Finding the relationship between the client and the environment.
a) Identifying the problem - in terms of behaviour, not thinking.
b) Client strengths - the best way to train behaviour is reinforcement. We need to know what we can work with by finding what the client can and cannot do.
c) Specify ABC - Antecedents to the behaviour we wish to changed.
Behaviour itself.
Consequences of that behaviour, what happens after.
d) Frequency of Behaviour - this gives a baseline, so we can determine what is the normal frequency of the behaviour is to measure change against.
e) Identify Potential Reinforcement - This is the art of behaviour therapy. Finding the right reinforcers and putting them into action increases and decreases the behaviour. Aversive Training, gives the opportunity to prevent punishment. Many things in daily life are done in order to avoid punishment, eg: working, to earn money, so that we dont end up homeless.
f) Treatment Goals - Specific measurable goals to be met. Ie: smoking 10 cigarettes less a day, rather than less smoking in general. .
Effective CBT therapists must get the client to understand they can control the environment and the reinforcers themselves, therefore they can implement the therapy on a daily basis themselves. Client must be educated in all of the above in order for treatments to work.
Problems with CBT.
It appears to be moving the problem rather than solving it.
Changing behaviour leads to generalisation, therefore changing one behaviour may impact all behaviours.
Good points.
CBT is more measurable. And what matters is quality of life and well-being. If a person has an illness and can manage to have a normal enough life then isn't that ok?.
CBT has goals - the function of goals and the need to have them must be examined - why use goals?.
CBT goals should reflect the concerns of the client more than any other therapy. It uses more direct questions and is far easier to get a working contract.