Cognitive Behavioral Therapy
Workshop
Wendy Danicourt, CAP, CET, CMHP
Operation PAR, Inc.
This product was supported by the Florida Department of Children and Families
Substance Abuse and Mental Health Program Office funding.
Welcome
Objectives
Understand the basic principles of Cognitive
Behavioral Therapy (CBT) and their application in
clinical practice.
Explore methods to engage a client/patient in
CBT, establish a collaborative relationship and
set goals.
Practice basic CBT techniques, including
cognitive exercises, behavioral exercises, and
use of homework.
Why Are You Here Today?
Overview of CBT
What is CBT?
Based on Cognitive Behavioral Theory
Collaborative between therapist and client
Learning skills and applying skills
Who Uses CBT?
Mental Health
Substance Abuse
Medical
Behavioral
Who Else?
What Is It Good For?
Depression
OCD
Anxiety
Chronic Pain
Substance Abuse
Eating Disorder
Anger Management
Insomnia
Post Traumatic Stress
Disorder (PTSD)
…….
Personality Disorders
Cultural Implications
Essential - understand and respect
Who is in charge of the challenges and
determination
Limitations
or are they?
Positive Thinking
Superficial
Technique-oriented
No therapeutic relationship
Focus on symptoms
Ignoring client past
Emotions are played down or result of faulty
thinking
Stand Alone?
Counseling Style
Evidence Based Practices
12 Step
Vs. Other Theories
Premise
Thinking, feeling and doing separate realms of
human process that become associated through
learning
Proximity of association increases the strength of
the relationship between thinking, feeling and
doing
Associations can become triggers and cues or
reinforce the desire for the associated behavior
B.F. Skinner
Behavior that is positively reinforced will reoccur;
intermittent reinforcement is particularly effective
Information should be presented in small
amounts so that responses can be reinforced
(SHAPING)
Condition vs. Innate Reflex
Carl Roger’s
Significant learning takes place when the subject
matter is relevant to the Learner
Learning proceeds faster when threat to self if
low
Most lasting learning - self-initiated
Bandura
Highest level of observational learning is
achieved by first organizing & rehearsing the
modeled behavior
Individuals more likely to adopt a modeled
behavior if it results in an outcome they value
Individuals are more likely to adopt a modeled
behavior if the model is similar to the observer,
has admired status & behavior has functional
value
Miller and Rollnick
Develop discrepancy, empathize, avoid
arguments, roll with resistance, support selfefficacy (DEARS)
Change elicited from the client
Client in charge - articulate and resolve
ambivalence
Therapeutic relationship - partnership
Key Concepts
Assessment
Precise Goals
Plan
Evaluate
Dispute irrational beliefs/
catastrophizing/
misconceptions
Break through isolation
Homework
Realistic
Change language
Recognize px & link to
consequences
Skill development
Psych educational
Feedback
Role-playing
Promotes change
Alleviate emotional distress
Addresses whole person
Collaborative
Structured and focused
Role - Therapist
Therapist: combine empathy and sensitivity
Technical competence
Client centered
Creative, active, interactive
Knowledgeable and skilled in strategies
Able to educate
Catalyst/guide
Role - Client/Patient
Very active - in session and out of session
Identify the distortions in thinking
Summarize
Self-discovery
Becoming their own therapist
Settings - Individual
Settings - Family
Family schemata
Exerting a mutual influence on one another
Dattilio: selective attention, attributions,
expectations, assumptions, and standards
Settings - Group
Welcome
Check-in
Review
Introduce new skill
Education
Use of skill
Homework
Commitment
Summary
Sessions - Helpful Hints
Go in with a goal
Have and know
information/education
Structure
Small steps
Comfort with Role-play
Role Play
Summary