Introduction to the Techniques of Cognitive Behavioral Therapy

Abstract

The previous two chapters covered the structure of cognitive behavior therapy, discussing what goes on in the assessment and orientation phase and presenting the typical structure of subsequent therapy sessions. This and subsequent chapters address the techniques of cognitive behavioral therapy. The Rationale for the Techniques Cognitive Behavioral Therapy Cognitive behavioral therapy argues that the beliefs one holds about a situation, rather than the situation itself, are what determine an individual's resulting emotional experience, behavioral reactions, and physiological response (Beck et al. 1979; Beck, 1995). Individuals with chronic conditions are forced to experience real-world situations that would be interpreted as negative or frightening by almost anyone. When this is simply the case, cognitive behavioral therapy approaches aimed at restructuring cognition are not indicated. Dysfunctional Thinking and Beliefs The circumstance of having a chronic condition can be accompanied by repeated experiences of rejection, alienation, exclusion, discrimination, loss, or failure at once-valued activities. Vulnerable individuals are at risk for developing dysfunc-tional thinking and beliefs over time. These maladaptive cognitive patterns include • Errors in thinking • Preoccupations Individuals with psychiatric overlay may not only bring dysfunctional thinking and beliefs into the experience of having a chronic condition, they are also likely to react to its stresses with increased tendencies toward cognitions that worsen their situation. 79