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COGNITIVE BEHAVIOUR
THERPAY: Introduction
BY SUNDAS REHMAN &
ROSE BOGARTS
Sundas Rehman 1
 Origins of CBT
 Does it work?
 The underlying model
 Techniques
 Apps
Overview
Sundas Rehman 2
 Aaron Becks developed the approach known as cognitive
therapy as a result of his research on depression
 Becks observation of depressed clients revealed that they
had a negative bias in their interpretation of certain life
events, which contributed to distorted cognitive thoughts
 Today CBT is collection of theories and techniques
 It is called CBT as it uses a collection of cognitive, behaviour,
and emotive techniques
CT + BT = CBT
Origins of CBT
Sundas Rehman 3
 CBT is one of the most established researched
psychological therapies
 For some problems such as anxiety and depression,
CBT is as effective as medication and can also
enhance effects of medication (AustralianAssosciationofCBT,
2015)
Does CBT Work?
Sundas Rehman 4
Why use CBT for children and
adolescents?
Sundas Rehman 5
• Empowering, skills oriented, immediately
addresses issues
• Develops cognitive ability, empathy, moral,
reasoning
• Emotional regulation and behavioural self control
• Self control & educative
• Applied at individual, group, classroom levels
• Addresses a wide range of childhood disorders
• Is ‘best evidence’ not ‘best practice’
 Generalised Anxiety Disorder
 Child/adolescent behaviour problems
 Anger and aggression
 Panic
 Obsessive Compulsive Disorder
 Phobias
 Depression
 Eating disorder
 Brain injury
 Social anxiety
In particular CBT has demonstrated
effectiveness with individuals experiencing the
following problems:
Sundas Rehman 6
 --- “People are disturbed not by things but the
view that they take of them” Epictetus 1st
Century AD
 -- “…there is nothing either good or bad, but
thinking makes it so”. Hamelet, 2,2,254
What is CBT?
The underlying model
Sundas Rehman 7
 The basic belief behind CBT is that it is not
the environmental factors that are
responsible for how a person feels and
behaves. Rather it is the way an individual
thinks that causes a reaction.
 Thinking: different people can think
differently about the same event. It is the
way in which we think about the event that
influences how we feel and how we act.
What is CBT?
The underlying model
Sundas Rehman 8
A working model
Sundas Rehman 9
https://www.youtube.com/watch?v=WRRdSm4ZjX4
Sundas Rehman 10
 CBT model emphasises that it is not the
event/situation that causes the emotional
distress rather it is the individuals view of
that event or situation
 CBT works by focusing on those negative
thoughts and learning how to change
them as well as learning how to change
unhelpful behaviour
Underlying Cognitive Model
Sundas Rehman 11
 CBT aims to teach people that it is possible to have
control over your thoughts, feelings, and behaviour.
 CBT helps challenge the individuals negative
thoughts, behaviour, and feelings.
Techniques
CBT
CT BT
Sundas Rehman 12
 Involves identifying unhelpful thoughts or beliefs
1. being able to detect unhelpful thinking pattern
2. being able to challenge those unhelpful
thoughts and developing more helpful, adaptive way of
thinking
* “what evidence do you have for this?”
* “is there a more helpful way of
thinking?”
* “why must it absolutely be that way?”
Cognitive Therapy (CT)
Sundas Rehman 13
 Look for alternative explanations
 What is the evidence for and
against this thought?
 Is your thought factual?
 Are you jumping to conclusions?
 How can you check if your thoughts
are actually true?
Sundas Rehman 14
Challenging Negative Thoughts
* Reality testing
• Is there another way
you can look at this
situation
• What else could this
mean?
* Putting it into prospective
• Is the situation really as bad?
• What is the worst thing that can happen?
How likely is that?
• What is most likely to happen?
• Will this matter in 5 years time?
Sundas Rehman 15
 Exposure therapy
 Pleasant Event Scheduling- changing a persons
environment or activity that may help alter their
moods
 Relaxation- there are various ways to learn to relax,
including progressive muscular relaxation, applied
relaxation, mindfulness (new and popular technique)
Behaviour Therapy (BT)
https://www.youtube.com/watch?v=cDflnqo0TQs
Sundas Rehman 16
Sundas Rehman 17
Anger
management
technique
Sundas Rehman 18
Negative Nancy
• Draw a grumpy person and some
negative thoughts or statements
coming from her, around her
• Ask your student to brainstorm with
you the negative statements or
thoughts they have been thinking
• After, process the effects of being
negative
• Finally create a problem solving map
to help change those negatives into
positives
 Problem Solving
1. What is the problem?
2. What could I do?
3. What might happen if? (consider consequences for
each idea)
4. Pick best solution.
5. Do it.
6. Did it work?
Behaviour Therapy (BT)
Sundas Rehman 19
Assessing Behaviour
Sundas Rehman 20
• —Connection between thoughts, feelings, behaviours.
• —Ask about specific behavioural reactions to a typical
event?
• —How much control did the child have over their
behaviour?
• —How did the child feel about their behavioural
reaction?
• —Did the child understand fully the consequences of
their behavioural reaction?
• —What was the level of intensity of child’s behavioural
reaction?
Strategies for assessing behaviour
Sundas Rehman 21
• Ask how they behaved in relation to a particular
feeling
• Using goal-directed thinking: Assess how
behaviours help or don’t help a particular goal the
child wants to achieve
• Is thinking this way helping me
achieve my goals?
—
For the younger child:
Draw it out or use cartoons
 When teachers use CBT, they can help their students
control their own behaviour, rather than enforcing
external reinforcements
 CBT teaches students to use their inner-speech to
modify their underlying belief
 Cognitive strategies help students learn “how-to-
think, instead of “what to think”
 In the classroom it can be argued that it is even more
important to teach students HOW to use their
thinking to improve their own behaviour
Teachers using CBT
Sundas Rehman 22
 Overall numerous studies indicate that teaching
children cognitive strategies can strengthen pro-
social behaviour and decrease maladaptive behaviour
like disruption and aggression.
 We can equip our students with skills to remain in
control across various different situation if we teach
them to Stop and Think- Critically.
Teachers using CBT
Sundas Rehman 23
 Be aware of the developmental stage of the young
person (think about psychological, cognitive, and
emotional development)
 Involve families
 Make it interesting and engaging: use appropriate
language, worksheets, and/or videos
The Use of CBT with Young People
Sundas Rehman 24
Apps for mood- children and
adolescents
 1. The Grouchies
 2. Optimism
 3. My Mood Tracker
 4. Mood Tracker
 5. Mood Chart
 6. iMood Journal
 7. Sad Scale
 8. Mood Me
INSIDE OUT: MOVIE FOR
EMOTIONAL AWARNESS
Sundas Rehman 25
 Kendall, P.C. (2000). Child and Adolescent Therapy:
Cognitive-Behavioural Procedures. The Guildford
Press, New York
 Australian Association of Cognitive Behaviour
Therapy.(2015). Retrieved 19th of October 2015 from:
 http://www.aacbt.org/viewStory/WHAT+IS+CBT%3F
 O’Kelly, M. (2014). CBT in action, a practitioners guide.
Premier Publishing and Media, USA
References
Sundas Rehman 26
 Examples of disputes
 —Where is the evidence that …?
 —Am I what they say I am?
 —Am I an awful kid if I make mistakes?
 —Just because it happened once, will it always be this way?
 —Is it really so awful?
 —Does everything have to be easy?
 —Where is the evidence you can’t stand it?
 —What’s the worst thing that could happen & how likely is it that this
 will occur? What is the best thing that could happen? What is the
 most realistic outcome?
 —Where is it written that everything should be fair and go your way?
TIPS
Sundas Rehman 27

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What is COGNITIVE BEHAVIOUR THERPAY (CBT)

  • 1. COGNITIVE BEHAVIOUR THERPAY: Introduction BY SUNDAS REHMAN & ROSE BOGARTS Sundas Rehman 1
  • 2.  Origins of CBT  Does it work?  The underlying model  Techniques  Apps Overview Sundas Rehman 2
  • 3.  Aaron Becks developed the approach known as cognitive therapy as a result of his research on depression  Becks observation of depressed clients revealed that they had a negative bias in their interpretation of certain life events, which contributed to distorted cognitive thoughts  Today CBT is collection of theories and techniques  It is called CBT as it uses a collection of cognitive, behaviour, and emotive techniques CT + BT = CBT Origins of CBT Sundas Rehman 3
  • 4.  CBT is one of the most established researched psychological therapies  For some problems such as anxiety and depression, CBT is as effective as medication and can also enhance effects of medication (AustralianAssosciationofCBT, 2015) Does CBT Work? Sundas Rehman 4
  • 5. Why use CBT for children and adolescents? Sundas Rehman 5 • Empowering, skills oriented, immediately addresses issues • Develops cognitive ability, empathy, moral, reasoning • Emotional regulation and behavioural self control • Self control & educative • Applied at individual, group, classroom levels • Addresses a wide range of childhood disorders • Is ‘best evidence’ not ‘best practice’
  • 6.  Generalised Anxiety Disorder  Child/adolescent behaviour problems  Anger and aggression  Panic  Obsessive Compulsive Disorder  Phobias  Depression  Eating disorder  Brain injury  Social anxiety In particular CBT has demonstrated effectiveness with individuals experiencing the following problems: Sundas Rehman 6
  • 7.  --- “People are disturbed not by things but the view that they take of them” Epictetus 1st Century AD  -- “…there is nothing either good or bad, but thinking makes it so”. Hamelet, 2,2,254 What is CBT? The underlying model Sundas Rehman 7
  • 8.  The basic belief behind CBT is that it is not the environmental factors that are responsible for how a person feels and behaves. Rather it is the way an individual thinks that causes a reaction.  Thinking: different people can think differently about the same event. It is the way in which we think about the event that influences how we feel and how we act. What is CBT? The underlying model Sundas Rehman 8
  • 11.  CBT model emphasises that it is not the event/situation that causes the emotional distress rather it is the individuals view of that event or situation  CBT works by focusing on those negative thoughts and learning how to change them as well as learning how to change unhelpful behaviour Underlying Cognitive Model Sundas Rehman 11
  • 12.  CBT aims to teach people that it is possible to have control over your thoughts, feelings, and behaviour.  CBT helps challenge the individuals negative thoughts, behaviour, and feelings. Techniques CBT CT BT Sundas Rehman 12
  • 13.  Involves identifying unhelpful thoughts or beliefs 1. being able to detect unhelpful thinking pattern 2. being able to challenge those unhelpful thoughts and developing more helpful, adaptive way of thinking * “what evidence do you have for this?” * “is there a more helpful way of thinking?” * “why must it absolutely be that way?” Cognitive Therapy (CT) Sundas Rehman 13
  • 14.  Look for alternative explanations  What is the evidence for and against this thought?  Is your thought factual?  Are you jumping to conclusions?  How can you check if your thoughts are actually true? Sundas Rehman 14 Challenging Negative Thoughts * Reality testing • Is there another way you can look at this situation • What else could this mean? * Putting it into prospective • Is the situation really as bad? • What is the worst thing that can happen? How likely is that? • What is most likely to happen? • Will this matter in 5 years time?
  • 16.  Exposure therapy  Pleasant Event Scheduling- changing a persons environment or activity that may help alter their moods  Relaxation- there are various ways to learn to relax, including progressive muscular relaxation, applied relaxation, mindfulness (new and popular technique) Behaviour Therapy (BT) https://www.youtube.com/watch?v=cDflnqo0TQs Sundas Rehman 16
  • 18. Sundas Rehman 18 Negative Nancy • Draw a grumpy person and some negative thoughts or statements coming from her, around her • Ask your student to brainstorm with you the negative statements or thoughts they have been thinking • After, process the effects of being negative • Finally create a problem solving map to help change those negatives into positives
  • 19.  Problem Solving 1. What is the problem? 2. What could I do? 3. What might happen if? (consider consequences for each idea) 4. Pick best solution. 5. Do it. 6. Did it work? Behaviour Therapy (BT) Sundas Rehman 19
  • 20. Assessing Behaviour Sundas Rehman 20 • —Connection between thoughts, feelings, behaviours. • —Ask about specific behavioural reactions to a typical event? • —How much control did the child have over their behaviour? • —How did the child feel about their behavioural reaction? • —Did the child understand fully the consequences of their behavioural reaction? • —What was the level of intensity of child’s behavioural reaction?
  • 21. Strategies for assessing behaviour Sundas Rehman 21 • Ask how they behaved in relation to a particular feeling • Using goal-directed thinking: Assess how behaviours help or don’t help a particular goal the child wants to achieve • Is thinking this way helping me achieve my goals? — For the younger child: Draw it out or use cartoons
  • 22.  When teachers use CBT, they can help their students control their own behaviour, rather than enforcing external reinforcements  CBT teaches students to use their inner-speech to modify their underlying belief  Cognitive strategies help students learn “how-to- think, instead of “what to think”  In the classroom it can be argued that it is even more important to teach students HOW to use their thinking to improve their own behaviour Teachers using CBT Sundas Rehman 22
  • 23.  Overall numerous studies indicate that teaching children cognitive strategies can strengthen pro- social behaviour and decrease maladaptive behaviour like disruption and aggression.  We can equip our students with skills to remain in control across various different situation if we teach them to Stop and Think- Critically. Teachers using CBT Sundas Rehman 23
  • 24.  Be aware of the developmental stage of the young person (think about psychological, cognitive, and emotional development)  Involve families  Make it interesting and engaging: use appropriate language, worksheets, and/or videos The Use of CBT with Young People Sundas Rehman 24
  • 25. Apps for mood- children and adolescents  1. The Grouchies  2. Optimism  3. My Mood Tracker  4. Mood Tracker  5. Mood Chart  6. iMood Journal  7. Sad Scale  8. Mood Me INSIDE OUT: MOVIE FOR EMOTIONAL AWARNESS Sundas Rehman 25
  • 26.  Kendall, P.C. (2000). Child and Adolescent Therapy: Cognitive-Behavioural Procedures. The Guildford Press, New York  Australian Association of Cognitive Behaviour Therapy.(2015). Retrieved 19th of October 2015 from:  http://www.aacbt.org/viewStory/WHAT+IS+CBT%3F  O’Kelly, M. (2014). CBT in action, a practitioners guide. Premier Publishing and Media, USA References Sundas Rehman 26
  • 27.  Examples of disputes  —Where is the evidence that …?  —Am I what they say I am?  —Am I an awful kid if I make mistakes?  —Just because it happened once, will it always be this way?  —Is it really so awful?  —Does everything have to be easy?  —Where is the evidence you can’t stand it?  —What’s the worst thing that could happen & how likely is it that this  will occur? What is the best thing that could happen? What is the  most realistic outcome?  —Where is it written that everything should be fair and go your way? TIPS Sundas Rehman 27

Notas del editor

  1. * Discuss the aim of this workshop- to enhance your skills in managing your own mental health along with that of your students. To give you your own tool box to deal with situations may cause anxiety, depression and so on. This intern will eqip you will skills to understand what your students maybe feeling.
  2. CBT is a general term used today to describe a variety of techniques all of which use beneficial tools in the classroom
  3. Children or adolescents most commonly experience high level of anxiety and depression. Often in our counselling sessions these two are the main areas we tackle.
  4. Classic example is that when looking at the glass of water filled halfway, one person will see it half full and the other half empty.
  5. Thoughts underline an individuals core beliefs, for example a student is not attempting maths at all at school, they think they just can’t do it, not capable hence their core belief is they are not capable so why try i.e. behaviour towards maths “I am not even going to try”
  6. The goal is to become more self aware, have a better understanding of self and improve self control
  7. CBT is a combination of cognitive therapy and behavioural therapy
  8. Hand out worksheet “core belief”
  9. Play a mindfulness video https://www.youtube.com/watch?v=cDflnqo0TQs