cognitive therpay

CBT is a form of psychotherapy which is applied worldwide and is evidence-based.  Beckian Cognitive Therapy is founded on the model of a dynamic interaction between a specific context, biology, thoughts, feelings and behaviour and integrates some of the philosophical and theoretic contributions from Epicetus, Adler, Ellis, Lazarus and Wolpe.  Case conceptualization and treatment emphasis differs from that of i.e. REBT.   

The focus of therapy is determined by the specific problem and is individually tailored to the person. The process of therapy is facilitated by guided discovery, whereby thinking is tested by what is termed ‘collaborative empiricism’.  The truth is hereby investigated and derived at together through the therapist's facilitative questions.  Therapy consists of various cognitive and behavioural interventions, and the encouragement of appropriate affect. The therapeutic relationship provides the medium through which change is brought about and is determined by the condition treated.  It is always based on trust and compassion.  

"Cognitive Therapy seeks to harnass the best of clinical art and science in the service of helping people to overcome the burdon of maladaptive negative beliefs, biases in thinking and their emotional and behavioural consequences". A.T. Beck  

Principles


In view of standardizing the treatment CBT, Fidelity standards were developed. The Cognitive Therapy Rating Scale (www.beckinstitute.org> CBT Resources> Professional Tools & Resources or www.ed.ac.uk/polopoly_fs/1.155959!/fileManager/CTRSmanual.pdf) is used for training and supervision purposes. Qualities such as therapeutic skills, conceptualization, strategy and technique are ensured herein.

The general principles of Cognitive Therapy include working collaboratively towards clear goals, with the therapist taking an active role. Strategies are based on individually tailored conceptualizations of problems. Specific protocols for specific diagnoses are available, which emphasize a point of focus (whether on emotional expression, behavioural activation or skill development, on thought modification, on physiological intervention or on circumstantial change). Work between sessions is encouraged and relapse prevention is accommodated.1

CBT Therapies

First Wave

Behaviour Therapy: Contributed by Thorndike, Wolpe, Lazarus, Skinner, Eysenck. Consists of a wide range of techniques that help to change unhealthy behaviour. Based on the theory that all behaviour is learned.


Second Wave

REBT (Rational Emotive Behaviour Therapy): Founded by Albert Ellis. Directive approach, therapist is actively involved. Defined many cognitive distortions, theory based on ABCDEF model.

CT (Cognitive Therapy): Aaron T Beck, father of contemporary CBT. Collaborative, based on individual case conceptualization. Focused on understanding internal reality and origins thereof. CT model consists of linking biology, thoughts, feelings and behaviour within context of the person. Thoughts are explored to bring about change in other areas. Emotions, behaviour and circumstances (present and past) may all be points of focus during therapy, depending on treatment protocols and therapeutic relationship.


Third wave

ST (Schema Therapy): Created by Jeff Young. Focus on complicated/chronic cases and Personality Disorders. Based on a combination of CBT, experiential, interpersonal and psychoanalytic therapies.

ACT (Acceptance and Commitment Therapy): Designed by Steven Hayes. Using Acceptance and Mindfulness strategies, opening up to unpleasant feelings and moving to ‘valued behaviour’.

MBCT (Mindfulness Based Cognitive Therapy): CT incorporating Mindfulness and Meditation to prevent depression relapse vs MBSR (Mindfulness Based Stress Reduction) which targets stress management vs MBRP (Mindfulness Based Relapse Prevention) which works with addiction. Similar in theory. Focus on living in the moment, ‘decentring’ techniques meaning being aware of thoughts and feelings without reacting to them.

MCT (Meta Cognitive Therapy): Originated by Adrian Wells. Discovering what people believe about their thoughts, ‘thinking about thinking’. Therapy includes experiential, attentional and mindfulness components.

TBCT (Trial Based Cognitive Therapy): Written by Irismar De Oliveira. Metaphorical, organized and focused on changing Core Beliefs.

CBASP (Cognitive Behavioural Analysis System of Psychotherapy): Initiated by McCullough. Treatment designed for chronic depression, with an interpersonal focus.

CFT (Compassion Focused Therapy): By Paul Gilbert. In cases of shame, guilt experienced. Creating inner warmth, safety via compassion training.

Imagery rescripting: Reliving and transforming distressing images into self-soothing images.

EFT (Emotion Focused Therapy): Includes elements of Gestalt, person centred, systemic and attachment theory. Emotional awareness, regulation, reflection and transformation brings about required change through the therapeutic relationship.

DBT (Dialectical Behaviour Therapy): Created by Marsha Linehan, often used for Borderline Personality Disorder, Bipolar Disorder, substance abuse, suicidality. Based on CBT plus emotional regulation, distress tolerance and mindfulness. Combination of individual and group therapy.

UP (Unified Protocol for trans diagnostic conditions): Owned by David Barlow. Emotion focused CBT consisting of one protocol for anxiety and co-morbid conditions. Treatment consisting of five elements (emotional awareness, cognitive flexibility, identifying patters of emotional avoidance and maladaptive behaviour, awareness and tolerance of physical sensations, exposure exercises).

Resource: Wikipedia

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