Cognitive Behavioral Therapy

1. COGNITIVE BEHAVIORAL
THERAPY
Manlongat, Oflunra Abby A.

2. Emotive Techniques
• REBT practitioners use a variety of emotive procedures,
including unconditional acceptance, rational emotive
role playing, modeling, rational emotive imagery, and
shame attacking exercises.
• Clients are taught the value of unconditional self-
acceptance.
• Even though their behavior may be difficult to accept,
they can decide to see themselves as worthwhile
persons.
• Clients are taught how destructive it is to engage in
“putting oneself down” for perceived deficiencies.

3. Emotive Techniques
• Although REBT employs a variety of emotive
techniques, which tend to be vivid and
evocative in nature, the main purpose is to
dispute clients’ irrational beliefs (Dryden,
2002)

4. Emotive Techniques
Rational emotive imagery.
• This technique is a form of intense mental practice designed to
establish new emotional patterns.
• Clients imagine themselves thinking, feeling, and behaving exactly
the way they would like to think, feel, and behave in real life
(Maultsby, 1984)
Using humor.
• REBT contends that emotional disturbances often result from taking
oneself too seriously. One appealing aspects of REBT is that it
fosters the development of a better sense of humor and helps put
life into perspective (Wolfe, 2007).
• Humor has both cognitive and emotional benefits in bringing about
change.

5. Emotive Techniques
• Role playing.
Role playing has emotive, cognitive, and behavioral components, and
the therapist often interrupts to show clients what they are telling
themselves to create their disturbances and what they can do to
change their unhealthy feelings to healthy ones. Clients can rehearse
certain behaviors to bring out what they feel in a situation.
• Shame-attacking exercises.
Ellis developed exercises to help people reduce shame over behaving
in certain ways. He thinks that we can stubbornly refuse to feel
ashamed by telling ourselves that it is not catastrophic if someone
thinks we are foolish. The main point of these exercises, which
typically involve both emotive and behavioral components, is that
clients work to feel unashamed even when others clearly disapprove
of them.

6. Emotive Techniques
• Use of force and vigor.
Ellis has suggested the use of force and energy
as a way to help clients go from intellectual to
emotional insight. Clients are also shown how to
conduct forceful dialogues with themselves in
which they express their unsubstantiated beliefs
and then powerfully dispute

7. Behavioral Techniques
• REBT practitioners use most of the standard behavior
therapy procedures, especially operant conditioning,
self-management principles, systematic
desensitization, relaxation techniques, and modeling.
• Behavioral homework assignments to be carried out in
real-life situations are particularly important. These
assignments are done systematically and are recorded
and analyzed on a form.
• Homework gives clients opportunities to practice new
skills outside of the therapy session, which may be
even more valuable for clients than work done during
the therapy hour (Ledley et al., 2005)

8. Research Efforts
• If a particular technique does not seem to be
producing results, the REBT therapist is likely to
switch to another. This therapeutic flexibility
makes controlled research difficult.
• As enthusiastic as he is about cognitive behavior
therapy, Ellis admits that practically all therapy
outcome studies are flawed.
• According to him, these studies mainly test how
people feel better but not how they have made a
profound philosophical-behavioral change and
thereby get better (Ellis, 1999, 2001a).

9. Applications of REBT to Client
Populations
• REBT has been widely applied to the treatment of
anxiety, hostility, character disorders, psychotic
disorders, and depression; to problems of sex,
love, and marriage (Ellis & Blau, 1998); to child
rearing and adolescence (Ellis & Wilde, 2001);
and to social skills training and self-management
(Ellis, 2001b; Ellis et al., 1997).
• With its clear structure (A-B-C framework), REBT
is applicable to a wide range of settings and
populations, including elementary and secondary
schools.

10. Applications of REBT to Client
• REBT can be applied to couples counseling and family
therapy.
• In working with couples, the partners are taught the
principles of REBT so that they can work out their
differences or at least become less disturbed about them.
• In family therapy, individual family members are
encouraged to consider letting go of the demand that
others in the family behave in ways they would like them
to.
• Instead, REBT teaches family members that they are
primarily responsible for their own actions and for changing
their own reactions to the family situation.

11. REBT as a Brief Therapy
• REBT is well suited as a brief form of therapy,
whether it is applied to individuals, groups,
couples, or families.
• Ellis originally developed REBT to try to make
psychotherapy shorter and more efficient than
most other systems of therapy, and it is often
used as a brief therapy.
• Ellis has always maintained that the best therapy
is efficient, quickly teaching clients how to tackle
practical problems of living.

12. REBT as a Brief Therapy
• The A-B-C approach to changing basic
disturbance-creating attitudes can be learned
in 1 to 10 sessions and then practiced at
home. Ellis has used REBT successfully in 1-
and 2-day marathons and in 9-hour REBT
intensives.

13. Application to Group Counseling
• Cognitive behavior therapy (CBT) groups are
among the most popular in clinics and
community agency settings. Two of the most
common CBT group approaches are based on
the principles and techniques of REBT and
cognitive therapy (CT).

14. Application to Group Counseling
• Ellis recommends that most clients experience
group therapy as well as individual therapy at
some point.
• This form of group therapy focuses on specific
techniques for changing a client’s self-defeating
thoughts in various concrete situation.
• This approach helps group members see how
their beliefs influence what they feel and what
they do.

15. Application to Group Counseling
• CBT groups have targeted problems ranging from
anxiety and depression to parent education and
relationship enhancement
• Cognitive behavioral group therapy has been
demonstrated to have beneficial applications for
some of the following specific problems:
depression, anxiety, panic and phobia, obesity,
eating disorders, dual diagnoses, dissociative
disorders, and adult attention deficit disorders
(see White & Freeman, 2000).

16. Aaron Beck
• Developed an approach known as Cognitive
Therapy (CT) as a result of his research on
depression.
• Cognitive therapy is based on the theoretical
rationale that the way people feel and behave
is determined by how they perceive and
structure their experience.

17. • Cognitive therapy perceives psychological
problems as stemming from commonplace
processes such as faulty thinking, making
incorrect inferences on the basis of
inadequate or incorrect information, and
failing to distinguish between fantasy and
reality.

18. Similarities of REBT and CT
• Active
• Directive
• Time-limited
• Present-centered
• Problem-oriented
• Collaborative
• Structured
• Empirical
• Make use of Homework

19. DIFFERENCES BETWEEN CT AND REBT
REBT
• is often highly directive, persuasive, and confrontational.
• It also focuses on the teaching role of the therapist.
• The therapist models rational thinking and helps clients to
identify and dispute irrational beliefs.
CT
• Uses a Socratic dialogue by posing open-ended questions
to clients with the aim of getting clients to reflect on
personal issues and arrive at their own conclusions.
• CT places more emphasis on helping clients discover and
identify their misconceptions for themselves than does
REBT.