Cognitive Behavioral Family Therapy

Front 1

CBFT: Therapist

Back 1

Directive relationship

Teacher

Coach

Front 2

CBFT: People of Influence

Back 2

Gerald Patterson and Marion Forgatch

Neil Jacobsen and Andrew Christensen

Norman Epstein

John Gottman

Frank Dattillio

Front 3

Functional Family Therapy: People of Influence

Back 3

James Alexander, Bruce Parsons, Thomas Sexton

Front 4

CBFT: Theoretical Foundations and Founders

Back 4

Joseph Wolpe (systematic desensitization)

B. F. Skinner (operant conditioning)

Robert Liberman (role rehearsal and monitoring)

Richard Stuart (contingency and contracting)

Albert Ellis and Aaron Beck (CBT)

Front 5

CBFT: Overview of Treatment

Back 5

Step 1: Assessment

Step 2: Target behaviors and thoughts for change

Step 3: Educate

Step 4: Replace and retrain

Front 6

CBFT: Therapeutic Relationship

Back 6

Written contract, directive educator and expert

empathy to create rapport

Contemporary Alliance:

• Actively collaborate with patient

• Demonstrate empathy

• Adapt therapeutic style to client

• Alleviate distress

• Elicit feedback at end of session

Front 7

CBFT: Case Conceptualization

Back 7

ABC Theory

Couple Cognition Types

Functional Analysis and Mutual Reinforcement

Family Schemas and Core Beliefs

SORKC (stimulus, state of the organism, target response, contingency of consequences)

Front 8

CBFT: Goals

Back 8

1) Extinguish undesired behavior and reinforce positive alternatives

2) Educational agenda - how to use cognitive strategies to resolve problems in the future

Front 9

CBFT: Interventions

Back 9

Reinforcement and Punishment

Frequency of reinforcement and punishment

Behavior exchange & quid pro quo

Communication & Problem solving training

Psychoeducation

Challenging irrational beliefs

Thought records

Homework tasks

Mindfulness Training

Time-out

Immediate rewards -> intermittent -> Punishment

Verbal reprimand & ignoring to extinguish behavior

Contingency contracting (teenagers)

Good faith contract

Behavior exchange

Problem-solving training

Front 10

CBFT: Family

Back 10

Family normality-

Behavior exchange theory - giving and getting remain balanced

Positive Reinforcement control

Good communication skills and conflict resolution

Front 11

CBFT: Concepts/Theoretical Foundations

Back 11

• Behavior is maintained by its consequences

- Consequences are reinforcers or punishers

• Theory of social exchange: people strive to maximize rewards and minimize costs in relationships

• Cognitive Theory: our interpretation of other people's behavior affects how we respond to them

• Schemas: core beliefs

• Premack Principle: High probability behavior is chosen to reinforce behavior with low probability of occurence

Front 12

Symptomology

Back 12

Symptoms: learned responses

Social Reinforcer

Intermittent reinforcement makes symptoms more resistant to extinction

Cognitive Distoritions

Front 13

Parent Training Program

Back 13

Patternson and Forgatch

• Teaching compliance with parental requests with the goal socialization

• Improving parental requests - few in number, polite, statements, made only once before enforcing consequence, specific, well-timed

• Monitoring and tracking

• Creating contingent environment

• 5 minute work chore

Front 14

Functional Analysis

Back 14

Families: Precise contexts, antecedents, consequences of the problem behavior

Couples:

• Strengths and Skills in relationship

• Presenting Problems

• Sex and affection

• Future prospects

• Social Environment

• Individual Functioning

Front 15

Family Schemas and Core Beliefs

Back 15

Arbitrary Influence- belief based on little evidence

Selective Abstraction- focusing on one detail and ignoring context

Overgeneralization- sweeping generalizations made of a persons character based on isolated incidences

Magnification and Minimization- overemphasizing or underemphasizing based on facts

Personalization- arbitrary inference where attributing external events to oneself

Dichotomous Thinking- all or nothing thinking

Mislabeling- assigning personality trait to someone based on isolated incidences, ignoring exceptions

Mind Reading- believing you know what the other is thinking based on assumptions or generalizations

Front 16

Classical Conditiioning

Back 16

1. Natural state of affairs (Unconditioned stimulus and unconditioned response)

2. Process of pairing conditional stimulus with response (UCS+ Conditional stimulus = Conditional Response)

3. Resulted Pairing (Conditioned Stimulus + Conditioned Response)

Front 17

Operant Conditioning

Back 17

Shaping behavior in small steps - closer approximations to desired behavior

Four Options:

Positive Reinforcement- reward desired behavior by adding something desirable

Negative Reinforcement- reward desired behavior by removing something undesirable

Positive Punishment- reduce undesired behavior by adding something undesirable

Negative punishment- reduce undesirable behavior by removing something desirable

Front 18

Thought Records

Back 18

Confronting irrational thought in records:

1. Trigger situation

2. Automatic negative thought

3. Emotional response

4. Evidence for:

5. Evidence against:

6. Cognitive distortions

7. Alternative Thought- realistic

Front 19

Communication and Problem Solving Training

Back 19

• Begin with positive

• Single Subject

• Specific behavioral problems

• Describe impact

• Take Responsibility

• Paraphrase: other partner summarizes

• Avoid mind reading

• Disallow verbal abuse

Front 20

Mindfulness

Back 20

• Observing breath

• Focus on breath without judging experience

• Designed to change how they relate to inner thoughts and internal dialogue