Cognitive Behavior Modification

1. Cognitive Behavior Modification Chapter 27

2. Cognitive Behavior Modification • Cognition • Belief, thought, expectancy, attitude, or perception • Cognitive Behavior Modification – Cognitive Behavior Therapy • Helping clients through behavioral modification methods and through focusing on debilitating thoughts and beliefs

3. Cognitive Restructuring Methods • Assumptions: • Individuals interpret and react to events in terms of their perceived significance • Cognitive deficiencies can cause emotional disorders • Focus of therapy: Cognitive restructuring • Changing faulty thinking patterns • Approaches include behavior modification components

4. Cognitive Restructuring Methods • Rational-Emotive Behavior Therapy (REBT) • Developed to help individuals change irrational thought • Utilizes in vivo behavioral homework assignments • Procedure: • Identify irrational thoughts • Challenge thoughts • Teaching client (through modeling and homework) to replace the irrational self-statements with statements based on “rational” beliefs

5. Effectiveness of REBT • More effective than no treatment • More effective than various other treatments in decreasing client’s irrational self-talk (46%) • More effective than other treatments in reducing emotional distress (27%) • No effect on behavioral measures (approaching feared object)

6. Cognitive Restructuring Methods • Beck’s Cognitive Therapy • Faulty and negativistic though patterns lead to behavioral and emotional problems • Procedure: • Identification of dysfunctional thoughts • Use various methods to counteract the dysfuctional thoughts • Ex: Hypothesis testing • Use of homework assignments that utilize behavior modification procedures to develop desirable daily activities • Gentler, less confrontational approach than REBT

7. Beck’s Distorted Thought Patterns • Dichotomous thinking – all or none evaluations • Overgeneralization – rule or belief applied too broadly • Arbitrary Inference – drawing inaccurate conclusions based on insufficient, ambiguous, or contrary evidence • Magnification – exaggeration of the meaning or impact of an event

8. Effectiveness of Cognitive Therapy • Effective in treating depression • Most research has focused on treatment of depression • More research needed to evaluate this treatment for other disorders

9. Self-Directed Coping Methods • Self-Instructional Training • Five steps: • Adult demonstration of self-instructing • Child performs while adult verbalizes • Child performs the task and verbalizes out loud • Fading of overt self-instructions • Task performance with covert self-instructions

10. Self-Directed Coping Methods • Meichenbaum’s Stress Inoculation Training • Teaches cognitive skills that allow clients to deal with stressful events • Three Phases: • Reinterpretation phase • It is not the stressor that is the cause of stress reaction but it is the way the client views the event • Coping training phase • Clients learn coping strategies • Relaxation, self-instruction, and self-reinforcement • Application phase • Clients practice skills in stressful situations

11. Effectiveness of Stress Inoculation • Many of the components (relaxation, modeling, desensitization) have been validated when applied independently • Evidence suggests that this method is as effective as its component procedures

12. Self-Directed Coping Methods • Problem Solving Training • Teaches people how to proceed through logical reasoning to satisfactory solutions to personal problems • Steps in personal problem solving: • General orientation • Problem definition • Generation of alternatives • Decision making • Implementation • Verification • Evaluation of problem solving methods • Adults and children can rapidly learn skills, but do not often apply them appropriately

13. Mindfulness and Acceptance • Mindfulness • Awareness, observation, and description of one’s overt and covers behaviors, as they occur, in a nonjudgmental way • Acceptance • Set of behaviors in reaction to mindfulness • Refraining from judging one’s sensations, feelings, and behaviors • Thoughts are viewed as just responses, just passing events

14. Mindfulness and Acceptance • Acceptance and Commitment Therapy (ACT) • Three phases: • Learning that past attempts to control troublesome thoughts and emotions have not only been unsuccessful, but increased the frequency of these thoughts • Learning to experience thoughts and emotions in a nonjudgmental way • Done through use of mindfulness training and acceptance exercises • Identifying values in various life domains and then translating these values into goals and actions • Evaluation • Early studies find positive results • Equivalent to systematic desensitization for treatment of math anxiety • Effective in reducing stress in the workplace • Relatively new approach and more research needed