GENERAL INTRODUCTION and HISTORICAL

DEVELOPMENT OF COGNITIVE BEHAVIORAL

THERAPY
Prof. Dr. Aslıhan DÖNMEZ, M.D., Ph.D.
Psychiatrist
Certified CBT Therapist and Trainer Consultant of Academy of Cognitive Therapy
Certified CBT Therapist of European Association for Behavioural and Cognitive Therapies
CBT Trainer of Association for Cognitive and Behavioural Psychotherapies -Turkey
 Syllabus
week

1 Introduction to CBT and historical development

General principles of CBT
2 Cognitive theory and techniques

3 Behavioral theory and techniques

4 Structuring the session in CBT

Formulation in CBT
5 Midterm exam

6 CBT techniques for anxiety-general

CBT for specific phobia
7 CBT for social phobia

8 CBT techniques for exam anxiety

9 CBT techniques for depression

10 CBT for anger management

11 CBT for eating disorders

12 Case discussions

13 Case discussions
 Other subjects
• CBT tehniques for bullying
• CBT techniques for ADHD
• CBT techniques for school refusal
• CBT techniques for substance use prevention
 Recommended readings…
• General (in English)
- Beck AT, Emery G, Greenberg R. Anxiety Disorders and Phobias: A Cognitive Perspective.
- Beck AT. Cognitive Therapy and Emotional Disorders.
- Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression.
- Beck JS. Cognitive Behavioral Therapy- Basics and Beyond.
• Children and adolescents
- Bunge EL, Mandil J, Consoli AJ, Gomar M. CBT Strategies for Anxious and Depressed Children and
Adolescents: A Clinician’s Toolkit.
- Mennuti RB, Freeman A, Christner RW. Cognitive-Behavioral Interventions in Educational
Settings: A Handbook for Practice.
- Phifer LW, Crowder AK, Elsenraat T, Hull R. CBT Toolbox for Children & Adolescents.
- Weisz JR. Psychotherapy for Children and Adolescents: Evidence-Based Treatments and Case Examples.
- Morin A. 13 Things Mentally Strong Parents Don’t Do.
• General (in Turkish)
- Türkçapar H. Bilişsel Davranışçı Terapi.
- Leahy RL. Bilişsel Terapi Yöntemleri.
- Leahy RL, Holland SJ. Depresyon ve Anksiyete Bozukluklarında Tedavi Planları ve Girişimleri.
A useful source for various kinds of CBT techniques for children and adolescents:
http://effectivechildtherapy.fiu.edu/professionals/
 Course evaluation system
• A mid-term exam (30 points): Multiple choice
• A final exam (50 points): Case study
• One pop-up quize (10 points)
• General attendance (10 points)
 Why apply CBT?
• Most widely used psychotherapy in the world
• Evidence based treatment
• Cost affective
• Specific techniques
• Easily applied to children and adolescents
* Learning theories---Behavioralism
* Cognitive psychology
Behavioralism
A branch of psychology which
emphasize behavior, since it is
observable, measurable and
objectively describable.
CBT applies these
theories to
psychotherapy
Cognitive Psychology
A branch of psychology which
emphasize mental processes,
such as organization of cognitions,
learning, attention, language use,
memory, perception, problem
solving, creativity, and thinking
 Learning theories
• Ivan Pavlov
• John Watson
• B. F. Skinner
• Seligman
• Bandura
 Ivan Petrovic Pavlov (1849-1936)

• Klasik koşullanma

In anxiety disorders, a neutral stimulus (e.g. palpitations) becomes an anxiety

provocating (conditioned) stimulus because of fearful thoughts (e.g. I am having
a heart attack).
The technique developed from classical conditioning= Systematic desensitization
The new response= Relaxation
 John Watson (1878-1958)
• How can we apply CC to humans?
• Little Albert experiment: Fear can be learned
• Give me a dozen of healthy children…..
 Little Albert experiment
https://www.youtube.com/watch?v=9hBfnXACsOI
 B.F. Skinner (1904-1990)
• Operant (instrumental) conditioning
• Trigger
Skinner boxes
• Reinforcement= The stimulus that strengthen the
behavior, or increase the probability of a behavior
reoccurring Temporal Automatic
relief thoughts
• Positive reinforcement= Reinforcing event is
something applied
• Negative reinforcement= Reinforcing event is
something removed or avoided
• Radical behaviorism

Perception
Avoidance
of danger

Anxiety
 Operant conditioning experiment
https://www.youtube.com/watch?v=I_ctJqjlrHA
 Martin Seligman (1942- )

• Learned helplessness: An animal

model of depression
• If an organism is forced to endure
an aversive stimuli and perceives
the stimuli as inescapable, it
learns/believes that it cannot
control the situation and therefore
does not take any action to avoid
it.
• Clinical depression may result
from a real or perceived absence
of control over the outcome of a
situation.
 Albert Bandura (1925- )
• Bobo doll experiment
• 1961: Two groups
1.Group: Watches an adult playing normally with toys
2.Group: Watches the adult playing aggressively with
bobo doll
Aggression: 2>1 (more influenced by same-
sex models)
1.Group: Punishment (warning)
2.Group: Reward (candies)

Aggression: 2>1
• 1963: Four groups
1.Group: watches the parent
2.Group: watches the movie
3.Group: watches the cartoon
4. Group: watches an ordinary documentary
Aggression: 1, 2, 3, > 4
Overall: boys > girls
Social Learning (Observational Learning)
Theory: Most of the human behavior are
learned through observation and
modelling.
 Bobo doll experiment
https://www.youtube.com/watch?v=hHHdovKHDNU
 Summary…
• Behaviorists: There is no cognition between
the stimuli and organism’s response (blank
mind)
• Cognitivists: There are cognitions between the
stimuli and organism’s response
 Aaron Beck (1921-2022)

• Founder of Cognitive Behavioral Therapy

• 1958 Philadelphia Psychoanalysis Institute
• «Human emotions are better explained by
cognitions rather than complex psychoanalytic
concepts»
• Negative cognitive triad in depressed patients:
Negative thoughts about oneself (I am
worthless), world/people (world is not fair) and
future (future is hopeless)

Cognitive theory: Psychological problems are mostly caused by the

dysfunctional thoughts of the individual.
Our reactions to specific events are caused by our interpretations
about that event, not the event itself.
 Albert Ellis (1913-2007)

• Rational Emotive Behavioral Therapy (REBT)

• Psychoanalytic orientation in his early life
• Focus on beliefs rather than thoughts
• Irrational beliefs are:
* Distortions of the reality
* Expressed in an absolute and unconditional manner
* They cause inappropriate emotions
* They are dysfunctional
• 1. wave: Cognitive Therapy
• 2. wave: Cognitive Behavioral Therapy
• 3. wave:
* ACT: Acceptance and Commitment (Steven Hayes)
* DBT: Dialectic Behavioral Therapy (Marsha Linehan)
* Metacognitive therapy (Adrian Wells)
* Mindfulness based CBT
* Schema therapy
* Self compassion therapy