

the temporary reoccurrence of the unreinforced response during extinction

behaviors that a person deliberately undertakes to acheive self-selected outcomes

Assessment of mental health, screening

systematically observing one's own behavior over time.

behaviors are performed in the presence of specific stimuli.

the individual is free to reward him or herself at any time, regardless of whether a particular response is performed

training a person to engage in response to interfere with or replace an undesirable response?

providing info to people about their ongoing physiological processes

• Developed by Albert Ellis
• based on view that psychological problems arise from faulty or irrational thought patterns

to examine the implicit self-verbalizations people make, challenge them and point out the irrationality, and to substitute more adaptive self-verbalizations