• Greek Symbol used for Psychology

    An interesting take on the "Greek" letter Psi.

“Blog-istory 101″.

Have you ever wondered how counseling theories developed? They just don’t appear one day in a text.  Well perhaps they do, but that’s after a great deal of effort and thought, one must give some thought to the historical timeline and how the theories evolved. This helps us understand the key contributor’s focus.   I suppose I am a novice historian and usually focus on time lines and historical perspectives when I tackle an unfamiliar topic. 

Cognitive Behavioral Therapy (CBT) is an evolution of ideas and thinking by some interesting philosophers, scientists, psychologists, and physicians.   CBT is a blending of two theories BEHAVIORAL and COGNITIVE.  The research clearly focuses on the 1950’s with the development of Albert Ellis’s, Rational Emotive Therapy.

Albert Ellis

 Prior to this time period, recall the pioneering behaviorists such as Pavlov & Skinner who paved the way for the behavioral treatment of emotional disorders. Corey,G. (2005).Theory and practice of counseling and psychotherapy (7th edition).,pgs. 273-275 Belmont,CA:Brooks/Cole.

The author Gerald Corey emphasizes Ellis in some detail crediting his theories with a historical perspective, as well.  Ellis was described as a thinker interested in the “Stoics”.  Who were the Stoics?  

The great “Stoics” and their philosophical discussions are linked to social evolutions and the development of monotheism; and specifically the advent of moralistic discussions regarding man and his roles in society.  Zeno of Citium, c.334-c.262 BC sited to be the founder of modern philosophy.

 Ellis was interested in Epictetus a “Stoic Philosopher”; Epictetus, c.AD 50-c.AD 138., 

Click to read up on Epictetus

 

who emphasized indifference to external goods and taught that the true good is within oneself, (Corey, G.,p. 276 (2009).     Alfred Adler (1870-1937)  is credited by Dr. Ellis as an influential precursor as well, (Corey, G.,p. 276 (2009).  .

Alfred Adler

 Cognitive therapy was developed by Aaron T Beck, MD;  a result and a break in his original belief of psychoanalysis, CT was developed in conjunction with his clinical practice searching for solutions to depression.   

Aaron Beck

Aaron Beck

He believed that focusing on the present was critical to successful treatment of depression, which was his inspiration for development of cognitive therapy.   According to some biographers he was inspired by Ellis’s writings and the development of RET. 

During the 60’s and the subsequent decades, there were significant developments in the realm of research and publishing with both the Behaviorists’ and Cognitionists’.   Some have said this was a time of rivals.  We included a few milestones, important names and recent trend setters, Corey,G. (2005).

  •  B.F. Skinner (53) experimental analysis of behavior
  •  George Kelly (55)  developed personal construct psychology
  •  Joseph Wolpe (58) begins working with “Shell Shocked Soldiers”  now know as PTSD
  •  Maxie Maltsby (60’s)  Rational Behavior Therapy (RBT)
  •  William Glasser (65) Reality Therapy
  •  A. Lazarus (66) publishes book title Psychological Stress & Coping Process
  •  A. Beck (67) publishes book Depression Clinical Experimental and Theoretical Aspects
  •   & other names to know D. Meisembaum, M. Mahoney, D. Burns, S. Yochelson & S. Samenow

List of therpist from: http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

Albert Ellis

Albert Ellis (1913-2007) is known as the grandfather of cognitive behavior therapy. In 1955, he developed rational emotive therapy or better known as rational emotive behavior therapy of REBT from combining philosophical, humanistic and behavioral therapy. Dr. Ellis was a sickly child and eventually developed diabetes at age 40.Despite his health issues, Dr. Ellis worked tirelessly up to 16 hours a day until 2006 when he developed pneumonia and had to go into rehabilitation. He worked up to 7 days a week practicing group therapy, family and marriage counseling, sex therapy and psychotherapy and would see up to 60 patients a week. He was a prolific writer and authored and coauthored over 80 books and 1000 articles. He founded and then became the president emeritus of the Albert Ellis Institute in New York City, (Corey, G.,p. 273 (2009).  

Click to read more about Alber Ellis

 The cognitive behavioral approaches can be quite different including the above mentioned REBT, Aaron Beck’s cognitive therapy (CT), and Donald Meichenbaum’s cognitive behavior therapy (CBT). However they all share four characteristics including: “(1)a  collaborative relationship between client and therapist,(2) the premise that psychological distress is largely a function of disturbances in cognitive processes,(3) a focus on changing cognitions to produce desired changes in affect and behavior, and (4) a generally time limited and educational treatment focusing on specific and structured target problems.”(Corey,G. (2005).Theory and practice of counseling and psychotherapy (7th edition).,p. 271 Belmont,CA:Brooks/Cole.

 

 

Aaron Beck

Aaron T. Beck, MD (1921-  ) is a practicing psychiatrist and professor emeritus of psychiatry at the University of Pennsylvania.  Daniel. B. Smith’s  article ‘The Doctor is In, At 88, Aaron Beck is now revered for an approach to psychotherapy and pushed Freudian analysis aside’   describes Dr. Beck’s  semi retirement yet  reveals a vibrant and very active person  involved with his non for profit organization, teaching and counseling patients.   Dr. Beck began his study of psychology a little reluctantly serving a six month residency in psychology. Dr. Beck hoping to originally become a neurologist, spent his lifetime in a career he passions (Corey, G.,p. 274 (2009).   According to Smith, Becks’ enormous success stems from CBT’s pragmatism and efficiently.  Smith’s interview with Beck describes CT’s proficiency by stating that the average anxiety or depression case, typically reports a lessening of symptoms after 12 to 14 sessions.   Smith points out that, “the power of this approach has led it to be adopted, in one form or another, by a vast number of mental health professionals”.  Corey states that Dr. Beck continues his research and notes he has published 450 articles and 17 books to date, (Corey, G.,p. 274 (2009).  

 To understand cognitive therapy development, one must realize that Dr. Beck  became disenchanted with psychodynamic theories for the treatment of depression.  Beck spent time analyzing himself afterhours in his basement and soughtout remedies for his patients’ depression.   Beck theorized that cognitive symptoms of depression preceded the cause and affective or mood symptoms, Smith, D.B (2009).   Essentially negative thoughts result in negative moods.   He expanded his theory into a “cognitive model of depression”, Butchner, J.  (et al) p.245 (2007). This model presents negative biased thoughts or errors into three themes, self, world and future.   See an interpretation of Beck’s depression Triade below.♣

Becks Negative Cognitive Triad

Beck’s focus on behaviorism proved to be a scientific and clinical windfall according to Smith, D.B (2009).   Becks contributions have been meaningful to say the least, James Butchner, reminds the reader that Beck later in his career extended his theories to the treatment of anxiety disorders, eating disorders, personality disorders, adolescent conduct disorders, and substance abuse disorders; noting that cognitive and cognitive behavioral therapy are terms for the most part terms used interchangeably, Butchner, J.  (et al) p.625 (2007).

Click to read more about Aaron Beck

Judith Beck

Dr. Judith Beck is the daughter of Aaron T. Beck and the director of the non-for profit Beck Institute for Cognitive Therapy and Research. She is actively involved in all aspects of the institute including administration as well as consultation and training. She is a Clinical Associate Professor of Psychology in Psychiatry at the University of Pennsylvania. Dr. Beck is a consultant for various organizations including teaching hospitals and community mental health centers and assists with either creating or improving their existing cognitive therapy programs.

   Dr. Beck has authored the popular textbook Cognitive Therapy: Basic and Beyond which has been translated into 20 languages. The text is used by students of psychiatric nursing, psychology, psychiatry and social work in both the US and around the world. She is the author of the 2007 NY Times best seller, The Beck Diet Solution and The Beck Diet Solution Weight Loss Workbook. She has written hundreds of articles and book chapters on cognitive therapy. (References are from Wikipedia and www.beckinstitute.org).

Judith Beck

Edna B. Foa

Dr. Edna B. Foa is one of the many fascinating psychologists and psychiatrists who have taken cognitive behavioral therapy to another level. (see list of cognitive-behavioral therapies) Dr. Foa developed prolonged exposure therapy after more than 20 years of careful research. It is a highly effective form of treatment for patients suffering from Post Traumatic Stress Disorder, related depressions, anxiety and survivors of traumas such as disasters, rape, child abuse, combat and motor vehicle accidents.

 

She is a Professor of Clinical Psychology in Psychiatry at University of Pennsylvania and serves as the Director of the Center for the Treatment and Study of Anxiety. Dr. Foa is considered an expert in Obsessive –Compulsive Disorder and Post-Traumatic Stress Disorder. Dr. Foa’s work is now being used to assist combat related PTSD.

Click to read more about Edna B. Foa

Linkto www.ptsd.va.gov/public/pages/prolonged-exposure-therapy.asp.

Donald Meichenbaum

Donald Meichenbaum developed cognitive behavior modification (CBM) as an alternative to Ellis’s REBT. A crucial element of CBM is that the client must learn how they are impacting others and become aware of how they feel, think and behave. To make changes in their behavior, the “clients need to interrupt the scripted nature of their behavior so that they can evaluate their behavior in various situations.” (Meichenbaum,1986).

CBM is less direct then REBT and utilizes self instructional training to help the client learn to become more self aware of their self talk. Through working with the therapist, the client uses role playing and practices self instructions to address everyday problems in life. In turn they can learn ways to change their aggressive or impulsive behaviors or even learn to overcome the fear of public speaking or taking tests,(Corey, G p.292, 2009).

Click to read more about Donald Meichenbaum

CBT Uses

There are several reasons why REBT is an effective tool for VR counselors. It is intended to be a short term approach to treatment.”Because REBT is essentially a cognitive and directive behavioral process, an intense relationship between therapist and client is not required”(Corey,p. 278). Instead, the client is encouraged to accept themselves and others without preconceptions. The therapist is willing to work with all kinds of clients. This is ideal since the VR consumer can be a person suffering from a variety of mental health issues.

Essentially REBT has been used in the treatment of character disorders, anxiety, hostility, psychotic disorders and depression to problems with love and sex that occur in relationships to even learning how to raise children and adolescents. Self management and social skills training is also addressed in REBT.

According to Ellis, he recommended group therapy as well as individual therapy as well as individual therapy. He thought the average client would benefit from weekly individual sessions from 5 to 50sessions. He developed successful one and two day intensive workshops intended to change a person’s disturbance-creating attitudes. They were supplied with books and tapes and other material to take home with them so they could continue to practice what they had learned in the classes.(Corey, p.282-283)

Donald Meichenbaum developed cognitive behavior modification (CBM) as an alternative to Ellis’s REBT. A crucial element of CBM is that the client must learn how they are impacting others and become aware of how they feel, think and behave. To make changes in their behavior, the “clients need to interrupt the scripted nature of their behavior so that they can evaluate their behavior in various situations.” (Meichenbaum,1986).CBM is less direct then REBT and utilizes self instructional training to help the client learn to become more self aware of their self talk.

Through working with the therapist, the client uses role playing and practices self instructions to address everyday problems in life. In turn they can learn ways to change their aggressive or impulsive behaviors or even learn to overcome the fear of public speaking or taking tests.(Corey,p.292)

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