Cognitive Behavioral Therapy: Overview and Skill Building Trainer: Michael Torch, MA, MLADC

45th Annual New England School of Addiction Studies and the 14th New England School of Prevention Studies Worcester State University, Worcester, MA.

Thoughts (Cognitions)

Emotions

Behavior

Cognitive Behavioral Therapy (CBT)

•  Behavioral Theory •  Classical conditioning •  Operant Learning •  Cognitive Social Learning Theory

Addiction Socialization •  Paranoia •  Depression •  Narcissism •  Intimacy •  Manipulation •  Risk-taking •  Authority •  Morality

Operant Learning

Practice Dimension: Counseling

Element: Individual Counseling

Competency 75: Establish a helping relationship with the client characterized by warmth, respect, genuineness, concreteness, and empathy.

Knowledge

Skills

Attitudes

Cognitive Therapy of Substance Abuse Aaron T. Beck et al

“The structure of the therapy session is one of the more noticeable and essential characteristics of cognitive therapy.”

BASIC CBT SESSION STRUCTURE

1/3- Check-in 1/3-Teaching new information or Skill Building 1/3- Assignment for next session and assessment of clinical progress or clinical impressions

Combined Behavioral Intervention Therapist Manual

Strong Professional Bias: “ If its not manualized it’s not CBT

Rapport

“A positive feeling of understanding and mutual regard between therapist and patient.” Erickson & Rossi (Collected Works)

“The sharing of a common rhythm. Brain responding to perceptual cues that are quicker than conscious awareness.” Brown (The Hypnotic Brain)

Matching and Pacing

•  Match and Pace patient’s verbal and non-verbal communications

•  Identify the patient’s primary representational system

Verbal Cues to Representational System Dilts, Robert, Applications of Neurolinguistic Programming

Visual See Look Perspective Focus Color (any) Bright Picture Shows Imagine Notice

Auditory

Hear

Listen

Sounds

Tone

Tune

Tells

Loud

Noise

Amplify

Say

Kinesthetic

Feel

Grasp

Touch

Grab

Hold

Soft

Warm

Handle

Rough

Smooth

Oral Feedback Model

O = Observe

R = Report

A = Assumption

L = Level

110 122

Learning Collaborative

•  Form triads

•  Interviewer, Interviewee, observer

•  Interview each other to establish rapport and identify the interviewee’s major representational system.

Learning Collaborative: Skill building Exercise

Gathering the data: 1.  Client Services Request form 2.  Desired Effects form 3.  Temptation form

Learning Collaborative: Skill building Exercise

Skill building and cognition clarification Decisional Balance Worksheet

Functional Analysis

Context of Substance Use

Mood

Coping Skills

Immediate Environment

Thoughts Competing Responses

Physical sensations

Social Pressure

Anticipated effects

Functional Analysis

Objectives: 1. Identify the functional relationship

between events that trigger substance use and the desired effects of substance use.

2. Develop a plan for treatment

Functional Analysis

Shift in treatment from contemplating the benefits of change to considering how to go about change. Introduce the topic:

Summarize change talk from previous session. Focus from why to how Begin to understand how use fits into life.

Learning Collaborative: Skill building Exercise

Functional analysis using NEW ROADS

New Roads Worksheet

Triggers Effects

Learning Collaborative: Skill building Exercise

STORC Thought Replacement

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