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Cognitive restructuring

Article Discussion

Template:Short description Template:Sidebar with collapsible lists Cognitive restructuring (CR) is a psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts known as cognitive distortions,<ref name="Gladding 2009">Gladding, Samuel. Counseling: A Comprehensive Review. 6th. Columbus: Pearson Education Inc., 2009.</ref> such as all-or-nothing thinking (splitting), magical thinking, overgeneralization, magnification,<ref name="Gladding 2009"/> and emotional reasoning, which are commonly associated with many mental health disorders.<ref>Template:Cite journal</ref> CR employs many strategies, such as Socratic questioning, thought recording, and guided imagery, and is used in many types of therapies, including cognitive behavioral therapy (CBT) and rational emotive behaviour therapy (REBT). A number of studies demonstrate considerable efficacy in using CR-based therapies.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref><ref name="Taylor S., Woody S., Koch W.J., McLean P., Paterson R.J., Anderson K.W. 1997 487–511">Template:Cite journal</ref>

OverviewEdit

Cognitive restructuring involves four steps:<ref name="Hope, D.A. 2010">Template:Cite journal</ref>

  1. Identification of problematic cognitions known as "automatic thoughts" (ATs) which are dysfunctional or negative views of the self, world, or future based upon already existing beliefs about oneself, the world, or the future<ref name="Gladding 2009"/>
  2. Identification of the cognitive distortions in the ATs
  3. Rational disputation of ATs with the Socratic method
  4. Development of a rational rebuttal to the ATs

There are six types of automatic thoughts:<ref name="Hope, D.A. 2010"/>

  1. Self-evaluated thoughts
  2. Thoughts about the evaluations of others
  3. Evaluative thoughts about the other person with whom they are interacting
  4. Thoughts about coping strategies and behavioral plans
  5. Thoughts of avoidance
  6. Any other thoughts that were not categorized

Clinical applicationsEdit

Cognitive restructuring has been used to help individuals experiencing a variety of psychiatric conditions, including depression,<ref>Template:Cite journal</ref> substance abuse disorders,<ref name="Gladding 2009"/><ref>Template:Cite journal</ref> anxiety disorders collectively,<ref>Template:Cite journal</ref> bulimia,<ref>Fairburn, C. G., Marcus, M. D., & Wilson, G. T. (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment and treatment (pp. 361–404). New York: Guilford Press.</ref><ref>Template:Cite journal</ref> social phobia,<ref name="Taylor S., Woody S., Koch W.J., McLean P., Paterson R.J., Anderson K.W. 1997 487–511"/><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> borderline personality disorder,<ref>Linehan, M.M. (1993). Cognitive behavioural treatment of borderline personality disorder. Nueva York: Guilford Press.</ref> attention deficit hyperactivity disorder (ADHD),<ref>Template:Cite journal</ref> and problem gambling.<ref>Template:Cite journal</ref>

When utilizing cognitive restructuring in rational emotive therapy (RET), the emphasis is on two central notions: (1) thoughts affect human emotion as well as behavior and (2) irrational beliefs are mainly responsible for a wide range of disorders. RET also classifies four types of irrational beliefs: dire necessity, feeling awful, cannot stand something, and self-condemnation. It is described as cognitive-emotional retraining.<ref>Ellis, A., & Grieger, R. (1977). Handbook of rational emotive therapy. New York: Springer</ref><ref name="Frojan-Parga, M.X. 2009">Template:Cite journal</ref> The rationale used in cognitive restructuring attempts to strengthen the client's belief that (1) "self-talk" can influence performance, and (2) in particular self-defeating thoughts or negative self-statements can cause emotional distress and interfere with performance, a process that then repeats again in a cycle. Mood repair strategies are implemented in cognitive restructuring in hopes of contributing to a cessation of the negative cycle.<ref name="Werner">Werner-Seidler, A., Moulds, M. L. "Mood repair and processing mode in depression". Oct 24, 2011. US: American Psychological Association.</ref>

When utilizing cognitive restructuring in cognitive behavioral therapy (CBT), it is combined with psychoeducation, monitoring, in vivo experience, imaginal exposure, behavioral activation, and homework assignments to achieve remission.<ref name="Huppert, J.D. 2009">Template:Cite journal</ref> The cognitive behavioral approach is said to consist of three core techniques: cognitive restructuring, training in coping skills, and problem solving.<ref name="Frojan-Parga, M.X. 2009"/>

Applications within therapyEdit

There are many methods used in cognitive restructuring, which usually involve identifying and labelling distorted thoughts, such as "all or none thinking, disqualifying the positive, mental filtering, jumping to conclusions, catastrophizing, emotional reasoning, should statements, and personalization."<ref name="Huppert, J.D. 2009"/> The following lists methods commonly used in cognitive restructuring:

  • Socratic questioning
  • Thought recording
  • Identifying cognitive errors
  • Examining the evidence (pro-con analysis or cost-benefits analysis)
  • Understanding idiosyncratic meaning/semantic techniques
  • Labeling distortions
  • Decatastrophizing
  • Reattribution
  • Cognitive rehearsal
  • Guided imagery
  • Listing rational alternatives
  • Rational emotive behavior therapy (REBT) includes awfulizing, when a person causes themselves disturbance by labelling an upcoming situation as 'awful', rather than envisaging how the situation may actually unfold, and Must-ing, when a person places a false demand on themselves that something 'must' happen (e.g. 'I must get an A in this exam'.)

CriticismEdit

Template:See also Critics of cognitive restructuring claim that the process of challenging dysfunctional thoughts will "teach clients to become better suppressors and avoiders of their unwanted thoughts" and that cognitive restructuring shows less immediate improvement because real-world practice is often required.<ref>Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and commitment therapy for anxiety disorders: A practitioner’s treatment guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland, CA: New Harbinger.</ref> Other criticisms include that the approach is mechanistic and impersonal and that the relationship between therapist and client is irrelevant.Template:Citation needed Neil Jacobson's component analysis of cognitive behavioural therapy (CBT), claims that the cognitive restructuring component is unnecessary, at least with depression. He argues that it is the behavioural activation components of CBT that are effective in giving therapy, not cognitive restructuring, as delivered by cognitive behavioural therapy.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Others also argue that it's not necessary to challenge thoughts with cognitive restructuring.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

See alsoEdit

ReferencesEdit

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External linksEdit

Template:Psychology Template:Psychotherapy Template:Cognitive behavioral therapy

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