Cognitive Behavioral Therapy Course

Founding Assumptions

  • No bad intentions
    • Accept without judgment
  • Past != Future
  • No one is broken
  • Everything is possible
  • Empowerment via responsibility

Factors that impede or ability to listen/learn

  • External factors
    • and mental situation
  • Response Rehearsal
  • Fact finding
  • Being Judgmental
  • Problem Solving
  • Imposing Personal View

Identity labels: We are meaning making machines. We will assign labels or meanings to events - that will affect the way we process it.

Situation -> Thoughts -> Emotions -> Behavior -> Outcome -> Thoughts -> ...

ABC of CBT

  • Events(Activating event/trigger)
    • World
    • Other People
    • Experiences
    • Personal History
    • Future
  • Thoughts(Beliefs)
    • Attitudes
    • Rules
    • Beliefs
    • World Views
    • Opinions
  • Emotions (Consequences)
    • Good
    • Bad
    • Useful
    • Un-useful
  • Behaviors (Consequences)
    • Constructive
    • Destructive

Map is not the territory. Means - Perception is not reality

Mental Filter

Before we store an event in our memory, it goes thru many filters. So the final memory is very different from the actual event. The filters are...

  • Deletions
  • Distortions
  • Generalizations
  • Personalisations

CBT Standard

  • Therapist
    • Available
    • Self Aware
    • Attentive
  • Client
    • Open
    • Receptive
    • Appreciative

Cognitive Distortions

Commonly found wrong beliefs - or pattern of thinking.

  • Black or white thinking
  • Over generalization
  • Cognitive Filtering
  • Disqualifying the good
  • Jumping to conclusions
  • Emotional Reasoning
  • Rigid Rule Keeping
  • Catastrophising / Worst case scenario-ing
  • Labeling/Self Labeling

Thought-Feeling Link

Activating Event/Trigger -> Belief(Assigned Meaning) -> Consequential Outcome(Response)

Using B-C connections can help us identify our beliefs. If we know what our emotional reactions are, we can identify what types of beliefs we may have, e.g., sadness = loss; anxiety = future threat; anger = violation of our rights.

Free will is a muscle that requires exercise. If you don't exercise it often, you'll be swept along by emotional responses. Be aware of your emotions - learn to notice when they change

Thought Policing

When you get a thought that is affecting your emotions...

  • What are the evidences for that thought
  • What are the evidences against that thought
    • Decided based on that if its a valid thought or not.

Thought Review Process

  • What happened?(The situation)
  • What emotion did you feel?(Rate from 1-10 - 1 being worst.)
  • What were the physical sensations?
  • What did you think about/focus on?
  • What is a more useful perspective?
  • How will you prevent this happening again?
  1. The situation
  2. What was the initial thought
  3. Consider the consequences
  4. Challenge your initial thought
  5. (Optional) What are the cognitive distortions in effect.
  6. Background(Optional) - when did you first have thoughts like this? How deep is it in you?
  7. Alternative thinking?
  8. Positive belief and affirmation
  9. Action plan
  10. Improvement.

Locus of Control

Locus of Control considers the tendency of people to believe that control resides internally within them, or externally, with others or the situation.

  • The World - Least control
    • Religion
    • World Peace
    • Weather
    • Politics
  • Environment
    • Friends
    • Family
    • Work
    • Society
  • Me - Most control
    • Body
    • Attitude
    • Choices

The A-B-C Step-Through Framework - Instructions and Guide

THe Lazarus Technique: Focus and leverage - get the client to tell us the problem in just one word or one phrase.

Technique to control extreme emotion: Focus on the extreme emotion you are having - and just drop down thru it.

Emotional Time Travel

The emotions associated with mental time travel...

  • Past
    • Good
    • Bad
    • Happy
    • Sad
  • Future
    • Fear
    • Faith
    • Excitement
    • Anxiety

Commonly held wrong beliefs

The following stated beliefs are from Albert Ellis(he made Rational Emotive Behavior Therapy). This has some similarities to the TA Drivers

  • "I must do well and get the approval of everybody who matters to me or I will be a worthless person."
  • "Other people must treat me kindly and how I want them to treat me or else they are bad."
  • "I must have an easy, enjoyable life (without responsibilities) or I cannot enjoy living at all."
  • "All the people who matter to me must love me and approve of everything that I say and do."
  • "I must be a high achiever and succeed at everything I do, or I will be worthless."
  • "Nobody should ever behave badly and if they do, they must be condemned."
  • "I mustn't ever get angry or frustrated, and if I do, I am a bad person."
  • "When things are tough and I am under pressure, I must be sad and there's nothing I can do about this."
  • "When faced with the possibility of something unsafe or dangerous happening to me, I must obsess about it and make frantic efforts to avoid it."
  • "I can avoid my responsibilities and dealing with life's difficulties and still be fulfilled."
  • "My past is the most important part of my life and it will keep on dictating how I feel and what I do."
  • "Everybody and everything should be better than they are and, if they're not, it's a bad thing."
  • "I deserve to be happy by doing as little as possible and by just enjoying myself in life."

Detail

Taking responsibilityPassing responsibility
Master of emotionsMastered by Emotions
Seeking unityPromoting Disunity
FaithfulFearful
DecisivenessDouble Mindedness
Seeking Growth ChallengesSeeking Instant Gratification

Cognitive Conceptualisation

  • Relevant Childhood data

  • Core Beliefs

  • Conditional Assumptions

  • Compensatory Strategies - Defense Mechanism

  • Activating Event

  • Automatic Thought

  • Meaning of Automatic Thought

  • Emotion

  • Behavior(Consequential Outcome)

3 Realms of Confidence

  • Competence
  • Ability to learn and solve problems
  • One's own identity

Mistaken Beliefs Workbook

Use these questions to identify mistaken beliefs.

  1. What is the evidence that supports this belief? If I look objectively at all of my life experiences, what is the evidence that this belief is true?
  2. Is this belief always true for me?
  3. Does this belief consider the whole picture? Does it take into consideration both the positive and negative ramifications?
  4. Does this belief encourage my own peace of mind and well-being?
  5. Did I choose this belief or has it developed from the influence of my family/friends as I was growing up?

Remember that whatever value these mistaken beliefs may have offered you in the past, they no longer offer you and only serve to create stress and anxiety for you now.

Stages of Belief Development

AgeStateState
0-7Imprinting StageUnconscious
7-14Modelling StageUnconscious
14-21Socialization StageUnconscious
21+Active LearningConscious

Pavlov’s 5 Major Conditioning Processes

  1. Acquisition: Is the initial learning that takes place. It is determined by how much time elapses between the presenting the neutral stimuli (NS) and the unconditioned stimuli (UCS).
  2. Extinction: Is how long it takes to forget or eliminate the conditioned response (CR).
  3. Spontaneous Recovery: Happens after the conditioned response (CR) reappears after a long period of time. It proved that Extinction only suppressed the conditioned response (CR), not completely eliminated it.
  4. Generalisation: Is the tendency to respond to stimuli that is similar to the conditioned stimuli (CS). For example Pavlov’s dog would drool upon hearing a buzzer as well as the bell.
  5. Discrimination: Is the learned ability to differentiate between similar stimuli (the dog learns eventually to tell the difference between the bell and the buzzer).

Feedback mechanisms...

  • Positive Reinforcement
  • Negative Reinforcement
  • Negative Punishment
  • Positive Punishment

Questions To Help Find Limiting Beliefs

  1. What is a problem or limitation that has held you back for a while?
  2. What is it you would like to do/have, except something is stopping you from getting it/doing it?
  3. What is it that is REALLY stopping you from getting what you want?
  4. This is a problem because?
  5. And this means? (Repeat as many times as necessary)
  6. What must you believe that makes this problem even exist?
  7. What is it you believe about YOURSELF that has made this a problem?
  8. What do you believe about the WORLD that has made this a problem?
  9. What is this problem an example of?
  10. ...and what is THIS an example of?
  11. When did you decide that your problem was a problem (roughly)?
  12. At what point in your life did you by into this concept?
  13. What decision did you make that caused this problem to be born?
  14. What does this problem mean to you?
  15. What will life be like when you don't have this problem?

Parental Timeline Building

  1. What is a Problem or Limitation that has held you back for a while?
  2. This is a problem because? And that means?
  3. What is this problem an example of?
  4. When did you decide that your problem was a problem (roughly)?
  5. When was this NOT a problem?
  6. See if you can tell me about this problem in relation to your parents?
  7. If you were to have learned/ modeled this problem from someone close to you (or who has been close to you), who would that be? (Mum, Dad, Sibling etc. ...)
  8. If you were to trust your gut instinct, when did you begin to start modelling this problem from that person? (What age might you have been roughly?)
  9. If there was something really important that this person could have KNOWN back then, that would have transformed EVERYTHING for them, what would it be?
  10. If this person had KNOWN who it was that they were back then, how would this have transformed YOUR memories of the past if this had been the case?

Self Worth could come from

  • Talented
  • Articulate
  • Good Looks
  • Confidant
  • Knowledgeable

Common Core Values..

  • Authenticity
  • Belief in Others
  • Caring
  • Commitment
  • Cooperation
  • Connection
  • Certainty
  • Dedication
  • Devotion
  • Effort
  • Excitement
  • Freedom
  • Forgiveness
  • Friendship
  • Faith
  • Fulfillment
  • Gratitude
  • Growth
  • Honesty
  • Hope
  • Integrity
  • Connection
  • Optimism
  • Patience
  • Progress
  • Peace
  • Respect
  • Risk
  • Sacrifice
  • Significance
  • Self-Worth
  • Security
  • Tolerance
  • Unity
  • Uncertainty

Questions For Self-reflection

An effective way to establish your own core values, or, those of another is to ask the following questions:

  1. What is most important to you in your work?
  2. What is most important to you in your relationships?
  3. What is most important to you in your social life?
  4. What do you look for in a new relationship?
  5. What do you look for in social groups or events to attend?
  6. What do you want from your future relationships?
  7. What do you want from your life a a whole?

Online Test

Goal Setting

Why Goal Setting fails...

  • Not writing goals down
  • Giving unclear motives
  • Setting Unrealistic goals
  • Not having a plan
  • Not taking action
  • Losing focus
  • No follow thru

Howard Gardner's nine different types of intelligence:

  • Naturalist (nature smart)
  • Musical (sound smart)
  • Logical-mathematical (number/reasoning smart)
  • Existential (life smart)
  • Interpersonal (people smart)
  • Bodily-kinesthetic (body smart)
  • Linguistic (word smart)
  • Intra-personal (self smart)
  • Spatial (picture smart)

Find your Strengths Assessment

"There are no solutions, only tradeoffs."

How to find your passion...

  1. What areas of your current life are working well for you — what do you find fulfilling, meaningful, enjoyable, and important?
  2. What areas of your current life are not working well for you — what makes you stressed and anxious, wastes your time or drains you?
  3. If you were financially secure and didn’t need a salary, how would you spend your time?
  4. What are some childhood interests or dreams you never were able to explore fully, but still find intriguing?
  5. If you could pick three things that you would like to be remembered for after you die - what would they be?
  6. Is there someone in your life or your past whose life and work inspires and excites you? Why?
  7. What skills or talents do you have that you are passionate about using?
  8. What skills or talents do you have that you are not passionate about using?
  9. Consider a previous or current job - what specific activities have you done that you enjoy and find engaging?
  10. Consider a previous or current job - what specific activities have you done that you dislike and never want to do again?
  11. During an average week, how much of your time is spent doing things you dislike or that you feel waste your time?
  12. What are your top 5 most prominent core values? (refer back to the previous section of the course)
  13. How do your life and work currently reflect those values?
  14. Which of your top values are you ignoring or not giving enough attention?
  15. How are you currently living outside of your own integrity?
  16. What lies are you currently telling yourself and others about who you are, what’s important to you and what you're passionate about?
  17. What is preventing you from pursuing your primary passion in life?
  18. What beliefs do you have about yourself and your ability to succeed in pursuing your main passion in life?
  19. How have your limiting beliefs and fears held you back from finding or pursuing your main passion in the past?
  20. What credible evidence do you have to suggest that your fears or limiting beliefs that are holding you back are true?
  21. If there is evidence that your fears or limiting beliefs might come to pass, is the risk significant enough to prevent you from going after your passion?
  22. Can you tolerate some risk and uncertainty in relation to finding your passion, and if so, how much?
  23. What do you prioritize over pursuing your main passion in life? (Your income? Your job? Your lifestyle? Your home? The opinion of others?)
  24. What is the main concern that's holding you back from committing to pursuing your primary passion in life?
  25. What specific actions can you take to reduce and manage this fear?
  26. Is there anyone in your life who is preventing you from pursuing your passion? Who are they and how are they holding you back?
  27. How could you communicate with this person (or people) to either gain their support or get them to step out of the way?
  28. Are you willing to disengage from people who are undermining your ability to pursue you passion in life? If not, why not?
  29. Do any people close to you have genuine concerns about your life passion or your ideas? How can you address and overcome these?
  30. What hobbies or interests have you had in the last few years that intrigue you and that you might consider pursuing as a life passion?
  31. Are you willing to spend time pursuing these interests to learn more — by volunteering, part-time work, interning, finding a mentor, etc.?
  32. If you think you know what your passion might be, what concrete work have you done to learn more about it and actually experience it? What are you willing to do to better yourself in this area?
  33. Do you have enough savings to allow you to live for six months during a job transition or while you search for (or pursue) your passion?
  34. What can you do to create a cushion of savings if you don’t have any?
  35. What is the minimal salary that you can afford to live on?
  36. Would you be willing to make cut backs in your lifestyle in order to follow your passion?
  37. What is the worst thing that could happen if you decided to commit fully to pursuing your passion? Could you live with this?
  38. What is the likelihood of this worst thing actually happening (if you were to commit yourself fully 100%)?
  39. What would your ideal day look like if you were doing what you love?
  40. What are the things that you’d really like to achieve or accomplish with your life before you die?
  41. To date, what steps have you taken towards making these things happen?
  42. Would you be willing to work in a less-than-passionate job to pursue your passion outside of work or as a part-time job?
  43. Imagine you woke up nearly every day feeling happy, fulfilled, and content about your life and work - how would that impact you physically, mentally, emotionally, in your relationships, and also in your self-confidence?
  44. How has living a less-than-passionate life affected you? Give specific examples.
  45. What life achievement would make you feel proud of yourself?
  46. How do you live, act, or behave in a way that isn’t really you?
  47. If you had the chance to start fresh all over again with your life, your relationships, and your career, what would you do differently?
  48. Can you go back for a “re-do” on any of these things? If you answer “no,” are you 100% sure?
  49. If you live to age 80, how many days do you have left to live? (80 minus your current age multiplied by 365)
  50. How many of those days are you willing to live disliking any aspect of your life? For example, your work, your relationships or even yourself?

Communication

Don't focus on the clients emotions or their "stories"(interpretation of events)

  1. When you're communicating (generally), do you spent more time trying to understand, or trying to be understood?
  2. In your conversations with other people, how much time do you spend thinking about what your next response will be?
  3. When communicating with other people, how aware are you of their non-verbal communications? How aware have you historically been of other peoples non-verbal communications?

Ladder of Inference

This is how we interpret interactions with other people.

  1. Data/Observation
  2. Filtering
  3. Assign Meaning
  4. Assumptions
  5. Conclusions
  6. Adjustments
  7. Actions

Active Listening

  • Remove Distractions
  • Listening to what's being said
    • Observe body language
  • Feedback what you have understood
    • Paraphrase what the other person said
  • Roadblocks to Active Listening
    • Daydreaming
    • Response Rehearsal
    • Filtering
    • Judging

Bridging The Gap Between Sessions

These questions can be used to jog both yours and your clients memory of the last session

  1. What main points did we reach in our last session? What did you learn from the last session? Did anything come to mind in the past week about our previous session that you’d like me to know or that you’d like to discuss?
  2. Were you uncomfortable about anything we talked about in our last session? Is there anything you wish we had discussed that we didn’t?
  3. How is your mood? (How is your physical health?) Compared with last week, is it better or worse?
  4. What specific goals would you like to work on today? What problems would you like to put on the agenda?
  5. What homework did you attempt or complete after the last session? What did you learn from doing it?
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