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(95%)

behavior. Not surprisingly, all of these are important targets for intervention in cognitive therapy. The initial goal of cognitive therapy is to break the cycle or cycles that perpetuate and amplify the client's problems (see Table 9.2). This could potentially be done by modifying the client's automatic thoughts, by improving the client's mood, by working to counteract the biasing impact of mood on recall and perception, and/or by changing the client's behavior. These interventions may break the cycle or cycles that perpetuate the client's problems and alleviate the client's immediate distress. However, if therapy stops at this point, the client would be at risk for a relapse whenever he or she experienced events similar to the ones that precipitated the current problems. To achieve lasting results, it would also be important to modify the factors that predispose the client to his or her problems and to help the client plan effective ways to handle situations that might precipitate a relapse.

The basic principles of cognitive therapy are summarized in Table 9.3. Cognitive therapy is an "eclectic" approach in the sense that cognitive therapy provides a coherent conceptual framework within which a wide range of intervention techniques

Table 9.3

General Principles of Cognitive Therapy

• Therapist and client work collaboratively towards clear goals.

• The therapist takes an active, directive role.

• Interventions are based on an individualized conceptualization.

• The focus is on specific problem situations and on specific thoughts, feelings, and actions.

• Therapist and client focus on modifying thoughts, coping with emotions, and/or changing behavior as needed.

• The client continues the work of therapy between sessions.

• Interventions later in therapy focus on identifying and modifying predisposing factors including schemas and core beliefs.

• At the close of treatment, therapist and client work explicitly on relapse prevention.

can be used. As therapist and client endeavor to work together toward shared goals, the therapist is free to select from a wide range of intervention techniques.

Guided Discovery

One part of cognitive therapy's collaborative approach is an emphasis on a process of guided discovery. The therapist guides the client by asking questions, making observations, and asking the client to monitor relevant aspects of the situation. This helps therapist and client to develop an understanding of the problems, to explore possible solutions, to develop plans for dealing with the problems, and to implement the plans effectively. Guided discovery has an advantage over approaches in which the therapist unilaterally develops an understanding of the problems and proposes solutions in that it maximizes client involvement in therapy sessions and minimizes the possibility of the client's feeling that the therapist's ideas are being imposed on him or her. In addition, because the client is actively involved in the process of developing an understanding of the problems and coming up with a solution, he or she has an opportunity to learn to deal with problems effectively and should be better able to handle future problems as they arise.

Self-Monitoring

One of the primary interventions used in cognitive therapy is helping the client to identify the specific automatic thoughts that occur in problem situations and to recognize the effects these thoughts have on the client's emotions and behavior (A. T. Beck et al., 1979, chapter 8; A. T. Beck et al., 1990, pp. 80-90; Freeman et al., 1990, pp. 49-68). Negative, self-deprecating, or other problematic thoughts typically are a habitual part of the client's life and come "fast and furious" without the client's necessarily being aware of their presence or their relationship to his or her distress. It is possible to identify these cognitions through guided discovery during the therapy session. However, this involves relying on the client's retrospective recall of his or her thoughts, feelings, and actions. Frequently, cognitive therapists have clients observe their thoughts, feelings, and actions as they occur in problem situations and write them down in the hope of providing more complete, detailed information. Many different formats can be used for self-monitoring. One of the formats used most frequently is illustrated in Table 9.2, which shows the thoughts and feelings a client with Dependent Personality Disorder recorded in response to a fight with her boyfriend.

Rational Responses

One technique for helping clients learn to deal effectively with thoughts that prove problematic is to help them develop the ability to look critically at the thoughts and to formulate more realistic alternative views, which are termed rational responses. Table 9.4 shows rational responses to the thoughts from Table 9.2, which the client developed with her therapist's help. A detailed discussion of the process through which therapists help clients master the process of "talking back" to their dysfunctional thoughts is beyond the scope of this chapter. Detailed discussions of this process can be found in a number of sources (e.g., see J. Beck, 1995; Freeman et al., 1990; Greenberger & Padesky, 1995).

Table 9.4

"Rational Responses" Developed with the Therapist's Assistance

Table 9.4

"Rational Responses" Developed with the Therapist's Assistance

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Power Of Positive Thoughts In The Post Modern Age

Power Of Positive Thoughts In The Post Modern Age

The Power Of Positive Thinking In The Post Modern Age Manifest Positive Thoughts In This Fast Pace Age. Positive thinking is an attitude that admits into the brain thoughts, words and pictures that are conductive to development, expansion and success.

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