An introduction to Cognitive Behavioural Therapy - Aaron Beck

0:01 if you're watching this on Moodle or floating by on YouTube a very warm welcome my name is Rory Le Oaks and in this presentation we're going to look at an introduction to cognitive behavioral therapy the father of cognitive behavioral therapy is a man called Aaron Beck and at the time of this broadcast he's still alive he's 91 and he lives in America and he developed his ideas from the research and work of Albert Alice who developed to similar therapy called rational emotive behavioral therapy and if you want to know a little more about Albert Alice's work then you can find his work on this channel if you just look in the search bar for rebt or Albert Alish you'll see a number of presentations that come up discussing

0:47 his work but in this presentation we're going to look at the work of work work of Aon Beck so the idea of cognitive behavioral therapy is quite an elegant one it talks about about how we think influences how we feel and how we feel influences how we behave and how we behave influences how we live our lives and the choices we make and if you think about it if you have a phobia or a fear say of flying say of driving say of even people then your life is going to be limited by that fear it means you'll be able to trust or fly or even go out and

1:32 sometimes some people want to make a change in their lives want to work with the anxiety that comes from not being able to do things and they seek therapy and one of the ways of working with anxiety or even depression is cognitive behavioral therapy now cognitive behavioral therapy draws on an rebt view of psychological disturbance and rebt just to remind you again is rational emotive behavioral therapy and it works on the ABC model so let's have a look at what that is a is action B is belief and C is consequence so an activating event happens something happens in your life that's an

2:18 activating event you then develop a belief from that and then you live the consequences of it and I'm going to show you in this little scenario in the next slide how that looks in real life so let's have a look at what might be called an unhelpful thought process the situation is you are coming home from work after having a bad day as you walk down the road you pass a friend but she walks by and apparently ignores you the thoughts that you might generate in an unhelpful thought proc process are she ignored me they don't like me or she doesn't like me the emotional feelings may be low rejected and sad the physical reac action of the emotional feelings is you might get stomach cramps low energy even feel sick and then the action is go

3:06 home avoid it and if you see that person again you might want to avoid her or it might feel just very difficult to talk to her so that's one view of the world but it might be that if you went to a therapist and discussed this they may help you come to another conclusion which is a helpful thought process so let's have a look at that so it's the same situation you're you're coming home from work you've had aad day you walk down the road and pass a friend she ignores you apparently but it might be a different view the thoughts might be she looks preoccupied I wonder if she's all right or okay the emotional feelings would then change so once you have a different thought then your emotional feelings change so it's gone from feeling a bit sick and nauseous and sad

3:53 to a concern from you for your friend the physical signs well there's none you feel comfortable you're just concerned about your friend and the action is you phone them to see if they're okay quite a different outcome from the first slide where you're avoiding your friend and indeed you're trying if you met them again it might be very uncomfortable and this all comes from how you think and CBT helps you or the therapist helps you think about different thought processes and certainly different ideas of what you've seen try to interpret them maybe in a different way so the methods used in CBT are disputing irrational beliefs what what does that look like well say for instance you have

4:39 someone who's afraid of crossing the road because they get might get run over it might be the therapist asks that person to do some research on how many people get run over in any given year and you might find it's very very small percentage of the population so initially that's the disputing irrational beliefs every time you cross the road you are not likely to get run over how however people do get run over but the percentage is is lower than you believe the second would be is doing some cognitive homework and when we talk about cognitive we're talking about thinking homework so it may be that you start Crossing smaller roads or you start crossing your driveway and then build up to crossing a bigger

5:27 Road it changeed you can change your language and I think that that's quite a powerful way of changing your thought process so if you say I'm not Crossing this road because it's dangerous and I'll get killed and almost certainly your thought process will drive you into a position where you're not going to cross the road but if you use a language such as this is a busy road if I cross it without being careful I might get knocked down or hurt so I'll make sure that when I cross it I'm in a safe place and also there's not a lot of traffic you're changing your thought processes from one of cannot do to one of can do with a strategy and a plan in mind you could use humor I think one of

6:14 the most powerfulest ways of defeating things that fear is is to laugh at them so you know a therapist and I as a therapist I certainly would encourage people to kind of be a little bit kind of self-deprecating maybe and just have a bit of a laugh about it you know not not take it too seriously admit it's something that's holding someone up and and try and see the funny side of it humor really does defeat irrational thinking eventually I think it's it's a really useful tool rationally emotive imagery well this is about getting the client to think about what it feels like to cross the road and what you could do is a very simple exercise in that you can get them to walk from one side of the room to another while they're imagining

6:59 crossing the road and talking about the steps they're taking to make sure they're Crossing safely so um in in the UK we learned curb drill and the Green Cross code as children and that was about making sure that when we cross the road we were looking and listening and making sure that we didn't cross from behind Park cars or par buses so any other vehicle could clearly see us so that really brings us on to the next thing role playing checking it out see if it works also shame attacking exercises sometimes people with um irrational fears are ashamed of it they think that there's something wrong with them um I've heard the term mental I'm a bit mental um I'm a bit oldd and I think

7:47 part of the therapist work and building that relationship with the client is to help them unshame themselves from what's going on saying to them maybe that well this is just where you're at now but actually there's no shame it you're here for help and um and lots of other people go through this so try and you know try and take the kind of Mallet off your head if you like stop getting get stop getting people beat stop you beating yourself up so much use some motivation well I guess if you're if you're going to go to work and you have to cross roads then um you're going to have to Cross Roads a motivation maybe about the therapist saying well if you cross these roads what's likely to happen what's the benefit the benefit is you go to work and and make your money and if you don't cross the roads well

8:34 you know the downside that is you may not get to work could lose your job and could find yourself out of work desensitization well this is an easy one for crossing the road um you just get someone to cross the road with you and just keep doing it and the one of the methods in CBT is keep doing something keep doing it until it becomes second nature so in terms of crossing the road it would just be crossing the road again and again and again using um the skills that you've used IE making sure there's no traffic coming listening for cars making sure that you can get across the road in the time you've got um and slow but surely you desensitize yourself from the fear and are able to

9:20 cross the road without a second thought and skills training well if we stay on the theme of crossing the road that would be about teaching people about how to cross the road where to cross the road what to look out for what to listen for um and and also maybe use using the crossing using the The Pedestrian Crossing and assertiveness training um some people who who are find it difficult in life aren't very assertive so sometimes it's okay to teach the clients how to be assertive and importantly the difference between being assertive and being aggressive asking for what you want as opposed to barging in and bullying for what you want a

10:07 important skill in life is assertiveness being assertive so let's have a look at back's cognitive therapy in a little more detail well it's called Insight Focus therapy and that means it emphasizes changing negative thoughts and maladaptive beliefs so it changes negative thoughts into more positive and reality-based thoughts and also looking at beliefs and testing them against reality the theoretical assumptions are people's internal communication is accessible to reflection I.E those thoughts we have in our heads that can hold us back they are um accessible and we can change them if we think about it and think about other Solutions then we

10:53 can change our behaviors it respects clients beliefs and they they have highly personal meaning so a therapist in CBT would't dismiss someone's beliefs but they try and work with them to change them in a way that are more beneficial to them and more importantly the meanings can be discovered by the client rather being taught or interpreted by the therapist so there's a an amount of therapeutic almost person centered approach here where it's not an analysis of the client it is indeed the client working out where these thoughts came from and where did they first come and why is it that their thoughts are holding them back perhaps thinking about the activating

11:41 events so steps to changing dysfunctional living are acknowledging we are responsible for creating our own emotional problems so taking responsibility and ownership and saying that you know we could change the way we live and the way we think think about situations that's a really important step and I think about 90% of the therapy once someone's decided to change then change is possible accepting we have the ability to change disturbances significantly so having the belief that we can have a different view of life and we can live our lives differently recognize that emotional problems stem from irrational beliefs so the idea that those emotional problem s

12:29 sad happy angry come could come from irrational beliefs things that aren't true but we perceive them as the ability to clearly perceive perceive these ideas and these beliefs so if we talk about crossing the road understand that the problem with getting to work is crossing the road and the reason that you cannot cross the road and the and the faulty belief clients have to believe that seeing the value of the therapist dis disrupting the self deting defeating belief is valuable so if you have a client who you're saying well look if you use the if you use the crossing if you use the crossing lights at the road you be able to cross if they can see

13:14 there's a value in them disputing the the irrational beliefs that's fine but if you get CLI says well I still might get run over then there's some work to go so people have to really want to change and that's that's the sense in any therapy isn't it and six accepting the fact to change we must work hard in emotional how we feel and behavioral ways what we do to counteract irrational beliefs and dysfunctional feelings in behavior in other words we have to make the change ourself and as I've said before keep doing it keep repeating the new ideas and the new behavior until it becomes second nature so let's look at irrational ideas uh from the CBT perspective well irrational ideas is lead to

13:59 self-defeating Behavior some examples I must have love are approval from all the significant people in my life how logical is it that everybody you'll meet will love or approve of you it isn't there's there's people in there's people in life that will never love or approve of you and that is just life so people have to kind of get that idea into them and believe that not everybody's going to love or like them some other irrational beliefs are I must perform important tasks competently and perfect well as I've said to clients on a number of occasions there's nobody who is perfect and sometimes that comes from childhood it comes from parental

14:45 intervention where children are told they have to be perfect and they grow up with this activating idea and this belief that they have to be perfect and sometimes it's a relief to be told well actually um you don't have to be perfect and if the therapist and I would say this I'm not perfect I make mistakes I make loads of mistakes that's fine and if they can see the therapist isn't a perfect person who make they make mistakes then it's certainly easier for the client to see that in themselves and what's called aiz if I don't get what I want it's terrible and I can't stand it and you know there are people who just cannot stand not getting what want well the message is

15:30 unfortunately we cannot always get what we want and sometimes if we want a happier life we just have to find ways of living with the fact we can't get all we want so those are some ideas of irrational thinking practice makes perfect the therapist will challenge or dispute irrational thinking so that's the therapist job to help you think in a different way or help you look at the situ ation you find yourself in from a different perspective of thinking the therapist also encourages the client to practice new thought processes and check thinking out against evidence so if you go back to crossing the road the client would be crossing the road would be trying to cross the road and actually checking out how many times they cross

16:17 the road how safe is it using the new skills so it's about practice and the idea is that once you practice and keep practicing like with any other skill it becomes second nature and if you think about driving when you first start to drive um if you're a stick shift user or use a use a gearbox as we do in the UK it can take forever to get the right gear and the right pedals in place and that type of thing and then one day when you pass your test and you're going to your work or you're going to the office or going home you realize that you've really had no conscious idea of how you've changed gear or how you've used the clutch or how you've driven and that is because it is a um subconscious start process done from practice practice makes perfect so the more you practice

17:04 the better you'll get at any task and that includes your life I guess if you want further information if you watching on Moodle I'll put some information on rebt sites a little bit about Arn backck so that you can see a little bit more about his life and his work if you're watching on um YouTube if you click the arrow Below in the space bar below the video I'll put a link on to the rebt video so you can watch the origins of CBT and I'll also put some links on to other CBT sites so you can get a really good idea of what cognitive behavioral therapy is and indeed what it does and finally thank you for watching