Name of the patient
Age
Sex
Eductaional
Qualification
Occupation
Marital Status
Religion
Diagnosis
Date of Admission
Treating Doctor
Subjective:
Chief Complaints
Objective
CBT therapy Given on
PATIENTS’S PROFILE
Cognitive Behaviour Therapy (CBT)
INTRODUCTION
CBT is a psychotherapeutic approach that aims to solve problems
concerning dysfunctional emotions, behaviours and cognitions through a
goal-oriented, systematic procedure.
CBT combines the Cognitive Therapy developed by Aron Beck and
Behaviour Therapy techniques.
Thoughts cause Feelings and Behaviors
Emphasis placed on current behavior.
CBT is a collaborative effort between the therapist and the client.
Client role - define goals, express concerns, learn & implement
learning
Therapist role - help client define goals, listen, teach, encourage.
Based on "rational thought." - Fact not assumptions.
CBT is structured and directive. Based on notion that maladaptive
behaviours are the result of skill deficits.
Homework is a central feature of CBT.
Cognitive therapies do not appear to work as well with those who are
cognitively impaired.
DEFINITION
Focused form of psychotherapy based on a model suggesting that
psychiatric/psychological disorders involve dysfunctional thinking
The way an individual feels and behaves in influenced by the way s/he
structures his experiences.
Modifying dysfunctional thinking provides improvements in symptoms
and modifying dysfunctional beliefs that underlie dysfunctional thinking
leads to more durable improvement.
INDICATIONS
Cognitive therapy was originally developed for use in the treatment of
depression.
Personality disorders
Seasonal affective disorders
Generalized anxiety disorders
obsessive-compulsive disorders
Mood disorders-depression
MAJOR CONCEPTS & PROCEDURE
The General Cognitive Model
The Cognitive Triad
Negative view of the self (e.g., I’m unlovable, ineffective)
Negative view of the future (e.g., nothing will work out)
Negative view of the world (e.g., world is hostile)
Automatic Thoughts
Negative thoughts about yourself, your world, or your future
Examples of automatic thoughts
Catastrophizing - extreme consequences of events
All or nothing - seeing things in black and white - no grey
areas
Emotional reasoning - if I feel it, it must be true
Self-defeating (irrational) beliefs as per Ellis
Ellis suggested that a small number of core beliefs underlie most unhelpful
emotions and behaviours. Core beliefs are underlying rules that guide how
people react to the events and circumstances in their lives. Here is a sample list
of such of these:
11. I need love and approval from those around to me.
12. I must avoid disapproval from any source.
13. To be worthwhile as a person I must achieve success at whatever I
do.
14. I cannot allow myself to make mistakes.
15. People should always do the right thing. When they behave
obnoxiously, unfairly or selfishly, they must be blamed and
punished.
16. Things must be the way I want them to be.
17. My unhappiness is caused by things that are outside my control –
so there is nothing I can do to feel any better.
18. I must worry about things that could be dangerous, unpleasant or
frightening – otherwise they might happen.
19. I must avoid life’s difficulties, unpleasantness, and responsibilities.
20. Everyone needs to depend on someone stronger than themselves.
21. Events in my past are the cause of my problems – and they
continue to influence my feelings and behaviours now.
22. I should become upset when other people have problems, and feel
unhappy when they’re sad.
23. I shouldn’t have to feel discomfort and pain.
24. Every problem should have an ideal solution.
Helplessness
I am inadequate, ineffective, incompetent, can’t cope
I am powerless, out of control, trapped
I am vulnerable, likely to be hurt, weak, needy
I am inferior, a failure, a lower, not good enough, defective, don’t
measure up.
Hopelessness
I am unlikable, unwanted, will be rejected or abandoned, always be
alone
I am undesirable, unattractive, ugly, boring, have nothing to offer
I am different, defective, not good enough to be loved by other, a
nerd
The Cognitive Model
The Basic Goals of CBT
To challenge the thoughts about a particular situation by
identifying the cognitive traps
To help the patient to identify less threatening alternatives
To test out these alternatives in the real world
To challenge the assumptions that lead to the automatic thoughts
The Basic Tenets of CBT
Cognitive specificity
Socratic dialogue
Collaborative empiricism
Conclusion
Cognitive behavioral therapy (CBT) is an established treatment for
a number of psychiatric disorders.
The CBTs are the best-studied psychological treatments of major
depressive,panic, generalized anxiety, and obsessive-compulsive
disorders. (Friedman, Thase & Wright, 2008)
The CBTs have become one of the standard psychosocial treatment
approaches for mental disorders.
References
[Link] HI, Sadock BJ. Synopsis of Psychiatry , Behavioral Sciences/ Clinical
Psychiatry. 9th ed. Hong Kong :William and Wilkinson Publishers ;1998.
[Link] ES, Thase ME, Wright JH. Cognitive and behavioral therapies,
in Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A.
Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
[Link], A. Symptoms in the Mind: An Introduction to Descriptive
Psychopathology (3rd ed). Elsevier, 2002.