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Cognitive-Behavior Modification

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Chapters (9)

Now that you are forewarned by Paivio, let me convey in this chapter how one cognitive-behavior therapist has tried to tame the seductress.
Cognitive strategies as described by Gagné and Briggs are similar to Skinner’s (1968) self-management behaviors. The self-instructional training regimen is designed to teach such cognitive strategies and self-management skills; to teach clients “how” to think. In a number of laboratories an exploration of the potential therapeutic value of self-instructional training procedures with various other clinical populations has begun. Examples of three of these populations are now offered.
Since my initial study with Goodman in 1971, self-instructional training has undergone substantial refinement. This chapter brings together the various observations from our laboratory and from others’ concerning the process of conducting self-instructional training. The chapter deals primarily with children because most of the work with the procedure has been with children. However, these same observations apply to self-instructional training with adults. The treatment suggestions offered are not based upon careful empirical studies but rather represent a sort of cumulative “wisdom” culled from our own experiences and from the literature. I hope attention to the sorts of details presented in this chapter will enable us to avoid the “negative” results with which the last chapter concluded.
Initial research on self-instructional training indicated that the likelihood of obtaining generalization and persistence of treatment effects was increased if we attended to the client’s cognitions. If operant training procedures could be improved by explicitly including in the treatment regimen a client’s thoughts and images, then perhaps other behavior therapy techniques could similarly be improved. In other words, if the Risley and Hart quote that introduces this chapter has any validity, then altering behavior therapy procedures in “reorganizing and restructuring the patient’s verbal statements” should enhance their efficacy. This hypothesis was translated into a program of treatment studies in which we assessed the efficacy of “standard” behavior therapy procedures (such as desensitization, modeling, aversive conditioning) relative to behavior therapy procedures that included self-instructional components (that is, procedures that supplemented the behavior therapy techniques with an explicit concern for the client’s cognitions). This chapter will describe this phase of our research program and summarize the available evidence for the role of cognitions in behavior therapy procedures.
By now, it should be apparent that something is happening to behavior therapy. Its “learning theory” basis is being challenged and is being replaced, in part by a cognitive orientation. The conceptual basis of “learning theory” that provided the framework and heuristic background for a variety of behavior therapy procedures is being oppugned on both theoretical grounds (e.g., Bandura, 1974; Breger & McGaugh, 1965; McKeachie, 1974) and empirical grounds (e.g., Brewer, 1974; Mahoney, 1974; Meichenbaum, 1974a). Such time-honored concepts as the automaticity of reinforcement and the continuity assumption between overt and covert events are being seriously questioned. As Bandura stated in his presidential address to the American Psychological Association: So-called conditioned reactions are largely self-activated on the basis of learned expectations rather than automatically evoked. The critical factor, therefore, is not that events occur together in time, but that people learn to predict them and to summon up appropriate reactions. (1974, p. 860)
Cognitive restructuring therapy and semantic therapy are generic terms that refer to a variety of therapeutic approaches whose major mode of action is modifying the patient’s thinking and the premises, assumptions, and attitudes underlying his cognitions. The focus of therapy is on the ideational content involved in the symptom, namely, the irrational inferences and premises. Thus, the semantic or cognitive therapist attempts to familiarize himself with his patient’s thought content, style of thinking, feelings, and behaviors, in order to understand their interrelationships.
Central to the theory of behavior change proposed in this book is the phenomenon of internal dialogue or inner speech. Before we consider the theory, per se, let us first examine the function and structure of internal dialogue.
The student of psychotherapy is faced with a conundrum. Many therapists, espousing a wide variety of theories and techniques, claim to be therapeutically effective. In some instances their claims are empirically supported. Moreover, behavioral change results from nonprofessional contacts which persons encountered during the course of day-to-day life. The conundrum, then, is attempting to understand and explain the behavioral change process as it occurs in so many different contexts. What are the underlying mechanisms of change that are common to the various procedures and contexts in which change occurs?
Although one may disagree with Shapiro and Ravenette’s evaluation of the various tests cited, their quote does sensitize us to the need to develop more explicit ways of assessing our client’s affects, cognitions, and volitions. The present chapter conveys some preliminary attempts at developing this assessment armamentarium, which follow from a cognitive-behavioral treatment approach. Specifically, the present chapter has two purposes. The first is to examine various assessment strategies that have been employed to study psychological deficits. This analysis indicates some shortcomings and an alternative, namely a cognitive-functional analysis approach. The second purpose of the chapter is to describe specific techniques that can be employed to assess more directly the client’s cognitions. Let’s begin with an examination of the current assessment and research strategies.
... Menurut Meichenbaum (1977), dalam bukunya "Cognitivebehavior modification: An integrative approach", psikoedukasi adalah pendidikan tentang aspek mental dan emosional dari kondisi medis atau masalah kesehatan yang bertujuan untuk membantu individu memahami dan mengatasi masalah mereka melalui pemahaman dan pengendalian perilaku. Proses psikoedukasi memfokuskan pada peningkatan keterampilan untuk mengatasi stres dan meningkatkan kualitas hidup. ...
... Teori Modifikasi Kognitif-Perilaku yang dikemukakan Meichenbaum (1977) menggabungkan elemen dari teori terapi kognitif dan behaviorisme. Menurut teori ini, perilaku dapat dipelajari melalui proses belajar dan dapat diubah melalui pengalaman dan penguatan. ...
... The first wave (~1960) was Ellis [93] and Beck [92] postulating that thinking about anxieties can relieve anxieties and promote more adaptive behavior. The second wave (~1980) included the contributions of Meichenbaum [111], Lazarus [112], and Mahoney [113] and the new version of Ellis' [114] formulation as Rational Emotive Behavioral Therapy (REBT). These approaches like those of the subsequent waves, have tried to provide strategies for overcoming any reluctance to engage with the cognitive work. ...
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A review of the past one hundred and fifty years of child and adolescent mental health practice, in five three-decade periods, is presented to background the upcoming developments in this century, while also documenting what has been of value as the field moves forward. There has been much loss of corporate memory as we have moved into the Twenty-First Century. Professional amnesia is a condition with grave consequences. The final list of twenty lessons provide a view as to how these lessons can be absorbed into clinical training and into clinical practice. This summary is necessarily brief, but the references will provoke enquiry and the learning of old ideas.
... The standard steps of self-management (Marlatt & Parks, 1982;Meichenbaum, 1991) used here include selfmonitoring of target behaviors, defining specific behaviors to be changed, setting quantifiable intervention goals, breaking down behaviors into smaller steps, specifying an action plan, evaluating and obtaining feedback, and reinforcing progress. Skills training relates to modifying fat in the diet and includes problem solving, assertiveness, stress management, and cognitive-restructuring skills. ...
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Studies collectively named the Women's Health Initiative (WHI) are currently enrolling 164,500 postmenopausal women in several overlapping clinical trials and an observational study. The overall goals of WHI are to understand the determinants of postmenopausal women's health and to evaluate the efficacy of practical interventions in preventing the major causes of morbidity and mortality in older women. This article reviews the research leading to the WHI studies; describes the study designs and protocols, with an emphasis on what's new about WHI from a psychological perspective; and outlines the major psychosocial hypotheses under investigation and the major challenges WHI presents to psychological science.
... Coping instructions. After the baseline cold-pressor immersion, subjects in this condition received 20 min of instruction in procedures taken from Meichenbaum (1977) and from Scott and Barber (1977) that were designed to enhance their ability to cope with pain. The instructions presented a number of different strategies that subjects could use to "reduce the discomfort of the pain." ...
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A social learning model of pain perception and tolerance was evaluated. Responses to cold-pressor pain were examined in 4 groups of 20 Ss each. One group was given instruction in cognitive coping strategies, the 2nd was given a monetary incentive contingent on tolerance time, the 3rd was given both cognitive training and monetary reinforcement, and a no-treatment control group was given neither. Incentive and coping instructions significantly increased tolerance but did not alter pain perception. A path analysis indicated that pain tolerance was affected by self-efficacy, which in turn was predicted by pain expectancy and the provision of incentives. Incentive also had an impact on tolerance that was independent of self-efficacy. Pain perception was strongly affected by pain expectancy, but was unrelated to self-efficacy.
... For the purpose of providing convergent validity for the categories of cognitive behaviors, the cognitive behaviors in the present study were inferred from two procedures. One, called think aloud, has been described by Meichenbaum (1977) as a promising method for studying cognitive strategies. This procedure involves subjects overtly verbalizing their thoughts and feelings while anticipating or performing a task and has been found to distinguish successfully the cognitive behaviors of helpless and mastery-oriented children (Diener & Dweck, 1978) and high and low general trait anxious children (Fox, Houston, & Pittner, 1983). ...
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Attempted to develop self-report measures of cognitive and somatic trait and state anxiety for children and to evaluate the utility of distinguishing between cognitive and somatic anxiety. 67 4th-grade children anticipated and then performed a mathematics task either in a high- or low-stress condition. While Ss anticipated performing the task, measures of 7 cognitive behaviors were obtained by means of both a "think aloud" procedure and a questionnaire. Results indicate that the trait and state measures of cognitive and somatic anxiety were reliable. The trait measures of cognitive and somatic anxiety were relatively impervious to induced anxiety states. As expected, cognitive trait anxiety but not somatic trait or state anxiety was related to task performance. High cognitive state and/or trait anxiety was associated with more preoccupation and performance denigration as well as taking less of an analytic attitude toward the situation. Somatic trait and state anxiety were associated with preoccupation. Results support the construct validity of the measures developed and the utility of distinguishing between cognitive and somatic anxiety in children. (22 ref)
... These findings replicate a number of studies which found that subjects' levels of reported pain were influenced by their ongoing cognitive activity Spanos et al., 1975Spanos et al., ,1979. They also support the notion that analgesia suggestions exert their effects by modifying the cognitions subjects engage in during noxious stimulation (Meichenbaum, 1977;Spanos et al., 1979). With respect to the carry-over effects of the present study, these findings are consistent with the hypothesis that subjects responded to their varying treatment demands by modifying their cognitive activity in line with their expectations. ...
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40 undergraduates who scored high on the Harvard Group Scale of Hypnotic Susceptibility were randomly assigned to 1 of 4 groups. Each group received 3 60-sec immersions of cold-pressor pain stimulation. Immersions were associated with either hypnotic, waking, or no analgesia (control) instructions. The treatments and their order were varied across groups to induce different expectations about the efficacy of hypnotic and waking analgesia. Magnitude estimates and category scale ratings of pain indicated that hypnotic analgesia was more, less, or equally as effective as waking analgesia, depending on the expectations induced by varying treatment order. Pain ratings were also related to the type of cognitive activity (e.g., imaginative coping) engaged in during an immersion. (46 ref)
... Such comprehensive assessment would allow the determination of which situations and events the person responds to with blood pressure elevations and whether they are mediated by dysfunctional patterns of thinking, emoting, and behaving. A more comprehensive approach to training would make use of specific behavioral techniques, cognitive restructuring (Goldfried, 1977), and stress management techniques such as anxiety management (Bloom & Cantrell, 1978) and stress inoculation training (Meichenbaum, 1977). It is hoped that future research will examine whether these techniques that aim at systematically teaching active coping skills produce greater blood pressure effects than the more passive techniques of blood pressure control described in this review. ...
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Reviews recent studies (1971–1978) that investigated psychological approaches to the treatment of essential hypertension. 20 studies that use techniques of biofeedback, relaxation, and meditation training are summarized in table form. They are subjected to a detailed methodological critique, and suggestions for methodological improvements and directions for future research are proposed. Most experiments demonstrated blood pressure reductions too small to be of clinical significance. A combination of biofeedback and relaxation/meditation with other behavioral techniques appears most promising, and suggestions for a more comprehensive approach to assessment and training are made. Although studies comparing biofeedback and relaxation/meditation were inconclusive, relaxation/meditation is suggested to hold more promise because it requires no sophisticated technology and has been reported to simultaneously reduce other stress-related complaints. (3½ p ref)
... The possible inclusion of additional subvocalized statements as a supplement to the cue word appears promising. In this manner, many of the task-orienting self-verbalizations recommended by Meichenbaum (1977) could be incorporated into the cue-controlled relaxation treatment. Cognitive behavior modification approaches, without relaxation, could also be compared to cue-controlled relaxation. ...
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Studied the effect of using electromyographic (EMG) biofeedback to increase the efficacy of cue-controlled relaxation training in the treatment of test anxiety. 40 college undergraduates scoring in the upper third on the Test Anxiety Scale were randomly assigned to 1 of 4 treatment conditions––EMG-assisted cue-controlled relaxation, cue controlled relaxation alone, attention-placebo relaxation, and no-treatment control. Pre–post self-report measures of test anxiety, state anxiety, and trait anxiety (State-Trait Anxiety Inventory) were obtained. In addition, a performance measure (Otis-Lennon Mental Abilities Test) was administered. Ss from the 3 relaxation groups received 6 45-min individual sessions over 2 wks. All treatments were conducted using audiotape recordings. Results indicate that cue-controlled relaxation is effective in increasing test performance for test anxious Ss, that EMG biofeedback does not contribute to the effectiveness of this procedure, and that self-report measures of anxiety are susceptible to a placebo effect. (26 ref)
... the lack of clear therapeutic guidelines as well as to the absence of an empirical data base for its clinical effectiveness. This situation is clearly changing, and steps are currently being taken to incorporate many of Ellis' concepts and procedures into the field of cognitive behavior therapy (Beck, 1976;Goldfried & Davison, 1976;Goldfried, Decenteceo, & Weinberg, 1974;Mahoney, 1974;Meichenbaum, 1977). A number of outcome studies have appeared in the literature, demonstrating that speech anxiety (Meichenbaum, Gilmore, & Fedoravicious, 1971;Trexler & Karst, 1972), interpersonal anxiety (Di-Loreto, 1971; Kanter & Goldfried, Note 1), unassertive behavior (Thorpe, 1975;Wolfe & Fodor, in press;Linehan, Goldfried, & Goldfried, Note 2), and test anxiety (Holroyd, 1976;Meichenbaum, 1972;Osarchuk, 1976) can be reduced by intervention procedures that focus on training individuals to modify their unrealistic belief systems. ...
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This collaborative clinical outcome study with 36 18–49 yr old Ss compared 2 procedures for reducing test anxiety with a waiting list control. In the first, systematic rational restructuring, the participants were trained to realistically reevaluate imaginally presented test-taking situations. In the second, a prolonged exposure condition, Ss were presented the same hierarchy items but with no instructions for coping cognitively. Ss were administered the following measures of test anxiety; the S-R Inventory of Anxiousness, Achievement Anxiety Test, Test Anxiety Questionnaire, Fear of Negative Evaluation, Social Avoidance and Distress Scale, and the Trait Scale of the Stait-Trait Anxiety Inventory. Results show greater anxiety reduction in the systematic rational restructuring condition, followed by the prolonged exposure group, with no changes for the control. Only those in the rational restructuring condition reported a significant decrease in subjective anxiety when placed in an analog test-taking situation. Ss in the restructuring condition also reported greater generalized anxiety reduction in social-evaluative situations. Within the broader context of cognitive behavior therapy, these results indicate that the cognitive reappraisal of anxiety-provoking situations can offer an effective treatment procedure for the reduction of anxiety. (31 ref)
... Likewise, though not necessarily ascribing causal significance, others have maintained that cognitive variables play a fundamental role in serving to perpetuate and possibly exacerbate emotional distress once initiated (Ingram & Smith, 1984;Smith & Greenberg, 1981). Furthermore, numerous therapeutic approaches have also been developed that seek to treat psychopathological emotion by specifically altering some aspect of what Kendall (1985) has referred to as distorted or deficient cognitive functioning (e.g., Beck, Rush, Shaw, & Emery, 1979;Emery, Hollon, & Bedrosian, 1981;Kendall &Hollon, 1979;Meichenbaum, 1977). ...
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Cognitive approaches to emotional distress posit that specific cognitive factors are critically linked to the etiology, course, or treatment of dysfunction. Although a number of empirical studies have assessed cognitive factors in emotional disorders such as depression and anxiety, research has yet to assess these variables simultaneously and with identical cognitive measures. Using depression and test anxiety as models of dysfunctional affective states, we examined cognitive specificity on measures of information processing, attributions, automatic thinking, and cognitive interference. Results indicated a pattern of specificity showing several differences and similarities in depression and anxiety. Specifically, “purely” depressed individuals showed evidence of selectively processing depressive information, making dysfunctional attributions, and engaging in more negative automatic thinking. “Purely” anxious individuals, on the other hand, showed evidence of selective anxious information processing and increased cognitive interference. Results are discussed in terms of a taxonomy for classifying depressive and anxious cognition.
... area of interest in cognitive processes associated with anxiety has focused more on excesses of certain types of cognitive activity than on anxiety-induced deficits. Several investigators (Meichenbaum 1972(Meichenbaum , 1977Meichenbaum & Turk, 1976;Sarason, 1972Sarason, , 1975Wine, 1971) emphasized the importance of self-focused, negative patterns of thought in anxiety states. Such formulations have typically proposed that production of and attention to patterns of negative and ruminative covert speech or thought are the cause of both the dysphoric affect and poor task performances associated with anxiety states. ...
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Theoretical and empirical efforts concerning cognitive processes associated with anxiety have typically emphasized either cognitive deficits (i.e., reduced learning, memory, and task performance) or cognitive excesses (i.e., increased self-focused, ruminative thought). Evidence of these 2 types of cognitive processes has primarily been based on different types of sources (performance measures and self-reports), which precludes direct comparisons of the extent to which cognitive deficits and/or excesses characterize anxiety states. The present study attempted to directly compare the cognitive excesses and deficits associated with social anxiety by operationalizing both types of cognitive phenomena with similar performance measures. 97 undergraduates, selected on the basis of high or low scores on the Social Avoidance and Distress Scale, performed a modified self-referent depth-of-processing paradigm under stress or no-stress conditions. Socially anxious Ss in a socially evaluative situation evidenced a specific type of cognitive excess (i.e., concern over evaluations by others) but not cognitive deficits. Results are discussed in terms of person-by-situation models of anxiety and the nature and treatment of social anxiety. (42 ref)
... Learned Resourcefulness, derived from the cognitive-based behavioral self-control models of Bandura (1977Bandura ( , 1978Bandura ( , 1982, Kanfer (1977), and Meichenbaum (1977), is a personality repertoire of cognitive skills and goal directed, self-controlled behaviors when facing everyday problems or disruptions. LR may positively influence perception of stressors as a challenge and ability to cope, resulting in more successful academic performance. ...
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Objective This correlational longitudinal study examined levels and relationships of Learned Resourcefulness (LR), stressors, and academic performance in baccalaureate nursing students at a North Carolina university. Method Gadzella‘s Student-life Stress Inventory (SSI) and Rosenbaum’s Self-Control Scale (SCS) administered to 85 students in two groups upon admission and graduation. Results LR increased, while stress decreased significantly in both groups ( p < 0.05). Both groups (95.3% female, 85.8% Caucasian) reported similarly high frustration, pressure, and emotional reactions to stress. Significant relationship between taking tests and stress ( p < 0.01). Stressors ( p < 0.05) and age ( p < 0.01) significant predictors of academic performance. Significant correlations of LR and work status ( p < 0.01), and increased self-esteem ( p < 0.05). No significant relationships among LR, stressors, and academic performance. Conclusion Results validate high levels of stress and suggest that higher LR enhances coping skills and decreases stress longitudinally, which can improve academic performance and retention. Implications for International Audience Trends and relationships in stressors and LR should be explored internationally in larger, more diverse samples of college students in nursing and other majors in relation to depression, anxiety, health-related behaviors, demographics, and academic performance. LR can be assessed, taught, learned, and enhanced. Greater numbers of qualified, competent nursing graduates with stronger clinical judgment, coping, and problem-solving skills will address the critical global nursing shortage and improve the quality, safety, and access of health care worldwide.
... Temelinin 1970'li yıllara dayandığı öğrenilmiş güçlülük kavramının uygulaması ilk kez başa çıkma yetenekleri kapsamında ele alan Meichenbaum (1977) tarafından yapılmıştır. Bununla beraber, öncesinde Meichenbaum, Goodman (1971) ile yapmış olduğu "Training impulsive children to talk to themselves: A means of developing self-control" isimli çalışmasında da öğrenilmiş güçlülük kavramından öz denetim (self control) şeklinde bahsetmiştir. ...
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Amaç: Çalışma hayatının her alanında özellikle hizmet sektöründe çalışan ve örgütler arasında farklı beklentiler bulunmaktadır. Karşılıklı bu beklentiler her zaman yazılı ve sözlü ifade edilmese de örgütün kuralları olarak çalışanların karşısına çıkmaktadır ve zaman zaman bu durum çalışanlar için zorlayıcı olmaktadır. Bu çalışma, öğrenilmiş güçlülük ve duygusal uyumsuzluğun psikolojik sözleşme ile arasındaki ilişkiyi araştırma amacı taşımaktadır. Yöntem: Araştırmanın amacı doğrultusunda söz konusu ilişkiyi araştırmak için sağlık çalışanları üzerinde nicel bir araştırma yürütülmüştür. Bu doğrultuda, büyük bir çoğunluğu A hastanesinden olmak üzere B, C ve D hastaneleri sağlık çalışanları katılımıyla toplamda 203 sağlık çalışanı araştırmaya katılmıştır. Araştırmada kolayda örnekleme yönteminden yararlanılmıştır. Araştırmadan elde edilen veriler SPSS 26.0 ve AMOS 24 programı ile test edilmiştir. Bulgular: Araştırmadan elde edilen bulgular (n=203) neticesinde öğrenilmiş güçlülük ile psikolojik sözleşme arasında çok zayıf, pozitif yönlü bir ilişki olduğu sonucuna ulaşılırken duygusal uyumsuzluk ve psikolojik sözleşme arasında anlamlı bir ilişkiye rastlanmamıştır. Sonuç: Araştırma bulgularına göre öğrenilmiş güçlülük düzeyi yüksek olan sağlık çalışanları, psikolojik sözleşme durumunda az da olsa baş edebilmektedirler. Öğrenilmiş güçlülük ile psikolojik sözleşme arasında zayıf düzeyde, duygusal uyumsuzluk ve psikolojik sözleşme arasında ise anlamsız ilişki çıkmasında Covid-19 döneminin devam ettiği süreçte yapılan çalışmada sağlık çalışanlarının büyük sorumluluk üstlenmesinin etkisi olduğu düşünülmektedir.
... Future research should investigate other workplace domains that may be susceptible to the effect of stereotype threat (e.g., performance appraisals). Future research should also address whether changing dysfunctional to functional self-talk of women, using techniques developed by Meichenbaum (1971Meichenbaum ( , 1975Meichenbaum ( , 1977 mitigates stereotype threat. This technique has proven to be effective for displaced managers (Millman & Latham, 2001) as well as native North Americans (Latham & Budworth, 2006) and Muslim women over the age of 40 in Turkey (Yanar, Budworth, & Latham, 2009) in finding jobs. ...
Article
When women are in a situation whereby they are at risk of being judged by a negative stereotype, they underperform relative to men. This quandary is called stereotype threat. The present study examined whether stereotype threat affects the performance of men versus women in a simulated job interview. The stereotype that women are not suitable for managerial jobs was unobtrusively embedded in a job description presented to interviewees (n = 50) prior to the interview. The interviews were evaluated by four HR managers, two male and two female. The results showed that stereotype threat disadvantages females vis- -vis those in the control group, and it disadvantaged them relative to men in the stereotype threat condition. This occurred regardless of whether the HR manager was male or female
... Self-talk in mind skills has similar constructs to automatic thought [29] and inner dialogue [38] as the counselor's thoughts appear in verbal sentences in the counselor. Like dialogue with other people, selftalk can also have specific effects on a counselor's feelings, physiology, and decision-making. ...
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The internal counselor competence refers to the metacognition skills to manage all their mental experiences and internal conditions. These are in the form of Mind skills. In particular, in the industrial revolution 4.0 and the covid-19 pandemic situation, online counselors face many unpredictable and unfamiliar conditions. This study aims to identify the state of level the counselor's mind skills during online counseling sessions. This research method uses survey research methods of 181 online counselors in various regions in Indonesia. Mind Skills Journal is the instrument used for data collection to assess the four levels of counselor metacognition (Reflective, Strategic, Aware, and Tacit). The analysis used basic statistics and graphs. The results showed the overall score of the Mind skills level was 78.166%, which was in the Strategic Use level. The Mind skills contribution can be counselor self-regulation, counselor assessment, verbalization, information visualization description, causal analysis, and predictive planning. Suggestions based on research results are the need for an alternative to improve mind skills through reflective learning of prospective counselors and reflective supervision activities of counselors in the field.
... En la mayoría de los apartados que se han desarrollado a través de la evolución de la teoría cognitiva existen varios autores que han ampliado su entendimiento llevando a niveles mucho más prácticos y coherentes la aplicación de la misma en el campo de la salud mental, generando cada vez más seguidores y facilitando el desarrollo de su aplicación en la sociedad, mencionamos por ejemplo la terapia racionalemotiva de Ellis (1962), la cual se enfoca principalmente en resolver problemas emocionales y conductuales que pueden surgir en la cotidianidad de las personas, empleado un modelo de intervención en terapia de forma directivo, activo, filosófico y empírico, básicamente hace que la persona analice de una manera estructural todo el contexto en el cual se desenvuelve dichas situaciones que le producen malestar, determine cuáles son las ideas que están siendo las causantes de su desequilibrio y emplee diferentes alternativas a emplear para mejorar la misma, de una manera ordenada, está se encuentra representada por la secuencia literal A,B,C. Otros autores que aportaron y contribuyeron a la formación de la terapia cognitiva se pueden destacar, a la modificación cognitivoconductual (Meichenbaum, 1977); la terapia multimodal (Lazarus, 1976); los estudios realizados en personas con alta ansiedad y conductas adictivas (Mahoney, 1991); y por ultimo las aportaciones al campo de la terapia cognitiva de (Guidano y Liotti, 1983). ...
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This research aims to conduct a comprehensive literature analysis, employing a comparative synthesis process, to elucidate the distinctive features of two counseling approaches rooted in the transpersonal psychology paradigm. The objective is to scrutinize, compare, and synthesize the perspectives, focal points, techniques, and outcomes inherent in these two transpersonal approaches. This endeavor is imperative in light of the growing demand for therapeutic methodologies grounded in spiritual dimensions and belief systems encompassing forces beyond the confines of human material existence. The employed methodology involves a thorough literature study, culminating in the synthesis of the two transpersonal paradigms. The resultant synthesis is intended to serve as a robust reference for forthcoming therapeutic counseling practices. By doing so, it aims to contribute to the ongoing evolution of more specialized counseling models within an expanding transpersonal paradigm. This synthesis, in turn, is poised to serve as a cornerstone for counseling models that transcend the constraints of materialism and modernis
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Purpose: Enhance well-being; acquire adaptive decision-making skills; Relationship breakdown, mental health enhancement, and unemployment problem-solving are all focus areas. Design/Methodology/Approach: Secondary data for this study came from a wide range of places, such as case studies, books, periodicals, journals, articles, and online searches. Findings/Results: Stress has many facets, both in terms of its causes and its effects. It’s more of a personal journey than a general truth to determine what helps you cope with pressure. The client will be taught techniques for dealing with every day and unexpected tension sources. Cognitive and behavioral strategies are helpful for stress management. Mindfulness-based stress reduction therapies have received much research and attention recently. Due to its association with numerous diseases, stress management is paramount. Outcome: The outcomes include the concept of stress management, various stages of stress and how to overcome the stress, the causes and effects of individual stress, the management of stress effectively through the use of cognitive behavioral techniques, and how to use mindfulness-based interventions for stress management. Originality/Values: This research sheds light on the many sources of stress in the lives of humans, including but not limited to increased workload, increased risk of physical and mental illness, and strategies for coping with stress at different levels. How one chooses to spend one’s life determines the particular sources of stress that they will face. Type of Paper: Literature review
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The cognitive behavioural therapies (CBTs) are the choice psychotherapies for many clinicians treating a wide range of adult psychological disorders including various anxieties, mood, substance use, eating, schizophrenia and personality‐related. Empirical research in the CBTs is ever increasing, and the accumulating evidence supporting efficacious treatments is substantial and well documented. However, with prolific research comes a seemingly accelerating and worrying trend of purportedly different therapies, and numerous hybrids and combinations of therapies and techniques. For many clinicians this is increasingly confusing and not helpful in clinical practice. This article is a critique of current trends and directions in clinical research, which show signs of limited effectiveness, fragmentation, and obfuscation. An alternative strategy is proposed—examining transdiagnostic therapeutic effects, which appear related to treating pervasive dysregulated emotions, with component analyses of four principal self‐regulation components (viz., self‐monitoring; functional analysis; identifying values, goals and treatment‐plans; and feedback). Such a strategy is likely to lead to a more coherently synthesized and effective CBT.
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Background Exposure to rape, sexual assault and sexual abuse has lifelong impacts for mental health and well‐being. Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitisation and Reprocessing (EMDR) are among the most common interventions offered to survivors to alleviate post‐traumatic stress disorder (PTSD) and other psychological impacts. Beyond such trauma‐focused cognitive and behavioural approaches, there is a range of low‐intensity interventions along with new and emerging non‐exposure based approaches (trauma‐sensitive yoga, Reconsolidation of Traumatic Memories and Lifespan Integration). This review presents a timely assessment of international evidence on any type of psychosocial intervention offered to individuals who experienced rape, sexual assault or sexual abuse as adults. Objectives To assess the effects of psychosocial interventions on mental health and well‐being for survivors of rape, sexual assault or sexual abuse experienced during adulthood. Search methods In January 2022, we searched CENTRAL, MEDLINE, Embase, 12 other databases and three trials registers. We also checked reference lists of included studies, contacted authors and experts, and ran forward citation searches. Selection criteria Any study that allocated individuals or clusters of individuals by a random or quasi‐random method to a psychosocial intervention that promoted recovery and healing following exposure to rape, sexual assault or sexual abuse in those aged 18 years and above compared with no or minimal intervention, usual care, wait‐list, pharmacological only or active comparison(s). We classified psychosocial interventions according to Cochrane Common Mental Disorders Group’s psychological therapies list. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We included 36 studies (1991 to 2021) with 3992 participants randomly assigned to 60 experimental groups (3014; 76%) and 23 inactive comparator conditions (978, 24%). The experimental groups consisted of: 32 Cognitive Behavioural Therapy (CBT); 10 behavioural interventions; three integrative therapies; three humanist; five other psychologically oriented interventions; and seven other psychosocial interventions. Delivery involved 1 to 20 (median 11) sessions of traditional face‐to‐face (41) or other individual formats (four); groups (nine); or involved computer‐only interaction (six). Most studies were conducted in the USA (n = 26); two were from South Africa; two from the Democratic Republic of the Congo; with single studies from Australia, Canada, the Netherlands, Spain, Sweden and the UK. Five studies did not disclose a funding source, and all disclosed sources were public funding. Participants were invited from a range of settings: from the community, through the media, from universities and in places where people might seek help for their mental health (e.g. war veterans), in the aftermath of sexual trauma (sexual assault centres and emergency departments) or for problems that accompany the experience of sexual violence (e.g. sexual health/primary care clinics). Participants randomised were 99% women (3965 participants) with just 27 men. Half were Black, African or African‐American (1889 participants); 40% White/Caucasian (1530 participants); and 10% represented a range of other ethnic backgrounds (396 participants). The weighted mean age was 35.9 years (standard deviation (SD) 9.6). Eighty‐two per cent had experienced rape or sexual assault in adulthood (3260/3992). Twenty‐two studies (61%) required fulfilling a measured PTSD diagnostic threshold for inclusion; however, 94% of participants (2239/2370) were reported as having clinically relevant PTSD symptoms at entry. The comparison of psychosocial interventions with inactive controls detected that there may be a beneficial effect at post‐treatment favouring psychosocial interventions in reducing PTSD (standardised mean difference (SMD) ‐0.83, 95% confidence interval (CI) ‐1.22 to ‐0.44; 16 studies, 1130 participants; low‐certainty evidence; large effect size based on Cohen’s D); and depression (SMD ‐0.82, 95% CI ‐1.17 to ‐0.48; 12 studies, 901 participants; low‐certainty evidence; large effect size). Psychosocial interventions, however, may not increase the risk of dropout from treatment compared to controls, with a risk ratio of 0.85 (95% CI 0.51 to 1.44; 5 studies, 242 participants; low‐certainty evidence). Seven of the 23 studies (with 801 participants) comparing a psychosocial intervention to an inactive control reported on adverse events, with 21 events indicated. Psychosocial interventions may not increase the risk of adverse events compared to controls, with a risk ratio of 1.92 (95% CI 0.30 to 12.41; 6 studies; 622 participants; very low‐certainty evidence). We conducted an assessment of risk of bias using the RoB 2 tool on a total of 49 reported results. A high risk of bias affected 43% of PTSD results; 59% for depression symptoms; 40% for treatment dropout; and one‐third for adverse events. The greatest sources of bias were problems with randomisation and missing outcome data. Heterogeneity was also high, ranging from I² = 30% (adverse events) to I² = 87% (PTSD). Authors' conclusions Our review suggests that survivors of rape, sexual violence and sexual abuse during adulthood may experience a large reduction in post‐treatment PTSD symptoms and depressive symptoms after experiencing a psychosocial intervention, relative to comparison groups. Psychosocial interventions do not seem to increase dropout from treatment or adverse events/effects compared to controls. However, the number of dropouts and study attrition were generally high, potentially missing harms of exposure to interventions and/or research participation. Also, the differential effects of specific intervention types needs further investigation. We conclude that a range of behavioural and CBT‐based interventions may improve the mental health of survivors of rape, sexual assault and sexual abuse in the short term. Therefore, the needs and preferences of individuals must be considered in selecting suitable approaches to therapy and support. The primary outcome in this review focused on the post‐treatment period and the question about whether benefits are sustained over time persists. However, attaining such evidence from studies that lack an active comparison may be impractical and even unethical. Thus, we suggest that studies undertake head‐to‐head comparisons of different intervention types; in particular, of novel, emerging therapies, with one‐year plus follow‐up periods. Additionally, researchers should focus on the therapeutic benefits and costs for subpopulations such as male survivors and those living with complex PTSD.
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