Structure Strategy Cognitive Therapy Training Session 1 Introduction to the Cognitive Model The cognitive model proposes that distorted or dysfunctional thinking which influences the patients mood and behavior is common to all psychological disturbances ID: 712789
Download Presentation The PPT/PDF document "Cognitive Therapy Model" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Cognitive Therapy
Model
Structure StrategySlide2
Cognitive Therapy
Training Session 1: Introduction to the Cognitive ModelSlide3
The cognitive model proposes that distorted or dysfunctional thinking [which influences the patient’s mood and behavior] is common to all psychological disturbances.
[Beck, Cognitive Therapy: Basics and Beyond, p.1]
The Cognitive ModelSlide4
Cognitive Therapy is based on an ever-evolving formulation of the patient and his/her problems in cognitive terms.
Cognitive Therapy requires a sound therapeutic alliance.
Cognitive Therapy emphasizes collaboration and active participation.
Cognitive Therapy is goal oriented and problem focused
Cognitive Therapy initially emphasizes the present
[
Beck,J. (1993) Cognitive Therapy: Basics and Beyond, pp. 5-9]
Principles of Cognitive Therapy
1Slide5
Cognitive Therapy is educative, aims to teach the client to be his/her own therapist, and emphasizes relapse prevention.
Cognitive Therapy aims to be time limited.
Cognitive Therapy sessions are structured
Cognitive Therapy teaches clients to identify, evaluate, and respond to their dysfunctional thoughts and beliefs.
Cognitive Therapy uses a variety of techniques to change thinking, mood, and behavior.
[Beck,J. (1993) Cognitive Therapy: Basics and Beyond, pp. 5-9]
Principles of Cognitive Therapy
2Slide6
Beliefs
From fundamental to superficial thought responsesSlide7
From Thought to EmotionSlide8
Response ProcessSlide9
…the most fundamental level of belief.Slide10
It is an idea, not necessarily a truth
You can believe it quite strongly, even “feel” it to be true, and yet have it be mostly or entirely untrue.
As an idea, it can be tested.
It is rooted in childhood events; it may or may not have been true at the time you first came to believe it.
Core Belief Operations
1Slide11
It continues to be maintained through the operation of your schemas, in which you readily recognize data that support the core belief while ignoring or discounting data to the contrary.
You and your therapist can use a variety of strategies over time to change this idea so that you can view yourself in a more realistic way.
Core Belief Operations
2Slide12
Categorizing Core BeliefsSlide13
…Rules, Attitudes, and AssumptionsSlide14Slide15
Identify the Core Beliefs, Automatic thoughts, and Intermediate Beliefs…Slide16
…the most superficial level of cognitionSlide17
Begin to look for automatic thoughts when the client’s emotional response could be rated at a
7
< on a scale from
1-10
if
10
is the greatest emotional response.Automatic Thought Clues…Slide18
Identifying Automatic ThoughtsSlide19
Case Study-Group Exercise
Presenting Problem: Tosha needs to go to the grocery store, but this activity creates panic symptoms for the client. Tosha explained to her therapist, “If something bad is going to happen, it will happen to me.” Tosha gave this explanation to justify avoiding a trip to the grocery store. She went on to explain that she believes she might “pass out” or have a “heart attack” while she is in the store. “My husband does not usually mind doing our grocery shopping, but he is very sick this week and he needs chicken soup…I don’t know what to do...I can’t do this.” The therapist asks, “How have you managed this situation in the past?” The client explained that sometimes her adult children have been able to help her, and other times she has chanted small prayers to herself until she made it through the event. Slide20
Make a list of possible automatic thoughts
What might be the client’s intermediate beliefs
What might the client’s activated core belief[s] be?
Group Exercise, part 1Slide21
Case Study-Team Review
1
Presenting Problem: Tosha needs to go to the grocery store, but this activity creates panic symptoms for the client. Tosha explained to her therapist, “
If something bad is going to happen, it will happen to me.
” Tosha gave this explanation to justify avoiding a trip to the grocery store. She went on to explain that she believes she might “
[I will]pass out
” or have a “
[I will have a] heart attack
” while she is in the store. “My husband does not usually mind doing our grocery shopping, but he is very sick this week and he needs chicken soup…
I don’t know what to do
...
I can’t do this
.” The therapist asks, “How have you managed this situation in the past?” The client explained that sometimes her adult children have been able to help her, and other times she has chanted small prayers to herself until she made it through the event. Slide22
Case Study-Team Review
2
Presenting Problem: Tosha needs to go to the grocery store, but this activity creates panic symptoms for the client. Tosha explained to her therapist, “If something bad is going to happen, it will happen to me.” Tosha gave this explanation to justify avoiding a trip to the grocery store. She went on to explain that she believes she might “[I will]pass out” or have a “ [I will have a] heart attack” while she is in the store. “
My husband does not usually mind doing our grocery shopping
, but he is very sick this week and he needs chicken soup… I don’t know what to do...I can’t do this.” The therapist asks, “How have you managed this situation in the past?” The client explained that sometimes her
adult children have been able to help her
, and other times she has
chanted small prayers to herself
until she made it through the event.
Life is scary. [Attitude]
I must have others to function in daily life. [Rule]
If I avoid, then bad things will not happen to me. [Assumption]
If I am weak enough, then others [even God] will take care of me. [Assumption]Slide23
Case Study-Team Review
3
Presenting Problem: Tosha needs to go to the grocery store, but this activity creates panic symptoms for the client. Tosha explained to her therapist,
“If something bad is going to happen, it will happen to me.”
[
I am fragile
or I am weak] Tosha gave this explanation to justify avoiding a trip to the grocery store. She went on to explain that she believes she might “[I will]pass out” or have a “ [I will have a] heart attack” while she is in the store. “My husband does not usually mind doing our grocery shopping, but he is very sick this week and he needs chicken soup… I don’t know what to do...
I can’t do this
.” [
I am not capable
or
I am helpless
] The therapist asks, “How have you managed this situation in the past?” The client explained that sometimes her adult children have been able to help her, and other times she has chanted small prayers to herself until she made it through the event. Slide24
Group Exercise, part 2
Create a diagram using the case study example.Slide25
What did you cover today that’s important for you to remember? Slide26
Cognitive Therapy
Training Session 2: Structuring TreatmentSlide27
About 16 to 20 sessions
Value of creating a strong therapeutic alliance in a timely manner
Introduce structure in first session to set the pace for therapy
Structure is based on the Cognitive Model’s principle of being goal-oriented and problem focused and operates in the context of the well-formed alliance.
Overall Treatment StructureSlide28
Session 1
A guide for structuring your first session…Slide29
First Session GoalsSlide30
Session 1
Goals of the First Session-1Slide31
Session 1
Goals of the First Session-2Slide32
Creating a Therapeutic AllianceSlide33
First Session OutlineSlide34
Session 1
Structuring the First Session-1Slide35
Session 1
Structuring the First Session-2Slide36
Session 1
Structuring the First Session-3Slide37
Session 1
Structuring the First Session-4Slide38
Working SessionsSlide39
Working Sessions
Structuring the Working Sessions-1Slide40
Working Sessions
Structuring the Working Sessions-2Slide41
Working Sessions
Structuring the Working Sessions-3Slide42
Working Sessions
Structuring the Working Sessions-4Slide43
Termination/Relapse Prevention SessionsSlide44
Termination/Relapse Prevention Sessions
Goals of the Termination Process Sessions-1Slide45
Termination/Relapse Prevention Sessions
Goals of the Termination Process Sessions-2Slide46
Tying it all together…
CT NotesSlide47
Mood Check
Agenda
Treatment Plan Goal Addressed
Symptoms
Progress Note Components
Fidelity Friendly-1Slide48
Identifying Automatic Thoughts
Guided Discovery
Interventions to Challenge Automatic Thoughts
Behavioral Interventions
Progress Note Components
Fidelity Friendly-2Slide49
Problem Solving Skills
Identifying and Modifying Schemas
Preparation for Termination and Relapse Prevention
Home Exercises
Therapist Seeks Feedback
Progress Note Components
Fidelity Friendly-3Slide50
Cognitive Therapy
Training Session 3: Strategy and FidelitySlide51
Cognitive Therapy ToolsSlide52
Case Conceptualization Diagram
Conceptualizing ToolsSlide53
Diagrams of the Cognitive Model
Recommended Reading
Handouts: What Should I Know About Cognitive Therapy
Recommended Reading List
Cognitive Model Education ToolsSlide54
Common Symptoms of Depression
Monica Ramirez
Basco
, Ph.D.
Diagnosis Education ToolsSlide55
Identifying Automatic Thoughts
Automatic Thought Questionnaire
Dysfunctional Thought Record
Evaluating Automatic Thoughts
Coping Card Activity
Thought Response Tools
-1Slide56
Thinking Error Identification
Core Belief Operations
Categorizing Core Beliefs
Core Belief Worksheet
Identifying and Assessing Schemas
Thought Response Tools
-2Slide57
Identifying Emotions
Rating Emotions
Pairing Emotional Responses with Specific Events/Situations
Emotional Response ToolsSlide58
Activity Monitoring
Pleasure and Accomplishment Ratings
Coping Errors Worksheet
Relaxation Strategies
Behavioral Intervention ToolsSlide59
Problem Solving Worksheet
Problems List
Assessing Your Solutions
Advantages and Disadvantages Analysis
Problem Solving ToolsSlide60
Self-Guided Sessions
Recommended Reading List
Preparation for Termination ToolsSlide61
Cognitive-Behavior Therapy Supervision Checklist
Developed by Donna
Sudak
, M.D., Jesse H. Wright, M>D., Ph.D., David Bienenfeld, M>D., and Judith Beck, Ph.D., 2001
Supervision ToolsSlide62
Fidelity
Components to be included in treatment and documentationSlide63
CBT Therapeutic Process
-1
In addition to the vital interpersonal skills required for any effective therapeutic relationship…Slide64
CBT Therapeutic Process
-2
…
provision of CBT involves specific therapeutic behaviors Slide65
The CBT therapist:
Collaborates with the consumer to develop an agenda for each session
Effectively manages time within sessions.
Structured and Agenda Directed Sessions Slide66
Guided Discovery
-1
The CBT therapist uses exploration, information seeking, and questions to assist the consumer in…
Slide67
Guided Discovery
-2
The therapist avoids …Slide68
The CBT therapist seeks explicit statements from the client about his or her understanding and perception of the therapy process itself, and to gauge whether there is reciprocal understanding or clarity between the therapist and client.
Therapist Seeks Feedback Slide69
Therapy Report ExerciseSlide70
Home Exercises Slide71
Use of Cognitive Behavioral Therapeutic Techniques Slide72
The CBT therapist explains automatic thoughts to clients and teaches them how to recognize and "catch" negative automatic thoughts. Automatic thoughts are defined as cognitions or images that arise for an individual without deliberate focus.
Identifying Automatic Thoughts Slide73
Identifying Automatic ThoughtsSlide74
The CBT therapist works with consumers to evaluate automatic thoughts.
The therapist works to make incremental changes in the consumer's belief in key cognitions and strives to teach the consumer skills to self-examine their thoughts.
Interventions to Challenge Automatic Thoughts Slide75
Behavioral Interventions Slide76
The CBT therapist teaches the consumer problem-solving strategies to address issues important to the consumer.
Problem-Solving Skills Slide77
Identifying and Modifying Schemas
I am unwantedSlide78
The CBT therapist discusses termination and prepares the client to use the skills taught within therapy after termination.
Preparation for Termination and Relapse Prevention Slide79
What was the most important part of the training for you?