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Introduction to Cognitive Behavioural Therapy


									Cognitive Behavioural Coaching
      Presented by

      Dr. Damian Davy, A.F. Ps.S.I., Reg. Psychol. Ps.S.I.,

      Doc. Occ. Psych. UEL.
      MSc. Work & Organisational Psychology, DCU
      BSc. (Hons) Psychology, OU
      Dipl. Counselling TCD,
      Cert. EAP, Cert R.E.B.T., Cert CISM. Cert Supervision.

      Registered Psychologist, Psychotherapist, Clinical Supervisor
      EAP Consultant

      Phoenix Consultants.
                                      Who I am
Psychological Society of Ireland, (Associate Fellow & Registered Member).

PSI Division of Work & Organisational Psychologists (Registered Member).

PSI Coaching Psychology Group (Member)

PSI Division of Counselling Psychologists (Registered Member)

PSI Division of Teachers and Researchers in Psychology (Member)

International Association of Applied Psychologists (Member).

British Psychological Society (Member).

Irish Association for Counselling and Psychotherapy (Past President, Accredited Member, Accredited Supervisor).

Employee Assistance Professionals Association-Ireland (Founder member & Past President).

Employee Assistance Certification Commission US. (International Commissioner).

Employee Assistance European Forum (Member/Irish Representative and Researcher).
           What is Coaching ?

   „Coaching is the facilitation of learning and
    development with the purpose of improving
    performance and enhancing effective action,
    goal achievement and personal satisfaction.
    It invariably involves growth and change,
    whether that is in perspective, attitude or
    behaviour‟ – Bluckert [2005]

“Cognitive therapy aims to adjust information-
  processing and initiate positive change in all
  systems by acting through the cognitive system”

“It initially addresses symptom relief, but its ultimate
   goals are to remove systematic biases in thinking
   and modify the core beliefs that predispose the
   person to future distress”

                                       Aaron Beck
          History of CBT

    Developed in the 1960s by Dr.Aaron Beck,
     University of Pennsylvania.
    Theory comes from three main sources:

1.   Phenomenological Theory (Rogers)
2.   Structured Theory (Freud)
3.   Construct Theory (Kelly)
     CBT in Action

As a Cognitive Therapist you are:

1.    Co-investigator
2.    Guide
3.    Teacher
     Types of Therapy Models
    Therapy Model                     Focus
   Psychoanalytic              Unconscious
   Behavioural                 Environment/learning
   Client Centred              Nurturing the Core Self
   Interpersonal Systemic      Faulty Relationship
   Cognitive Behavioural       Meaning-making
CBT General Characteristics
   Meaning determines response
   Collaboration
   Emphasises conceptualisation
   Structured
   Goal-oriented
   Empowers the person through self-help
   Enables the person to become “mindful” and
    make choices
    CBT Solution Plan

   Identify the Problems
   Identify specific Goals
   Identify strategies to address the problems
    and achieve goals
   Identify blocks to achieving goals
   Agree number of sessions
   Assess suitability for short term work
   Refer On
  Strengths, Skills and Resources
         Exercise (Triads)
Identify a moment in your life when
  you succeeded in overcoming some
  recurrent problem and reflect and
  encourage the “Coachee” to reflect on
  each of the following:
How would you describe your state of mind on
that occasion. How did you feel? What kind of
attitude did you take towards your situation?
How did you act to achieve a positive result?

What strengths/skills did that situation reveal
about you as an individual?

What resources did you draw on to help you
achieve a positive outcome in that situation?
        How CBT Works.
   CBT is based on the Cognitive Model of Emotional Response.

   CBT is Briefer and Time-Limited.

   A sound therapeutic relationship is necessary for effective therapy, but
      not the focus.

   CBT is a collaborative effort between the therapist and the client.

   CBT is based on stoic philosophy.

   CBT uses the Socratic Method.

   CBT is structured and directive.

   CBT is based on an educational model.

   CBT theory and techniques rely on the Inductive Method.

   Homework is a central feature of CBT.
            History of REBT
   Founded by Dr. Albert Ellis, 55 years ago
    (September 27, 1913 – July 24, 2007)
   Dissatisfied with psychoanalysis.
   Originally known as Rational Psychotherapy.
   Later became Rational Emotive Therapy.
   The philosophic origins of RET go back to
    the Stoic philosophers, including Epictetus
    and Marcus Aurelius.
   Now known as Rational Emotive Behaviour
    Therapy (because it stresses the importance
    of the interaction of cognitive, emotive and
    behavioural factors in human lives)
   The Interaction in Human

Physiology                        Emotions/feelings

   Thought for the moment

„The unexamined life is not worth living‟

Epictetus wrote in The Enchiridion, "Men are
disturbed not by things, but by the view which
they take of them."

                        First century A.D.

   What do
   you see?

  Which line
 Fantasised
 Experiences
 Appearing
 Real
I worried about many things in life,
  much of which never came to pass.

                  Mark Twain
Who’s This?

     In 1943 Abraham Maslow,
     one of the founding fathers
     of humanist approaches to
     management, wrote an
     influential paper that set out
     five fundamental human
     needs needs and their
     hierarchical nature.
The five needs
 Physiological needs are to do with the maintenance of the human
  body. If we are unwell, then little else matters until we recover.
 Safety needs are about putting a roof over our heads and keeping
  us from harm. If we are rich, strong and powerful, or have good
  friends, we can make ourselves safe.
 Belonging needs introduce our tribal nature. If we are helpful and
  kind to others they will want us as friends.
 Esteem needs are for a higher position within a group. If people
  respect us, we have greater power.
 Self-actualization needs are to 'become what we are capable of
  becoming', which would be our greatest achievement.
Maslow’s Structure
Brief History
          Reality Therapy was
           developed by Dr.
           William Glasser, a
           psychiatrist who trained
           in psychoanalysis.
          People behaving in
           inappropriate ways do
           not need help to find a
           defense for their
          Reality Therapy is
           Needs driven
     The Theory (Reality Therapy)
We are born with at least two needs

1.    The need to belong and be loved
2.    The need for gaining self-worth and
         Our Five Basic Needs
1.   Power
2.   Love and Belonging
3.   Freedom
4.   Fun
5.   Survival

One of the core principles of Reality Therapy is that
   whether we are aware of it or not, we are all the time
   acting to meet these needs.
The Reality Therapy Circle

       Love      Power

       Freedom   Fun
       Getting What we Want

There are three basic questions asked in
  Reality Therapy

   What do you want?
   What are you doing to get what you
   Is it working?
     Where do we get our
    negative beliefs from ?

 Many of our beliefs are formed in our
  developmental years
 From care givers, relatives and
 From our own incorrect
 From experiences
      Cognition /Thinking

            B = Beliefs and self talk

A = Situation               C = Emotional Reaction
“The cream cake made me eat it”

          Windy Dryden
A rigid belief where the person dogmatically insists that
  certain conditions must or must not exist.

They are absolutes.

I would like to pass my driving test…and therefore I have to
   do so. (I must pass my driving test)
I want you to treat me fairly… and therefore you absolutely
   have to do so. (You must treat me fairly).
It would be really nice if my house did not have
   subsidence…and hence it must absolutely be
   subsidence free. (My house must not have subsidence).

We sometimes refer to this as MUSTERBATION
         Awfulising Beliefs
An awfulising belief is an extreme belief that
   has one or more of the following meanings,
1. 100% Bad or „nothing can be worse‟
2. Worse than 100% Bad
3. No good can possibly come from this

It would be bad if I did not pass my driving
    test…and therefore it would be awful. (It
    would be awful to fail my driving test).
    Low Frustration Tolerance
A low frustration tolerance belief asserts
 that the negative event at A cannot be
 tolerated and is therefore extreme (It
 must absolutely not exist)
Not passing my driving test would be
 hard to bear…and therefore it would be
 unbearable. (Not passing my driving
 test would be intolerable)
       Depreciation Beliefs
A depreciation belief tends to stem from
 the following demand: I, you or life
 must conform to my desires.

Not passing my driving test would be a
 failing…and would prove that I am a
 failure. (I would be a failure for failing
 my driving test).
     Five Questions to Challenge
           Mistaken Beliefs
1.   What is the evidence for this belief? Looking
     objectively at all of my life experiences, what is the
     evidence that this is true?
2.   Does this belief invariably or always hold true?
3.   Does this belief look at the whole picture? Does it
     take into account both positive and negative
4.   Does the belief promote my well-being or peace of
5.   Did I choose this belief on my own or did it develop
     out of my experience of growing up in my family?
    Modification of Unrealistic
   Disputing the logic of thoughts (evidence)
   Contradict the thoughts or beliefs e.g. talk
    to people you believe dislike you
   Persist in challenging thinking and behave
    in ways which contradict the beliefs
   Does the belief always hold true?
   Does the belief look at the whole picture?
   Does it promote my well-being?
   Did I choose it myself or did it come from

Steps                              Questions/Actions
1. Problem identification          What is the concern?
2. Goal selection                  What do I want?
3. Generation of alternatives      What can I do?
4. Consideration of consequences   What might happen?
5. Decision making                 What is my decision?
6. Implementation                  Now do it!
7. Evaluation                      Did it work?

Wasik (1984)
           Managing Distress
   What happened?           What am I assuming
   What am I feeling?        „should be‟?
   What am I thinking?      Is there a real
   How am I behaving?        concern?
   What am I telling
                             Am I over-reacting?
    myself? (self-talk)
                             Healthy
                              can I do about the

CORE Irrational Beliefs
 Based on the work of
    Dr. Albert Ellis
     Perfection v Discovery
Perfection says: “Is this good enough or
 not?” “Does this meet my impeccably
 high standards?”

Discovery says: “How fascinating! What
 are the possibilities here?”
 Man‟s Search for Meaning

“He who has a Why to live can bear with
 almost any How”

           Viktor E. Frankl 1946
 Right or Wrong?                  Failure!
 Do I measure up?                 Do you measure up?
 Life is a struggle.              Life is hard work.
 Mistakes are unacceptable.       I have to be right.
 Judgement.                       Blame.
 Unbendable beliefs about         Don‟t take chances!
what‟s proper.

               Perfection sets up
              “Winners & Losers”
   Exploration.                     Acceptance.
   Enthusiasm.                      Play.
   Let‟s take a risk.               Inquiry.
   What are the possibilities?      Experiment.
   Everything‟s a success.          How else can we look at

           Discovery invites
         “Winners & Learners”
      Willingness to Resolve
Projection and Shadow. (Jung)
Projection is when we see our own thoughts
 and feelings in the minds and behaviours
 of others and not in ourselves.
Persona describes the conscious aspects of
 personality, good and bad aspects which
 are known to the person.
Jung called the unknown side of who we are
    Acknowledge Projection
To be willing to resolve we need to acknowledge
  our projection.
 Suppressed needs: Failing to recognise my
  need for companionship. I am deeply hurt when
  a friend postpones time we had planned to be
 Unresolved personal history: If I was seriously
  let down as a child I may become really wild
  when people don’t do what they promised.
 Unacceptable qualities: Because I don’t accept
  my own anger, I don’t accept it in others.
       Socratic Questions
 Conceptual clarification questions
 Probing assumptions
 Probing rationale, reasons and
 Questioning viewpoints and
 Probe implications and consequences
 Questions about the question
Solution Focused Brief
Thank you for your participation and

My contact details are,

Phoenix Centre
165 New Cabra Road, Cabra, Dublin 7.
Phone: 353 87-2505405

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