Components of CBT

• Engagement strategies

  • Used at the start of therapy
  • Create a rapport with clients and discuss any worries they have about CBT
  • This can be done so the therapist builds trust with the client
• Cognitive strategies

  • Identify irrational thoughts 
  • Teach clients strategies to challenge their irrational thoughts
  • Several different strategies the therapist might use
• Dysfunctional Thought Diary

  An example of a cognitive strategy

  • Form of ‘homework’ client does between sessions
  • Aims to gain insight into client’s existing dysfunctional thought process + recognize faulty thinking patterns for themselves
  • Client records negative automatic thoughts/emotions they experience in response to an event + how much they believe in it
  • Then write an alternative, rational response to that same event 
  • Client rerates how much the still believe in their initial negative thought + having considered an alternative way of processing their belief in that thought decreases
• Behavioral skills

  • Teaches the client behaviors that will help manage their symptoms
  • Once thoughts have been broken down the therapist can then help the client learn alternative ways of thinking
  • Can teach behaviors that prevent the automatic faulty thoughts from kicking back in
• Pleasant Activity Scheduling

  A form of behavioural skills

  • Plan a pleasant activity each day throughout the therapy
  • Should be something that produces a sense of accomplishment or a total break from routine
  • Provide pleasant emotions and distract the client from the negative thoughts in hopes to reinforce a more positive view on the world
  • Client gradually changing their behaviour -  this is called behaviour activation
  • Taking steps towards positive experiences moves the client away from their negative thinking/maladaptive behavior
• Cognitive restructuring - cognitive strategy

  • Identify + challenge irrational thoughts identified by diary
  • Collaborative - therapist works with client to break down faulty thoughts + rebuild them with more rational + positive
  • Challenging if negative thoughts are fixed, therapist may need to forthright in helping dispute
  • Different methods , e.g. empirical disputation: 
  • ‘evidence-based’ , therapist challenges client to give evidence that supports their irrational thoughts
  • Failing to back up their thoughts helps to understand thoughts are not based in reality + accept they need changing