Monthly Archives: October 2013

Cognitive Behavioral Therapy for Depression and Depressive Cognitions

CBT and Depressive Thoughts

Cognitive Behavioral Therapy (CBT) is an empirically tested form of psychotherapy that has been shown to be effective in improving various mental health disorders, including anxiety, depression and anger. Cognitive behavioral therapy and its components have progressed over the last 50 years or so. One of the founders of the cognitive behavioral therapy model, Albert Ellis, was one of the first psychologists who recognized that thoughts or beliefs were directly related to his or her emotional experiences and behaviors. Albert Ellis developed a psychotherapy called Rational Emotive Behavior Therapy (REBT), which is still commonly practice in the field of psychology today. Another front runner in cognitive behavioral therapy was Aaron Beck, whose Cognitive Therapy model also involved focusing on the clients thoughts as the route to their mental health dysfunction. Both Cognitive Therapy and Rational Emotive Behavior Therapy are effective in treating depressive disorders.

Cognitive Therapy

The Cognitive Behavioral Therapy (CBT) model involved identifying and restructuring ones maladaptive beliefs, under the premise that once these beliefs change, so will resultant negative emotions and behaviors. According to Beck’s Cognitive Therapy, there are different levels to one’s cognitions. At the surface, one’s thoughts are termed automatic thoughts. These are thoughts that spontaneously come to people’s minds frequently, on a daily basis. If someone is experiencing depression, it is often the case that these automatic thoughts are distorted, or not based in reality. There are numerous types of distorted automatic thoughts. One type of distorted automatic thought is called mind reading. If someone is mind reading they believe that they know what another person is thinking about him or her. It is often the case in which a depressed person mind reads and believes that other people are thinking negatively of him or her. Another type of distorted automatic thought is called fortune-telling. When someone is fortune-telling he believes that he can predict the future, which often coincides with anxiety and depression. For example, people will often negatively predict about the future (“I am going to fail the test”). Another type of distorted automatic thought is called labeling. When someone is labeling they generalize about themselves or someone else based on one trait. For example, if somebody cut them in a line they would refer to the person as a “loser.” Similarly, they may view themselves with an overall negative quality, based on one negative behavior that may have occurred. Another type of distorted automatic thought is called catastrophizing. Catastrophizing occurs when someone perceives a small incident in reality to be something bigger than it actually is. For example, ruminating about forgetting someone’s name would be catastrophizing that incident. Negative filtering is a distorted automatic thought in that a person focuses on negative occurrences, and fails to acknowledge the positive ones. Unfair comparisons occur when somebody compares himself to another person who is better than them in a specific area, which results in a person feeling less than. People who have depressive symptoms often compare up, rather than down.

Automatic Thoughts in Cognitive Therapy

According to Cognitive Therapy, underlying these distorted automatic thoughts are assumptions. Assumptions involve deep-rooted beliefs a person has about he should behave. Maladaptive assumptions often seen in people with depressive symptoms involve people thinking they should be perfect, should be better and never fail. Finally, underlying maladaptive assumptions are core beliefs a person has about himself. Core beliefs may involve a person believing that he is worthless, unlovable or a failure. It is often the case where core beliefs result from a person’s learning history, possibly criticism from his parents. It is important for cognitive behavioral therapist to explore childhood issues, as they pertain to a person’s maladaptive core beliefs.

Cognitive Distortions in Cognitive Therapy

It is the role of a cognitive behavioral therapist to help a client identify all three levels of maladaptive thinking and help the client to restructure these thoughts. A cognitive behavioral therapist restructures a client’s thoughts by pointing out that they are not entirely based in reality. Cognitive disputation is the technique used by cognitive behavioral therapist, in which they use various techniques to help the client see that his thoughts are maladaptive. One technique used in Cognitive Therapy in thought disputation involves having the client pretend he is talking to a friend, disputing his friends maladaptive thoughts. It is often the case in which a client can easily dispute his friends maladaptive ways of thinking, which will then help him to dispute his own maladaptive thoughts. Cognitive behavioral therapists dispute maladaptive thoughts I asking the client for evidence supporting his maladaptive thought and for evidence against his maladaptive thought. Cognitive behavioral therapist help clients understand that they do not have much evidence for their maladaptive thinking, thereby helping them to realize that it is illogical.

It is important for a cognitive behavioral therapist to begin thought disputation at the outset of therapy, yet keep in mind the clients level of receptivity. Being that thought disputation can be perceived as argumentative, if the therapist is not skilled at doing so, it is important that rapport and trust has been established at the outset of the therapeutic relationship.

Cognitive Behavioral Therapy for Attention Deficit Hyperactive Disorder (ADHD)


Cognitive Behavioral Therapy for ADHD Treatment

Cognitive Behavioral Therapy (CBT) is an empirically-based psychotherapy used for the treatment of various childhood mental health disorders. Attention Deficit Hyperactivity Disorder (ADHD) has attracted increased attention over the last two decades. Research shows that ADHD is in fact a real disorder stemming from malfunctions with a persons prefrontal lobe of the brain. While medication management is effective in treating certain symptoms of the disorder, the best results are seen with medication management plus cognitive behavioral therapy techniques.

ADHD Diagnosis in Children

ADHD is often diagnosed in childhood, though adults struggle with this disorder just the same. It is first important for the cognitive behavioral therapists to understand and express to the parents of a child with ADHD that it is a medical condition and largely beyond the control of the child. Parents often become frustrated and discouraged with their ADHD child, feeling as though they have tried everything to improve the child’s behavior to no avail. Parents often place blame on the child for his behavior, and teachers may do the same. When a child internalizes that it is his own fault for having this disorder, self-esteem is negatively impacted. It is common for children with ADHD to feel depressed about the disorder and have a low self-esteem related to it. A cognitive behavioral therapist would work with the child and parents to help them understand that it is not the child’s fault that he is diagnosed with ADHD. Rather, help the parents and child to understand that there are certain aspects of the disorder that may be controlled with behavior management. Cognitive behavioral therapists must work with parents consistently on adhering to the plan they devise in sessions.

Cognitive Behavior Therapist Specializing in ADHD

A cognitive  behavioral therapist working with a child with ADHD will do a thorough intake on the specific symptoms of the disorder. Common symptoms of children diagnosed with ADHD include, forgetfulness, poor attention, easy distractibility, failure to prevail on tasks that require sustained mental effort, fidgety behavior, seeming like one is “driven by a motor,” interrupting, and often does not seem to be listening when someone is speaking to him. Cognitive behavioral therapists should work closely with the child’s school to help lessen the severity and frequency of the child’s ADHD symptoms. For example, forgetfulness may often result in the child forgetting to bring home his homework, books or school supplies. One technique of cognitive behavioral therapist may use is to call the schoolteacher and arrange for the teacher to check the students school bag before he leaves school. This will ensure that he has the necessary materials he needs to complete the homework assignment. The cognitive behavioral therapist may also encouraged parents to check that the child’s homework assignment is completed before returning to school the following day. Cognitive behavioral therapists may work with parents on homework completion issues. It is often the case for children diagnosed with ADHD to struggle with completing homework. The cognitive behavioral therapist may recommend breaking down homework into smaller chunks of time, setting a timer, and rewarding the child for completing work with in those specific blocks of time. Organization skills are highly important for children diagnosed with ADHD. A cognitive behavioral therapist may have the child bring his school bag into session and teach them how to organize is bad. Teaching the child how to organize his school binder and books is also important. It is often the case for children diagnosed with ADHD to have messy notes. A cognitive behavioral therapist may work with the school to have a copy of the notes given to the child, so that he does not go without school notes.