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KNR 253 Cognitive Therapy Anger Management Humor Overview n Cognitive Therapy 2009 ¨ Austin, ¨ McKay, Davis, & Fanning, 1981 n Anger Management ¨ Dattilo& McKenney, 2011 ¨ Internet n Humor ¨ Dattilo& McKenney, 2011 ¨ Austin, 2009 ¨ Internet Cognitive Therapy n Psychotherapy ¨ Started in 1960’s ¨ Aaron Beck ¨ Albert Ellis n Used with ¨ Depression ¨ Anxiety n Post Traumatic Stress Disorder n Obsessive Compulsive Disorder ¨ Anger ¨ Stress ¨ Others Cognitive Therapy Based on… 1. All of your moods are created by your thoughts. You feel the way you do right now because of the thoughts you are thinking at this moment 2. Emotions have little to do with actual events. In between the event and the emotion is realistic or unrealistic self-talk 3. Emotions come from what you say to yourself…your interpretation of the event 4. If you are feeling depressed, your thoughts are dominated by pervasive negativity 5. Negative thoughts that cause emotional turmoil nearly always lead to gross distortions or distortive cognitions Cognitive Therapy n Seeks to identify and change distorted unrealistic ways of thinking and influence behaviors and emotions n These thoughts occur rapidly while in middle of a situation or when recall events from past n These are thoughts we always say to ourselves in certain situations Cognitive Therapy n These thoughts are … ¨ Automatic ¨ Repetitive ¨ Pessimistic ¨ Unrealistic expectations ¨ Overly critical self evaluations ¨ Self-talk Distorted Thinking n Filtering ¨ Take negative details & magnify them while filtering out all positive aspects of the situation n Only see the negative comments in your performance appraisal and not see all the positive ratings n Polarized thinking ¨ Things are black or white, good or bad. You have to be perfect or you’re a failure. There is no middle ground n If you are not perfect you must be a failure Distorted Thinking n Overgeneralization ¨ You come to a general conclusion based on a single incident or piece of evidence. If something bad happens once you expect it to happen over and over again n I’ll never learn to dance n I’ll never be able to trust anyone again n Mind reading ¨ Without their saying so, you know what other people are feeling and why they act the way they do. In particular, you are able to know how people are feeling toward you n Jump to conclusions that are true for you and assume others share your belief n He’s just acting that way because he is jealous Distorted Thinking n Catastrophizing ¨ You expect disaster. You notice or hear about a problem and start “what ifs.” What if a tragedy strikes? n A small leak in your boat means it will sink n A headache means that you have brain cancer n Personalization ¨ Thinking that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who’s smarter, better looking, etc. n A man whose wife complains about rising prices hears the complaint on an attack on his ability as a breadwinner Distorted Thinking n Control fallacies ¨ If you feel externally controlled, you see yourself as helpless, a victim of fate ¨ If you feel internal control you are responsible for the pain and happiness of everyone around you Distorted Thinking n Fallacy of fairness ¨ You feel resentful because you think you know what’s fair but others won’t agree with you n If you love me then you will help do the dishes n If you love me you would go dancing with me n Blaming ¨ You hold other people responsible for your pain, or take the other tack and blame yourself for every problem n The teacher is responsible for my poor grade because she didn’t give good directions for the project Distorted Thinking n Shoulds ¨ You have a list of ironclad rules about how you and other people should act. People who break the rules anger you and you feel guilty if you violate the rules n I should never make mistakes n I should never be tired or get sick n Emotional reasoning ¨ You believe that what you feel must be true. If you feel stupid and boring, then you must be stupid and boring Distorted Thinking n Fallacy of change ¨ You expect that others will change to suit you if your just pressure or cajole them enough n Global labeling ¨ You generalize 1 or 2 qualities into a negative global judgment n A person who refused to help you with your project is a total jerk Distorted Thinking n Being right ¨ You are continually on trial to prove that your opinions and actions are right. Being wrong is unthinkable and you will go to any length to demonstrate your rightness n Heaven’s reward fallacy ¨ You expect all your sacrifice and self-denial to pay off, as if there were someone keeping score. You feel bitter when the reward doesn’t come § McKay, Davis, & Fanning, 1981 What Is Your Most Used Distortion? n Filtering n Fallacy of fairness n Polarized thinking n Blaming n Overgeneralization n Shoulds n Mind reading n Emotional reasoning n Catastrophizing n Fallacy of change n Personalization n Global labeling n Control Fallacies n Being right n Heaven’s reward fallacy Cognitive Therapy Interventions n Goal is to help recognize and change distorted thinking ¨ Focus on present ¨ Problem solve ¨ Learn basic principles ¨ Learn specific skills n Thought stopping ¨ Listen to thoughts. When cognitive distortion occurs, say “stop” to self or other person ¨ Restructure to a more realistic positive statement Cognitive Therapy Interventions n Affirmations ¨ Positive, reasonable statements are made about yourself ¨ They are stated in first person and in present tense n I am … ¨ They are stated with conviction and should be repeated throughout the day ¨ Helpful to place affirmations in places where they are visible and easy to read Cognitive Therapy Interventions n Visualization ¨ Practice desired behaviors in mind before doing them n Visualize yourself doing each component n Ignore negative thought n Relive successes instead of failures n Role play Cognitive Therapy Interventions n Cognitive restructuring ¨ Systematic plan where distortions are restructured into positive statements which are incompatible with distorted thought 1. Name your emotion 2. Describe the situation or event 3. Identify your distortions 4. Rewrite your distortions Anger Management Dattilo & McKenney, 2011 Anger Management n Is a cognitive-behavioral intervention ¨ Both learning and thinking are important in the acquisition and maintenance of behavior n Cognitive: based on distorted thinking; intervention seeks to change thoughts n Behavioral: problems based on environmental reasons that result in poor social skills and not distorted thinking n Cognitive-behavioral: intervention focuses on distorted thinking and social deficits Definitions n Anger ¨ Emotional excitement induced by intense displeasure n Grinding teeth, raised voices (behavior) n Tense muscles, perspiration (physiological) n Aggression ¨ Anger often is a precursor to aggression ¨ Exhibition of actions toward people or objects with some intent to hurt or injure n Physical n Verbal n Gestures n Bullying Definitions n Violence ¨ Violencemay come from aggression ¨ Frequently seen in media n Murder n Assault n Rape Anger Management n Uses ¨ Behavioral problems ¨ Mental health problems ¨ Legal problems (incarcerated, probation) ¨ Others Anger Management Interventions n Anger Control Program n Anger Coping Program n ZIPPER Strategy n Don’t Laugh at Me ZIPPER n Z: Zip your mouth ¨ Hand motion stop, deep breath, finger across mouth like zipper n I: Identify the problem ¨ Deep breath, put finger to temple, identify problem n P: Put off what you want to do ¨ Pause, deep breath, “I may find a better way to handle this,” “Don’t get angry.” n P: Put yourself in control ¨ “Stay cool,” put hands on hip, turn thumbs up, “I’m in control.” n E: Explore other solutions ¨ “What can I do?” Shrug shoulders, explore other options n R: Return to what you were doing ¨ “I’ve made it. Return to activity Humor Dattilo & McKenney, 2011 n Have you ever benefited from using humor in your own life? n What are some ways humor might be beneficial in a TR setting? Theoretical Foundations n Incongruity theory ¨ Differencebetween what is expected and what actually happens ¨ Has an element of unexpectedness n Psychological release ¨ Release tension Outcomes n Reduce anxiety & n Improve interpersonal depression relationships n Increase pain n Improve memory tolerance n Assist with recovery n Improve immune from surgery system functioning n Assist ability to learn n Improve self-concept Possible Uses in TR n Functional intervention/treatment ¨ Use with people receiving treatment for cancer, dialysis, burns, etc. ¨ Use to help with memorization skills ¨ Others n Leisure education ¨ Humor development ¨ Humor appreciation ¨ Stress and humor Possible Uses in TR n Recreation participation ¨ Humor rooms ¨ Humor carts ¨ Movies ¨ Skits produced by clients Sample Programs n The Humor Project n A Tonic You Can Afford n The Healing Power of Humor n How to Develop Your Sense of Humor n The Comedy Club n Humor Production Procedure n Also provides a couple exercises Activity: Add Some Nonsense n Making fun of problems can help people get new perspective and remove power of the problem ¨ Write 5 things that regularly cause you stress ¨ Number in order of least stressful to most stressful ¨ Write a short laugh sound after each sentence n “Ha ha” “Tee hee” n Nobody ever listens to me….ha ha Cognitive Therapy / Anger Management / Humor / Reminiscence Lab n Group session that enables group members to practice principles and techniques of cognitive therapy, anger management, humor, or reminiscence.
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