3.

In discussing her schoolwork, Beth says, I got a D on my first accounting

exam. I know I cant do accounting at all. This is an example of
a. irrational thinking
b. selective abstraction
c. overgeneralization
d. mislabelling
4. Beth says, I know when I go home this weekend and see my boyfriend, things
will go badly. Hes going to tell me I dont spend enough time with him, and will
just get mad at him. I know that Im going to get furious and things will go
terribly. This is an example of
a. catastrophizing
b. dichotomous thinking
c. minimization
d. personalization
5. Throughout school, Beth has come to believe that she will not do well
academically. She believes that other students are smarter that she is.
Furthermore, she believes that no matter how hard she works, she wont do well.
This set of beliefs can be called a (an)
a. critical incident
b. automatic thought
c. cognitive schema
d. cognitive shift
THEORY OF COGNITIVE THERAPY
In cognitive therapy, client and therapist combine to examine thinking
patterns and behaviors and change them so that the client can function more
effectively. The focus of therapy is often on distorted thinking, such as that
shown in the five previous questions. Assessment is quiet detailed, more so than
in REBT. Techniques challenge the clients distorted thoughts and replace them
with more weffective thinking.
GOALS OF THERAPY
Cognitive therapy focuses on distorted or biased thinking. Removing such
thinking is the goal of cognitive therapy. Since clients often have many negative
thoughts, therapists and clients prioritize goals and examine thoughts
specifically.
6. Which of these is most likely to be a goal for Beth?
a. to become a more fully functioning individual
b. to identify her catastrophic thinking and overgeneralizations, replacing them
with more accurate thinking

c. to become more aware of her unconscious motivation to fail

d. to be able to relax when studying
ASSESSMENT IN COGNITIVE THERAPY
Attention to detail is a hallmark of cognitive therapy. In interviews,
therapists ask many questions about the presenting problem, past problems,
past traumatic experiences and medical history. Questions elicit details to help
therapists make assessments about distorted thinking. Scales and
questionnaires, several developed by Aaron Beck, assess for depression, suicide
and other concerns. These may be administered to clients prior to each session.
Another method is self-monitoring that uses sheets such as the Dysfunctional
Thoughts Records. Still other methods are used for sampling thoughts.
Self-monitoring A method of assessing thoughts, emotions or behaviours outside
of therapy in which clients are asked to keep records of events, feelings and/ or
thoughts.
Thought sampling A means of obtaining samples of thoughts outside of therapy
by asking the client to record thoughts on tape or in a notebook at different
intervals.
A cognitive therapist might explain the concept of automatic thoughts to
Beth and ask her to write them down on a Dysfunctional Thought Record.
7. Which of these items would not be found on a Dysfunctional Thought Record?
a. automatic thoughts
b. actual events
c. emotions
d. rational response to the automatic thoughts
e. all would be found on the Dysfunctional Thought Record
8. If Beth records her thoughts randomly on a tape recorder and brings them in
to discuss with the therapist, she is using the technique of
a. self-monitoring
b. thought sampling
c. scaling
d. specifying automatic thoughts
THERAPEUTIC TECHNIQUES
Cognitive therapy techniques are often challenging and specific. Socratic
dialogue helps to challenge maladaptive beliefs and assumptions. Basically, it is
a series of questions that are designed to helpthe client arrive at logical answers
to and conclusions about a certain hypothesis. The three-question technique is a
form of guided discovery. Clients are often asked to specify automatic thoughts
by recording them on the Dysfunctional Thought Record or through thought
sampling. Such homework is common in cognitive therapy. The client can then
bring material to therapy so that the client and therapist can challenge

maladaptive assumptions or ineffective beliefs. Several different techniques are

used for challenging different distorted beliefs. The ones that are listed in the
text are defined here.
Challenging absolutes Statements that include words such as everyone,
never, no one, and always are usually exaggerations which therapists point
out to the client.
Reattributions Helping clients distribute responsibility for an event (such as an
argument) so as to equally place responsibility for the event.
Decatastrophizing A what if technique, in which clients are asked, What if X
happened, what would you do? It is designed to explore actual rather than
feared events.
Scaling A technique of turning a dichotomy into a continuum so that individuals
do not see things as all or nothing. It is used in challenging dichotomous
thinking.
Cognitive rehearsal A means of using imagination to think about having a
positive interaction or experience. For example, to imagine a positive interaction
with ones future in-laws.
Some cognitive therapy concepts are associated primarily with certain
disorders. For example, the cognitive triad and cognitive spiral are associated
particularly with depression but also may be used to describe negative views or
beliefs as they apply to other disorders. Habituation training is a technique that
is used most often with obsessive-compulsive disorder and more specifically with
obsessional thought.
Cognitive triad The negative views that individuals have about themselves, their
world, and their future.
Cognitive spiral The downward spiral of depression in which basic beliefs and
schemas can set off a series of negative reactions that may bring about a
depressed feeling.
Habituation training A technique deliberately evoking a thought, writing the
thought down, and focusing on an intrusive or obsessional thought.
In the following questions, you will be Beths therapist. Pick the statement
that fits most closely with cognitive therapy.
9. Beth says to you, All the other students can learn accounting better than I
can.
a. why do you think the course is so difficult for you?
b. have you considered getting tutoring so that you can do better?
c. you seem to assume that all the students in the class do better than you. How
do you know?
d. accounting is so frustrating for you.

10. Beth says to you, I never understand anything thats going on in class. The
cognitive technique that you are most likely to use is
a. challenging absolutes
b. challenging dichotomous thinking
c. labelling of distortions
d. reattribution
11. Beth says to you, Whenever I go to accounting class, everything is so blah.
You reply to her, What do you mean by blah? Can you tell me more about how
you feel? you are using the technique of
a. challenging absolutes
b. labelling of distortions
c. reattribution
d. understanding idiosyncratic meaning
12. Beth says, If I fail my accounting exam, I dont know what I will do. Theres
no reason to stay in school or to keep on living. Which of the following
techniques are you most likely to use?
a. understanding idiosyncratic meaning
b. decatastophizing
c. reattribution
d. cognitive rehearsal
13. Which of the following would help Beth decatastrophize her statement in
question 12?
a. Have you ever considered killing yourself before?
b. you seem to be thinking that hings will be all good or all bad.
c. getting an F is a big assumption. Lets really take a look at what would happen
if you got an F in accounting and what you would do.
d. what do you mean by failing?
14. Beth is planning to talk to her professor about her difficulty in the accounting
course. She is very much afraid of his potential criticism of her for doing badly.
Which technique are you most likely to use in helping her prepare for her talk
with her professor?
a. challenging absolutes
b. reattribution
c. decatastrophizing
d. cognitive rehearsal

15. You have identified that Beth has a failure cognitive schema. One negative
thought leads to another. She says, I know Ill fail. I know I cant do well in
accounting. I know Ill never be able to get a good job. My life looks so
bleak. In her depressed thinking, Beth is providing an example of
a. the cognitive triad
b. the cognitive spiral
c. cognitive fusion.
d. labelling distortions.
In working with Beth, you are likely to have an opportunity to challenge
her distorted thinking on many occasions. It is not necessary for you to challenge
her each time. You would also help her develop new alternative responses to her
automatic thoughts. You are also likely to use behavioural techniques such as
reinforcing her successes and teaching her new skills. There are also times when
you may respond to her empathically using person-centered techniques.

SPECIAL TOPICS
OE1. What aspects of patients and their problems are likely to make cognitive
therapy brief? (399)

__________________________________________________________________________________
OE2. Why do you think treatment manuals can be effective in cognitive
therapy? (400)

OE3. How are REBT and cognitive therapy different from each other? (400)
Both approaches try to make changes in the clients belief system. Ellis focusses
on irrational beliefs and uses the a-b-c-d-e theory challenge irrational beliefs of
all types. Beck identifies different types of cognitive distortions (a concept similar
to irrational beliefs) and has developed different methods for challenging these
distortions. Ellis applies his approach to all disorders. Beck has different
suggestions and techniques for different disorders. In many ways, their
approaches seem to be quite similar, but the language that they use is rather
different. Both do take a challenging view to working with the clients belief
system. Beck uses different challenging methods for different disorders, whereas
Ellis uses disputing primarily for most disorders.