COGNITIVE BEHAVIOURAL COUNSELLING

 

COGNITIVE BEHAVIOURAL COUNSELLING

INTRODUCTION

Cognitive behavioral approach is an umbrella term for many different theories that share some common elements.

Rational Emotive Behavior Therapy/Counselling (REBT), developed by Albert Ellis in the 1950s, and Cognitive Counselling, developed by Aaron T. Beck in the 1960s.

Cognitive Behavioural Approach is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. 

Specifically, our thoughts determine our feelings and our behavior.

                                          

Negative and unrealistic thoughts can cause us distress and result in problems.

For example, distress (feeling) is mainly a result of how we interpret situations (thinking), which affects the actions we take.

The approach focuses on helping people become aware of when they make negative interpretations, and of behavioral patterns which reinforce the distorted thinking. 

PRINCIPLES OF COGNITIVE BA

Mental representation [of our world] determines our interactions

 If our mental representations are inaccurate or our reasoning are inadequate then our emotions and behavior may become disordered.

 Faulty cognitions cause distortions in the way we see things;

  Ellis suggested it is through irrational thinking, while Beck proposed the cognitive distortion.

 Abnormality stems from faulty cognitions about others, our world and us.

 Faulty thinking may be through cognitive deficiencies (lack of planning) or cognitive distortions (processing information inaccurately).

RATIONAL EMOTIVE BEHAVIOUR
[ALBERT ELLIS]

Mental representation

•      Individuals hold a unique set of assumptions about themselves and the world that guide them through life and determine their reactions to the situations they encounter.

RATIONAL VS IRRATIONAL THOUGHT

Individuals are born with a potential for both rational (straight) thinking and irrational, or “crooked” thinking. For example, happiness, loving, communion with others and growth and self-actualization. 

 They also are capable of self-destruction, procrastination, endless repetition of mistakes, and self-blame, and avoidance of actualizing growth potentials. 

The role of interpretation

Basic assumption that people contribute to their own psychological problems and symptoms, by the way they interpret events and situations. 

    Because cognitions, emotions, and behaviors have a reciprocal cause-and-effect relationship

How we learn irrational beliefs

•       We learn irrational beliefs from significant others during childhood. 

•       We reinforce self-defeating beliefs by repetition of early-indoctrinated irrational thoughts which keep dysfunctional attitudes.

Emotional Disturbance

•       Our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations. Dogmatic “shoulds”, “musts,” “oughts,” demands, and commands create disruptive feelings and dysfunctional behavior.

•       Irrational thinking guide humans to act and react in ways that are inappropriate and that prejudice their chances of happiness and success. 

Albert Ellis calls these basic irrational or illogical thoughts/beliefs.

IRRATIONAL THOUGHTS

Examples of irrational thoughts:

 “ I must be thoroughly competent at everything”

 “I should be loved by everyone I know”

 “Everything should be as I want them to be”

 “[…] should make me happy”

“ What I did in the past defines who I am today”

 

ABC MODEL OF PERSONALITY.

The model describes how individuals develop irrational beliefs as a consequence of crooked thinking

It is not the event, situation or an individual who is responsible for our feelings but our own thinking.

A is a fact, an event, or the behavior or attitude of an individual. 

C is the emotional and behavioral consequence or reaction of the individual. 

A does not cause C.  Instead it is the interpretation of B (person’s belief about A) causes C

Main argument: Individuals can change the irrational beliefs that directly “cause” their disturbed emotional

 Examples of personal beliefs (illogical thoughts):

“I am totally to blame for the divorce.”

“I am a miserable failure, and everything I did was wrong,” 

  Ellis repeatedly makes the point that “you mainly feel the way you think.”

   Notice how the same Negative Event (A) causes different emotions (C)

  A: Rebecca gets low marks in

               a Biology test (failure)

   B: She believes she must have good                         grades or else she is worthless

   C: She feels depressed (A                                        confirms her belief)

COGNITIVE COUNSELLING THEORY
[AARON BECK]

Beck’s (1967) theory is similar to Ellis’s but has been most widely used in cases of depression.

He  believes that a person’s reaction to specific upsetting thoughts may contribute to abnormality.

When a person’s stream of automatic thoughts is very negative you would expect a person to become depressed (I’m never going to pass, my parents hate me - have you ever felt like this?)

MECHANISM OF DEPRESSION

1. The cognitive triad/distortion (of negative automatic thinking
2. Negative self schemas
3. Errors in Logic (i.e. faulty information processing (thoughts)

COGNITIVE TRIADS

The cognitive triad are three forms of negative (i.e helpless and critical) thinking that are typical of individuals with depression:

They make a person become obsessed with negative thoughts

NEGATIVE SELF SCHEMA

•       Beck believed that depressed individuals develop a negative self-schema.

•       They possess a set of beliefs and expectations about themselves that are essentially negative and pessimistic.

Beck claimed that negative schemas may be acquired in childhood as a result of a traumatic event such as:

1. Death of a parent or sibling.
2. Parental rejection, criticism, overprotection, neglect or abuse.
3. Bullying at school or exclusion from peer group.

COGNITIVE DISTORTIONS

•       Beck (1967) identifies a number of illogical thinking processes (i.e. distortions of thought processes).

•       These illogical thought patterns are self-defeating, and can cause great anxiety or depression for the individual.

EXAMPLES OF COGNITIVE DISTORTIONS.

Arbitrary Interference

Drawing conclusions on the basis of sufficient or irrelevant evidence.

 For example, thinking you are worthless because you were not accepted into a prestigious University such as Mwenge Catholic University

Selective Abstraction

Focusing on a single aspect of a situation and ignoring others.

  For example, you feel responsible for your team losing a football match even though you are just one of the players on the field.

Magnification

Exaggerating the importance of undesirable events.

 For example, if you fail to obtain the expected course work you see yourself as totally stupid.

Overgeneralization

Drawing broad negative conclusions on the basis of a single insignificant event.

  For example, you get a D for an exam when you normally get straight As and you, therefore, think you are going to fail all exams.

Personalization

Attributing the negative feelings of others to yourself.

For example, your teacher looks really upset when he comes into the room, so he must be upset with you personally.

COUNSELLING GOALS

To minimize client’s emotional disturbances and self-defeating behaviors by acquiring a more realistic and workable philosophy (values) of life. 

Cognitive Goal

•       Teach client to change their dysfunctional emotions and behaviors into healthy ones. 

•       If the client accepts themselves, they are more likely to unconditionally accept others.

COUNSELLING ROLES

1.To show clients that they have incorporated many irrational “shoulds,” “oughts,” and “musts.” 

2. Demonstrate to the client that they are keeping their emotional disturbances active by continuing to think illogically and unrealistically. 

3.Help the client modify their thinking and abandon their irrational ideas.

  Assist the client in understanding the vicious circle of the self-blaming process, which also changes their self-defeating behaviors.

4.Challenge clients to develop a rational philosophy of life so that they avoid irrational beliefs in the future. Teach clients how to substitute rational beliefs and behaviors for irrational ones.  

Client’s Experience in Counselling

•       The client is a learner and a doer.  Counselling is viewed as a re-educative process whereby the client learns how to apply logical thoughts for emotional change.

•       Counselling emphasizes here-and-now experiences (and no need to explore the past)

•       The client learn that by working hard and carrying out behavioral homework assignments they can minimize faulty thinking, which leads to disturbances in feeling and behaving. 

COUNSELLOR –CLIENTS RELATIONSHIP

•       An intense relationship between counsellor and client is not required (but rapport is necessary)

•       Counsellors show their full acceptance by refusing to evaluate their clients but honestly confront clients’ faulty thinking and self-destructive behaviors.

•       Open and direct disclosure of counsellor’s own beliefs and values is vital

TECHNIQUES

Cognitive methods:

•       Disputing irrational belief (teach the client how to challenge on thinking)

•       Doing cognitive homework (track down their “shoulds” and “musts” that are part of their internalized self-messages)

Emotive techniques

•       Rational-emotive imagery (clients imagine themselves thinking, feeling, and behaving exactly the way they would like to think, feel and behave in real life) 

•       Role playing (rehearsing certain behaviors to bring out what they feel in a situation)

•       Shame attacking exercises (increasing self-acceptance and mature responsibility)

    Helps clients learn that they often have no reason for continuing to let others’ reactions or possible disapproval stop them from doing the things they would like to do.

Behavioral techniques.

•       Use of operant conditioning, self-management principles, systematic desensitization, relaxation techniques, and modeling.

•       Use of the procedures such as desensitization, skill training, and assertiveness training.