Cognitive-Behavioral Approaches

Role playing

• Discuss wellness and stress management.

• Identify a 6 month goal; write it according to guidelines.

• Counselor, facilitate a discussion of strategies your partner can use to achieve their goal.

• Switch roles.

Debrief

• Did you mutually define a clear, achievable, concrete goal?

• Were you able to help the cx identify strategies they would be able and willing to use?

• Were you able to write goals and strategies appropriately?

• Questions?

Behavior Theory

1. Learning is the basis of our behavior, emotional experience and thinking.

2. Important types of learning• Classical conditioning• Operant conditioning• Social learning

Cognitive-Behavioral Theory

1. Identifies problematic beliefs in response to activating events.

2. These beliefs tend to be absolute, all or nothing, distortions of reality, irrational.

3. The beliefs lead to feelings.4. The feelings lead to problematic

experiences.• Negative and unproductive feelings• Problematic behaviors

Approaches Using Behavioral and CBT Strategies

Logical Consequences

• Logical vs. Natural• Positive• Negative• Short term• Long term

Demo using a wellness/stress management goal

Behavior chains-ABCs

A. Antecedents: people, places, things, thoughts, emotions, etc.

B. Behavior: Operationalize exactly what behavior is problematic

C. Consequences• Short and long term• Positive and negative

Key Questions

1. Where can we interrupt the chain?

2. How can we use the power of consequences to reinforce new behaviors?• Rewards• Punishments

Cognitive Restructuring

• Explore cx’s thoughts-handout• Identify those that are self-defeating,

irrational, absolute, inaccurate• Challenge them

– Is that really true? – What’s the evidence of that?– Is that true of others, or just you?

• Cx constructs positive alternative thoughts• Plan to “catch” the cognitive distortions

Fish Bowl Role Play

A cx at your supportive housing facility is struggling with feeling isolated and alone. He believes others don’t like him because he’s on meds and because he smells bad (even though he doesn’t); he says “every time I go into the game room, people stop talking and they even leave.” He is convinced he scares others.

As you observe…

1. Notice any cognitive distortions.

2. Identify how the counselor challenges them.

3. Write down your own possible challenges.

4. Come up with positive alternative thoughts.