Lecture Reading Assignment 29:
Therapy II: Cognitive-Behavioral Therapy
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Summary:
The twenty-ninth reading assignment introduces Cognitive-Behavioral Therapy. This form of Psychotherapy, in my opinion, is the most effective form discussed in this textbook. It provides a focus on current problems of relevance to the patient, has a clear underlying plan to the treatment being offered, and delivery that is built on an effective relationship with the practitioner. Its purpose is for patients to learn new skills of self-management that they will then put into practice in everyday life (Williams & Garland, 2002). In addition, Cognitive-Behavioral Therapy is intended to be short term, while its counterparts often consist of drawn out sessions that can span months and years.

Behavior Therapy
The effectiveness of modern Cognitive-Behavioral Therapy can also be attributed to Behavior Therapy. Much of what made Behavior Therapy effective, before its decline in popularity, was that psychotherapy often followed an effective Behavioral Analysis. It makes sense that the effectiveness of psychotherapy would be contingent on whether it addresses the pertinent issues at hand. However, many forms of psychotherapy do not consider this step. Many forms of psychotherapy have adopted strong assumptions about the origins of psychopathology (i.e., the Unconscious or dealing with unpleasant emotions) and do not assess readily available information that can be gained from the patient and the environment. Behavior Therapy and Cognitive-Behavior Therapy do not have such assumptions and instead focus on the process of addressing problematic environments and thoughts; that is, after systematically or scientifically assessing possible causes and addressing them (i.e., conducting a Behavioral Analysis).

The many forms of Exposure Techniques that serve as tools for Cognitive-Behavioral Therapist can also be attributed to Behavior Therapy. There are several forms of Exposure Techniques that are widely used today: Systematic Desensitization, Graded Exposure, Virtual Reality Exposure Therapy, and Flooding. All Exposure Techniques share the goal to enable patients to reduce anxieties experienced due to feared stimuli; however, they achieve this goal in different ways. For example, Systematic Desensitization is a classical conditioning technique that enables a client who once feared a particular stimulus to gradually relieve those fears. The client does this by imagining the stimulus in a state that reduces one's anxiety. The tremendous advancements in technology have resulted in the use of Virtual Reality Exposure Therapy to aid situations that might be dangerous or particularly costly. Imagine the cost and hardship involved with getting over a fear of flying. The patient could either waste a lot of money on unused airline tickets or the therapist would have to go to great lengths to arrange a realistic and mock boarding of an airplane.

If You Can’t Beat Them, Join Them!
Two additional techniques practiced by Cognitive-Behavioral Therapist include Modeling , Participatory Modeling, and Skills Training. Modeling can be a very an important tool, as a patient will almost never come in contact with a troublesome situation with forewarning and under direct supervision. As a result, the patient may not behave appropriately age. Observing how to behave can be a crucial step in improving the maladaptive behavior of the patient. Participatory Modeling is a branch of Modeling in which patients observe the therapist exhibiting desirable behavior and is then propositioned by the therapist to join in on the behavior. The patient may be prompted to join in a controlled setting, naturalistic setting, or a comprehensive approach that includes both settings. Skills Training, on the other hand, enables the therapist to teach the client to self-regulate desired behaviors to achieve specific goals. In the real-world, we do not often encounter situations that one behavioral response would suffice as a solution. Depending on your age, you may remember the “Say No to Drugs” campaign initiated by former first lady Nancy Reagan. Critics of the campaign argue that drugs are not typically solicited in a fashion that a simple “No” will suffice and if the pressure is still exerted they will not know how to cope. As a result, it might better serve the patient to teach children a variety of related techniques that can be used individually or in combination with each other. For example, it might prove most useful to aid in establishing an identity for the child that is not dependent on approval by one's peers.

While Cognitive-Behavior techniques aim to filter out unwanted behavior, Cognitive-Therapy techniques seek out dysfunctional thoughts that lay the groundwork for psychological disorders (Kowalski & Westen 2009). These approaches might relay solely on thought processes or might simply view them as a greater priority than modifying behavior, but still giving it ancillary attention. Possibly the greatest concern, as it pertains to thought processes, is whether a patient has a Pessimistic Explanatory Style. Research suggests that a Pessimistic Explanatory Style is associated with Depression and physical illness. Two famous therapists who did much research on Cognitive-therapy are Albert Ellis and Aaron T. Beck. Ellis proposed the ABC Theory of Psychopathology, which has proven to be an invaluable way of perceiving the relationship between the environment and behavior. Beck, on the other hand, developed Rational-Emotive Behavior Therapy that almost exclusively places importance on thought processes to improve the well-being of a patient.




References

Williams, C., & Garland, A. (2002). A cognitive–behavioural therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8, 172-179. doi:

Retrieved on June 14, 2013 from Gnthttp://apt.rcpsych.org/content/8/3/172.full#sec-1



Draft of Summary

James, E. (2012, Fall). Assignment 2.3. Draft of summary submitted in partial fulfillment of Introduction to Experimental (RPS 410).




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