Beck (1976) and J. Beck understanding of pathology
-faulty information processing (cognitive distortions) which is reinforced through learning throughout the lifespan. These enduring cognitive structures/ways of thinking (schemas) lead to a cognitive vulnerability that gets triggered in certain situations
Initially, the therapist helps the patient to
Beck (1976) and J Beck
-understand their faulty information processing by identifying and challenging the cognitive distortions (e.g. overgeneralization, arbitrary inference, personalization, magnification/minimization, all or none thinking, etc).
The role of the therapist
Beck (1976) and J. Beck
active teacher and model
Techniques of Beck and Beck
- collaborative empiricism: 3 column technique used to explore
- guided discovery: Socratic dialogue, hypothesis testing
- continuous evaluation: homework, rating scales, BDI
- cognitive specificity: autoprogramming, automatic thoughts, systematic biases
- In this form of therapy, manuals are often used. The therapist is time limited and goal oriented. Continued evaluation/monitoring – daily journal, periodic administering of self-report measures like BDI
- Plan termination with possible booster sessions.
Ellis (1960, 1973) REBT: pathology
-rooted in irrational beliefs. People construct emotional difficulties and maladaptive behavior tendencies by means of their irrational and self-defeating thinking, emoting, and behaving.
Ellis (1960, 1973) REBT irrational beliefs
-Irrational beliefs produce emotional disturbances that produce maladaptive behaviors, these irrational beliefs develop from childhood experiences and personal dogmas and are continued to be reindoctrinated through the continued reinforcement of these beliefs
Ellis (1960, 1973) REBT: ABC model of human disturbance
A = Activating event
B = belief about the event (rational or irrational)
C = consequences
REBT: therapy is what kind of process?
-educational process in which the therapist often active directively teaches the patient how to identify irrational and self-defeating beliefs and philosophies which in nature are rigid, extreme, unrealistic, illogical, and absolute. Then the therapist forcefully and actively questions and disputes them and replaces them with more rational and self-helping ones.
D = dispute irrational belief
E = effective philosophy developed
F = create new feelings
REBT’s goals for treatment
- Challenge and change or abandon irrational beliefs to help change personality
- Develop a more workable/rational philosophy in order to bring lasting change
- Achieve full self-acceptance
REBT approach to treatment
-Use cognitive thinking, the emotive process, and behavioral techniques to create change in the patient
-Help patient give up musts, oughts, shoulds and perfectionism through disputing these irrational beliefs with logical and semantic precision, use Socratic questions, cognitive homework
-Homework
• Emotive- really feel it
• Dramatization or preferences and musts, imagine the worst, role play
• Use humor and sarcasm
-Behavioral
• Risk taking assignments
• Use punishments and rewards
• Relaxation, modeling
• Behavioral procedures such as exposure to interceptive somatic cues and breath retraining in panic disorder to help identify misrepresentation of bodily sensations and challenge faulty beliefs
Healing aspects of REBT
- Disputing irrational beliefs
- Effective philosophy developed
- Create new feels
- Once ABCs of pathology are understood, it becomes clear that the proper route to removing distressing consequences lies directly in modifying irrational beliefs
Expectations in REBT regarding therapist
- Directive and confrontational
- Unconditional acceptance
- Teacher, guide, help the patient understand how cognitions affect behaviors and feelings
- Catalyst for corrective experience
- Demystifies therapist, there is nothing magical happening, understand rationale for approach
- Assess distress, help patient specify what problems will be focused on
- Focus on general themes
Expectations regarding client in REBT
- Provides data for therapy to focus on
- Helps set the agenda and goals, including overall and weekly goals as well as determining the therapeutic themes
- Focus on here and now
- Actively engaged in therapy
- Focused on the present
- Homework completion, practices skills
Expectations for therapeutic relationship in REBT
- full acceptance and tolerance of client
- does not encourage transference
Goals of REBT treatment
- Correct fault information processing, help patient modify assumptions which maintain problems
- Challenge dysfunctional beliefs
- Modify assumptions- thereby developing more realistic assumptions
- Remove systematic biases- shift to more neutral processes
- Obtain symptom relief
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Ethical Issues in Psychotherapy7
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Therapy Outcome Research and Curative Factors6
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Classic Psychoanalysis6
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Pathology in Classic Psychoanalysis46
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Psychoanalytic Ethics12
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Ego Psychology11
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Object Relations29
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Behavioral Therapy12
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Existential Psychotherapy5
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Cognitive Behavioral Therapy15
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Contemporary Psychoanalytic1
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Self Psychology5
