Depression and the identification of irrational beliefs

Techniques/procedures for identifying specific cognitive structures/irrational beliefs

Socratic questioning/ Open-ended questioning/Inductive questioning/ Guided discovery; Theory-driven questioning; Imagery; Role-playing; Noticing patient reactions during session (mood shift during the session); Daily record of dysfunctional thoughts and diaries; Techniques and methods used primarily with children and adolescents.

Socratic questioning/ Open-ended questioning/Inductive questioning/ Guided discovery

Socratic questioning involves asking the client questions which: (a) (b) (c) (d) the client has the knowledge to answer; draw the clients attention to information which is relevant to the issue being discussed but which may be outside the clients current focus; generally move from the concrete to the more abstract so that the client can, in the end, apply the new information to either reevaluate a previous conclusion or construct a new idea.

Theory-driven questioning 1
Questions can also be directly derived from the CBT/ REBT theory;This line of questioning prompts the client to be more specific in formulating his/her answers and focus on hot cognitions rather then on automatic thoughts. What did you think he/she ought to have done in that situation to make yourself angry at him/her?, How did you think you should have reacted at that point to make yourself guilty about not doing so?, How did you request life should be to make yourself miserable that it was not? (to focus on absolutistic demands).

Theory-driven questioning 2
What kind of person you thought would lie like you did?, How do you call a person that acts unjustly like you did?, What did you call yourself for making such a mistake? (to focus on negative global evaluation); Was his ignoring you very hard to stand?, Was loosing your job unbearable for you?, Did you have difficulty putting up with your childs behavior? (to focus on low frustration tolerance); Did you expect the criticism from your boss to be awful for you?, Did you think it was terrible to fail that exam?, Did you think it would be horrible to be rejected like that? (to focus on awfulizing).

Imagery 1
Imagery/guided imagery techniques involve the mental generation of perceptual experiences in several sensory modalities, in the absence of external perceptual input (Richardson, apud Arbuthnott, Arbuthnott, & Rossiter, 2001, p.123).
While some therapeutic interventions require the use of realistic images (e.g., exposure to phobic stimuli), in other cases clients seem to benefit more from the inclusion of metaphoric ones. This way, the risk of later mistaking imagined experiences for perceived life situations, and thus create false memories, could be drastically reduced (Arbuthnott et al., 2001).

Imagery 2

Imagery is used in cognitive behavior interventions for different purposes:

(1)
(2) (3)

to expose clients to phobic stimuli (behavior therapy Wolpe, 1973); as a part of stress management training (SIT Meichenbaum, 1985; Selye, 1974); as a way to access and restructure clients automatic thoughts and core beliefs (cognitive therapy and rational emotive behavior therapy - Dryden, & DiGiuseppe, 1990; Edwards, 1990).

Role playing

According to Norton and Hope (2001), Role-played scenarios involve the simulation of an interaction between the client and another individual or a group in the clinical setting (p. 59). For the purpose of triggering dysfunctional thinking, if the client can get sufficiently involved in the scenario results are often satisfactory (Young, & Beck, 1980).

Noticing patient reactions during session (mood shift during the session)
Changes in clients mood that occur during session are accurate indicators for the activation of dysfunctional thinking. Therefore, instead of dismissing these emotions and helping the client feel better by distracting his/her attention from the troubling thoughts, therapist can deliberately focus on them (Young, & Beck, 1980). Mood shift can be indicated by sudden changes in behavior (e.g., becoming aggressive, crying, lowering the head, wringing the hands, etc.) and in physiological responses (e.g., hyperventilating, blushing, etc.).

Daily record of dysfunctional thoughts and diaries

Client is instructed to keep a diary or fill in a selfmonitoring form when, or shortly after the activating event takes place. It is a method similar to an in vivo exposure to activating events while monitoring cognitive, emotive, physiological and behavioral reactions. In CBT, the self-monitoring of dysfunctional thoughts is often prescribed as homework, thus involving the client as a collaborator in the psychotherapeutic process. Client

and therapist then review the beliefs that were monitored between sessions and discuss them as well as their impact on emotion and behavior.

Techniques and methods used primarily with children and adolescents 1

When clients are children or adolescents finding the dysfunctional thoughts could sometimes take more work and less verbal methods. Most of the time young clients can only identify surface cognitions, and secondary irrational processes like awfulizing, self-downing and low frustration tolerance.
Thought records (Though bubbles, animal or plant drawings );
Board games; Rational stories; Incomplete sentence fragments; Songs, poetry etc;

Techniques and methods used primarily with children and adolescents 2

THOUGHTS

FEELING TYPE

FEELING INTENSITY

EVENT