Brief Demonstration of Cognitive Behavioral Therapy (CBT)
-By Timothy Lyons
Session two which began at a Brief Demonstration of Motivational Interviewing will contain a Brief Demonstration of Cognitive Behavioral Therapy and will involve using the cognitive behavioral therapy (CBT) strategies of cognitive disputation in both mental and physical Rational Self-analysis (RSA) format to assist the client in seeing his faulty thinking errors. But more to allow him to see that he is thinking in the way that he is thinking. Although there is a disagreement between the CBT community and the Acceptance and Commitment Training/Therapy (ACT) community about these very issues I believe that they can be integrated for a specific purpose as stated above.
The client presents with the issues that this last week he was very worried that his mother, who had access to his bank account has been taking some of the money to pay for her own bills. He has admitted that he did owe her some money but that it was not ok for her to take it and now he could not take his girlfriend out to the fair. I will attempt to walk through a verbal RSA and then assign a homework that will help in the client’s access to his own thoughts. We will begin by using a Brief Demonstration of Cognitive Behavioral Therapy
Session 2 in a Brief Demonstration of Cognitive Behavioral Therapy:
H-So Trent, please tell me about what happened with this incident. T- My money was not in my account. My mom took it out because I owed her the money. I knew it and I was pissed off. I stormed around the house yelling. I asked her about it and she lied to me and said that she didn’t take it. But she did. She lied to me about it. H-So you went to your bank account to get some money out to take your friend to the fair, you discovered that there was not enough money in the account. T- Yeah and I was pissed (his face shows anger and is turning red and he clenches his fist.) H- That was your money, and you felt violated and then you got angry? T- Yeah, like she just went through my account like that. I felt like she had no right to just take it. Violated. H- Then you yelled and screamed and really let her have it. What did you feel after that? T- I felt so mad and… like crap. I didn’t feel any better once I stopped yelling. She deserved that though. She can’t just take my money. I am supposed to be paying her. Not her taking it. H- I am going to ask you some questions and walk through a tool that I use myself. Would you allow me to do that? T- Ok I’ll try. H- Let’s take a look at the situation again for a moment so that we can try to get some clarity. You also told me that your mom said she did not take it. Is that possible? T- He got upset for a moment and said no way she and I have that account together and I didn’t take it. H- You went to the account you saw the money missing. Then you knew for a fact that your mom took it. Is there any possibility even if it is really small that the money came out some other way? T- Sure I suppose. H- Ok so you spoke to her and she said she didn’t do it. There is also the possibility that she is telling the truth. T- Yeah but I doubt it. H-What other ways could the money come out of the account that was not you or her? T- Well the bank might take it. But I don’t know. Or my boss shorted me. H- You did not look at those options when you discovered the money missing. T- No man I didn’t even think of those things. H- But now that we are discussing it you might have been wrong and jumped to a conclusion that got you and your mom in an argument. T- this really sucks I just thought she was the only way. H- I suggest that you go to the bank and get the details. Or go online and check to see how much you got paid and if there were any monthly fees or something like that where the bank took the money. Eliminate the other possibilities to make sure you know all the facts. One of the things that I want to do with you is to give you a homework assignment. We talked about this a little that I might do this with you and I really need your participation on this one. Can you help me with this? T- I will try.
In using a Brief Demonstration of Cognitive Behavioral Therapy, I explained the concept of the RSA to Trent. He took the form that I gave him and whenever he is feeling the way that he does not want to feel (reasons that he might be using Marijuana) he is supposed to write down the incident that happened to make him feel that way. Then he writes down how he felt and what he did. In the next box he steps back for a moment and objectively tries to see the incident with only the facts that he knows right then and write it down. I give him some simple examples that are easy to follow. These do not involve his incident so that I use social modeling to demonstrate the technique and I throw in my own incidents and let him know that. It further builds on the rapport and therapeutic relationship. Then I show him where to write down a different way of thinking about the incident once he has seen it clearly. I tell him the last area on the form is where he is to write down how he wants to feel and what he would do if he was not in the situation once he sees it more clearly. I let him know that it’s a way for him, after pausing, to be more objective and to gather facts about situations before he jumps and gets into arguments. And that taking that break just might make a difference between him saying Screw it and using drugs and him being able to have a clear head.
Using the technique of rational self analysis (RSA) from a Brief Demonstration of Cognitive Behavioral TherapyI can help people see that they have internal dialogue. That they think and act based upon what they think. Most important is for them to see that they think. It is difficult, as many persons with issues never are able to see that they think. It’s important for clients to be able to see this and to be able to take a moment to clarify what they are thinking based on being as objective as possible. It’s also vital for them to stop before they act so they can help themselves to not feel poorly from questionable social interactions that result from their actions from irrational thinking. I can also introduce these clients to their thinking so that they can begin to have mindfulness of their thoughts. This is a great way to introduce them to Acceptance and Commitment.
You can read the next installment of this session at a Brief Demo of Acceptance and Commitment Therapy
References for Brief Demonstration of Cognitive Behavioral Therapy
The Albert Ellis Institute. (n.d.). Rational Emotive & Cognitive-Behavior Therapy. Retrieved March 10, 2017, from http://albertellis.org/rebt-cbt-therapy/
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (2nd ed.). New York, NY: Guilford Press.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational Interviewing in Health Care (1 ed.). London: The Guilford Press.