Cognitive Behaviour Therapy (CBT): preparing organisations for psychological change

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Aims of This Discussion

• To understand how CBT can help organisations with well being, behaviour change and performance

• To reflect on workplace challenges, training needs, and research opportunities

Psychological theories & approaches in the workplace

• CBT (Beck, 1979) and MI (Miller & Rollnick, 1991; 2002) are psychological approaches, underpinned by evidence, that can help organisations and individuals overcome challenges related to physical, emotional, behavioural and situational factors.

• Issues within the workplace maybe; stress, resistance, burnout, presenteeism, absenteeism, sickness ill health, counter-productive work behaviours, physical ill health, poor mental health and so on.

WHAT IS THE AIM OF CBT?

• To increase self-awareness

• To encourage a better self-understanding

• To help us recognize the ‘negative traps’ or ‘vicious cycles’ we get caught in

• To improve self-control by developing more appropriate cognitive and behavioural skills

Cognitive Behaviour Therapy

CBT is ‘a process and identifying and re-evaluating self defeating thinking so that a person is persuaded to engage in more effective ways of thinking, feeling, and behaving’. • A therapy using a mixture of cognitive

(thought processing) and behavioural techniques to look at the links between a person’s environment, thoughts, feelings and behaviours and the impact of these on their health and functioning

• Cognitive techniques address thoughts and thought patterns which may be ‘unhelpful’ and may trigger and/or increase anxiety

• Behavioural techniques address behaviours which may be used by a person to reduce their anxiety or avoid it altogether

Situation

THOUGHTS

PHYSICAL REACTIONS FEELINGS

BEHAVIOURS

Overly negative

Self-critical

Thinking things are going to go wrong

Thinking there is danger

Imagining people will judge you harshly

Imagining that you will look foolish

Unpleasant

Anxious

Angry

Depressed

Heart pounding

Feeling hot

Sweaty

Shakiness

Headache

Stomach ache/cramps

Nausea

Avoid situations

Run away from situations (escape)

Give up

Don’t try to go places or do things

Characteristics of

Cognitive-Behavioral Therapies:

1. Thoughts cause Feelings and Behaviors.

2. Brief and Time-Limited.

3. Emphasis placed on current behavior.

4. CBT is a collaborative effort between the

therapist and the client.

Client role - define goals, express concerns,

learn & implement learning

Therapist role - help client define goals, listen,

teach, encourage.

5. Teaches the benefit of remaining calm or

at least neutral when faced with difficult

situations. (If you are upset by your

problems, you now have 2 problems: 1) the

problem, and 2) your upsetness.

6. Based on "rational thought." - Fact not assumptions.

7. CBT is structured and directive. Based on notion that maladaptive behaviors are the result of skill deficits.

8. Based on assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting.

9. Homework is a central feature of CBT.

Three assumptions

1. Cognitive activity impacts behavior.

2. Cognitive activity can be monitored and changed.

3. A desired change in behavior can be accomplished through changing cognitions.

Symptoms

Physical

Feelings Thoughts

Behavioural

Negative

automatic

thoughts

Incidents

Past

experience

in workplace

CBT and self defeating thinking in the workplace

Core beliefs

Underlying

assumptions or

life rules

WHAT CAN DO?

COGNITIVE • Identify negative thoughts and

thinking patterns which make you feel unpleasant using a thought diary (Appendix A)

• Label the type of ‘thinking error’ (Appendix B)

• Develop balanced thinking by looking for evidence for and against the thoughts and finding new evidence you might otherwise miss

• Learn new skills i.e. distraction, positive self-talk, problem-solving skills

BEHAVIOURAL • Activity monitoring – link activity,

thoughts and feelings

• Become more active – this leaves you less time to worry or listen to your negative thoughts

• Increase pleasant activities

• Break tasks into small achievable steps

• Face your fears – try to break negative cycles by dropping avoidance, escape and safety behaviours

How understanding theory and practice may help you and your organisation

• Help identify and achieve health and work goals

In particular

Dealing with change and resistance

Modification of health and worked related beliefs

Solution focused approach to development of action plans

Training needs of yourself and your workforce

Applying consultancy for your organisational needs

Policy drivers and evidence

• Health Work & Well Being Programme DOH & HSE

• CBT and Employment IAPT programme

• Cognitive behavioural approaches in the workplace (McMahon, 2007)

• Working our Way to Better Mental Health (Health, Work and Wellbeing, 2012)

• The Psychologically Flexible Workplace (Lloyd and Flaxman, 2011)

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