identif ib depr

7/28/2019 Identif IB Depr

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Depression and the identification

of irrational beliefs


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Techniques/procedures for identifying specific

cognitive structures/irrational beliefs

Socratic questioning/ Open-endedquestioning/Inductive questioning/ Guided discovery;

Theory-driven questioning; Imagery; Role-playing; Noticing patient reactions during session (mood shift

during the session); Daily record of dysfunctional thoughts and diaries; Techniques and methods used primarily with children

and adolescents.


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Socratic questioning involves asking the client questionswhich:

(a) the client has the knowledge to answer;

(b) draw the clients attention to information which is

relevant to the issue being discussed but which may beoutside the clients current focus;

(c) generally move from the concrete to the more abstractso that

(d) the client can, in the end, apply the new information to

either reevaluate a previous conclusion or construct anew idea.

Socratic questioning/ Open-endedquestioning/Inductive questioning/ Guided discovery


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Theory-driven questioning 1

Questions can also be directly derived from the CBT/ REBTtheory;This line of questioning prompts the client to be morespecific in formulating his/her answers and focus on hot

cognitions rather then on automatic thoughts.What did you think he/she ought to have done in thatsituation to make yourself angry at him/her?,

How did you think you should have reactedat that point tomake yourself guilty about not doing so?,

How did you request life should be to make yourselfmiserable that it was not? (to focus on absolutisticdemands).


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Theory-driven questioning 2

What kind of person you thought would lie like you did?,How do you call a person that acts unjustly like youdid?, What did you call yourself for making such a

mistake? (to focus on negative global evaluation);Was his ignoring you very hard to stand?, Was loosing

your job unbearablefor you?,Did you have difficultyputting up with your childs behavior? (to focus on lowfrustration tolerance);

Did you expect the criticism from your boss to be awfulfor you?, Did you think it was terrible to fail thatexam?, Did you think it would be horrible to berejected like that? (to focus on awfulizing).


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Imagery 1

Imagery/guided imagery techniques involve the mentalgeneration of perceptual experiences in several sensorymodalities, in the absence of external perceptual input(Richardson, apud Arbuthnott, Arbuthnott, & Rossiter,2001, p.123).

While some therapeutic interventions require the use ofrealistic images (e.g., exposure to phobic stimuli), in othercases clients seem to benefit more from the inclusion of

metaphoric ones. This way, the risk of later mistakingimagined experiences for perceived life situations, and thuscreate false memories, could be drastically reduced

(Arbuthnott et al., 2001).


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Imagery 2

Imagery is used in cognitive behavior interventions fordifferent purposes:

(1) to expose clients to phobic stimuli (behavior therapy -Wolpe, 1973);

(2) as a part of stress management training (SITMeichenbaum, 1985; Selye, 1974);

(3) as a way to access and restructure clients automatic

thoughts and core beliefs (cognitive therapy andrational emotive behavior therapy - Dryden, &DiGiuseppe, 1990; Edwards, 1990).


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Role playing

According to Norton and Hope (2001), Role-playedscenarios involve the simulation of an interaction between

the client and another individual or a group in the clinicalsetting (p. 59).

For the purpose of triggering dysfunctional thinking, ifthe client can get sufficiently involved in the scenario

results are often satisfactory (Young, & Beck, 1980).


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Noticing patient reactions during session(mood shift during the session)

Changes in clients mood that occur during session areaccurate indicators for the activation of dysfunctionalthinking.

Therefore, instead of dismissing these emotions andhelping the client feel better by distracting his/herattention from the troubling thoughts, therapist candeliberately focus on them (Young, & Beck, 1980).

Mood shift can be indicated by sudden changes in

behavior (e.g., becoming aggressive, crying, loweringthe head, wringing the hands, etc.) and in physiologicalresponses (e.g., hyperventilating, blushing, etc.).


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Daily record of dysfunctional thoughts and

diariesClient is instructed to keep a diary or fill in a self-monitoring form when, or shortly after the activatingevent takes place.

It is a method similar to an in vivo exposure toactivating events while monitoring cognitive, emotive,physiological and behavioral reactions.

In CBT, the self-monitoring of dysfunctional thoughts is

often prescribed as homework, thus involving the client asa collaborator in the psychotherapeutic process. Clientand therapist then review the beliefs that weremonitored between sessions and discuss them as wellas their impact on emotion and behavior.


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Techniques and methods used primarily withchildren and adolescents 2

EVENT

THOUGHTS

FEELING TYPE

FEELING INTENSITY

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