Angeles University Foundation
Cognitive Behavioral
Therapies
A Report on Theories of Counseling and Psychotherapy
Rosell L. Rabina
MA in Clinical Psychology
Date: March 29, 2025
OVERVIEW
Cognitive behavior therapies are based on the assumption that
our thoughts, beliefs, behaviors, emotions, and physical
reactions are all interconnected.
Negative cognitions can result to maladaptive patterns of
behavior, and the goal of this approach is to modify the thinking
patterns of an indiviual.
Objectives
1
2
Identify common attributes shared
by all cognitive behavior
approaches
Describe A-B-C model as a way of
understanding the interaction
among feelings, thoughts and
behavior
3
Application of Cognitive methods
4
Discuss different cognitive
approaches
5
Identify strengths and limitations in
multicultural perspective
Brief History of CBT
1
2
3
4
5
1920s-1950s: Behaviorism
dominated (Skinner, Pavlov)
1950s-1970s: Ellis (REBT) & Beck
(Cognitive Therapy) challenged
behaviorsim
1970s-1990s: Cognitive and
behavioral methods combined - CBT
was born
1990s-Present: CBT expanded
into newer therapies (MBCT,
ACT, DBT)
Introduction
widely recognized
and empirically
supported
aims to equip
individuals with
PRACTICAL
strategies
changing
dysfuntional
thoughts and
behaviors
Attributes shared by
cognitive approaches
A collaborative relationship between client
and therapist
The premise that psychological distress is
often maintained by cognitive processes
A focus on changing cognitions to
produce desired changes
A present-centered, time-limited focus
An active and directive stance by the
therapist
An educational treatment focusing on
specific and structuredtarget problems
Cognitive Behavior
Therapy
What we FEEL depends on what we
THINK
Cognitive Behavioral Approaches
Key Concepts
Cognition - are higher-order mental
process that help us to gather and
process information
Schema - cognitive structures or
patterns that organize and process
incoming information
Automatic Thoughts - occurs
spontaneously, without effort or
choice. In psychological disorders
automatic thoughts are distorted,
extreme, or otherwise inaccurate
Cognitive
Behavioral
Approaches
3 Major Divisions
as organized by Mahoney and Arnkoff
(1978)
1) Cognitive restructuring - emotional
distress is the consequence of
maladaptive thoughts, and the goal
of clinical intervention is to examine
and challenge maladaptive thought
patterns and to establish more
adaptive thought patterns.
Cognitive
Behavioral
Approaches
3 Major Divisions
as organized by Mahoney and Arnkoff
(1978)
2) Coping skills therapies – focus
on the development of a repertoire
of skills designed to assist the
client in coping with a variety of
stressful situations.
Cognitive
Behavioral
Approaches
3 Major Divisions
as organized by Mahoney and Arnkoff
(1978)
3) Problem-solving therapies – may be
characterized as a combination of cognitive
restructuring techniques and coping skills
training procedures. It emphasize the
development of general strategies for dealing
with a broad range of personal problems ,
and stress the importance of an active
collaboration between client and therapist in
the planning of treatment programs.
I. Albert Ellis’s Rational
Emotive Behavior
Therapy (REBT)
first cognitive behavior therapy, based on the
basic assumption that cognitions, emotions,
and behaviors interact significantly and
have a reciprocal cause-and-effect
relationship.
I. View of Emotional Disturbance
A. Key
Concepts
We learn irrational beliefs from
significant others during
childhood and then re-create
these irrational beliefs
throughout our lifetime.
Blame can be at the core of
many emotional disturbance
Three basic musts (or irrational beliefs) we internalize that
inevitably lead to self-defeat (A. Ellis & Ellis, 2011):
“I must do well and
be loved and
approved by others”
“Other people must
treat me fairly, kindly,
and well”
“The world and my
living conditions must
be comfortable,
gratifying, and just,
providing me with all
that I want in life”
II. A-B-C Framework
A. Key
Concepts
Central to REBT theory and
practice
Thus, to maintain a state of
emotional health, individuals
must constantly monitor and
challenge their basic belief
systems.
After A, B, and C comes D
(Disputing)
3 Disputing Process:
1. Detecting - detect irrational beliefs
2. Debating - debate on these dysfunctional
beliefs by logically, empirically, and
pragmatically questioning them
3. Discriminating - clients learn to discriminate
irrational (self-defeating) beliefs from
rational (delf-helping) beliefs.
Scenario:
Sarah applied for a job, but she didn’t get it. She starts thinking:
"I’m a complete failure. I will never succeed in life."
Now, let’s go through the 3 disputing processes step by step.
1. Detecting:
The therapist helps Sarah recognize that she is engaging in irrational thinking by
assuming that one rejection means total failure.
Example:
Therapist: “You seem really upset. What thought is making you feel this way?”
Sarah: “I didn’t get the job, which means I’m a failure.”
✅ The irrational belief detected: "If I fail once, I am a complete failure."
Scenario:
Sarah applied for a job, but she didn’t get it. She starts thinking:
"I’m a complete failure. I will never succeed in life."
Now, let’s go through the 3 disputing processes step by step.
2. Debating:
The therapist encourages Sarah to question whether her belief is true, logical, or
helpful.
Example:
Therapist: "Is it true that not getting one job means you will never succeed?"
Sarah: "Well, I guess not. There are many successful people who faced rejection."
Therapist: "Is there any evidence that you are a total failure?"
Sarah: "Not really. I have done well in other areas before."
✅ Logical questioning helps Sarah see that her belief is not based on
facts.
Scenario:
Sarah applied for a job, but she didn’t get it. She starts thinking:
"I’m a complete failure. I will never succeed in life."
Now, let’s go through the 3 disputing processes step by step.
3. Discriminating
Sarah learns to replace irrational thoughts with rational, self-helping beliefs.
Example:
Irrational Thought: “I’m a complete failure.”
Rational Thought: “Not getting one job doesn’t mean I’m a failure. I still have skills
and other opportunities.”
✅ This helps Sarah feel more hopeful and take positive action, like
applying for more jobs.
I. Therapeutic Goals
B. The
Therapeutic
Process
The basic aim is to teach clients
how to change their
dysfunctional emotions and
behaviors into healthy ones.
Assist clients in the process of
achieving unconditional selfacceptance (USA), unconditional
other-acceptance (UOA), and
unconditional life-acceptance
(ULA)
To show clients how they have incorporated
many irrational absolute “should”, “oughts”,
and “musts” into their thinking
B. The
💡
Example:
Therapeutic Client: “I must always make everyone happy. If I
don’t, I’m a bad person.”
Process
Therapist: “Why ‘must’ you make everyone happy?
II. Therapist’s
Function and
Role
Is that really possible?”
Client: “I guess not… but I feel like I should.”
Therapist: “Let’s change ‘must’ to ‘it would be nice
if.’ Instead of saying ‘I must,’ you can say, ‘I would
prefer to, but I don’t have to.’”
New Thought: “I would prefer to make people
happy, but I don’t have to sacrifice my own wellbeing for it.”
✅
Demonstrate how clients are keeping their
emotional disturbances active
Example:
Client: “My boyfriend broke up with me. This proves
I’m unlovable.”
Therapist: “You’re assuming that one breakup
means no one will ever love you. Can you
absolutely prove that?”
Client: “Well… no, but it feels that way.”
Therapist: “That belief is keeping you stuck in
sadness. What would be a more balanced way of
looking at it?”
New Thought: “My boyfriend broke up with me,
but that doesn’t mean I’m unlovable. I still have
people who care about me.”
B. The
💡
Therapeutic
Process
II. Therapist’s
Function and
Role
✅
Help clients change their thinking and
minimize their irrational ideas
Example:
Client: “If I fail this exam, my life is over.”
Therapist: “Over? Can you never take another
test? Will one failure really destroy
everything?”
Client: “I guess I can retake it… and I’ve failed
before and been okay.”
Therapist: “So what’s a more realistic way to
look at this?”
New Thought: “Failing this exam would be
disappointing, but I can learn from it and
improve next time.”
B. The
💡
Therapeutic
Process
II. Therapist’s
Function and
Role
✅
Strongly encourage clients to develop a
B. The
rational philosophy of life
Therapeutic
💡 Example:
Client: “Life should always be fair.”
Process
II. Therapist’s
Function and
Role
Therapist: “Is life always fair? Can we control
everything?”
Client: “No, but it’s frustrating when bad things
happen.”
Therapist: “Instead of demanding fairness,
how can you cope when things aren’t fair?”
New Thought: “Life isn’t always fair, but I
can focus on what I can control and make the
best of my situation.”
✅
III. Client’s Experience in Therapy
B. The
Therapeutic
Process
Emphasizes here-and-now
experiences and client’s present
ability to change the patterns of
thinking and emoting that they
constructed earlier.
Transference is not encouraged
Clients are encouraged to actively
work outside therapy sessions –
homework
IV. Relationship between
Therapist and Client
B. The
Therapeutic
Process
Respectful relationship between
therapist and client
Clients are taught about the cognitive
hypothesis of disturbance and help
clients understand how they are
continuing to sabotage themselves
and what they can do to change.
I. The practice of REBT
C. Application:
Therapeutic
Techniques
and
Procedures
Cognitive Methods
Disputing Irrational
Beliefs
Doing Cognitive
Homework
Bibliotherapy
Changing one’s language
Psychoeducational
methods
I. The practice of REBT
C. Application:
Therapeutic
Techniques
and
Procedures
Emotive Techniques
Rational Emotive Imagery
Humor
Role Playing
Shame-attacking
Exercises
I. The practice of REBT
C. Application:
Therapeutic
Techniques
and
Procedures
Behavioral Techniques
Operant Conditioning
Self-Management
Principles
Systematic
Desentisization
Relaxation Techniques
Modeling
II. Application of REBT as a
Brief Therapy
C. Application:
Therapeutic
Techniques
and
Procedures
The best and most effective
therapy quickly teaches
clients how to tackle present
as well as future problems
Clients learn self-therapy
techniques that they can
continue to apply through
their own ongoing work and
practice
III. Application to Group
Counseling
C. Application:
Therapeutic
Techniques
and
Procedures
In group therapy members are
taught how to apply REBT
principles to one another. Group
members:
(1) learn how their beliefs inluence what
they feel and what they do
(2) explore ways to change selfdefeating thoughts in various concrete
situations
(3) learn to minimize symptoms
through a profound change in their
philosophy
Aaron Beck’s
Cognitive Therapy
(CT)
It is similar to REBT and unlike
behavior therapy that it is based
on the theoretical rationale that
the way people feel and behave is
influenced by how we perceive and
place meaning on their experience
3 Theoretical
Assumptions of CT
People’s thought
processes are
accessible to
introspection
People’s beliefs
have highly
personal
meanings
People can discover
these meanings
themselves rather than
being taught or having
them interpreted by
the therapist
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Psychological distress can be
thought of as an exaggeration
of normal adaptive human
functioning.
Faulty information processing
is
a
prime
cause
of
exaggerations
in
adaptive
emotional
and
behavioral
reactions.
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Beck identified several common
cognitive distortions:
Arbitrary inferences: conclusions
drawn without supporting
evidence
Selective abstraction: forming
conclusions
based on an
isolated detail of an event while
ignoring the other information
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Beck identified several common cognitive
distortions:
Overgeneralization: process of holding
extreme beliefs on the basis of a single
incident and applying them
inappropriately to dissimilar events or
settings
Magnification and minimization:
consist of preserving a case or
situation in a greater or lesser light
than it truly deserves
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Beck identified several common
cognitive distortions:
Personalization: tendency for
individuals to relate external
events to themselves, even when
there is no basis for making this
connection.
Dichotomous thinking: involves
categorizing experiences in
either-or extremes.
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Beck identified several common
cognitive distortions:
Labeling and Mislabeling:
involves portraying one’s
identity on the basis of
imperfections and mistakes
made in the past and allowing
them to define one’s true
identity
A. A Generic
Cognitive
Model
provides a comprehensive
framework for
understanding
psychological distress, and
some of its major principles
Major principles on which the
model is based:
Our beliefs play a major role in
determining what type of
psychological distress we will
experience
Central to cognitive therapy is the
empirically supported observation
that “changes in beliefs lead to
changes in behaviors and emotions”
If beliefs are not modified, clinical
conditions are likely to occur
B. Basic
Principles
of Cognitive
Therapy
CT is an insight-focused therapy
with a strong psychoeducational
component that emphasizes
recognizing and changing
unrealistic thoughts and
maladaptive beliefs.
Highly collaborative and involves
designing specific learning
experiences to help clients
understand the links between their
thoughts, behaviors, emotions,
physical responses, and situations
B. Basic
Principles
of Cognitive
Therapy
The goal of CT is to help clients
learn practical skills that they
can use to make changes in their
thoughts, behaviors, and
emotions and how to sustain
these changes over time
CT is focused on present
problems, regardless of a client's
diagnosis.
C. The
ClientTherapist
Relationship
Therapeutic relationship is basic
to the application of cognitive
therapy.
Therapist must have a cognitive
conceptualization of cases
Cognitive therapist functions as
a catalyst and a guide who helps
clients understand how their
beliefs and attitudes influence
the way they feel and act
C. The
ClientTherapist
Relationship
Cognitive therapist identify
specific, measurable goals and
move directly into the areas
that are causing the most
difficulty for clients (Dienes et
al, 2011 as cited in Corey, 2017)
D.
Applications
of Cognitive
Therapy
Cognitive therapy has been
successfully used to treat
depression and other
psychological disorders.
With children and adolescents,
CT has been shown to be
effective in the treatment of
depression and anxiety
disorders and more effective
than medications for these
problems.
D.
Applications
of Cognitive
Therapy
1. Applying Cognitive
Techniques
Activity scheduling
Behavioral experiments
Skills training
Role playing
Behavioral rehearsal
Exposure therapy
2. Treatment Approaches
D.
Applications
of Cognitive
Therapy
Length and course varies
and dependent on specific
diagnoses
Panic Disorder – generally
lasts only 6-12 sessions and
targets catastrophic beliefs
about internal physical and
mental sensations.
2. Treatment Approaches
D.
Applications
of Cognitive
Therapy
Depression – usually last
16-20 sessions and begins
in behavioral activation.
Therapist will try to guide
the clients to activities that
can boost moods.
D.
Applications
of Cognitive
Therapy
3. Application to Family
Therapy
Cognitive theory emphasizes
schema (core beliefs) as key
aspect of therapeutic process.
Therapist help families restructure
distorted beliefs (schema) in order
to change dysfunctional
behaviors.
Family schemata – influenced by
the parent’s family of origin
StrengthsBased
Cognitive
Behavioral
Therapy
Strengths-Based Cognitive Behavior Therapy
(SB-CBT)
a variant of Aaron Beck’s cognitive therapy
developed by Christine Padesky and her colleague
Kathleen Mooney. One central addition is an
emphasis on identification and integration of client
strengths at each phase of therapy.
A. Basic Principles of SB-CBT
Strengths are integrated into each phase
of treatment in SB-CBT beginning with the
intake interview
Positive interests and strengths are
identified in early therapy sessions
SB-CBT therapist help clients develop and
construct new positive ways of interacting
in the world.
B. The Client-Therapist Relationship
·Similar with Beck CT, therapist are
collaborative, active, here-and-now
focused, and client centered
·Therapist do not take an “expert”
stance but instead serve as curious
assistants and guides clients to their
own discovery and growth
C. Applications of Strengths-Based CBT
An add-on for classic CBT – ·when
clients come to therapy with goals to
reduce problematic
moods(depression, anxiety, anger),
behaviors (eating disorders,
substance misuse) or other difficulties
(psychoses, hypochondriasis)
C. Applications of Strengths-Based CBT
A four step model to build resilience and
other positive qualities:
(1) Search
(2) Construct
(3) Apply and
(4) Practice
C. Applications of Strengths-Based CBT
·The new paradigm for chronic
difficulties and personality
disorders – comprehensive and
requires clients to vividly
construct new ways to feel, think,
and behave in their life.
C. Applications of Strengths-Based CBT
Steps include:
(1) Conceptualize the OLD system of
operating and help clients understand they
do things for “good reasons”
(2) Construct NEW systems
(3) strengthen the NEW and
(4) relapse management
Cognitive Behavior
Modification
Donald Meichenbaum’s Cognitive
Behavior Modification (CBM) focus on
changing the client’s self-talk. In some
books it is called Self-Instructional
Training
Cognitive
Behavior
Modification
Self-statements affect a person’s
behavior in much the same way
as statements made by another
person.
Basic premise: clients, as a
prerequisite to behavior change,
must notice how they think, feel,
and behave and the impact they
have on others
Meichenbaum’s self-instructional
training focuses more on helping
clients become aware of their
self-talk and the stories they tell
about themselves.
A. How Behavior
Changes
Phase 1: Self-Observation
Phase 2: Starting a new
internal dialogue
Phase 3 : Learning a new skill
B. Stress Inoculation
Training
application of a coping
skills program teaching
clients stress
management
techniques by way of
strategy
The following procedures are
designed to teach these coping skills:
B. Stress
Inoculation
Training
Expose clients to anxiety-provoking
situations by means of role playing
and imagery
Require clients to evaluate their
anxiety level
·each clients to become aware of the
anxiety-provoking cognitions they
experience in stressful situations
Help clients examine these thoughts
by reevaluating their self-statements
Have clients note the level of anxiety
following this reevaluation
The phases of Stress
Inoculation Training:
B. Stress
Inoculation
Training
The conceptual-educational phase:
primary focus is on creating a
therapeutic alliance with clients
The skills acquisition and consolidation
phase: focus is on giving clients a
variety of behavioral and cognitive
coping skills to apply to stressful
situations
The application and follow-through
phase: the focus is on carefully
arranging for transfer and maintenance
of change from the therapeutic situation
to everyday life.
CBT from a Multicultural
Perspective
Cognitive behavioral approaches
have several strength in working
with individuals from diverse
cultural, ethnic, and racial
backgrounds.
Aspects that contribute to an integrative
framework
Interventions are tailored to the unique
needs and strengths of the individual
Clients are empowered by learning
specific skills they can apply in daily
life (CBT) and by the emphasis on
cultural influences that contribute to
client’s uniqueness (multicultural
therapy)
Aspects that contribute to an integrative
framework
Inner resources and strengths of clients
are activated to bring about change
Clients make changes that minimize
stressors, increase personal strengths
and supports, and establish skills for
dealing more effectively with their
physical and social (cultural)
environments
B. Shortcomings
from Diversity
·Emphasis of CBT on assertiveness,
independence, verbal ability, rationality,
cognition, and behavioral change may
limit its use in cultures that value subtle
communication over assertiveness,
independence, listening and observing
over talking, and acceptance over
behavior change.
Summary
Approach
Rational
Emotive
Behavior
Therapy (REBT)
Beck’s Cognitive
Therapy (CT)
Key Theorist
Core
Principles
Techniques
Focus
Albert Ellis
Irrational beliefs
cause distress;
changing core
beliefs leads to
emotional wellbeing.
ABC Model
(Activating event,
Belief,
Consequence),
Disputing irrational
thoughts, Homework
assignments
Identifying and
replacing
irrational
thoughts
Negative automatic
thoughts and
cognitive
distortions
contribute to
emotional distress.
Socratic
questioning,
Thought
records,
Behavioral
experiments
Identifying
and
challenging
cognitive
distortions
Aaron Beck
Approach
Key Theorist
Core
Principles
Strengths-based
Cognitive
Behavior
Therapy
(SB-CBT)
Christine
Padesky &
Kathleen
Mooney
Focuses on
strengths rather
than deficits; builds
resilience
Strengths-based
case
conceptualization,
guided discovery,
imagery
Enhancing
strengths and
resilience
Donald
Meichenbaum
Self-instructional
training, behavior
change occurs
through internal
dialogue
Self-Instruction,
Stress
inoculation
training,
Modeling
Changing selftalk and
coping
strategies
Cognitive Behavior
Modification (CBM)
Techniques
Focus
Approach
Limitations from a multicultural Perspective
REBT
Highly individualistic, which may not align with collectivist cultures.
Direct and confrontational style may not be comfortable for cultures
valuing harmony and indirect communication.
Heavy reliance on logic and reason may not fit well with cultures
that prioritize spirituality, intuition, or community-based reasoning.
CT
Focuses on cognitive restructuring, which assumes clients value
introspection and self-analysis—this may not be emphasized in some
cultures.
The structured, therapist-led approach may not align with cultures that
expect healing to be a shared, communal experience.
Assumes that cognitive distortions are universal, but some thought
patterns considered "distorted" in Western views may be culturally
normative.
Approach
Limitations from a multicultural Perspective
SB-CBT
Strengths identification may be challenging in cultures where
humility is valued over self-promotion.
Western definitions of “strengths” and “resilience” may not align with
culturally specific strengths.
The approach may downplay structural inequalities that impact
mental health in marginalized communities.
CBM
The emphasis on self-instruction and self-talk may not fit well with cultures
that value external guidance from elders, communities, or religious leaders.
Stress inoculation training assumes that exposure and rational coping
mechanisms are effective for all cultures, but some may prioritize different
coping strategies (e.g., spiritual rituals, storytelling).
The model is Western-centric in its understanding of stress and coping, which
may not align with diverse cultural explanations of mental health challenges.
Thank you for
listening!