Matt Butler MSSA LISWS LICDC Clinical Supervisor Objectives for Today Were going to do these things this afternoon Discuss the history and underlying theory behind CBT Learn and practice specific CBT skills for use with persons with a substance use disorder ID: 910297
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Slide1
Cognitive Behavioral Therapy for Beginners
Matt Butler, MSSA, LISW-S, LICDC
Clinical Supervisor
Slide2Slide3Objectives for Today
We’re going to do these things this afternoon:
Discuss the history and underlying theory behind CBT.
Learn and practice specific CBT skills for use with persons with a substance use disorder.
Review shortcomings of a CBT-based approach.
Make a plan for future training and refinement of these skills.
Slide4CBT: Where’d it come from?
Aaron Beck (the 1960s)
Experiments on depression
“Automatic Thoughts”
CT became CBT!
Slide5CBT: What is it?
If you heard me say “You feel the way you think”, what would that mean to you?
“A psycho-social intervention that aims to improve mental health and…focuses on challenging and changing cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies.” (APA)
Slide6Breaking down the CBT definition:
Cognitive: mental processes.
Behavior: everything you do.
Therapy: how we try to address an issue.
Slide7Basic Principles of CBT:
A scientific approach
Brief and time limited
Present centered
Thought focused
Practice and homework
Slide8Two main aspects of CBT interventions:
Functional Analysis
Skills Training
Slide9Looking at thinking:
Look at these ten different people and their reaction to the same event (having their partner treat them inconsiderately):
Angry
Depressed
Jealous
Hurt
Guilty
Anxious
Happy
Annoyed
Disappointed
Ashamed
Slide10What’s a thinking
error?
Slide11Types of Thinking Errors
Catastrophizing
All-or-Nothing Thinking
Fortune-Telling
Mind-Reading
Emotional Reasoning
Overgeneralizing
Labelling
Making Demands
Mental Filtering
Disqualifying the positive
Low Frustration Tolerance
Personalizing
Slide12Learn your ABCs…
Activating Event
Beliefs
Consequences
Slide13Let’s Practice!
Now practice: In your small group, one of you pick a time when something upsetting happened to you that led to you feeling or acting badly. The other person should talk you through the ABCs (Activating Event, Beliefs, Consequences):
What happened? (Activating Event)
How did you respond? (Consequences)
What thoughts did you have that led you to that response? (Beliefs)
Next, ask questions about the beliefs and challenge whether they’re accurate.
How should you use the ABC model?
Slide14Debrief!
Slide15CBT for Substance Use Disorders:
Functional Analysis
What are some thoughts, feelings and behaviors that lead to a person using?
Skills Training
Learn different coping skills other than use.
Slide16Thoughts on CBT for Substance Use Disorders:
CBT appears to be effective for SUD.
Individual or group settings.
Motivational Interventions
Contingency Management
Relapse Prevention
Different strategies for different DOC
Often encouraged
by justice system
Slide17Let’s Practice (Again)!
Thoughts
:
What was going through your mind?
Feelings
:
How did you feel physically and emotionally?
Behaviors
:
What did you do next? (Use or skills)
Positive Results
:
What did you like about drinking/using?
Negative results
:
What bad things happened after you used/drank?
Do a Functional Analysis for SUD:
Slide18Slide19CBT: The Drawbacks
Sometimes, the problem isn't in your head.
Many EBPs aren't normed for everyone.
Some clients feel this technique is superficial.
Maybe you're not interested in homework?
If all you have is a hammer...
Trauma-informed care is important.
CBT doesn't work as well as it used to!
Slide20How can you get better at this?
Do more CBT training!
Look up resources! (Books, videos, worksheets)
Practice some of these skills in your own life.
Try to judge times when CBT is appropriate (they aren’t all).
Slide21Any
questions?
Slide22Call or email anytime!
Matt Butler
(440)855-3236
Matt.butler@cccohio.com
Slide23References
“Cognitive
Behavioural
Therapy for Dummies”, Branch, R. and
Willson
, R.: Wiley (2010).
https://hawaiianrecovery.com/rehab-blog/cognitive-behavioral-therapy-cbt
https://americanaddictioncenters.org/cognitive-behavioral-therapy
https://www.healthline.com/health/abc-model#how-it-works
https://www.simplypsychology.org/cognitive-therapy.html
https://beckinstitute.org/about-beck/history-of-cognitive-therapy/
https://bettertherapy.com/blog/not-cbt-therapist/
https://www.theguardian.com/lifeandstyle/2015/jul/03/why-cbt-is-falling-out-of-favour-oliver-burkeman
“Feeling Good: The New Mood Therapy”, Burns, D.: Harper (2008).
https://www.mentalhealth.va.gov/substanceuse/cbt-sud.asp
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/