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#CBT #cognitivebehavioral #counselingtechniques

CBT Interventions
Group Activities
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs Counseling CEUs and Specialty Certificates
Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery

Objectives
– Explore ways to teach Cognitive behavioral interventions in group

Basis
– Changing thoughts (cognitions) has a direct impact on physiological response (urges and behaviors)
– Changing behaviors has a direct response on thoughts and emotional reactions
– At its core CBT has the principles of noticing, understanding and addressing thoughts feelings and behaviors

Functional Analysis
– The process of identifying the antecedents (causes/triggers) and consequences (positive/negative) of behaviors
– Causes
– Emotional
– Mental
– Physical
– Social
– Environmental (including time & Date)

Problem Identification and Solving
– Stop. Use self talk, distress tolerance and/or relaxation techniques to restrain impulsive actions
– Identify the problem—Who, where, what, why
– Develop alternative solutions
– Explore the short and long term consequences/outcomes of solutions
– Choose a response
– Evaluate the outcome

Contracting
– Identify the problem/target behavior
– Identify a new behavior to replace it
– Identify rewards
– Write a contract
– Monitor behavior

Cognitive Distortions
– Personalization
– Taking everything personally—Its your fault. It was meant to hurt you.
– Exaggeration
– Making a mountain out of a molehill or seeing the worst-case scenario
– All-or-Nothing
– Viewing things in dichotomous terms
– Availability Heuristic
– Noticing what is most prominent in your mind

Cognitive Distortions
– Minimization
– Not giving credit where credit is due
– When you do good things
– When other factors are involved
– Selective Abstraction
– Seeing only what fits your mood/perspective

ABC-DE
– A=Activating Event
– B=Automatic Beliefs
– C=Consequences
– D=Dispute automatic beliefs
– E=Evaluate effectiveness of reactions

Cognitive Restructuring
– Literally changing your thoughts
– Find meaning in the current event
– Challenge the interpretation
– Develop a both/and perspective
– Examples of restructuring (Have clients give examples and practice)
– Threat vs. challenge (Interview, public speaking)
– Failure vs. learning experience (Relationships, hobby)
– Loss vs. opportunity (Job, relationship)
– Powerless vs. empowered (Forgiveness)

Systematic Desensitization
– Learning to effectively use coping skills to reduce distress through gradual exposure
– Levels
– Level 1: Imagine and describe the distressing event
– Level 2: Expose yourself, at a safe distance, to the distressing event
– Level 3: Experience the distressing event
– Process
– For each level, rate distress on a scale from 1-5.
– Use skills of choice to reduce your distress until you are at a 1.
– Practice until you can think about the event without getting distressed.

Cognitive Processing Therapy
– Using analytical questions to help identify cognitive errors and make more effective choices
– Questions
– What is the evidence for and against?
– Is this based on facts or feelings?
– Are all aspects of the situation being considered?
– Are you using all or nothing terms?
– Are you confusing high and low probability events?
– What is the most logical course of action?
– Example: Anxiety about heart attack/dying

Acceptance and Commitment
– Accepting reality as it is and committing to choosing thoughts and behaviors which will help you move toward a rich and meaningful life
– Commitment
– Determination to improve the next moment
– Realization that there are multiple aspects to commit to in your rich and meaningful life

Summary
– There are a variety of ways to help people explore and address the thoughts which may be keeping them stuck.
– Some techniques will work better in certain situations
– Since cognition is based on prior experiences, teaching CBT in group can help clients explore alternate interpretations and information in similar situations
– By developing a broader understanding of situations people can explore the effectiveness of their thinking in terms of how it impacts their ability to live a rich and meaningful life.

Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.

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