Cognitive behavioral therapy (CBT) is the most widely used evidence based practice for treating mental health conditions. This post will cover a few of the most common CBT interventions, and hopefully preparing you for what you may be tested on the EPPP. This will include cognitive therapy, rational-emotive behavior therapy, dialectical behavior therapy,and relapse prevention. The purpose of this post is to explore treatment and interventions that are based on cognitive behavioral theory, but the actual theory itself will be covered in another post. If you would like a refresher on the theory you can read about it here. The information is best used in collaboration with your own knowledge and what you have already been taught, your previous notes or textbooks, and research if you need more information on a particular topic. Or you can check out the product reviews page.
Founded in the 1960s by Aaron T. Beck. The therapy is built on the cognitive model which is based on the assertion that thoughts, feelings, and behavior are all connected. The therapy involves helping a client to identify unhelpful thinking and modifying them, noting problematic behaviors and changing them, and being aware of distressing emotions and managing them.
Cognitive therapy is commonly used to treat depression. According to Beck depression comes from maladaptive views: Negative view of the self, negative view of the world, and negative view of the future. This negative schema is believed to develop in childhood and adolescence, and as adults when they encounter situations that remind them of their childhood it activates this learned negative schema. Beck identified a number of cognitive distortions, and identifying and challenging these distortions is the key to the therapeutic intervention. You can read more about cognitive therapy here.
Rational Emotive Behavior Therapy
Developed by Albert Ellis in the mid 50’s, there are many similarities between Ellis and Beck’s models. The model is based on the assumption that it is not the circumstances themselves that are distressing, but rather the way that the individual views these circumstances that makes it distressing or not. The first step is learning the ABCDEF model. A-activating event, B-Belief, C-Consequences, D- Disputing the evidence, E-effective new philosophy, F-new Feelings.
When used in therapy the goal is to show clients how they have may
have needlessly upset themselves, and helping them regain control of the situation and teach them how to calm this upset, a process that is very empowering for the client. The therapist’s role is to understand the problem from the client’s point of view, and then to take on a teacher and encourager role. Sometimes this means the therapist directly identifies the irrational beliefs and actively disputes them. REBT is typically a brief intervention, and after the initial intervention the client learns to generalize the new learned skills to similar and relevant situations.
There is an expectation that the client work hard to get better, and there is usually daily homework such as desensitization techniques or a thought journal. Key to this therapeutic intervention is the empowerment and encouragement for clients to help themselves, which helps to keep the therapeutic intervention brief. You can read more about Rational Emotive Behavior Therapy here.
Dialectical Behavior Therapy
Developed by Marsha Linehan in the 1980’s, it is widely used for individuals experiencing mood disorders as well as personality disorders, eating disorders, suicidal ideation, self-harm and addictions. The purpose of the intervention is to help people increase their emotional regulation by identifying triggers and improving coping skills. The assumption is that the clients in therapy are doing the best they can, but have too many negative forces influencing them and can manage better through education and practice.
There are 4 modules that make up DBT. The first is mindfulness, which is important because it helps people tolerate the strong emotions they may feel when challenging themselves. Mindfulness originates from Buddhist practices, and DBT takes a portion of this practice, specifically the concept of nonjudgmentally paying attention to the present moment. The second is distress tolerance, which builds on mindfulness and teaches individuals to calmly recognize situations that are negative and cause distress. Rather than becoming overwhelmed or hiding from these distressing situation, the individual is able to make wise decisions about how to act. Third is emotional regulation as individuals with borderline personality characteristics and suicidal ideation can experience intense emotions. Developing these skills to regulate emotions involve teaching and training the client, often in group settings. The fourth module is interpersonal effectiveness, which can include assertiveness training to ask for what one needs, or to say no, or to cope with conflict. These skills are taught in order to increase the individuals chances of having their goals met in a way that does not damage the person’s relationship with another person or themselves.
DBT typically involves 4 conditions: The client agrees to work in therapy for a specific amount of time and attends all sessions, work to reduce suicidal ideation, agree to work on any behaviors that interfere with therapy, and attend skills training. The primary modes of treatment at individual therapy, telephone contact, skills training (typically in a group), and therapist consultation. You can read more about dialectical behavior therapy here.
Developed by Gordon Alan Marlatt in the 70’s. It builds on previous CBT theories, and relates it specifically to addiction and the common struggle of relapse. Marlatt changes the view of relapse as a failure in willpower, to an inevitable experience that can be learned from. The therapists role is to help the client identify triggers to relapse, which may be negative emotions and distressing situations. Then the client is assisted in developing new skills for coping with triggers. You can read more about Marlatt and his model here.
You may find the information on this site is not enough to help you feel confident about your ability to pass the exam, That is OK and only you can be the judge of what you need. If this information seems overwhelming to you it does NOT mean you will fail the exam, but you may require a little more in depth material than is offered here That is why there is a Product Reviews page which will give you a variety of additional options, as well as practice exam questions which I highly recommend as explained on the Study Tips page.
***There are other therapeutic interventions based on CBT including Rehm’s Self-Control Model of Depression and Meichenbaum’s Cognitive Behavior Modification. Please comment below with any other treatment or interventions based on Cognitive behavior therapy, or with any study tips or tricks you use to study for exams.