Document

Report
Cognitive Theory
SSS 571
Human Behavior
& the Social Environment
November 1, 2010
Eileen A. Dombo, MSW, PhD, LICSW
Today’s Plan
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Explore and challenge some misconceptions
Review a bit about theory in general
Present Cognitive theory via 7 questions
Focus on people's problems and how this
theory helps us help them change
Put it all together by applying to case examples
Cognitive Theory as Response to
Psychodynamic Psychotherapy
Theories of Cognition
in Social Work
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Conscious thinking is believed to be the basis
for almost all behavior and emotions.
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Our minds are actively engaged in constructing
the reality we seek to understand.
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So long as a person’s cognitive style helps to
achieve his or her goals, it is considered
healthy.
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However, a person’s thinking patterns can
become distorted, featuring patterns of bias
that ignore relevant information from the
environment.
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Cognitive errors are habits of thought that lead
people to distort input from the environment
and experience psychological distress.
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Social workers who practice from cognitive
theory assert that the individual’s thought
process, not their emotions, should be the
focus of intervention.
Cognition vs. Emotion
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COGNITION
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Conscious & preconscious thinking processes
Personal beliefs & subjective interpretations
Erroneous beliefs result from misinterpretations and
inaccurate conclusions; contribute to social dysfunction
EMOTION
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Feeling states based on our appraisal of stimuli
Affect—physiological expression of emotion
Mood—a more stable feeling disposition; less intense and
not situational
Meaning, Emotion
and Cognition
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Cognitive theorists explore the conscious
meaning of events (Beck).
People are “meaning makers.”
Public (objective) vs. private (unique).
The private meaning is influenced by the
emotional experience and is vulnerable to
distortion; accounts for differences in
emotional responses to situations.
Moving from Public to
Private Meaning
Event
Conscious
Meaning
Emotion
Private
Meaning
Why does Dr. Early get so irritated
when she hears “CBT”?
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Question: Is there such a thing as
Cognitive/Behavioral theory?
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Answer: No
Why Not?
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Cognitive theory
 Assumes that reality is constructed
“inside” - so each individual
determines her/his subjective reality
 According to cognitive theory, we
behave and change based on internal
mental processes
Why Not?
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Behavioral theory
 Assumes that there is one objective
reality “out there” that determines the
individual
 According to behavioral theory, we
behave and change based on external
environmental influences
“CBT” is not the name of a theory. . .
Cognitive-Behavioral Therapy (CBT)
is a practice model,
based on two theories:
cognitive theory and behavioral theory.
Ok, so what is theory?
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an interrelated set of concepts
that are based on observations
the relationship between concepts is
expressed as hypotheses
These concepts and hypotheses are tested
or testable
and are intended to explain or predict
phenomena.
What is clinical practice theory?
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An interrelated set of concepts that
Explains the bio-psycho-social-spiritual nature
of human beings
Explains the development of stable patterns of
adaptive and maladaptive thoughts, feelings,
and behavior of human systems in transaction
with their natural, built, and social
environments
Predicts how those stable patterns may change
Practice Theories
have two functions
Explanatory (or developmental)
function
 Change (or practice) function
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Practice Theory:
The explanatory function
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Practice theory’s developmental or
explanatory concepts explain how
systems develop normally, why
development goes awry, and/or how
problems develop.
Explanatory concepts are used in
assessment. This is the focus of 571.
Practice Theory:
The change function
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Practice theory’s change concepts predict
why systems change and how change can
be facilitated.
Change concepts are used in planning
and intervention.
Implementing the change function
of practice theory:
roles and techniques
Practice roles and techniques are the
concrete actions that flow from the
abstract change concepts of practice
theory. These actions, when performed
by the helping person, facilitate client
change.
7 Questions about Theory
1.
2.
3.
4.
5.
6.
7.
What are the major premises of the theory?
Who thought this theory up?
Who are the social workers building on this early
thinking?
How does the theory understand problems?
How did problems come to be?
How do problems go away on their own?
How do social workers help make problems go
away?
Cognitive Theory
QUESTION 1: What are the major
premises of cognitive theory?
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We are what we think.
We learn to think in the same ways we learn overt
behavior (continuity assumption)
That is, we learn to think in a particular way due to
exposure to experience.
To change what we are, we must change what we
think by becoming aware of, evaluating, and
challenging mediating thoughts
Mind as an information
processing system
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Repeated similar experiences are stored in memory as
thoughts about expectation, causation, attribution, etc.
These patterns become automatic and outside of
consciousness.
Patterns of thought mediate between events and
actions (mediational model)
Memories are applied to multiple new events so they
become less individual memory and more patterns for
organizing experience (schema)
Change comes through disputing or altering
mediating thoughts.
The Cognitive ABC
Activating
Event
Belief
Consequential
Feelings and
Behavior
QUESTION 2: Who thought this theory
up?
Albert Ellis, PhD
 Aaron Beck, MD
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The Fathers of Cognitive Theory:
Aaron Beck and Albert Ellis
Albert Ellis
““Negative
self rating is the major
cause of human disturbance;
we disturb ourselves.”
Aaron Beck
“The thesis that the special meaning of an event
determines the emotional response forms the
core of the cognitive model of emotions and
emotional disorders: The meaning is encased
in a cognition – a thought or an image.”
QUESTION 3: Who are the social
workers building on this early
thinking?
Sharon Berlin
 Paula Nurius
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Sharon Berlin & Paula Nurius
“This filtering is at the heart of the concept of
mediation. As one kind of lens, or filtering
mechanism, our self-conceptions tend to bias us in the
direction of reconfirming what we already believe to
be true about ourselves.”
QUESTION 4: How does cognitive
theory understand “problems”?
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Problems are generally feelings and behaviors that are
maladaptive for a person
Problem feelings and behaviors emerge in response to
activating events that are mediated by a distorted
interpretive thought
These immediate (automatic) thoughts are triggered
by external events but are shaped by internal
schemata, or ways of thinking, that may be distorted
Present events “recruit” different schema that were
learned in the past
QUESTION 5: How did problems
come to be?
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Problem feelings and behaviors are the result
of patterns of thinking that were learned in the
past
They are triggered in the present by activating
events and mediated by situation specific
automatic thoughts shaped by more general
deeply held core beliefs
Problems (often feelings &
behaviors)
A
Activating event
B
belief
C
consequential feeling
or behavior
feeling
(sadness)
activating
event
(boyfriend breaks up
with me)
automatic
thought
(“of course it didn’t work”)
core belief
(I’m unlovable)
behavior
(get drunk)
Raylene
Raylene
Shame/Self-Blame
Date-raped
“It’s my fault”
Goes back to abusive ex
Bad things happen to me
because I am a bad person
Bob
Fight with wife
anger
She doesn’t
respect me
storms out
anger
abates
I am powerless
QUESTION 6: How do problems go
away on their own?
Through changing one’s mind
 Cognitive activity affects behavior
 Cognitive activity may be monitored and
altered
 Desired behavior change may be affected
through cognitive change.
We process much information
that makes sense
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Some information comes is easily processed
through existing meaning structures (schema)
The information “fits,” or is congruent.
the information makes sense; it is meaningful
But we also process information
that makes no sense
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Other information cannot be processed easily
through existing meaning structures (schema),
The information does not fit; it is discrepant,
when we experience contrasts between
 what we want and what we have;
 how things were and how they are;
 what we expect and what actually happens.
The information makes no sense; it is
meaningless
How to Adapt to Discrepant
Informational Cues (DIC)
When faced with discrepant informational
cues (DIC), people adapt by
1.
2.
3.
Retreat: Changing the DIC (removing oneself
from poisoned environment or remove the stressor)
Assimilation: making the DIC fit with existing
schema (distort the information to fit the schema)
Accommodation: Reorganizing existing schema to
fit the new DIC (change schema to fit the
information)
QUESTION 7: How do social workers
help make problems go away?
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Techniques to recognize maladaptive
automatic thoughts and core beliefs
Techniques to evaluate maladaptive automatic
thoughts and core beliefs
Techniques to challenge and restructure
maladaptive automatic thoughts and core
beliefs
Techniques to recruit and strengthen existing
adaptive thoughts (the strengths perspective –
introduced by the social workers!)
Cognitive Distortions/Errors
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Absolute thinking
Overgeneralization
Selective abstraction (focus on negative)
Arbitrary inference (negative conclusion without sufficient
evidence)
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Magnification
Minimization
Personalization
The Cardinal Question of
Cognitive Therapy
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Aaron Beck directs, “Whenever you
experience an unpleasant feeling, try to recall
what thought you had prior to it.”
Judith Beck says the cardinal question of
cognitive therapy is, “What was going through
your mind when the mood changed?”
From concept to technique in
cognitive therapy
Focus on mediating thoughts and beliefs
 Recognizing or becoming aware of thoughts
 Evaluating thoughts to determine viability
 Challenging and restructuring
those that do not serve one’s goals
Critiques
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Cognitive theories are criticized for ignoring
the environment
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Behavioral theories are criticized for reducing
all human behavior to simple responses to
stimuli without critical thought or feeling
involved (more on this next week).
Social Learning Theory
“People are neither entirely determined by
internal causes nor environmental stimuli, but
psychological functioning is accounted for by
a reciprocal interaction of personal &
environmental determinants.”
(Bandura, 1977)
Philosophical underpinnings:
 Behavior is learned when individuals respond
to environment through stimuli, reinforcement,
& imitation
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Behavior is influenced by personal
interpretations & expectations about the
environment
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The central process in learning is imitation
Behavior is the result of modeling + thought
and reasoning
Employs moral and cognitive development by
addressing self-efficacy and self-reinforcement
We do what makes us feel personally
competent
Behavior becomes self-regulated through selfreinforcement
Dysfunctional thoughts lead to dysfunctional
behavior
In closing . . . . . . . . . . . . . . . . . . . .
We are what we think; to change what we
are, we must change what we think.

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