Institute Inbrief - 09/09/2014
Welcome to Edition 210 of Institute Inbrief! If you are a mental health helper of almost any stripe, it would be surprising for you not to have heard of CBT (Cognitive Behaviour Therapy), such is its fame in the mental health professions. In this edition we introduce you to CBT’s fundamentals: the principles and practices of this widely-used therapeutic approach.
Also in this edition:
- Latest news and updates
- Articles and CPD information
- Social media review
- Upcoming seminar dates
Enjoy your reading!
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AIPC is Australia’s largest and longest established educator of Counsellors. Over the past 22-years we’ve helped over 55,000 people from 27 countries pursue their dream of becoming a professional Counsellor.
The Bachelor of Counselling is a careful blend of theory and practical application. Theory is learnt through user-friendly learning materials that have been carefully designed to make your studies as accessible and conducive to learning as possible.
You can gain up to a full year’s academic credit (and save up to $8,700.00 with RPL) with a Diploma qualification. And the program is government Fee Help approved. With Fee-Help you can learn now and pay later: the government will finance all or part of your tuition fees, which you only start to repay from $40 per week once your income exceeds $51,309.
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- Study externally from anywhere in Australia, even overseas.
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Psychology is one of the most versatile undergraduate courses, leading to many different career opportunities. And now there's a truly flexible way to get your qualification – with internal or external study options. It means working while you study is a realistic alternative.
Cost of living pressures and lifestyle choices are evolving the way we learn and Australian Institute of Psychology (AIP) is paving the way through flexible, innovative learning models:
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AIP is a registered Higher Education Provider with the Australian Government, delivering a three-year Bachelor of Psychological Science. The Bachelor of Psychological Science is accredited by the Australian Psychology Accreditation Council (APAC), the body that sets the standards of training for Psychology education in Australasia.
APAC accreditation requirements are uniform across all universities and providers in the country, meaning that Australian Institute of Psychology, whilst a private Higher Education Provider, is required to meet exactly the same high quality standards of training, education and support as any university provider in the country.
Diploma of Counselling
Imagine Being Passionate About Your Work
And Assisting People Every Day Lead Better Lives
It’s rare these days to hear people talk about their work with true passion. You hear so many stories of people working to pay the bills; putting up with imperfect situations; and compromising on their true desires.
That’s why it’s always so refreshing to hear regular stories from graduates living their dream to be a Counsellor. They’re always so full of energy, enthusiasm and passion. There’s no doubt that counselling is one of the most personally rewarding and enriching professions.
Just imagine someone comes to you for assistance. They’re emotionally paralysed by events in their life. They can’t even see a future for themselves. They can only focus on their pain and grief. The despair is so acute it pervades their entire life. Their relationship is breaking down and heading towards a divorce. They can’t focus on work and are getting in trouble with their boss. They feel they should be able to handle their problems alone, but know they can’t. It makes them feel helpless, worthless. Their self-esteem has never been lower. They’re caught in a cycle of destruction and pain.
Now imagine you have the knowledge and skills to help this person overcome their challenges. You assist to relieve their intense emotional pain. You give them hope for the future. You assist to rebuild their self-esteem and lead a satisfying, empowered life.
As a Counsellor you can experience these personal victories every day. And it’s truly enriching. There is nothing more fulfilling than helping another person overcome seemingly impossible obstacles.
43,300+ views for AIPC’s video lecture on Narcissism!
Earlier this year we released a video lecture on Narcissism titled “Spot the Narcissist”. In the lecture, Richard Hill MBMSc, BA (Linguistics), DipProfCouns, MA (Social Ecology), MEd, DPC explores the symptoms that characterise narcissism, how the disorder initially develops, and why we often let narcissists get away with their behaviour. The consequences of someone acting narcissistically are huge; Richard also explores those and provides a few survival tips for dealing with a narcissist.
In just under seven months this video has been watched by over 43,000 people around the world, and received more than 100 comments via the YouTube discussion page. Narcissism seems to be a very popular topic! Have you ever had a relationship with a Narcissist? Or known someone that has? Do you know how to spot – and deal with – one?
Click here to watch this insightful video lecture and learn more about the subject.
What counselors need to know about schizophrenia
The adjective “schizophrenic” needs to be removed from counselors’ vocabulary, says Elizabeth Prosek, a counselor and assistant professor at the University of North Texas (UNT). Schizophrenia has a great deal of stigma and negative connotations associated with it, and referring to clients in the first person can lessen these, she says.
“I encourage counselors to advocate for what clients with schizophrenia can do rather than [focusing on] the limitations of experiencing psychosis,” says Prosek, who has counseled clients with severe mental health disorders and served on a support team for individuals with schizophrenia living independently. “I once heard someone discuss the ‘aggressive nature’ of those diagnosed with schizophrenia. I could not help but wonder where that perception evolved. In my experience, clients did not demonstrate aggressive behavior or language.”
Better Sleep Equals Better Brain
A new study shows a link between poor sleep quality and faster rates of decline in brain volume. According to researchers, sleep is the “brain’s housekeeper,” working to repair and restore the brain.
The study from researchers at the University of Oxford in the United Kingdom included 147 adults between the ages of 20 and 84. Researchers examined the link between sleep difficulties, such as having trouble falling asleep or staying asleep at night, and brain volume. All participants underwent two MRI brain scans, an average of 3.5 years apart, before completing a questionnaire about their sleep habits.
What is CBT? Principles and Practices
If you are a mental health helper of almost any stripe: social worker, counsellor, psychologist, psychotherapist, or even psychiatrist, it would be surprising for you not to have heard of CBT (Cognitive Behaviour Therapy), such is its fame in the mental health professions. We can broadly define it as a combination of cognitive and behavioural therapeutic approaches used to help clients modify limiting, maladaptive thoughts and behaviours, ones that are often inconsistent with consensual reality (Beck, Rush, Shaw, & Emery, 1979). The basic premise of CBT is that emotions are difficult to change directly, so CBT targets emotions by changing the thoughts and behaviours that are contributing to the distressing emotions.
Generally considered a short-term therapy, CBT often consists of about 8 to 12 sessions in which client and therapist work collaboratively to identify problem thoughts and behaviours. The therapist then uses the troublesome thoughts and behaviours to furnish the client with tools and techniques to alter the way they think, feel, and behave in a given situation. The CBT-generated skill set enables the individual to be aware of thoughts and emotions; to identify how situations, thoughts, and behaviours influence emotions; and to improve feelings by changing dysfunctional thoughts and behaviours. Some have noted that “CBT” is an umbrella term and that there are a variety of CBT-based techniques used for different populations and different presenting issues.
The underlying principle of therapy, however, remains the same: there is collaborative CBT skill acquisition and “homework” in between sessions (components which set CBT apart from typical “talk” therapies) (Schmied & Tully, 2009; Gasper, n.d.; Grazebrook, Garland & the Board of BABCP, 2005).
In the beginning...
The work of Albert Ellis (1962) gave major impetus to the development of cognitive behaviour therapies through his Rational Emotive Behaviour Therapy (REBT), originally called Rational Emotive Therapy, or RET. Both Ellis and the founder of Cognitive Therapy, Aaron Beck, believed that people can consciously adopt reason. Both viewed the client’s underlying assumptions as targets of intervention. Both rejected their analytic training and replaced passive listening with active, direct dialogues with clients.
The ABC Paradigm
Ellis’ ABC Paradigm holds that when a person experiences a highly-charged emotional event – called a “C” or Consequent Emotion – following a significant activating event, or “A”, A does not cause C, although it may seem to. In fact, what happens is that emotional consequences are mostly created by “B”, the individual’s belief system. When an undesirable emotional consequence occurs, such as profound anxiety, it usually can be traced to the person’s irrational beliefs. When these beliefs are effectively disputed (at “D”) by challenging them rationally and behaviourally, the disturbed consequences are reduced. Because REBT has viewed cognition and emotion integratively (with thought, feeling, desires, and action interacting with each other), it is a comprehensive cognitive-affective behavioural theory and practice of psychotherapy (Ellis, 1995). But where Ellis confronted and persuaded clients that the philosophies they lived by were unrealistic, Beck regarded the client as a colleague who would research verifiable reality (Beck & Weishaar, 1995).
Beck’s collaborative empiricism
Beck’s Cognitive Therapy is based on a theory of personality which holds that how one thinks greatly determines how one feels and behaves. As noted, it is not just a therapy of collaborative empirical investigation, but also reality testing and problem solving between therapist and client. The client’s maladaptive interpretations and conclusions are treated as testable hypotheses. Both behavioural experiments and verbal procedures are used to examine alternative interpretations, generating contradictory evidence that supports more adaptive beliefs. These in turn lead to desired change (Beck & Weishaar, 1995).
CBT strategies
CBT is based on the idea that the processing of information is crucial for the survival of any organism, but in various psychopathological conditions – such as anxiety disorders, depression, mania, and paranoid states – a systematic bias has been introduced into the client’s information-processing system, causing interpersonal problems and possibly even threatening survival, at least indirectly. Thus, the selective bias of depressed clients leads them into themes of loss and defeat. Those with anxiety selectively and systematically interpret themes of danger, while paranoid clients lean toward attributing abuse or interference, even when there isn’t any. The overall strategies of CBT are, first, collaborative empiricism between therapist and client to explore dysfunctional interpretations and try to modify them. Then guided discovery attempts to discover what threads run through the client’s misperceptions and beliefs; these are linked where possible to analogous experiences of the past, creating a rich tapestry telling the story of the client’s disorder.
As clients tune into the nature of the “program” causing their information-processing glitches, a cognitive shift may occur in which clients realise how the data admitted, and the manner of integrating them, determined the behaviour (usually neurotic) which then resulted. The shift involves installing a new “program” which is more adaptive. A person suffering from an anxiety disorder, therefore, may realise that his or her “survival program” was causing selective attention to danger signals. Now, post-shift, attention can be turned to safety signals, with the “program” for “danger signals” being de-activated or at least turned down in “volume”. The shift to the neutral program (i.e., “there are some danger signals and some safety signals”) can be checked in the world. This feedback into the person’s system helps to reverse misinterpretations, catalysing readjustment (Beck & Weishaar, 1995).
CBT techniques, cognitive and behavioural
In CBT, verbal techniques are used to bring forth the client’s automatic thoughts, analyse the logic behind the thoughts, identify unhelpful assumptions, and examine the validity of the assumptions. Assumptions, once identified, are open to modification, which can occur by asking the client if the assumption seems reasonable, by having the client generate reasons for and against maintaining the assumption, and by presenting evidence contrary to the assumptions. Specific cognitive techniques include the following:
Decatastrophising: the “what-if” technique which helps clients prepare for feared consequences. This is helpful in decreasing avoidance.
Reattribution: a technique which tests automatic thoughts and assumptions by considering alternative causes of events. This particularly helps when clients perceive themselves as the cause of problem events.
Redefining: helps clients mobilise when they believe problems are beyond personal control; these techniques may make problems more concrete, stating them in terms of the client’s own behaviour.
Decentring: used chiefly to help clients who erroneously believe that they are the focus of everyone’s (usually negative) attention.
Behavioural techniques are also used to modify automatic thoughts and assumptions. These employ behavioural experiments designed to challenge specific maladaptive beliefs and promote new learning. A client might, for example, (1) predict that a certain outcome will obtain, based on automatic thoughts, (2) carry out the agreed behaviour, and then (3) evaluate the evidence in light of the new experience. Some of the chief behavioural techniques used to foster cognitive change are:
Homework: opportunities to apply CBT principles between sessions. Assignments typically focus on self-monitoring, structuring time effectively, and implementing procedures for dealing with actual situations.
Hypothesis testing: with both cognitive and behavioural components, this technique must make the hypothesis both specific and concrete.
Exposure therapy: thoughts, images, bodily symptoms, and levels of tension are experienced by, say, an anxious client. Exposure to the anxiety triggers provides data for the client, who can examine specific thoughts and images for distortions.
Behavioural rehearsal and roleplaying: used to practice skills or techniques which are later applied in real life. Role-playing may be taped in order to provide objective feedback with which to assess performance.
Diversion techniques: Activities such as social contact, work, play, visual imagery, and physical activity are used to reduce strong emotions and decrease negative thinking.
Activity scheduling: provides structure and encourages involvement. By rating, say, the degree of mastery and pleasure of an activity, depressed clients, for example, are able to see that they were not depressed at the same, unvarying level all day. They are able to contradict a belief that they cannot enjoy anything, and are further shown that activity takes some planning, so someone does not come to be an inert “couch potato” due to an inherent defect.
Graded task assignment: the client initiates an activity at a “safe” level and the therapist gradually increases the difficulty of assigned tasks (Beck & Weishaar, 1995).
Making it work in real life
Carrying out a program of CBT in real life presents certain challenges. Confidentiality is maintained, but occasionally audio- or videotaping needs to be conducted, so therapists must gain informed consent from clients. Some therapists give clients their home phone numbers in case of emergency. And therapists also – with client permission – bring significant others into a therapy session to review treatment goals and also to explore ways in which family members and others can assist in achieving them (this is especially true where some significant others may not understand the nature of the client’s disorder and/or are behaving in ways which are counterproductive to the therapy effort). Persons close to an individual can be invaluable in helping with reality testing and encouraging the client to complete the homework assignments.
Occasionally problems occur with clients misinterpreting – due to their automatic thoughts – what the therapist has said. Together, therapist and client can elicit these wrongly interpreted statements, looking for alternative interpretations (and if the therapist has made an error, of course, he or she accepts responsibility and corrects it). Nevertheless, problems can arise from unrealistic expectations about how quickly change should occur, from incorrect application of techniques, or – sometimes – from therapist automatic thoughts or logical distortions which prevent maximal effectiveness and problem-solving.
Beck and Emery (1979) issued guidelines for working with challenging clients and those who had already experienced “failure” of therapy:
- Avoid stereotyping the client as being the problem rather than having the problem
- Remain optimistic
- Identify and deal with your own dysfunctional cognitions
- Remain focused on the task instead of blaming the client
- Maintain a problem-solving attitude
Always, the therapist can provide a positive, powerful model for the client, showing that frustration does not necessarily lead to anger and despair (Beck & Weishaar, 1995).
© 2014 Mental Health Academy
This article was adapted from the upcoming Mental Health Academy CPD course “Using CBT with Social Anxiety Disorder”. Click here to learn more about MHA.
References:
Beck, A., Rush, A.J., Shaw, B.J., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press. ISBN (cloth): 0-89862-0007; ISBN (paperback): 0-89862-919-5.
Beck, A. T. & Emery, G. (1979). Cognitive therapy of anxiety and phobic disorders. Philadelphia: Center for Cognitive Therapy.
Beck, A.T. & Weishaar, M.E. (1995). Cognitive Therapy. In Current Psychotherapies, 5th Ed., Corsini, & Wedding, Eds. Itasca, Illinois: F.E. Peacock Publishers, Inc.
Gasper, P. (n.d.) Assessment & formulation in CBT. The Marian Centre. Retrieved on 30 June, 2014, from: hyperlink.
Grazebrook, K., Garland, A., & the Board of BABCP (British Association of Behavioural and Cognitive Psychotherapies). (2005). What are cognitive and/or behavioural psychotherapies? International Institute for Cognitive Therapy. Retrieved on 25 June, 2014, from: hyperlink.
Schmied, V. & Tully, L. (2009). Effective strategies and interventions for adolescents in a child protection context: Literature review. Ashfield, NSW: Centre for Parenting & Research, NSW Department of Community Services. Retrieved on 24 June, 2014, from: hyperlink.
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The Institute has a list of recommended textbooks and DVDs that can add great value to your learning journey - and the good news is that you can purchase them very easily. The AIPC bookstore will give you discounted prices, an easy ordering method and quality guarantee!
This fortnight's feature is...
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Counselling Sexual and Gender Minorities: Three Key Issues
To come into relationship with the notion that one is – and probably has always been – different from the “norm” of heterosexuality is for many individuals a terrifying experience, bringing with it a plethora of social, interpersonal, intrapersonal, employment, and sometimes religious and legal issues. Once the dawning of awareness has happened, however, few feel like it is possible to go back to the pre-dawn consciousness of attempting to engage life as before. Most wish to continue the journey of authenticity, finding out how to be in life as their inner identities dictate. Many will desire assistance from counsellors, psychotherapists, and psychologists for this journey. Yet how many mental health helpers are prepared (as in: qualified, skilled, experienced, and willing) to work with this population?
to continue reading this article.
A Case Using Behaviour Therapy
Rose has come to counselling to help relieve her fears about driving. About 15 years ago, she had an accident while driving and has not driven a car since. She has recently applied for a job, and she will need to use a car to get there. She feels motivated to learn to drive again, however every time she even thinks about driving she experiences mild anxiety attacks. The Counsellor has decided to use Behaviour Techniques with Rose to help her overcome her fears. A précis of the sessions is as follows. For ease of writing the Professional Counsellor is abbreviated to “C”.
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- Spiritual Emergence: Case Studies
- Psychoeducation for Clients
- Counselling the Gender-Diverse Client
- Using CBT with Social Anxiety Disorder
Have you visited Counselling Connection yet? There are over 650 interesting posts including case studies, profiles, success stories, videos and much more. Make sure you too get connected (and thank you for those who have already submitted comments and suggestions).
Graduate Story – Angelie Miaco
Studying at AIPC was definitely a choice in life that I will never forget or regret. The lecturers and teachers modelled exceptional care, excessive knowledge, as well as being so supportive in all areas of learning. It was excellent to see that they were not only there to teach, but they understood the significance of being patient with their students and helping them through the criteria of the work required. The studying options were so convenient and worked around the lifestyle I was in, where I was able to receive my Diploma of Counselling successfully. Within my experience, AIPC provide a comfortable way of learning for their students and provide online submissions, as well as in-class interaction. In-class interaction was a great way to meet other people who were also studying the same course and it allowed friendships to take place. The workbooks are provided with plenty of information and each question given in the workbooks allow a new level of understanding. I felt like I gained so much knowledge from a topic after reading just one paragraph!
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"You have power over your mind - not outside events. Realise this, and you will find strength."
~ Marcus Aurelius
Many students of the Diploma of Counselling attend seminars to complete the practical requirements of their course. Seminars provide an ideal opportunity to network with other students and liaise with qualified counselling professionals in conjunction with completing compulsory coursework.
Not sure if you need to attend Seminars? Click here for information on Practical Assessments.
Below are upcoming seminars available for the remainder of 2014.
BRISBANE (9.00am – 5.00pm)
The Counselling Process: 27-28/09, 29-30/11
Communication Skills I: 18/10, 14/12
Communication Skills II: 20/09, 15/11
Counselling Therapies I: 29-30/11
Counselling Therapies II: 08-09/11
Legal & Ethical Framework: 02/11
Family Therapy: 14/09, 13/12
Case Management: 22-23/11
GOLD COAST (9.00am – 5.00pm)
The Counselling Process: 24-25/10, 05-06/12
Communication Skills I: 15/11
Communication Skills II: 20/09, 12/12
Counselling Therapies I: 26-27/09
Counselling Therapies II: 21-22/11
Legal & Ethical Framework: 28/11
Case Management: 17-18/10
SUNSHINE COAST (9.00am – 5.00pm)
The Counselling Process: 27-28/09
Communication Skills I: 08/11
Communication Skills II: 09/11
Counselling Therapies I: 25-26/10
Counselling Therapies II: 30-31/08
Family Therapy: 11/10
Case Management: 22/11
MELBOURNE (9.00am – 5.00pm)
The Counselling Process: 20-21/09, 25-26/10, 15-16/11, 06-07/12
Communication Skills I: 11/10, 22/11, 13/12
Communication Skills II: 12/10, 23/11, 14/12
Counselling Therapies I: 13-14/09, 18-19/10, 29-30/11
Counselling Therapies II: 20-21/09, 25-26/10, 06-07/12
Legal & Ethical Framework: 27/09, 01/11, 05/12
Family Therapy: 28/09, 02/11, 12/12
Case Management: 04-05/10, 08-09/11
DARWIN (9.00am – 5.00pm)
The Counselling Process: 18/10
Communication Skills I: 13/09, 06/12
Communication Skills II: 13/09, 06/12
Counselling Therapies I: 13/12
Counselling Therapies II: 25/09
Legal & Ethical Framework: 29/11
Family Therapy: 27/09
Case Management: 15/11
ADELAIDE (9.00am – 5.00pm)
The Counselling Process: 18-19/10, 13-14/12
Communication Skills I: 08/11
Communication Skills II: 09/11
Counselling Therapies I: 30-31/08, 22-23/11
Counselling Therapies II: 13-14/09, 06-07/12
Legal & Ethical Framework: 15/11
Family Therapy: 16/11
Case Management: 20-21/09, 29-30/11
SYDNEY (9.00am – 5.00pm)
The Counselling Process: 22-23/09, 09-10/10, 03-04/11, 27-28/11, 15-16/12
Communication Skills I: 29/09, 06/11, 18/12
Communication Skills II: 30/09, 07/11, 19/12
Counselling Therapies I: 07-08/10, 11-12/12
Counselling Therapies II: 24-25/09, 20-21/11
Legal & Ethical Framework: 02/10, 03/12
Family Therapy: 03/10, 04/12
Case Management: 05-06/12
LAUNCESTON (9.00am – 5.00pm)
The Counselling Process: 19/09, 05/12
Communication Skills I: 21/11
Communication Skills II: 21/11
Counselling Therapies I: 31/10
Counselling Therapies II: 28/11
Legal & Ethical Framework: 07/11
Case Management: 12/12
HOBART (9.00am – 5.00pm)
The Counselling Process: 19/10
Communication Skills I: 14/09, 07/12
Communication Skills II: 14/09, 07/12
Counselling Therapies I: 14/12
Counselling Therapies II: 26/10
Legal & Ethical Framework: 30/11
Family Therapy: 09/11
PERTH (9.00am – 5.00pm)
The Counselling Process: 04-05/10, 15-16/12
Communication Skills I: 13/09, 22/11
Communication Skills II: 14/09, 23/11
Counselling Therapies I: 11-12/10, 06-07/12
Counselling Therapies II: 18-19/10, 13-14/12
Legal & Ethical Framework: 25/10
Family Therapy: 01/11
Case Management: 08-09/11
Important Note: Advertising of the dates above does not guarantee availability of places in the seminar. Please check availability with the respective Student Support Centre.
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