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COGNITIVE APPROACHES TO COUNSELING:Stress-Inoculation Therapy

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Theory and Practice of Counseling - PSY632
VU
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
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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
VU
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
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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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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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Table of Contents:
  1. INTRODUCTION:Counseling Journals, Definitions of Counseling
  2. HISTORICAL BACKGROUND COUNSELING & PSYCHOTHERAPY
  3. HISTORICAL BACKGROUND 1900-1909:Frank Parson, Psychopathic Hospitals
  4. HISTORICAL BACKGROUND:Recent Trends in Counseling
  5. GOALS & ACTIVITIES GOALS OF COUNSELING:Facilitating Behavior Change
  6. ETHICAL & LEGAL ISSUES IN COUNSELING:Development of Codes
  7. ETHICAL & LEGAL ISSUES IN COUNSELING:Keeping Relationships Professional
  8. EFFECTIVE COUNSELOR:Personal Characteristics Model
  9. EFFECTIVE COUNSELOR:Humanism, People Orientation, Intellectual Curiosity
  10. EFFECTIVE COUNSELOR:Cultural Bias in Theory and Practice, Stress and Burnout
  11. COUNSELING SKILLS:Microskills, Body Language & Movement, Paralinguistics
  12. COUNSELING SKILLS COUNSELOR’S NONVERBAL COMMUNICATION:Use of Space
  13. COUNSELING SKILLS HINTS TO MAINTAIN CONGRUENCE:
  14. LISTENING & UNDERSTANDING SKILLS:Barriers to an Accepting Attitude
  15. LISTENING & UNDERSTANDING SKILLS:Suggestive Questions,
  16. LISTENING & UNDERSTANDING SKILLS:Tips for Paraphrasing, Summarizing Skills
  17. INFLUENCING SKILLS:Basic Listening Sequence (BLS), Interpretation/ Reframing
  18. FOCUSING & CHALLENGING SKILLS:Focused and Selective Attention, Family focus
  19. COUNSELING PROCESS:Link to the Previous Lecture
  20. COUNSELING PROCESS:The Initial Session, Counselor-initiated, Advice Giving
  21. COUNSELING PROCESS:Transference & Counter-transference
  22. THEORY IN THE PRACTICE OF COUNSELING:Timing of Termination
  23. PSYCHOANALYTIC APPROACHES TO COUNSELING:View of Human Nature
  24. CLASSICAL PSYCHOANALYTIC APPROACH:Psychic Determination, Anxiety
  25. NEO-FREUDIANS:Strengths, Weaknesses, NEO-FREUDIANS, Family Constellation
  26. NEO-FREUDIANS:Task setting, Composition of Personality, The Shadow
  27. NEO-FREUDIANS:Ten Neurotic Needs, Modes of Experiencing
  28. CLIENT-CENTERED APPROACH:Background of his approach, Techniques
  29. GESTALT THERAPY:Fritz Perls, Causes of Human Difficulties
  30. GESTALT THERAPY:Role of the Counselor, Assessment
  31. EXISTENTIAL THERAPY:Rollo May, Role of Counselor, Logotherapy
  32. COGNITIVE APPROACHES TO COUNSELING:Stress-Inoculation Therapy
  33. COGNITIVE APPROACHES TO COUNSELING:Role of the Counselor
  34. TRANSACTIONAL ANALYSIS:Eric Berne, The child ego state, Transactional Analysis
  35. BEHAVIORAL APPROACHES:Respondent Learning, Social Learning Theory
  36. BEHAVIORAL APPROACHES:Use of reinforcers, Maintenance, Extinction
  37. REALITY THERAPY:Role of the Counselor, Strengths, Limitations
  38. GROUPS IN COUNSELING:Major benefits, Traditional & Historical Groups
  39. GROUPS IN COUNSELING:Humanistic Groups, Gestalt Groups
  40. MARRIAGE & FAMILY COUNSELING:Systems Theory, Postwar changes
  41. MARRIAGE & FAMILY COUNSELING:Concepts Related to Circular Causality
  42. CAREER COUNSELING:Situational Approaches, Decision Theory
  43. COMMUNITY COUNSELING & CONSULTING:Community Counseling
  44. DIAGNOSIS & ASSESSMENT:Assessment Techniques, Observation
  45. FINAL OVERVIEW:Ethical issues, Influencing skills, Counseling Approaches