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Donald Meichenbaum
Meichenbaum's theory of CBT combines principles from cognitive and behavior therapy. The goal of Cognitive-Behavioral Therapy is to modify dysfunctional cognitions as well as behaviors.
Basic Principles
Cognitive-Behavior Therapy emphasizes cognitions over behaviors but implement strategies and guidelines for the two approaches and a collaborative manner. "CBT combines myriad treatments and techniques that all share a common principle that thoughts, rather than external circumstances, cause feelings and behaviors" (Seligman & Reichenberg, 2014, p. 344).
Treatment Approach
Cognitive-Behavior Modification
Meichenbaum developed cognitive-behavior modification to integrate psychodynamic and cognitive treatment systems with the "technology of behavior therapists"(Meichenbaum, 1993, p. 202).
The three assumptions to clarify how they are integrated(Meichenbaum, 1993).
1. Constructive narrative- people construct their own reality(203)
2. Information processing- activating events trigger a person's core cognitions leading to thought distortions
3. Conditioning- cognitions are covert behaviors that have been conditioned.
Meichenbaum developed cognitive-behavior modification to integrate psychodynamic and cognitive treatment systems with the "technology of behavior therapists"(Meichenbaum, 1993, p. 202).
The three assumptions to clarify how they are integrated(Meichenbaum, 1993).
1. Constructive narrative- people construct their own reality(203)
2. Information processing- activating events trigger a person's core cognitions leading to thought distortions
3. Conditioning- cognitions are covert behaviors that have been conditioned.
Techniques and Interventions
Both Behavioral and Cognitive strategies are used to create a treatment system that is client-specific. Behavioral strategies are also utilized as well.
Stress Inoculation training- gradually exposing client to mild stressors to train them to cope with increasing levels of stress. It involves three phases conceptualization, skill acquisition and rehearsal and application and follow through (Meichenbaum, 1985, p.3)
Behavioral activation therapy- increasing activity on a daily basis to motivate clients who are low energy or depressed(Seligman& Reichenberg, 2014).
Habit reversal training- helping clients to identify behaviors that happen prior to an unwanted behavior and modifying, in a sense changing the pattern. It teaches clients to perform alternative behaviors that are not compatible with the unwanted behavior(Adams, Adams, & Miltenberger, 2008; Veale & Neziroglu, 2010).
Exposure- client learns to identify fear responses, identify maladaptive cognitions, confront the feelings without running and establish more control over the distress(Bandura, 1977).
Problem-solving therapy- learning new problem solving skill to address stress, anxiety, mood disorders etc.
Stress Inoculation training- gradually exposing client to mild stressors to train them to cope with increasing levels of stress. It involves three phases conceptualization, skill acquisition and rehearsal and application and follow through (Meichenbaum, 1985, p.3)
Behavioral activation therapy- increasing activity on a daily basis to motivate clients who are low energy or depressed(Seligman& Reichenberg, 2014).
Habit reversal training- helping clients to identify behaviors that happen prior to an unwanted behavior and modifying, in a sense changing the pattern. It teaches clients to perform alternative behaviors that are not compatible with the unwanted behavior(Adams, Adams, & Miltenberger, 2008; Veale & Neziroglu, 2010).
Exposure- client learns to identify fear responses, identify maladaptive cognitions, confront the feelings without running and establish more control over the distress(Bandura, 1977).
Problem-solving therapy- learning new problem solving skill to address stress, anxiety, mood disorders etc.
Dialectical Behavior Therapy
-the third generation of behavior therapy
"DBT is based on a dialectical philosophy, a biopsychosocial view of disorders, and the integration of behavioral therapy with the Eastern beliefs and attitudes of mindfulness, acceptance and compassion"(Seligman & Reichenberg, 2014, p. 351). DBT helps clients to accept their feelings to increase distress tolerance.
DBT treatment has four stages
1. Clinicians help clients make a commitment to treatment and to keeping themselves safe
2. Desensitization and strategies to help clients deal with trauma
3. Looking to the future and establishing goals and self-respect
4. Integration and generalization of gains, development of spirituality, acceptance of self, achievement of goals and better coping skills
DBT treatment has four stages
1. Clinicians help clients make a commitment to treatment and to keeping themselves safe
2. Desensitization and strategies to help clients deal with trauma
3. Looking to the future and establishing goals and self-respect
4. Integration and generalization of gains, development of spirituality, acceptance of self, achievement of goals and better coping skills