CrownCounseling                                                                                               An Evidence Based Psychotherapy Practice                   

The basis of cognitive therapy is that thoughts can influence feelings, and that one's emotional response to a situation comes from one's interpretation of that situation. Cognitive therapy suggests that many of our emotions are due to our thinking. Throughout our lives we are learning, and at times we develop misguided ways of thinking and interpeting our world.  Someone might view the world as unforgiving, problems due entirely to faults within themselves, and consequently feel depressed.  Someone else might set unrealistic expectations for him or herself, thus garnering frustration and perhaps anxiety and depression.  In cognitive therapy it is expected that unhealthy, distorted, biased, or illogical thinking affects emotion. Additionally, with these types of maladaptive thinking, we develop ineffective ways of behaving.

In cognitive therapy, clients learn to:

• Distinguish between thoughts and feelings.
• Become aware of the ways in which thoughts can influence feelings in ways that sometimes are not helpful.
• Learn about thoughts that seem to occur automatically, without even realizing how they may affect emotions.
• Evaluate critically whether these "automatic" thoughts and assumptions are accurate, or perhaps biased.
• Develop the skills to notice, interrupt, and correct these biased thoughts independently.

According to Wikipedia, Behavior therapy is a form of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychopathology. Its philosophical roots can be found in the school of Behaviorism which states that psychological matters can be studied scientifically by observing overt behavior, without discussing internal mental states. Without holding inner states as causal, Skinner's radical behaviorism accepted internal states as part of a causal chain of behavior, but continued to hold that the only way to improve the internal state was through environmental manipulation.

There are several different methods of changing behavior, many specific to the disorder. For instance, systematic desensitzation has been proven effective for improving anxiety related to phobias. Listed below are the main behavior techniques:

Systematic desensitization                     Exposure and response prevention                   Behavior modification                  Flooding                                                Operant conditioning                                       Observational learning              Contengency management                     Extinction       

     Relapse Prevention Therapy (RPT) can prevent relapse or help get you back on track.  Relapse prevention intervention strategies can be grouped into three categories: coping skills training, cognitive therapy, and lifestyle modification.  Coping skills training strategies include both behavioral and cognitive techniques.

     Cognitive therapy procedures are designed to provide clients with ways to reframe the habit change process as learning experience with errors and setbacks expected as mastery develops, and to help clients understand how thinking can help or deter their progress. Finally, lifestyle modification strategies such as meditation, exercise, and spiritual practices are designed to strengthen a client's overall coping capacity.  In clinical practice, cognitive therapy forms one cornerstone of RPT, teaching clients strategies to recognize erroneous thinking, recognize justifications, challenge self-defeating thinking, reframe negative thoughts, recognize how thinking supports or deters the cycle that leads to relapse or uninterrupted recovery.

     Coping skills training forms another cornerstone of RPT, teaching clients strategies to understand relapse as a process, identify and cope effectively with high-risk situations, cope with urges and cravings, stay engaged in treatment even after a lapse or relapse, and to learn how to create a more balanced lifestyle. Importantly, coping skills training helps you implement damage control procedures during a lapse to minimize its negative consequences.

Motivational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.

The purpose of Behavioral Couples Therapy (BCT) is to build support for abstinence and to improve relationship functioning among married or cohabiting individuals seeking help for alcoholism or drug abuse. BCT sees the substance abusing patient with the spouse or live-in partner to arrange a daily “sobriety contract” in which the patient states his or her intent not to drink or use drugs and the spouse expresses support for the patient’s efforts to stay abstinent. For patients taking a recovery-related medication (e.g., disulfiram, naltrexone), daily medication ingestion witnessed and verbally reinforced by the spouse also is part of the contract. Self-help meetings and drug urine screens are part of the contract for most patients. BCT also increases positive activities and teaches communication skills.  Research shows that BCT produces greater abstinence and better relationship functioning than typical individual-based treatment and reduces social costs, domestic violence, and emotional problems of the couple’s children.