Adler (1927, 1931)

-“We are not victims of, but creators of emotion”

-act as if your beliefs/expectations are true

-lifestyle is influenced by goals

-Encourage pts. To take responsibility and action

-Socratic method-guides clients to insights---generate decisions and plans for action

-role-playing, future scenarios, cognitive rehearsa

Karen Horney (1937, 1939)

-Tryanny of shoulds

-give up idealized self-image

-encourage self-acceptance; focus on love, mastery, and freedom

Piaget (1948)

Schema-cognitive template-forming categories of knowledge that influences how you categorize

-Experiences---new info may modify, add to, or change prev. schemas

-What do we call the variety of schema changes: Assimilation; accomodation

-Dissatisfaction with prime role given the the UNCONSCIOUS, emphasis on PAST, and long-term

-Freud-Biological determinist

-Beck-trained as psychoanalyst, originally studied depression (need for punishment)  and anger; found that thoughts & dreams of depressed-themes of loss, sadness, and need for ACCEPTANCE

-Doesn’t say cognitions cause depression---many things/unknown etiology; but influences behavior, emotion, & physiology

(-evolution of depression-conserving energy)

-Ellis-trained as psychoanalyst, originally practiced sex/family therapy

*Pre-conscious-Not in awareness but easily accessible thoughts; cog structures-rules/assumptions

*Unconscious-Implicit knowledge structures; not easily accessed or shared

            -habits/culture

            -What cognitive structure?  Core beliefs/schemas

*Ancestors-Behaviorism

Behavior therapy-OVERT (skinner-1953)/operant conditioning

-Reciprocal Inhibition, systematic desensitization-COVERT (Wolpe-1958)

-Stimulus-response patterns (mind=black box); contingent behavior; private events

-Wolpe-imaginal procedures (no base until 70s)

-Non-mediational behavioral approach-seen as inadequate

*Increase in Cognition-began in 50s and increased in 1970s

-BT didn’t target the internal dialogue; realized cognitions maintain malad. Bhvr

-Mahoney-warned to cease/desist cog.---heretical views

construct theory (emphasize cog factors as part of personality/abnormal bhv)

-Fixed role therapy

-personal constructs-how we perceive, explain, interpret events

-person=scientist

Expectancy Learning theory (subj expectation that bhv will lead to particular outcome/rein)

            -pathology=irrational expectations

            -over or underestimate likelihood of reinf, & both distortions can b a problem

Influences of CT

-Bandura (1969)- cog meditational processes in regulation of bhvr; self-efficacy/mastery

-4 conditions necessary for learning to occur:

1.  Attention

2.  Cognitive Representation-in memory (verbal/imagery)

3.  Behavioral Production

4.  Motivation

Tridactic Reciprocal Determinism (environment, person, behavior)

*Ellis, then Beck, then Mahoney, then Meichenbaum; Bandura (social learning theory)

(integration of psychodynamic and bhvr- Psychoanalysis and Behavior Therapy)

*Evolution of CT-Convergent or Divergent?

-CT-relationships-cognition, emotion, & behave (in human functioning/psychopath)

Mahoney & Arnkoff-3 grps of inteventions

1.  Cognitive restructuring-RET, CT

2.  Problem-solving-systematic

3.  Coping skills-anxiety mngt/stress inoculation

application of cog and social psych research to CT

-Guidano’s personal cognitive organization

-Freeman-CT with personality d/o

-Beck-CT for schiz; lower SES

-Neuroimaging showing CT

Cognition affects

1.       bx

2.       emotion

3.       physiology

1.       cognitive – not thinking about it

2.       affective – compensate to not feel sad or emotional

3.       behavioral – not doing something that activates the schema

First session structure

1.       set an agenda – rationale

2.       mood check

3.       review and elaborate on presenting problem

4.       problem list with corresponding goals – how to operationalize someone’s verbalization  

5.       educate the client about CBT

6.       expectations for tx

7.       educate the pt. to the dx – normalize it

8.       collaborative HW – give a rationale to the client; need to specify

9.       summary

10.   feedback

Beck’s two categories of core beliefs

1.       Helplessness

2.       Unlovability

3.       May be entitlement

*Clinical motivation for behavior therapists: Realization that BT techniques did not targeted the internal dialog that pts engage in.

*They realized that these cognitions maintain maladaptive bx