Applications of Cognitive Theory to

Interpersonal Practice II
SW-8350
Marla K. Ruhana LMSW
Wayne State University
School of Social Work

A Review of Cognitive-Behavioral Theory

Principles Presented During the First
Semester of the 2-Course CBT Sequence

Cognitive Theory

The way we process information plays a

central role in determining our emotional and/or
behavioral reactions.

CT models explicitly acknowledge the mediating

or moderating role of cognitive factors in human
adaptation.

Sometimes the way that we process information

is influenced by cognitive distortions that result
in erroneous or maladaptive conclusions

CBT Basic Assumptions

(Dobson & Dozois, 2004)

Cognition plays a central role in human

adaptation; in the etiology and treatment of
emotional disorders.

Emotional disorders are the result of biased,

irrational, unrealistic, rigid and distorted thinking
which may be monitored and changed.

CT promotes cognitive change as a means of

promoting clinical improvement.

The Cognitive-therapy approach:

Cognitive conceptualization of clients issues

Present-oriented (i.e. here-and-now)

Problem-focused & solution-oriented (clients choice)

Empirically driven:

What about the past?

Collaborative empiricism
Research

Active participation of client and social worker

Strategies:

Technical eclecticism
The Socratic method; cognitive reframing
Thought Records
Homework
Behavioral experiments and rehearsals

Cognitive Behavioral Therapy (CBT)

Rational Emotive
Behavior Therapy (REBT)
Albert Ellis, PhD

Cognitive Therapy (CT)

Aaron Beck, MD

CBT
Self-Inoculation
Therapy (SIT)
Donald Meichenbaum, PhD

Dialectical Behavioral
Therapy (DBT)
Marsha Linehan, PhD

Others:
Systematic Desensitization
Exposure Therapy
Etc

Cognitive Case Conceptualization:

Relevant Background/Childhood Data
Core Beliefs
Intermediate Beliefs
Conditional Assumptions

Rules

Compensatory Strategies
Typical Problematic Situation

Automatic Thoughts
(situation specific)
Maladaptive emotions

Meaning of
The A. T.

Maladaptive behaviors

Behavioral Theories

All behavior is learned through the process of

conditioning.

Behavior can be modified by altering

environmental factors such as antecedents
(triggers), or consequences (reinforcers).

The focus is on observable and measurable

behaviors.

Behavior Theory Models

Classical Conditioning Theory

John Watson (based on Ivan Pavlovs work).

Focuses on antecedents of behavior

Operant Conditioning Theory

B. F. Skinner
Focuses on consequences of behavior

Social Learning Theory

Albert Bandura
Focuses on modeling, imitation, vicarious learning.

Key Concepts of Behavior Theory

Antecedents
Consequences
Reinforcement (Rewards & punishers)
Scheduling and shaping
Generalization
Extinction
Behavior modification/contingency management
plans.

Behavioral Case Formulation: The A-B-C Model

Antecedents

Affective
Somatic
Behavioral
Cognitive
Contextual
Relational

Behavior
(target)

Behavior Specific
Observable
Measurable

Frequency
Strength
Duration
How often?
How long?
Where?
With whom?

Consequences
secondary gain?

Affective
Somatic
Behavioral
Cognitive
Contextual
Relational

Cognitive-Behavioral Therapy
CBT

Integration of cognitive-behavioral principles to

bring about clinical improvement.

Although changing irrational thinking is important

there also must be a behavioral change.

Behavioral rehearsals & experiments are

incorporated to test out maladaptive beliefs &
assumptions and reinforce rational ones.

CBT & Social Work Practice

Person-In-Environment

Influence of:
Culture: shared values and beliefs?
Family: attitudes & rules?

A reciprocal interaction & influence

Sources and creation of meaning
The person receives socially-reinforced messages
about race, gender, age, sexual orientation, poverty,
wealth, war, peace, etc
All of this contributes to the individuals self and world
view (e.g. I am competent, The world is unfair,
People cannot be trusted, Men are tough).

CBT & Social Work Practice

A constructivist approach

We construct our minds view of reality

The subjective nature of reality

To have an accurate understanding of the individuals

self & world view, we must respect and listen to the
individuals story.

Adopt a bio-psycho-social approach.

Assess the total person

CBT & Social Work Ethical Principles

Service

Social Justice

CBT helps people in need address problems in ways that

promotes their self-interest (not selfishness)

CBT recognizes the detrimental impact of oppression &

discrimination and the irrational nature of the judgmental,
biased views that underscore such processes. CBT promotes
social interest

Dignity and Worth of the Person

CBT accepts the intrinsic worth of each person; refrains from

making global judgments of individuals; promotes selfdetermination, unconditional self/other acceptance and
empowers individuals to take healthy control of their lives.

CBT & Social Work Ethical Principles

Importance of Human Relationships

Integrity

CBT engages clients as equal partners in the therapeutic alliance

based on what Aaron Beck calls collaborative empiricism.

CBT promotes honest & ethical practice based on empirically

supported standards of practice.

Competence

CBT supports the enhancement of professional expertise by

promoting research and research-validated practice.

Concerns, Criticism & Limitations

Limited research re: applications of CBT across cultural and

gender dimensions.

Is CBT conceptually narrow?

Does it encourage rigid, formulaic treatment approaches?

How useful/effective is CBT with persons with limited

cognitive development?

Does it minimize the importance of the therapeutic

relationship as a facilitator of clinical improvement?