What is COGNITIVE BEHAVIOUR THERPAY (CBT)

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COGNITIVE BEHAVIOUR THERPAY: Introduction

BY SUNDAS REHMAN & ROSE

BOGARTS

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Origins of CBT

Does it work?

The underlying model

Techniques

Apps

Overview

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Aaron Becks developed the approach known as cognitive therapy as a result of his research on depression

Becks observation of depressed clients revealed that they had a negative bias in their interpretation of certain life events, which contributed to distorted cognitive thoughts

Today CBT is collection of theories and techniques

It is called CBT as it uses a collection of cognitive, behaviour, and emotive techniques

CT + BT = CBT

Origins of CBT

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CBT is one of the most established researched psychological therapies

For some problems such as anxiety and depression, CBT is as effective as medication and can also enhance effects of medication (AustralianAssosciationofCBT, 2015)

Does CBT Work?

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Why use CBT for children and adolescents?

• Empowering, skills oriented, immediately addresses issues

• Develops cognitive ability, empathy, moral, reasoning

• Emotional regulation and behavioural self control

• Self control & educative• Applied at individual, group, classroom

levels• Addresses a wide range of childhood

disorders• Is ‘best evidence’ not ‘best practice’

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Generalised Anxiety Disorder Child/adolescent behaviour problems Anger and aggression Panic Obsessive Compulsive Disorder Phobias Depression Eating disorder Brain injury Social anxiety

In particular CBT has demonstrated effectiveness with individuals

experiencing the following problems:

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--- “People are disturbed not by things but the view that they take of them” Epictetus 1st Century AD

-- “…there is nothing either good or bad, but thinking makes it so”. Hamelet, 2,2,254

What is CBT? The underlying model

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The basic belief behind CBT is that it is not the environmental factors that are responsible for how a person feels and behaves. Rather it is the way an individual thinks that causes a reaction.

Thinking: different people can think differently about the same event. It is the way in which we think about the event that influences how we feel and how we act.

What is CBT?The underlying model

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A working model

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https://www.youtube.com/watch?v=WRRdSm4ZjX4

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CBT model emphasises that it is not the event/situation that causes the emotional distress rather it is the individuals view of that event or situation

CBT works by focusing on those negative thoughts and learning how to change them as well as learning how to change unhelpful behaviour

Underlying Cognitive Model

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CBT aims to teach people that it is possible to have control over your thoughts, feelings, and behaviour.

CBT helps challenge the individuals negative thoughts, behaviour, and feelings.

Techniques

CBT

CT BT

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Involves identifying unhelpful thoughts or beliefs

1. being able to detect unhelpful thinking pattern

2. being able to challenge those unhelpful thoughts and developing more helpful, adaptive way of thinking

* “what evidence do you have for this?”* “is there a more helpful way of

thinking?”* “why must it absolutely be that way?”

Cognitive Therapy (CT)

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Look for alternative explanations What is the evidence for and

against this thought? Is your thought factual? Are you jumping to conclusions? How can you check if your

thoughts are actually true?

Challenging Negative Thoughts

* Reality testing• Is there another

way you can look at this situation

• What else could this mean?

* Putting it into prospective• Is the situation really as bad?• What is the worst thing that can

happen? How likely is that?• What is most likely to happen?• Will this matter in 5 years time?

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Exposure therapy

Pleasant Event Scheduling- changing a persons environment or activity that may help alter their moods

Relaxation- there are various ways to learn to relax, including progressive muscular relaxation, applied relaxation, mindfulness (new and popular technique)

Behaviour Therapy (BT)

https://www.youtube.com/watch?v=cDflnqo0TQs

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Anger management technique

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Negative Nancy

• Draw a grumpy person and some negative thoughts or statements coming from her, around her

• Ask your student to brainstorm with you the negative statements or thoughts they have been thinking

• After, process the effects of being negative

• Finally create a problem solving map to help change those negatives into positives

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Problem Solving1. What is the problem?2. What could I do?3. What might happen if? (consider

consequences for each idea)4. Pick best solution.5. Do it.6. Did it work?

Behaviour Therapy (BT)

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Assessing Behaviour

• Connection between thoughts, feelings, �behaviours.

• Ask about specific behavioural reactions to �a typical

event?• How much control did the child have over �

their behaviour?• How did the child feel about their �

behavioural reaction?• Did the child understand fully the �

consequences of their behavioural reaction?• What was the level of intensity of child’s �

behavioural reaction?

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Strategies for assessing behaviour

• Ask how they behaved in relation to a particular

feeling

• Using goal-directed thinking: Assess how behaviours help or don’t help a particular goal the child wants to achieve

• Is thinking this way helping me achieve my goals?

�For the younger child:

Draw it out or use cartoons

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When teachers use CBT, they can help their students control their own behaviour, rather than enforcing external reinforcements

CBT teaches students to use their inner-speech to modify their underlying belief

Cognitive strategies help students learn “how-to-think, instead of “what to think”

In the classroom it can be argued that it is even more important to teach students HOW to use their thinking to improve their own behaviour

Teachers using CBT

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Overall numerous studies indicate that teaching children cognitive strategies can strengthen pro-social behaviour and decrease maladaptive behaviour like disruption and aggression.

We can equip our students with skills to remain in control across various different situation if we teach them to Stop and Think- Critically.

Teachers using CBT

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Be aware of the developmental stage of the young person (think about psychological, cognitive, and emotional development)

Involve families

Make it interesting and engaging: use appropriate language, worksheets, and/or videos

The Use of CBT with Young People

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Apps for mood- children and adolescents 1. The Grouchies 2. Optimism 3. My Mood Tracker 4. Mood Tracker 5. Mood Chart 6. iMood Journal 7. Sad Scale 8. Mood Me

INSIDE OUT: MOVIE FOR EMOTIONAL AWARNESS

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Kendall, P.C. (2000). Child and Adolescent Therapy: Cognitive-Behavioural Procedures. The Guildford Press, New York

Australian Association of Cognitive Behaviour Therapy.(2015). Retrieved 19th of October 2015 from:

http://www.aacbt.org/viewStory/WHAT+IS+CBT%3F

O’Kelly, M. (2014). CBT in action, a practitioners guide. Premier Publishing and Media, USA

References

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Examples of disputes

Where is the evidence that …?� Am I what they say I am?� Am I an awful kid if I make mistakes?� Just because it happened once, will it always be this way?� Is it really so awful?� Does everything have to be easy?� Where is the evidence you can’t stand it?� What’s the worst thing that could happen & how likely is it that �

this will occur? What is the best thing that could happen? What is the most realistic outcome? Where is it written that everything should be fair and go your way?�

TIPS