COGNITIVE APPROACHES TO COUNSELING:Stress-Inoculation Therapy

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Theory and Practice of Counseling - PSY632

LESSON 32

COGNITIVE APPROACHES TO COUNSELING

Cognitive theorists agree with William Shakespeare's Hamlet who said "There is nothing either good or bad

but thinking makes it so"

Cognitions are thoughts, beliefs, and internal images that people have about events in their lives

(Holden.1993b). Cognitive theories of counseling focus on these mental processes and their influences on

mental health. A common premise of all cognitive theories is that how people think largely determines how

they feel and behave. As Burns (1980) points out, "every had feeling you have is the result of your distorted

negative thinking"

Best-known Cognitive Theoriess

1. Aaron's Beck's Cognitive Therapy

2. Albert Ellis's Rational Emotive Therapy

3. Eric Berne's Transactional Analysis

Cognitive approaches are widely employed to deal with anxiety and depression. The following bar diagram

shows that these approaches far exceed the other approaches of counseling:

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Theory and Practice of Counseling - PSY632

Common Aspects of cognitive counseling

Client Characteristics

They are average to above-average in intelligence.

They have moderate to high levels of functional distress.

They are able to identify thoughts and feelings.

They are not psychotic or disable by parent problems.

They are willing and able to complete systematic homework assignments.

They possess a repertoire of behavioral skills and responses.

They process information on a visual and auditory level.

This suggests that the clients although distressed are not visually impaired but suffer from dysfunctional

automatic thoughts (content specific to an event) and general schemata (general rules about themselves or

world).

Change Strategies

Chang strategies most often involve the following:

Using standardized guidelines for understanding in a concrete manner the events in people's lives.

Recording or reflecting people's thoughts about these events in a clear, precise way.

Finding a means to identify and challenge distorted thoughts

Implementing new ways of thinking that are realistic and productive.

Stress-Inoculation Therapy

Developed by Meichenbaum (1977)

Uses inoculation training to help people think optimistically when in stressful situations.

Use self talk or self instructions to modify behavior

Inoculating individuals to ongoing and future stressors

Three overlapping phases (Meichenbaum, 1996):

Conceptualizing phase

Skill acquisition and rehearsal phase

Application phase

Beck's Cognitive Therapy

Aaron Beck a Philadelphia psychiatric developed a cognitive approach to mental disorders at about the

same time that Albert Ellis was developing his ideas about rational-emotive therapy (in the late 1950s and

early 1960s). He emphasized the importance of cognitive thinking in his theory, especially dysfunctional

thoughts (thoughts that are nonproductive and unrealistic).

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Theory and Practice of Counseling - PSY632

Beck's Cognitive Triad

Cognitive Errors and the Depressive Cognitive Triad

Think negatively about oneself

Think negatively about the world

Think negatively about the future

In summary, Beck focuses on the importance of modifying thoughts in the treatment of mental disorders.

For him, there are six cognitive distortions to which the counselor should be attuned:

1. arbitrary inferences

2. selective abstraction

3. overgeneralization

4. magnification and minimization

5. personalization

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Theory and Practice of Counseling - PSY632

6. dichotomous thinking

Arbitrary Inference:

Your friend does not call you and you suspect he wants to break up with you.

Selective perception:

Depressed person focuses on negative events while ignoring positive life events

Overgeneralization:

Depressed persons draw negative conclusions about their self-worth, based on minimal

data

Magnification/minimization:

Person magnifies the significance of a negative event. You miss exercising for two days and

you tell yourself, "I'll never get in shape".

Personalization:

Thinking that everything negative is directed toward oneself.

Dichotomous thinking/ All-or-none thinking:

Everything is good or bad

Process & Techniques

Uncover/challenge self-defeating beliefs

Forcefully vs. collaboratively

Change these dysfunctional beliefs

What is the evidence to support this belief? Are these facts or your interpretation of them?

Is there another way to look at the situation?

Techniques

Experience distress in therapy

Diary of situation, feelings, irrational thoughts

Reading assignments

Rational Emotive Therapy (RET)

Albert Ellis

The founder of rational-emotive therapy (RET), Albert Ellis has been described by Weinrach (1980) as

"abrasive, impatient, and lacking in some of the basic social graces that my mother spent hours

indoctrinating me with "but also as "brilliant, sensitive, perceptive, humorous, and stimulating"

Albert Ellis was born in 1913 into a Jewish family in Pittsburg, Pennsylvania. His parents eventually had a

daughter and another son. Early in his life, Ellis's family moved to New York City, where he has spent most

of his life. Ellis describes his father in positive and neutral, although the elder Ellis was often absent from

home. From his father, Ellis believes he acquired his intelligence, drive, and persistence. His mother was

quite independent for her time, often idiosyncratic in her behavior as well as happy and non-smothering.

Ellis describes her way of parenting as benign neglect.

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Theory and Practice of Counseling - PSY632

His parents' divorce when he was 12 years old caused him to give up plans to be a Hebrew teacher, and he

became instead a self-described probabilistic atbeist.

He finally succeeded in obtaining psychoanalytic training from the Karen Horney group and practiced

classic psychoanalysis in the early 1950s. Dissatisfied with that approach, Ellis began the practice of his own

theory in 1955.

Rational-Emotive Therapy: Background

Rational-emotive therapy was primary a cognitive theory in the beginning.

RET has since broadened its base considerably and now includes behavioral and emotional concepts.

Ellis established two nonprofit institutes to promote RET: the institute for Rational Living, a scientific and

educational foundation established in 1959, and the Institute for Rational-Emotive Therapy, an institution

for professional training and clinical services established in 1968. Ellis, as a prolific writer, has produced

over 500 articles, some 50 books, and numerous films and tapes.

View of Human Nature

RET assumes that people are both "inherently rational and irrational, sensible and crazy"

According to Ellis (1989), this duality is biologically inherent and is perpetuated unless a new way of

thinking is learned. Irrational linking may include the invention of upsetting and disturbing thoughts. Ellis

(1962) lists 11 common irrational beliefs that can be quite disturbing.

These needs will be discussed in the next lecture.

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