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Cognitive Behaviour Therapy

Jules Gibson-Cranch
Expectations and Exceptions!
 Times and Breaks
 Introductions! Who am I? Who are you?
 Please do……….
 Ask Questions
 Say if you don’t understand
 Be active and present!
What we will hope to cover today!

 Basic CBT review – history, concepts and


theory
 Why CBT may work
 Working with children and families using
CBT
 Getting practical! Case studies
 Final Questions and further reading.
History of CBT development
 Ivan Pavlov – 1929 Classical Conditioning
~ a form of associated learning to
stimulus.
 When a stimulus is used at the same time
as an action, the brain learns to connect
the two.
 When the stimulus is used without the
action the learned response still occurs.
Little Albert
John B Watson, founder of behaviorism, demonstrated
classical conditioning empirically through experimentation
using the Little Albert experiment, in which a child
("Albert") was presented with a white rat (CS). After a
control period in which the child reacted normally to the
presence of the rat, the experimenters paired the
presence of the rat with a loud, jarring noise caused by
clanging two pipes together behind the child's head (US).
As the trials progressed, the child began showing signs of
distress at the sight of the rat, even when
unaccompanied by the frightening noise. Furthermore,
the child demonstrated generalization of stimulus
associations, and showed distress when presented with
any white, furry object—even such things as a rabbit,
dog, a fur coat, and a Santa Claus mask with hair.
Cognitive Therapy
 Cognitive therapy seeks to help the
patient overcome difficulties by identifying
and changing dysfunctional thinking,
behavior, and emotional responses.
 Aaron Becks (1960) built on the work by
Albert Ellis (Rational Emotive Behaviour
Therapy) to develop Cognitive therapy
further and combine it with Behaviour
Therapy.
Cognitive Behaviour Therapy
 The most commonly practiced type of
cognitive therapy
 It is based on the belief that using both
cognitive therapy and behavioural therapy
is more effective than just one of these
types.
 Very few therapists believe in using just
one style of therapy for success any more
CBT
 aims to solve problems concerning
dysfunctional emotions, behaviors and
cognitions through a goal-oriented,
systematic procedure.
 Treatment is often manualised, with
specific technique-driven brief, direct, and
time-limited treatments for specific
psychological disorders
Beck’s views
 Emotional disturbance has three main
areas of negativity:

 Self
 World / Environment
 Future
His daughter Judith says:
 The situation……
 Leads to automatic thoughts…..
 To which there is an automatic reaction

 The reaction contains, emotional,


behavioural and psychological components
What can you use CBT for?
 NICE (National Institute of Clinical
Excellence) recommends CBT for use in:
 PTSD
 Mood disorders
 Anxiety
 Obsessive Compulsive Disorders
 Severe Mental Disorders including
Schizophrenia
Why CBT may work
 What is our brain?

 More powerful than the best computer


 The controller for all our body functions
 Store house for all our memories; personal
and extended
What is the function of the
Autonomic Nervous System
 The ANS affects heart rate, digestion,
respiration rate, salivation, perspiration,
diameter of the pupils, micturition
(urination), and sexual arousal. Whereas
most of its actions are involuntary, some,
such as breathing, work in tandem with
the conscious mind.
The magic that happens when
memory links with ANS!
 Our brains store memories at many levels
 They retrieve information at a split second
 Information retrieval is prompted by
external or internal stimulus.
 The body automatically responds, before
the higher brain functions can intervene
This won’t hurt a bit!
Autonomic Nervous System
Your examples of learned
responses?
 Some of mine!
 Feeling hungry when I walk past the
bakers!
 Feeling scared of needles/injections
 Being at a party and feeling like a glass of
wine
 Heightened awareness when people
become aggressive
Working with Children and Families

 Things to bear in mind!


 Family Scripts
 Resilience
 Emerging or Urgent Symptoms
 Anxiety or Reality
 Linking with other treatment modalities
Undertaking CBT sessions
 The key to CBT is to identify the most
important thoughts, feelings and
behaviour that make up these reactions
and decide whether these responses are
rational and helpful.
 It can be the whole or part of a session or
treatment package.
Case Study 1 - Michael
 14 year old boy. Attends private school
with his twin brother. Mother Air Hostess,
away for long periods. Father factory
worker, drinks heavily (Irish). Grandfather
(maternal) lives with the family. Elder
brother and sister. Elder brother (18) has
Aspergers and attended a special school.
 Family are experiencing some financial
problems
Symptoms
 Extreme anxiety
 Repetitive behaviour – follows a sequence
and if disrupted becomes verbally and
physically aggressive
 Attempts to include all family members in
the ritual
 Needs to repeat the scenario and
behaviour
Case Study 2 - Angela
 8 year old girl. Elder sister (11 years old)
Parents married. Father successful
business, mother at home. Very strict
rules at home. Mum very fussy about
tidiness. Both girls doing very well at
school.
Symptoms
 Constant hand washing
 High Anxiety in new situations
 Separation anxiety
 Low mood and self esteem
 Negative thought processes
Reading list.
 Cognitive Behaviour Therapy for Dummies
by Rob Wilson and Rhena Branch
 Cognitive-Behavioral Therapy for
Impulsive Children, Second Edition
(9780898620139): Philip C. Kendall PhD,
Lauren Braswell PhD

Time to Stop!
Thank you for blessing me with
your company today!

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