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A Therapist’s Manual for Cognitive Behavior Therapy in Groups PDF

259 Pages·1984·3.675 MB·English
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A THERAPIST'S MANUAL FOR COGNITIVE BEHAVIOR THERAPY IN GROUPS A THERAPIST'S MANUAL FOR COGNITIVE BEHAVIOR THERAPY IN GROUPS Lawrence I. Sank and Carolyn S. Shaffer Center for Cognitive Therapy Bethesda, Maryland The George Washington University Medical Center Washington, D.C. PLENUM PRESS • NEW YORK AND LONDON Library of Congress Cataloging in Publication Data Sank, Lawrence, I., date- A therapist's manual for cognitive behavior therapy in groups. Bibliography: p. Includes index. 1. Behavior therapy-Handbooks, manuals, etc. 2. Cognitive therapy-Handbooks, manuals, etc. 3. Group psychotherapy-Handbooks, manuals, etc. I. Shaffer, Carolyn S., 1946- . II. Title. [DNLM: 1. Behavior therapy-Methods. 2. Cognition. 3. Psychotherapy, Group-Methods. WM 430 S277t] RC489.B4S175 1983 616.89'152 83·13652 ISBN-13: 978-1-4615-8332-5 e-ISBN-13: 978-1-4615-8330-1 001: 10.1007/978-1-4615-8330-1 © 1984 Plenum Press, New York Softcover reprint of the hardcover 1s t edition 1984 A Division of Plenum Publishing Corporation 233 Spring Street, New York, N.Y. 10013 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical. photocopying, microfilming, recording, or otherwise, without written permission from the Publisher We dedicate this volume to those who have so patiently supported us throughout the development of this program and the writing of this book: Jim, Linda, Jessica, Benjamin, and David. FOREWORD One of the great advantages of rational-emotive therapy (RET) and cog nitive behavior therapy (CBT) is that they frequently employ psycho educational methods-including bibliotherapy, workshops, lectures, courses, recordings, and films. I created RET at the beginning of 1955 after I had abandoned the practice of psychoanalysis because I found it to be highly inefficient and philosophically superficial. Being almost addicted to one-to-one therapy as a result of my analytic training and experience, I at first did RET only with individual clients and found this pioneering form of CBT considerably more effective than the other ther apies with which I had experimented. By 1957, however, I realized that RET could be taught to large num bers of persons through self-help books and articles and that RET -ori ented writings could not only prove valuable to the general public but that they could also be successfully employed to hasten and intensify the therapy of my individual clients. I therefore wrote a number of RET self help books-especially How to Live with a Neurotic (1957), Sex without Guilt (1958), A New Guide to Rational Living (with Robert A. Harper; original edition, 1961), and A Guide to Successful Marriage (with Robert A. Harper, 1961). The effectiveness of these books has surpassed my wildest expec tations-since they have sold millions of copies (notably in the paper back editions published by Wilshire Book Company, North Hollywood, California), have been recommended to clients by hundreds of thera- vii viii FOREWORD pists, have been translated into more than twenty foreign languages, have brought to my mailbox and to my face thousands of enthusiastic testimonials, and have encouraged the publication of many other CBT oriented self-help books, such as Robert Alberti and Michael Emmons's Your Perfect Right, Wayne Dyer's Your Erroneous Zones, and David Burns's Feeling Good. Spurred on by the psychoeducational success of How to Live with a Neurotic and A New Guide to Rational Living, I began in 1959 to apply RET to group therapy and to large-scale workshops. Again, it seemed to work significantly better than conventional therapies do when used in group form. I have now seen about 2,500 regular group-therapy clients during the last 24 years (since I lead 6 groups every week, each of which has a maximum of 13 clients) and have given over a thousand RET workshops to well over one hundred thousand people during this same period. Fol lowing my lead, the Institute for Rational-Emotive Therapy in New York, which I direct, and its allied branches and groups throughout the world now give hundreds of other RET workshops every year, and many other CBT therapists and centers (such as the Center for Cognitive Therapy in Philadelphia and in Bethesda, Maryland) give innumerable other CBT oriented talks, workshops, and other public presentations. All of which indicates-what? Presumably, that RET and CBT are not merely effective therapies on a one-to-one basis, but that they also have important group and psychoeducational applications. That is why this book by Lawrence I. Sank and Carolyn S. Shaffer, A Therapist's Man ual for Cognitive Behavior Therapy in Groups, is such a valuable volume. It takes four of the major aspects of CBT -relaxation training, cognitive restructuring, assertion training, and problem solving-and it shows in great detail how these methods can be used in a brief group-therapy for mat. It tells the therapist who would employ these modes of CBT exactly how to do so over a period of 15 weekly sessions. And it provides suitable handouts, bibliotherapy suggestions, and other materials that therapists of CBT groups can use to help themselves and their group members. It is remarkably complete in these aspects, and it is written in such a clear and simple manner, with a minimum of technical jargon, that virtually all therapists or counselors who want to use group CBT techniques can distinctly follow its procedures and add to their knowledge and their skills. Is A Therapist's Manual for Cognitive Behavior Therapy in Groups thor oughly comprehensive and flawless? Of course not. It only briefly men tions, for example, several important cognitive methods-such as mod eling, philosophical analysis, and the use of humor. It is skimpy in its employment of emotive-evocative techniques, such as rational-emotive FOREWORD ix imagery, forceful self-statements, and RET's famous shame-attacking exercises. But since cognitive behavior therapy now includes literally hundreds of possible methods, and since no book is likely to be truly comprehensive in explaining all of them, Drs. Sank and Shaffer cannot legitimately be faulted for not being all things to all readers. What the book does contain is distinctly good. It is hard-headed, practical, and right down to earth. It presents a CBT program that can be easily understood and utilized. It can be selectively used and discrimi natingly modified by those therapists who want to experiment with and add to or subtract from it. Like RET and CBT themselves, it presents no dogmas or unfalsifiable assumptions. Sank and Shaffer's book is a wel come addition to the CBT literature. I predict good results for the thera pists and clients who work at using it. ALBERT ELLIS, PH.D. Executive Director Institute for Rational-Emotive Therapy 45 East 65th Street New York, New York 10021 CONTENTS FOREWORD ............................................... . vii Albert Ellis INTRODUCTION ........................................... 1 Chapter 1 COPING SKILLS TRAINING AND COGNITIVE BEHAVIOR THERAPy.................................................. 9 Thomas L. McKain Chapter 2 THE SCREENING PROCEDURE 25 Chapter 3 THE RELAXATION MODULE ............................... . 41 Session 1 .............................................. . 41 Session 2 .............................................. . 49 Chapter 4 THE COGNITIVE RESTRUCTURING MODULE 63 Session 3 ................................. . 63 xi xii CONTENTS Chapter 5 ENHANCING COGNITIVE RESTRUCTURING SKILLS. . . . . . . . . . 77 Session 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Session 5 91 Session 6 99 Chapter 6 INDIVIDUAL SESSION/MIDWAY EVALUATION .............. 107 Session 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 107 Chapter 7 THE ASSERTION-TRAINING MODULE................. 113 Session 8 ......................... . 113 Session 9 .............................................. . 125 Session 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 133 Session 11 141 Chapter 8 THE PROBLEM-SOLVING MODULE ......................... . 149 Session 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 149 Session 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 157 Chapter 9 CLOSING SESSIONS 165 Session 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 167 Session 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 171 Chapter 10 BOOSTER SESSIONS 177 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 181 APPENDIXES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 187 1. Pretreatment Questionnaire (PTQ) . . . . . . . . . . . . . . . . . . . .. 187 2. Pregroup Screening Description of the Coping Skills Group. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 199 3. List of Symptoms Common to Patients Referred to the Coping Skills Group ................................. 201 4. Potential Goals for Each Module. . . . . . . . . . . . . . . . . . . . . .. 203 CONTENTS xiii 5. Coping Skills Group Screening Form-Individual Goal Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 6. Coping Skills Group Attendance/Performance Record and Contract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 207 7. Example of Completed Coping Skills Group Screening Form-Individual Goal Sheet. . . . . . . . . . . . . . . . . . . . . . . .. 209 8. Relaxation Practice Log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 211 9. List of Required and Suggested Readings. . . . . . . . . . . . . .. 213 10. Personal Reminder Form ............................. 215 11. Example of Completed Personal Reminder Form ........ 217 12. Relaxation Sequence ................................. 219 13. Cognitive Distortions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 221 14. Dispute Handles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 223 15. Homework Sheet for Cognitive Restructuring. . . . . . . . . .. 225 16. Advanced Homework Sheet for Cognitive Restructuring 227 17. Therapist's Example. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 18. Basic Irrational Ideas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 231 19. Homework Sheet for Cognitive Restructuring. . . . . . . . . .. 233 20. CBT Homework Sheet: Example Originally Prepared for Nondisclosure to Group. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 235 21. CBT Homework Sheet: Example Done at Home That Prompted Self-Disclosure in the Group. . . . . . . . . . . . . . . .. 239 22. Components of Assertive Behavior. . . . . . . . . . . . . . . . . . . .. 241 23. Scripted Assertive Scenes. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 243 24. Vignettes for Assertiveness Training . . . . . . . . . . . . . . . . . .. 245 25. Assertive Behavior Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 249 26. Problem-Solving Homework Sheet. . . . . . . . . . . . . . . . . . . .. 251 27. Completed Problem-Solving Homework Sheet. . . . . . . . .. 253 28. Example of Completed Goal Sheet for Final Interview. . .. 255 29. Worksheet for Remaining Problems. . . . . . . . . . . . . . . . . . .. 257 30. Individual Goal Sheet for Final Interview. . . . . . . . . . . . . .. 259 31. Log of Problem Situations and Skills Employed ......... 261 INDEX .................................................... . 263

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