Comprehensive Views on CBT and SW Practice: Historical Development to Modern Applications

1. CBT and It’s Applicationsfor SW Practice Yau Tat-yu

2. My Concerns • Comprehensive, Balanced and Critical Views towards CBT • It’s Implications to SW Practice • Paths for further Development / Learning

3. Historical Development Revisions on Behavioral Therapies • Classical Conditioning (CC)? • Operant Conditioning (OC)?

4. US UR + CS US UR CS CR (UR) Classical Conditioning (CC)

5. Behavior + Reinforcement Behavior + Reinforcement Operant Conditioning Behavior

6. Operant Conditioning • Why Operant Conditioning is frequently applied in working with MI / MR / children / residential setting? • Give examples for different schedules of reinforcement in our daily lives, and discuss the implications of its use in intervention

7. Operant Conditioning (OC) • Applications of Operant Conditioning • Reinforcement Vs punishment • Positive and negative reinforcement • Reinforcement: behavior is shaped by its desirable consequence • Shaping, Fading, Chaining,…

8. Behavior Therapies • Basic Assumptions • Behaviors are conditioned and shaped by stimulus and consequences • Human being is treated as ‘black box’.

9. Critical Remark 1 • Sheldon Rose’s View + Consequences Behavior Context

10. Critical Remark 2 • Read the following before using OC. 游達裕（2009）重讀「行為治療法」有感 於 他山之石 – 一個香港社工的觀察和體驗.香港：匯智出版社

11. Critical Remark 3 • Respecting clients (taking good care of their needs and starting where they are),being critical towards the oppression / power issues in practice scenario….!!

12. Social Cognitive Theory List three to five human capabilities that are important for our (social) livings?

13. Social Cognitive Theory • Basic capabilities • S____________ Capability • F____________ Capability • V____________ Capability • S____________ Capability • S____________ Capability

14. Social Cognitive Theory • Basic capabilities • Symbolizing Capability • Forethought Capability • Vicarious Capability • Self-regulatory Capability • Self-reflective Capability

15. B P E Social Cognitive Theory • Reciprocal Determinism

16. Social Learning • Most human behaviors are learned by observation. • Observation Learning –Attentional, Retention, Motor Production, Motivational • Model Variables – what are these?

17. Model Variables… • S______, P_______, S______, N________, C________ of O_______, V_______ of M _______, … • C_____ Vs M_____ Models, I_____ and I______ Models … • These all contribute to modeling effect in general, but its impact depends on its context

18. Model Variables… • Similarity, Proximity, Salience, Nurturance, Commonality of Outcomes, Variation of Models … • Coping Vs Mastery Models, In-Vivid and Imagery Models, … • These all contribute to modeling effect in general, but its impact depends on its context

19. Social Cognitive Theory Implications to Social Work Practice, So….?

20. Self-efficacy • Sources of developing Self-efficacy Enactive, Vicarious, Persuasory and Physiological. • Importance: Behavior expectancy (linking to positive outcome) and self-efficacy are two important determinants for behavior learning. • Role of self-efficacy in behavior learning • Self-fulfilling prophecy of Self-efficacy

21. Self-efficacy • Sources of developing Self-efficacy E______, V______, P_______ and P________. • Importance: B_____ E______ (linking to positive outcome) and S___ E_____ are two important determinants for behavior learning. • Role of self-efficacy in behavior learning • Self-fulfilling prophecy of Self-efficacy

22. Reinforcement • Three types of Reinforcement • Direct Reinforcement • Vicarious reinforcement • Self-reinforcement (SR and SE)

23. Rounding Up What are implications of CC, OC and SCT to behavior changes and skills learning?

24. Cognitive Behavior Therapies • Basic assumption: Cognition, Behavior and Emotion are influencing each other. • Some concepts get confused…?

25. B C E CBT - Assumptions

26. Cognitive Therapies (CT, REBT) • Appraisal – Beck, A.: Cognitive Therapy (CT), Ellis, A.: Rational Emotive Behavior Therapy (REBT) • Disputation (CT) Vs Collaborative Empiricism (REBT) • Ellis: IB  absolute ‘must’ • Beck: Thought Content and Information Processing

27. Cognitive Therapy What kinds of dysfunctional thoughts that you have come across?

28. Cognitive Therapy • Dysfunctional Thoughts (DT) • All-or-nothing thinking • Overgeneralization • Discounting the positives • Jumping to conclusions

29. Cognitive Therapy • Dysfunctional Thoughts (DT) (cont./) • Mind reading • Fortunetelling:  • Magnifying / minimizing: • Emotional reasoning:  • Making Labeling:  • Inappropriate blaming

30. Cognitive Therapt Appraisal • Three Major Domains – related to schema • Self: self-appraisal, self-acceptance, … • World: what the world should be, expectations on others, … • Future: what would happen in future, …

31. Cognitive Therapy Think about different types of Schema related to these three domains…?

32. Cognitive Therapy • General Process (psycho-educational): • Understanding the impact of thought on behavior and emotion • Educating functional / dysfunctional thoughts • Identifying thought (automatic thought / schema) • Cognitive Restructuring

33. T1 C1 A DT1 DT2 DT3 DT4...... T2 C2 A C ? ? DT1 ? T T DT2 ? DT3 ? Cognitive Therapy– general process

34. Cognitive Restructuring • Some Useful Strategies / Questions • Evidence? • Alternative Interpretations? • Implications? • Downward Arrow • 為信念的優缺點加權

35. Problem Solving • Spivack, G., Plat, J., Shure, M.B.: Interpersonal Cognitive Problem Solving (ICPS) • D’Zurilla, T.J., Nezu, A.M.: Social Problem Solving (SPS) • Overlapping a lot, but…

36. SPS • Social Problem Solving Orientation Outcome Problem Solving Style Positive Adapative / Positive Rational Problem Solving Impulsive / Careless Maladapative / Negative Negative Avoidant

37. SPS I – Problem Orientation • Problem Orientation: • Problem Recognition • Problem Attribution • Problem Appraisal • Perceived Control • Time / Effort Commitment

38. SPS 2 – Problem Solving • Problem Solving Skills: • Problem Definition and Formulation • Generation of Alternative Solutions • Decision Making • Solution Implementation and Verification

39. ICPS Five Stages Model • Problem recognition • Generating Alternatives • Means-ends Thinking • Consequential Thinking • Perspective Taking

40. Self Talk Statement Think about a positive self talk statement when you are in difficult time.

41. Self-Instructional Training • Self talk statement can incorporate different cognitive strategies, including… • SIT is a kind of self talk statement. • Impulsivity is highly related to lack of / underdevelopment of self-talk statement • SIT – a means of exercising covert control over behavior • General Strategy: From impersonal to personal, from over to covert training

42. Self Management • Kanfer: Self-monitoring, Self-Evaluation, and Self-control. • Applied both to Behaviors and Cognitions • A very useful strategy for generalization • Helping client to develop responsibility for his own

43. Rounding Up What CBT concepts / interventions have been used in the following programs / projects?