Cognitive TheoryCognitive TheorySSS 571SSS 571

Human Behavior Human Behavior & the Social Environment& the Social Environment

November 1, 2010November 1, 2010Eileen A. Dombo, MSW, PhD, LICSWEileen A. Dombo, MSW, PhD, LICSW

Today’s PlanToday’s Plan

Explore and challenge some misconceptionsExplore and challenge some misconceptions Review a bit about theory in generalReview a bit about theory in general Present Cognitive theory via 7 questionsPresent Cognitive theory via 7 questions Focus on people's problems and how this Focus on people's problems and how this

theory helps us help them changetheory helps us help them change Put it all together by applying to case Put it all together by applying to case

examplesexamples

Cognitive Theory as Response to Cognitive Theory as Response to Psychodynamic PsychotherapyPsychodynamic Psychotherapy

Theories of CognitionTheories of Cognitionin Social Workin Social Work

Conscious thinking is believed to be the basis Conscious thinking is believed to be the basis for almost all behavior and emotions.for almost all behavior and emotions.

Our minds are actively engaged in Our minds are actively engaged in constructing the reality we seek to understand. constructing the reality we seek to understand.

So long as a person’s cognitive style helps to So long as a person’s cognitive style helps to achieve his or her goals, it is considered achieve his or her goals, it is considered healthy. healthy.

However, a person’s thinking patterns can However, a person’s thinking patterns can become distorted, featuring patterns of bias that become distorted, featuring patterns of bias that ignore relevant information from the ignore relevant information from the environment.environment.

Cognitive errors are habits of thought that lead Cognitive errors are habits of thought that lead people to distort input from the environment and people to distort input from the environment and experience psychological distress.experience psychological distress.

Social workers who practice from cognitive Social workers who practice from cognitive

theory assert that the individual’s thought theory assert that the individual’s thought process, not their emotions, should be the focus process, not their emotions, should be the focus of intervention.of intervention.

Cognition vs. EmotionCognition vs. Emotion

COGNITIONCOGNITION Conscious & preconscious thinking processesConscious & preconscious thinking processes Personal beliefs & subjective interpretationsPersonal beliefs & subjective interpretations Erroneous beliefs result from misinterpretations and Erroneous beliefs result from misinterpretations and

inaccurate conclusions; contribute to social dysfunction inaccurate conclusions; contribute to social dysfunction

EMOTIONEMOTION Feeling states based on our appraisal of stimuliFeeling states based on our appraisal of stimuli Affect—physiological expression of emotionAffect—physiological expression of emotion Mood—a more stable feeling disposition; less intense and Mood—a more stable feeling disposition; less intense and

not situationalnot situational

Meaning, Emotion Meaning, Emotion and Cognitionand Cognition

Cognitive theorists explore the conscious Cognitive theorists explore the conscious meaning of events (Beck).meaning of events (Beck).

People are “meaning makers.”People are “meaning makers.” Public (objective) vs. private (unique).Public (objective) vs. private (unique). The private meaning is influenced by the The private meaning is influenced by the

emotional experience and is vulnerable to emotional experience and is vulnerable to distortion; accounts for differences in distortion; accounts for differences in emotional responses to situations.emotional responses to situations.

Moving from Public to Moving from Public to Private MeaningPrivate Meaning

Event Conscious Emotion Private Event Conscious Emotion Private

MeaningMeaning Meaning Meaning

Why does Dr. Early get so irritated Why does Dr. Early get so irritated when she hears “CBT”?when she hears “CBT”?

Question: Is there such a thing as Question: Is there such a thing as Cognitive/Behavioral theory?Cognitive/Behavioral theory?

Answer: NoAnswer: No

Why Not?Why Not?

Cognitive theory Cognitive theory Assumes that reality is constructed Assumes that reality is constructed

“inside” - so each individual “inside” - so each individual determines her/his subjective realitydetermines her/his subjective reality

According to cognitive theory, we According to cognitive theory, we behave and change based on internal behave and change based on internal mental processesmental processes

Why Not?Why Not?

Behavioral theoryBehavioral theoryAssumes that there is one objective Assumes that there is one objective

reality “out there” that determines the reality “out there” that determines the individualindividual

According to behavioral theory, we According to behavioral theory, we behave and change based on external behave and change based on external environmental influencesenvironmental influences

““CBT” is notCBT” is not the name of a theory. . . the name of a theory. . .

Cognitive-Behavioral Cognitive-Behavioral TherapyTherapy (CBT) (CBT)

is a practice model, is a practice model,

based on two theories:based on two theories:

cognitive theory and behavioral theory.cognitive theory and behavioral theory.

Ok, so whatOk, so what is is theory?theory?

an interrelated set of conceptsan interrelated set of concepts that are based on observationsthat are based on observations the relationship between concepts is the relationship between concepts is

expressed as hypotheses expressed as hypotheses These concepts and hypotheses are tested These concepts and hypotheses are tested

or testableor testable and are intended to explain or predict and are intended to explain or predict

phenomena.phenomena.

What is clinical practice theory?What is clinical practice theory?

An interrelated set of concepts thatAn interrelated set of concepts that Explains the bio-psycho-social-spiritual nature Explains the bio-psycho-social-spiritual nature

of human beingsof human beings Explains the development of stable patterns of Explains the development of stable patterns of

adaptive and maladaptive thoughts, feelings, adaptive and maladaptive thoughts, feelings, and behavior of human systems in transaction and behavior of human systems in transaction with their natural, built, and social environmentswith their natural, built, and social environments

Predicts how those stable patterns may changePredicts how those stable patterns may change

Practice Theories Practice Theories have two functionshave two functions

Explanatory (or developmental) Explanatory (or developmental) functionfunction

Change (or practice) functionChange (or practice) function

Practice Theory: Practice Theory: The explanatory function The explanatory function

Practice theory’s developmental or Practice theory’s developmental or explanatory concepts explain how explanatory concepts explain how systems develop normally, why systems develop normally, why development goes awry, and/or how development goes awry, and/or how problems develop.problems develop.

Explanatory concepts are used in Explanatory concepts are used in assessment. assessment. This is the focus of 571.This is the focus of 571.

Practice Theory: Practice Theory: The change functionThe change function

Practice theory’s change concepts predict Practice theory’s change concepts predict why systems change and how change can why systems change and how change can be facilitated. be facilitated.

Change concepts are used in Change concepts are used in planning planning and interventionand intervention..

Implementing the change function Implementing the change function of practice theory: of practice theory: roles and techniquesroles and techniques

Practice roles and techniques are the Practice roles and techniques are the concrete actions that flow from the concrete actions that flow from the abstract change concepts of practice abstract change concepts of practice theory. These actions, when performed theory. These actions, when performed by the helping person, by the helping person, facilitate client facilitate client changechange..

7 Questions about Theory7 Questions about Theory

1.1. What are the major premises of the theory?What are the major premises of the theory?

2.2. Who thought this theory up?Who thought this theory up?

3.3. Who are the social workers building on this early Who are the social workers building on this early thinking?thinking?

4.4. How does the theory understand problems?How does the theory understand problems?

5.5. How did problems come to be?How did problems come to be?

6.6. How do problems go away on their own?How do problems go away on their own?

7.7. How do social workers help make problems go How do social workers help make problems go away?away?

Cognitive TheoryCognitive Theory

QUESTION 1: What are the major QUESTION 1: What are the major premises of cognitive theory?premises of cognitive theory? We are what we think.We are what we think. We learn to think in the same ways we learn overt We learn to think in the same ways we learn overt

behavior (continuity assumption)behavior (continuity assumption) That is, we learn to think in a particular way due to That is, we learn to think in a particular way due to

exposure to experience.exposure to experience. To change what we are, we must change what we To change what we are, we must change what we

thinkthink by becoming aware of, evaluating, and by becoming aware of, evaluating, and challenging mediating thoughtschallenging mediating thoughts

Mind as an information Mind as an information processing systemprocessing system

Repeated similar experiences are stored in memory as Repeated similar experiences are stored in memory as thoughts about expectation, causation, attribution, etc. thoughts about expectation, causation, attribution, etc.

These patterns become automatic and outside of These patterns become automatic and outside of consciousness.consciousness.

Patterns of thought mediate between events and Patterns of thought mediate between events and actions (mediational model)actions (mediational model)

Memories are applied to multiple new events so they Memories are applied to multiple new events so they become less individual memory and more patterns for become less individual memory and more patterns for organizing experience (schema)organizing experience (schema)

Change comes through disputing or altering Change comes through disputing or altering mediating thoughts.mediating thoughts.

The Cognitive ABCThe Cognitive ABC

Activating Belief ConsequentialActivating Belief Consequential

Event Feelings andEvent Feelings and

BehaviorBehavior

QUESTION 2: Who thought this theory QUESTION 2: Who thought this theory up?up?

Albert Ellis, PhDAlbert Ellis, PhD Aaron Beck, MDAaron Beck, MD

The Fathers of Cognitive Theory: The Fathers of Cognitive Theory: Aaron Beck and Albert EllisAaron Beck and Albert Ellis

Albert EllisAlbert Ellis

““““Negative Negative self ratingself rating is the major is the major cause of human disturbance; cause of human disturbance;

we disturb ourselveswe disturb ourselves.”.”

Aaron BeckAaron Beck

“ “The thesis that the special meaning of an event The thesis that the special meaning of an event determines the emotional response forms the determines the emotional response forms the core of the cognitive model of emotions and core of the cognitive model of emotions and emotional disorders: The meaning is encased emotional disorders: The meaning is encased in a cognition – a thought or an image.”in a cognition – a thought or an image.”

QUESTION 3: Who are the social QUESTION 3: Who are the social workers building on this early workers building on this early thinking?thinking?

Sharon BerlinSharon Berlin Paula NuriusPaula Nurius

Sharon Berlin & Paula NuriusSharon Berlin & Paula Nurius

“ “This filtering is at the heart of the concept of This filtering is at the heart of the concept of mediation. As one kind of lens, or filtering mediation. As one kind of lens, or filtering mechanism, our self-conceptions tend to bias us in mechanism, our self-conceptions tend to bias us in the direction of reconfirming what we already believe the direction of reconfirming what we already believe to be true about ourselves.”to be true about ourselves.”

QUESTION 4: How does cognitive QUESTION 4: How does cognitive theory understand “problems”?theory understand “problems”? Problems are generally feelings and behaviors that Problems are generally feelings and behaviors that

are maladaptive for a personare maladaptive for a person Problem feelings and behaviors emerge in response to Problem feelings and behaviors emerge in response to

activating events that are mediated by a distorted activating events that are mediated by a distorted interpretive thoughtinterpretive thought

These immediate (automatic) thoughts are triggered These immediate (automatic) thoughts are triggered by external events but are shaped by internal by external events but are shaped by internal schemata, or ways of thinking, that may be distortedschemata, or ways of thinking, that may be distorted

Present events “recruit” different schema that were Present events “recruit” different schema that were learned in the pastlearned in the past

QUESTION 5: How did problems QUESTION 5: How did problems come to be?come to be? Problem feelings and behaviors are the result Problem feelings and behaviors are the result

of patterns of thinking that were learned in the of patterns of thinking that were learned in the pastpast

They are triggered in the present by activating They are triggered in the present by activating events and mediated by situation specific events and mediated by situation specific automatic thoughts shaped by more general automatic thoughts shaped by more general deeply held core beliefsdeeply held core beliefs

Problems (often feelings & Problems (often feelings & behaviors)behaviors)

AA B B C C Activating eventActivating event beliefbelief consequential feelingconsequential feeling

or behavioror behavior

feelingfeeling(sadness)(sadness)

activatingactivating automaticautomatic eventevent thoughtthought(boyfriend breaks up(boyfriend breaks up (“of course it didn’t work”)(“of course it didn’t work”) behaviorbehaviorwith me)with me) (get (get

drunk)drunk)core beliefcore belief(I’m unlovable)(I’m unlovable)

RayleneRaylene

RayleneRaylene

Shame/Self-Blame Shame/Self-Blame Date-raped Date-raped

“ “It’s my fault” It’s my fault”

Goes back to abusive exGoes back to abusive ex

Bad things Bad things happen to mehappen to me

because I am a bad personbecause I am a bad person

BobBob

Fight with wifeFight with wife angerangerShe doesn’t She doesn’t respect merespect me

storms outstorms out

anger abatesanger abatesI am powerlessI am powerless

QUESTION 6: How do problems go QUESTION 6: How do problems go away on their own?away on their own?

Through changing one’s mindThrough changing one’s mind Cognitive activity affects behaviorCognitive activity affects behavior Cognitive activity may be monitored and Cognitive activity may be monitored and

alteredaltered Desired behavior change may be affected Desired behavior change may be affected

through cognitive change.through cognitive change.

We process much informationWe process much information that makes sense that makes sense

Some information comes is easily processed Some information comes is easily processed through existing meaning structures (schema) through existing meaning structures (schema)

The information “fits,” or is The information “fits,” or is congruentcongruent. . the information the information makes sensemakes sense; it is meaningful; it is meaningful

But we also process information But we also process information that makes no sensethat makes no sense

Other information cannot be processed easily Other information cannot be processed easily through existing meaning structures (schema), through existing meaning structures (schema),

The information does not fit; it is The information does not fit; it is discrepant, discrepant, when we experience contrasts between when we experience contrasts between what we want and what we have; what we want and what we have; how things were and how they are; how things were and how they are; what we expect and what actually happens.what we expect and what actually happens.

The information The information makes no sensemakes no sense; it is meaningless; it is meaningless

How to Adapt to Discrepant How to Adapt to Discrepant Informational Cues (DIC) Informational Cues (DIC)

When faced with discrepant informational When faced with discrepant informational cues (DIC), people adapt bycues (DIC), people adapt by

1.1. RetreatRetreat: Changing the DIC (removing oneself : Changing the DIC (removing oneself from poisoned environment or remove the stressor)from poisoned environment or remove the stressor)

2.2. AssimilationAssimilation: making the DIC fit with existing : making the DIC fit with existing schema (distort the information to fit the schema)schema (distort the information to fit the schema)

3.3. AccommodationAccommodation: Reorganizing existing schema to : Reorganizing existing schema to fit the new DIC (change schema to fit the fit the new DIC (change schema to fit the information)information)

QUESTION 7: How do social workers QUESTION 7: How do social workers help make problems go away?help make problems go away?

Techniques to recognize maladaptive Techniques to recognize maladaptive automatic thoughts and core beliefsautomatic thoughts and core beliefs

Techniques to evaluate maladaptive automatic Techniques to evaluate maladaptive automatic thoughts and core beliefsthoughts and core beliefs

Techniques to challenge and restructure Techniques to challenge and restructure maladaptive automatic thoughts and core maladaptive automatic thoughts and core beliefsbeliefs

Techniques to recruit and strengthen existing Techniques to recruit and strengthen existing adaptive thoughts (the strengths perspective – adaptive thoughts (the strengths perspective – introduced by the social workers!)introduced by the social workers!)

Cognitive Distortions/ErrorsCognitive Distortions/Errors

Absolute thinkingAbsolute thinking OvergeneralizationOvergeneralization Selective abstraction Selective abstraction (focus on negative)(focus on negative)

Arbitrary inference Arbitrary inference (negative conclusion without sufficient (negative conclusion without sufficient evidence)evidence)

Magnification Magnification MinimizationMinimization PersonalizationPersonalization

The Cardinal Question of The Cardinal Question of Cognitive TherapyCognitive Therapy

Aaron Beck directs, “Aaron Beck directs, “Whenever you Whenever you experience an unpleasant feeling, try to recall experience an unpleasant feeling, try to recall what thought you had prior to it.”what thought you had prior to it.”

Judith Beck says the cardinal question of Judith Beck says the cardinal question of cognitive therapy is, cognitive therapy is, “What was going through “What was going through your mind when the mood changed?”your mind when the mood changed?”

From concept to technique in From concept to technique in cognitive therapycognitive therapy

Focus on mediating thoughts and beliefsFocus on mediating thoughts and beliefs Recognizing or becoming aware of thoughtsRecognizing or becoming aware of thoughts Evaluating thoughts to determine viabilityEvaluating thoughts to determine viability Challenging and restructuringChallenging and restructuring

those that do not serve one’s goalsthose that do not serve one’s goals

CritiquesCritiques

Cognitive theories are criticized for ignoring Cognitive theories are criticized for ignoring the environmentthe environment

Behavioral theories are criticized for reducing Behavioral theories are criticized for reducing all human behavior to simple responses to all human behavior to simple responses to stimuli without critical thought or feeling stimuli without critical thought or feeling involved (more on this next week).involved (more on this next week).

Social Learning TheorySocial Learning Theory

““People are neither entirely determined by People are neither entirely determined by internal causes nor environmental stimuli, but internal causes nor environmental stimuli, but psychological functioning is accounted for by psychological functioning is accounted for by a reciprocal interaction of personal & a reciprocal interaction of personal & environmental determinantsenvironmental determinants.” .”

(Bandura, 1977)

Philosophical underpinnings:Philosophical underpinnings: Behavior is learned when individuals respond Behavior is learned when individuals respond

to environment through stimuli, reinforcement, to environment through stimuli, reinforcement, & imitation& imitation

Behavior is influenced by personal Behavior is influenced by personal interpretations & expectations about the interpretations & expectations about the environmentenvironment

The central process in learning is imitationThe central process in learning is imitation Behavior is the result of modeling + thought and Behavior is the result of modeling + thought and

reasoningreasoning Employs moral and cognitive development by Employs moral and cognitive development by

addressing self-efficacy and self-reinforcementaddressing self-efficacy and self-reinforcement We do what makes us feel personally competentWe do what makes us feel personally competent Behavior becomes self-regulated through self-Behavior becomes self-regulated through self-

reinforcementreinforcement Dysfunctional thoughts lead to dysfunctional Dysfunctional thoughts lead to dysfunctional

behaviorbehavior

In closing . . . . . . . . . . . . . . . . . . . .In closing . . . . . . . . . . . . . . . . . . . .

We are what we think; to change what we We are what we think; to change what we are, we must change what we think.are, we must change what we think.