The DQ questions are due and first assignment are due on the 12th the rest on the 16th
What are the differences between cognitive therapy and behavioral therapy? Why is it important for counselors to know the differences between these two therapies?
Continue to complete your “Theory Review Chart” by completing all columns relating to cognitive-behavioral approaches. For each theory discussed identify:
1. View of human nature
2. Key theorists
3. Key terminology
4. Key concepts
6. Therapeutic techniques
7. Personal v
Glasser, the founder of reality theory, posits that from the moment of your birth, you are faced with choices. Your needs are the driving force behind the choices that you make and are reflected in your behaviors. What steps are involved in the WDEP System? What is the purpose of this process?
Review the following course materials:
1. Rational Emotive Behavior
2. Cognitive Therapy
In this assignment, you will review and respond to a therapy session conducted by professional counselors using one of the following theoretical frameworks: cognitive or rational emotive behavior.
Select on therapy session (rational emotive behavior or cognitive therapy).
Utilize the course material, in addition to the textbook, for the theoretical framework selected. Think about the techniques being used in the therapy session.
Create a 7-10-slide presentation about the selected session. Include or address the following in your presentation:
1. A title slide
2. The therapeutic techniques, used by the counselor
3. Was the approach successful and why?
4. A reference slide with a minimum of two scholarly resources.
Include speaker notes below each content-related slide that represent what would be said if giving the presentation in person. Expand upon the information included in the slide and do not simply restate it. Please ensure the speaker notes include a minimum of 50 words.
Theoretical Frameworks II
Rational Emotive Behavior Theoretical Framework
• “Rational Emotive Behavior Therapy Background,” located below.
• Therapy Session 2: the rational emotive behavior therapy session between Rebekah and Dr. Allen below. Take notes on the interaction between Rebekah and Dr. Allen.
• Complete the written assignment according to the assignment directions.
Rational Emotive Behavior Therapy Background
REBT is an action- and results-oriented psychotherapy which teaches clients how to identify self-defeating thoughts, beliefs and actions and replace them with more effective, life-enhancing ones. One of the first of the modern cognitive behavior therapies, REBT was developed in 1955 by Albert Ellis, Ph.D.
Using a technique called “uncovering the ABCs of personality formation,” REBT therapists state that it is not the (A) Activating event that causes emotional Consequences (C), but (B) the Belief (B) about the event. For instance, faced with the loss of a relationship, one client’s belief system might lead to suicidal depression, while another client’s belief system might leave him or her feeling fine about the breakup.
One role of the REBT therapist is to create (D) a Disputing intervention (D) for (B) the Belief that is irrational. This will (E) Effect a new, and better, (F) Feeling. REBT practitioners teach their clients to (1) analyze episodes of emotional and behavioral disturbance with the ABC model; (2) discriminate between irrational and rational beliefs; (3) distinguish healthy negative emotions from unhealthy emotions and (4) utilize a variety of means for modifying the irrational beliefs that support their emotional and behavior problems.
In working with clients, the REBT therapist uses a number of cognitive, behavioral, and emotive techniques, including.
1. Actively disputing irrational beliefs throughout the day.
3. Role-Playing new ways of living
4. Practicing what might be for the client new, unconventional ways of living in the world (e.g., an introvert acting extroverted at a party)
5. Imagery exercises, where the client imagines how he or she would like to be.
6. Practicing new behaviors through traditional behavioral techniques (e.g., conditioning, modeling, assertiveness training)
In the following role-play, watch how Dr. Korrie Allen uses the ABC of Rational Emotive Behavior Therapy to assist Rebekah with her feelings about a recent break-up with her girlfriend.
Rational Emotive Behavior Therapy Session
Dr. Allen: Good morning Rebecca, what brings you here?
Rebekah: Um, I’m just feeling depressed and upset, and just a little worthless.
Dr. Allen: is there anything that’s going on that’s different in your life right now?
Rebekah: Um, my girlfriend and I are having some problems. Um, she’s been talking about breaking up and um, actually I think that she’s gonna break up with me.
Dr. Allen: so that must be really difficult to think about. Um, what are some of the thoughts that are going through your head when you think of the possibility of you guys breaking up?
Rebekah: All kinds of things like, I need a girlfriend, I really miss her. I mean, just even now we’re having a lot of problems and ya know, I just miss things being the way it used to be. I want to have a family one day, we’ve just made all kinds of plans and it’s not going to happen.
Dr. Allen: And what if you were to break up?
Rebekah: Well, I mean I guess I think about the fact that I mean, we’ve been together for 3 years. I’m 25, I’ve already invested 3 years into this relationship. Um, we talked about the future and having kids. I need a girlfriend, I need a girlfriend to have all those things that I planned on having, that we had planned on having.
Dr. Allen: I hear you saying that you need a girlfriend in order to have certain things in your life in place. When I think of a need, I think of things that you absolutely must have. For example, if you didn’t have food, what would happen?
Rebekah: I would die
Dr. Allen: And what if you didn’t have water?
Rebekah: I would eventually die.
Dr. Allen: And even along a little bit of a different line, have you ever been….I know you’re in graduate school, I’m sure you have lots of tests. Have you ever been studying, go to get in your car and your car doesn’t start?
Dr. Allen: And how did you feel at that point?
Rebekah: Um, really mad. Just really upset.
Dr. Allen: Do you recall what was going through your mind at that time?
Rebekah: Just that I was really upset. Um, I needed my car to start so I could get to school.
Dr. Allen: Mmhmm, and were you able to problem solve and come up with a solution that you’re thinking “I need my car to start”, “I have to have it to start?”
Rebekah: Um, no.
Dr. Allen: You just kind of froze?
Rebekah: yea, well I guess I would just be so upset that my car wasn’t starting that I probably wouldn’t be able to think about anything else.
Dr. Allen: Mmhmm, do you think it was the fact that your car wasn’t starting that caused you to feel upset?
Dr. Allen: Ok, well in REBT, what we have are called the ABC’s. And A is the activating event, which in that situation would be the car not starting, and the B is the belief and C is the consequence. And do you think that it was the fact that the car didn’t start? Or what you were telling yourself about the car not starting? That was causing you to feel upset
Rebekah: Um, I guess it would be what I was telling myself.
Dr. Allen: And that was?
Rebekah: that I needed to have the car to start to get to school.
Dr. Allen: Mmhm, and in that situation what do you think you might have been able to say that would have caused you to feel a little less upset, and would have enabled you to problem solve and come up with an alternative solution quicker?
Rebekah: I guess if I wasn’t so focused on you know, my piece of crap car, I could think about “Ok my car won’t start, now what am I going to do?” I guess I need to call a friend, or just figured out another way to get to school.
Dr. Allen: Right, you’d really like it to start but you’re okay. You didn’t die because it didn’t start
Dr. Allen: And you’re able to get through the problem okay, right? So in that situation, you can see that it’s actually the belief that’s causing you to feel upset, not the fact that the car didn’t start, the activating event. Does that make sense?
Rebekah: Yea, I see what you’re saying…yeah
Dr. Allen: And this, to me sounds a little similar to some of the things that are going through your head about your girlfriend. If you’re saying to yourself “I need to have a girlfriend, I must have a girlfriend in order to be happy. I’m 25, I need to have a family, that’s what everybody’s doing that’s my age”, how are you feeling at that point?
Rebekah: Depressed, I mean that’s how I’m feeling now.
Dr. Allen: Right, and so how do you think you would feel if you were to say something along the lines of: “I’d prefer to have a girlfriend, I’d like to have a girlfriend, but if I don’t, it’s okay.” How do you think you would feel at that point?
Rebkah: I would still be upset, but I guess it would change my focus.
Dr. Allen: Do you think you would be as anxious around your girlfriend?
Rebekah: Probably not.
Dr. Allen: Right, and so if you had to explain to me the difference between a want and a need, what would you, how would you describe that?
Rebekah: Um, I guess like you said you know, if you’re talking about food and water, I mean it is something that you have to have or you’re gonna die. And a want is something that you would like to have, would be nice if you had.
Dr. Allen: And even if we go back to the car example, if you said to yourself: “I’d really like to have a car, I want to have a car, it’s important to be on time”. How do you think you would feel at that point?
Rebekah: Upset, but I would still…I would feel better about making other arrangements, and not being so focused on being angry.
Dr. Allen: Right, so what this models shows is when anybody, it doesn’t matter if you’re black, white, rich, poor, male or female; whenever you turn a preference or a desire or a want into an absolute must, you’re going to feel miserable. Do you see how that applies to you?
Rebekah: Yeah, I guess I never really thought about it that way.
Dr. Allen: Mmhm, and today we’ve talked really only about one need that you brought up. The need to really have a relationship and be with your girlfriend, but can you give me a different way to think about that that might help you feel a little less depressed?
Rebekah: Well, I guess I’m gonna still be upset but if we do break up and I don’t have her, I’m not gonna die. Even though it may feel that way, I’m not going to. I guess it’s a want, I would like to have, I would like for us to stay together, I would like to have her as a girlfriend.
Dr. Allen: Yeah, and when you’re with her and you’re thinking I would like to be with her, I enjoy being with her, how do you feel?
Dr. Allen: Good, but when you’re with her and you’re thinking “I really hope she doesn’t break up with me, I really need this relationship, its important that we stay together.” How do you feel at that point?
Rebekah: Bad, I mean, depressed I guess. A lot of pressure.
Dr. Allen: Yeah, and how do you act around her?
Rebekah: Strange (laughing)
Dr. Allen: Yeah, then she’s kinda going “okay.” Yeah. Um, so like I’m sure you’ve experienced many hassles and when you have, for example a test, a lot of times you don’t want to study for the test but you do. So when you take things like your wants and your desires to have a girlfriend and turn that into an absolute must, a need, it makes you feel depressed, it leads to a dysfunctional emotion. However, when you change that to more “I would like to be with my girlfriend, it’s important that we’re together and I enjoy spending time with her” you feel better, and you act differently around her. So one of the things that I really hope you’re able to see now is that it’s that belief about having the girlfriend that’s causing you to feel depressed than the activating event, the thought of her breaking up with you. Does that make sense?
Rebekah: Yeah. I’ve just never thought about things in that way before.
Dr. Allen: Right, well that’s great. I’m glad that you’re starting to make that connection cause that’s really the fundamental idea behind REBT, that it’s the belief that’s causing us to feel unhappy. So what I’d like you to do over this week is a little bit of homework. In REBT we always give homework. I want you to practice the process we’ve gone over. I’d like you to just jot down whenever you feel panicked or anxious or depressed during the week. And then once you put that down, think about what was the activating event, what was the event that kind of started that? And then what was the belief that you have that caused you to feel anxious, depressed, or self-hatred. Does that make sense?
Dr. Allen: Can you give me an example from what we’ve talked about today.
Rebekah: When I’m studying for a test and I get really really anxious and I just start thinking about, “I have to make an A, I have to study, I can’t be in graduate school, I can’t do bad.”
Dr. Allen: And so in that situation, the A is…the activating event would be…
Rebekah: Studying, I have to study
Dr. Allen: Right, and the belief is, the irrational thought is “I have to do well”
Rebekah: I have to make an A
Dr. Allen: Right, and that would cause you to feel anxious. Okay, so what could you maybe think a little differently that would cause you to feel less anxious? Because some anxiety is gonna be there, but what could cause you to feel a little less anxious?
Rebekah: That I studied and, you know, just to calm myself down “Okay, I studied for the test, I’m
gonna do well, I know the material, if I don’t make an A I’m not gonna get kicked out of the school.”
Dr. Allen: That’s great, and so what I want you to do this week is focus on those situations when they come up and really write down, what was the A, what’s the activating event, the belief, focus on that belief. And whether it’s rational or irrational, I want you to really focus on either one. And try to catch those irrational ones so you can start to really work on those and then whatever emotions they made lead to. So do you think you would be able to do that over the next week? Jot down those situations?
Dr. Allen: And then we can go over them next week and really start to identify some of the irrational beliefs that may be causing you to feel depressed and anxious.
Dr. Allen: Do you feel good about that?
Dr. Allen: Okay, well then I look forward to seeing you next week.
Rebekah: Okay, thank you.
Theoretical Frameworks II
Cognitive Theoretical Framework
• “Cognitive Therapy Background,” located below.
• Therapy Session 1: Read the case of Gwen on page 302. And answer at least three questions for reflection on Page 303.
• Therapy Session 2: the cognitive therapy session between Karen and Dr. McAuliffe below. Take notes on the interaction between Karen and Dr. McAuliffe.
• Complete the written assignment according to the assignment directions.
Cognitive Therapy Background
Cognitive therapists believe in changing clients’ inaccurate perceptions of themselves and their environments by uncovering faulty beliefs that are causing personal and interpersonal problems. Coming from the behavioral tradition, cognitive therapists believe thoughts can be considered behaviors which can be modified. Such modification occurs through the “disputation” of thoughts and by experimenting with new behaviors.
Many cognitive therapists believe that problems in living are caused by cognitive schemas or “floor plans” that influence how people make sense of the world. Once these cognitive schemas have been identified, the therapist helps the client uncover the moment-to-moment automatic thoughts that fuel the continuation of the schema. The counselor then helps the client discover the cognitive errors in those automatic thoughts. Examples of just a few of these include: all or nothing thinking, such as believing that life is either great or horrible; overgeneralization, such as believing that one must be fearful of flying because planes have crashed; and personalization, or seeing oneself as the cause of negative events such as believing that one was the reason for his or her parents’ divorce.
Today, most cognitive therapists believe in establishing a therapeutic alliance through careful listening and by collaborating with the client as they help him or her understand the cognitive therapy process. Cognitive therapists use questions to probe the client’s way of thinking. Eventually, therapists help the client acquire more adaptive thoughts and assist the client in devising a plan that includes practicing new behaviors that will reinforce new thoughts.
Cognitive therapists believe clients can make dramatic changes in how they think and act; however, they tend to focus on coping, not curing the client. Changing embedded ways of thinking and behaving does not occur easily.
Let’s see how Dr. Garrett McAuliffe helps Karen identify cognitive distortions as she works on issues related to how fear of loss has led her to avoid commitments in her life.
Cognitive Therapy Session
Dr. McAuliffe: Karen, hi again.
Dr. McAuliffe: We met once before and we talked about your fear of loss, and how it connects to your fear of commitment at this time in your life. I asked you to monitor some thoughts you might have had around specific incidents in your relationship and write down those thoughts when you felt a sense of dread about the current relationship with John, your partner. What have you noticed this week?
Karen: Um, I did try to think about my thoughts and one example I was remembering as I was driving over here was when John made reference to the fact that I don’t clean out the refrigerator, that I don’t you know, worry about that as something that I need to do. And um, I remember thinking, um the feelings that came up were like “See, I’m not good at everything. I don’t do the refrigerator, you know, things like that he’s not gonna like, it’s gonna negatively affect the relationship.” And I mean it just led from one thing to another um, and that feeling came back you know that the relationship will somehow end. It just kinda all builds together.
Dr. McAuliffe: How likely is that to be true?
K: Well, based on just the refrigerator incident, probably not very likely. Um, and I know that, but somehow those little things just build up and you know that fear feeling comes up when they happen.
Dr. McAuliffe: So you generalize from before.
Karen: Yes, yes.
Dr. McAuliffe: You’ve lost a father when you were very young, and a little brother when you were quite young, and you talked last week about a stepfather when you were an adolescent and then your older brother in your life. And so those are genuine losses that have happened to you. But what’s different about this relationship?
Karen: That’s where I get confused because I know that this relationship is different. But the feelings of loss that come up, just remind me that I don’t want to have to experience that again. So I know it’s different, um, but I don’t want to experience loss again.
Dr. McAuliffe: You’re afraid of feeling that pain again. You’re saying to yourself on some deep level, “Every time I get close, I’ll experience loss. Every time there’s a problem, things will end.” Is it true that every time there’s a problem, you will experience loss?
Karen: Well, not every time. I mean, you know he could die, but not every time, no.
Dr. McAuliffe: Right, relationships do end, but not every time that there’s a minor problem. You are generalizing and that’s one word that you can use, overgeneralizing from the past and another word that maybe you can remember is catastrophizing from those situations as if they’re the same as the current one. Do you see how you’re doing this?
Karen: Yes, yes. Um, cause every time there’s that little problem I get that pain so, yeah.
Dr. McAuliffe: So that pain’s a cue for you and then you start worrying. The pain comes from deeply embedded, now maladaptive thoughts, that really maybe were effective at the time but aren’t anymore. There’s a word for that called a cognitive schema, or a cognitive floorplan. That you’re operating from as if it’s true now what was true then. You’re saying to yourself, “If there’s any problem, then a relationship is going to end.”
Dr. McAuliffe: It’s so embedded that you don’t catch the thoughts in the present, as if they’re different now, but you still can come back to them.
Dr. McAuliffe: With new more adaptive thoughts, not maladaptive thoughts, but not generalizing like you’re doing or catastrophizing. What type of thoughts do you think that you can have now?
Karen: Well, um, I guess when that feeling comes up I know that I can say, you know that this relationship is different and that we can talk about things. And I know that John’s not gonna leave me, I feel very confident about that. Like I said, other than if he dies. Um, and he’s willing to work with me so I know I can…I have to just say those things.
Dr. McAuliffe: Good, then let’s work on what I’ll call a homework assignment. Is that okay with you?
Karen: Yes, I will work on it
Dr. McAuliffe: What situation with John might bring up these thoughts?
Karen: Um, it will probably be some complaint about the dog.
Dr. McAuliffe: Mmhm, and what will you say to him? To yourself.
Karen: I will try to remember and say, you know, “We can talk about this. He’s not going to leave, and just because we have a disagreement over the dog doesn’t mean that it’s going to lead to a loss.”
Dr. McAuliffe: Great! You’re reminding yourself not to catastrophize; that this relationship is different from all of those other experiences in the past. And one thing I think it’s important to remember is how long did it take to develop this fear of loss, this floorplan.
Karen: Well, my dad died when I was three so, my whole lifetime.
Dr. McAuliffe: So it’s gonna take some hard work to combat these embedded, we’ll call them, thoughts, your cognitive floorplan. It’s gonna have to slowly change.
Karen: Right, I see. I’m really gonna have to work on this.
Dr. McAuliffe: I have a suggestion. I’d like you to write down every incident that brings up those thoughts and then how you’ve combated each incident with the new thoughts that we’ve talked about today. Is that something you think you can do?
Karen: Yes. Yes, I can do that
Dr. McAuliffe: Great, I look forward to seeing how you do it.
Karen: Thank you. It’s gonna take a lot of work.