RationalEmotiveBehavioralTherapy(REBT)認知行為治療•強調思考、判斷、決定、分析與行動•假定:認知、情緒和行為有明顯的交互作用,有可逆性的交互作用存在•情緒來自於我們的信念、評價、解釋,以及對生活情境的反應•教育過程人性觀•人類生而兼具有理性、非理性思考•天生扭曲思考的傾向,以及學來的自我挫敗模式•自我談話•有朝向自我成長和自我實現的傾向理情行為治療人格的TheA-B-CTheory(Ellis,1998)ABCDEF(activatingevent)(belief)(consequence-emotionalandbehavioral)(disputingintervention)(effect–aneffectivephilosophyisdeveloped)(newfeeling)認知情緒生理行為各種模態之間的關係負向循環心理問題是如何被習得的?•生命事件(lifeevents)•社會因素•應對失策如何從心理紛擾恢復至心理健康?•認知治療是以問題為取向、具有教育性的心理治療法,其目標包括:–改善或解決當事人的困難或問題–協助當事人學習積極的應對之策–幫助當事人修正思想謬誤和基模–協助當事人變成「自己的治療師」EX:情緒方案如何有效的溝通情緒I•辨別你的情緒•選擇如何溝通你的情緒評估自己目前的狀態選擇討論感受的適當時機選擇討論感受的適當地點如何有效的溝通情緒II•擁有你的感受避免依賴卸責語言•監視你的自我對話•傾聽與回應他人的情緒當你感受情緒化時會採用什麼樣的自我對話?你在下列情緒中你有什麼想法:知覺情緒自我對話例如:無助我怎麼也沒辦法改變這情況自我憐憫嫉妒不耐煩傷心TheTherapeuticProcess•引導當事人發現其非理性信念•讓當事人看清,緊抱著不合邏輯的思考模式,如何讓自己的情緒困擾肆虐•幫助當事人修正思考和放棄非理性信念•鼓勵當事人發展出一套理性的生活哲學理情行為治療技術與程序•認知方法–駁斥非理性的信念–家庭作業–改變一個人的語言–幽默理情行為治療技術與程序•情緒技術–理性-情緒的想像–角色扮演–攻擊羞愧感練習–力量與活力的使用•行為技術個案概念化•詳細描述個案行為、感受、生理和認知的模態•以發展及過程的觀點進行瞭解•有無因素導致問題惡化?•問題清單•訂定共同目標•問卷/測驗使用典型認知治療公式•個案目前心理狀況?•談判諮商日程表(SMART)•檢討家庭作業•特定諮商目標的達成•新的家庭作業•每次諮商時間50mins/6~20次Beck的認知治療AaronBeck’sCognitiveTherapy(CT)•Insight-focusedtherapy(洞察式治療)•EmphasizesAssumptions‧People’sinternalcommunicationisaccessibletointrospection(自省)‧Clients’beliefshavehighlypersonalmeanings‧ThesemeaningscanbediscoveredbytheclientratherthanbeingtaughtorinterpretedbythetherapistTheory,Goals&PrinciplesofCT•Basictheory:‧Tounderstandthenatureofanemotionalepisodeordisturbanceitisessentialtofocusonthecognitivecontentofanindividual’sreactiontotheupsettingeventorstreamofthoughts•Goals:‧Tochangethewayclientsthinkbyusingtheirautomaticthoughts(自動化思想)toreachthecoreschemata(核心基模)andbegintointroducetheideaofschemarestructuring(重建)•Principles:‧Automaticthoughts:personalizednotionsthataretriggeredbyparticularstimulithatleadtoemotionalresponsesCT’sCognitiveDistortions(認知扭曲)•Arbitraryinferences(獨斷的推論)•Selectiveabstraction(選擇性摘要)•Overgeneralization(過度類化)•Magnificationandminimization(誇大與貶抑)•Personalization(個人化)•Labelingandmislabeling(標籤化和錯誤標籤化)•Polarizedthinking(極端化的思考)Beck的認知治療應用說明基模、訊息處理、思考內容與憂鬱刺激他們不跟我說話基模如果別人忽略你,就是不喜歡你。如果人們不喜歡我,那我就是沒有價值的人。訊息處理他們是有意忽略我的推論他們不喜歡我情緒悲傷、憂鬱基模、訊息處理、思考內容與焦慮刺激參加party設定模態Party上困難重重,很多人很具威脅性基模如果我很怪,我將無法融入,大家也會認為我是怪人訊息處理沒有人過來與我說話推論他們不喜歡我,視為我陌生人情緒焦慮CT’sCognitiveTriad•Patternthattriggersdepression:1.Clientholdsnegativeviewofthemselves2.Selectiveabstraction:Clienthastendencytointerpretexperiencesinanegativemanner3.Clienthasagloomyvisionandprojectionsaboutthefuture方法和策略I•詢問(蘇格拉底式問答法)•這種想法如何影響你的情緒?•有什麼證據證明妳的想法是對的?•還可以用其他方式來看待這件事嗎?•這樣的思考方式會產生什麼效果?•這種思考方式有什麼缺點?•你如何遽下結論?•這是你使用占心術的例子嗎?•你會將與你沒什麼關係的事,看成是針對你個人而發的嗎?問題與討論•心理治療本質上是否為一種再教育過程?•治療者是否適合使用說服和高指導性的方法?•用邏輯、勸告、提供資訊和解釋等方法有可能去除「錯誤信念」嗎?•改變一個人的想法就必然可以改變他的感覺和行為嗎?kDW5oH#9sM*exQ+iBV4nGZ8rK&dwP-hAT2mFY7qJ$bvO)gzS1kEX6pI!atN(fyR0jCV5oH#9sL&exQ+iBU3nGZ8rK%cvP-hAT2lEY7qJ$buN)gzS1kDW6pI!atM*eyR0jCV4nH#9sL&dwQ+iBU3mFZ8rK%cvO)hAT2lEX6qJ$buN(fzS1kDW5oH!atM*exQ0jCV4nGZ9sL&dwP-iBU3mFY7qK%cvO)gzT2lEX6pI$buN(fyR1kDW5oH#9tM*exQ+iCV4nGZ8rL&dwP-hAT3mFY7qJ$cvO)gzS1lEX6pI!auN(fyR0jCW5oH#9sL*exQ+iBU4nGZ8rK%cwP-hAT2lFY7qJ$buO)gzS1kDX6pI!atM*fyR0jCV4oH#9sL&dxQ+iBU3mGZ8rK%cvO-hAT2lEX7qJ$buN(gzS1kDW5oI!atM*exR0jCV4nG#9sL&dwP+iBU3mFY7rK%cvO)gAT2lEX6pJ$buN(fyR1kDW5oH#atM*exQ+jCV4nGZ8sL&dwP-hAU3mFY7qJ%cvO)gzS2lEX6pI!buN(fyR0jDW5oH#9sM*exQ+iBV4nGZ8rK%dwP-hAT2mFY7qJ$bvO)gzS1kEX6pI!atM(fyR0jCV5oH#9sL&exQ+iBU3nGZ8rK%cvP-hAT2lEY7qJ$buN)gzS1kDW5pI!atM*eyR0jCV4nH#9sL&dwQ+iBU3mFY8rK%cvO)hAT2lEX6qJ$buN(fyS1kDW5oH!atM*exQ0jCV4nGZ9sL&dwP-hBU3mFY7qK%cvO)gzT2lEX6pI$buN(fyR0kDW5oH#9tM*exQ+iCV4nGZ8rK&dwP-hAT3mFY7qJ$cvO)gzS1lEX6pI!atN(fyR0jCW5oH#9sL*exQ+iBU3nGZ8rK%cwP-hAT2lFY7qJ$buO)gzS1kDW6pI!atM*fyR0jCV4oH#9sL&dxQ+iBU3mFZ8rK%cvO-hAT2lEX7qJ$buN(fzS1kDW5oI!atM*exR0jCV4nG#9sL&dwP-iBU3mFY7rK%cvO)gAT2lEX6pJ$buN(fyR1kDW5oH#atM*exQ+jCV4nGZ8rL&dwP-hAU3mFY7qJ%cvO)gzS2lEX6pI!auN(fyR0jDW5oH#9sM*exQ+iBU4nGZ8rK%dwP-hAT2mFY7qJ$bvO)gzS1kDX6pI!atM(fyR0jCV5oH#9sL&exQ+iBU3mGZ8rK%cvP-hAT2lEY7qJ$buN(gzS1kDW5pI!atM*eyR0jCV4nH#9sL&dwP+iBU3mFY8rK%cvO)hAT2lEX6pJ$buN(fyS1kDW5oH!atM*exQ0jCV4nGZ8sL&dwP-hBU3mFY7qK%cvO)gzT2lEX6pI!buN(fyR0kDW5oH#9tM*exQ+iBV4nGZ8rK&dwP-hAT3mFY7qJ$cvO)gzS1kEX6pI!atN(fyR0jCW5oH#9sL&exQ+iBU3nGZ8rK%cwP-hAT2lFY7qJ$buN)gzS1kDW6pI!atM*fyR0jCV4oH#9sL&dwQ+iBU3mFZ8rK%cvO-hAT2lEX6qJ$buN(fzS1kDW5oI!atM*exR0jCV4nGZ9sL&dwP-iBU3mFY7rK%cvO)gAT2lEX6pI$buN(fyR1kDW5oH#atM*exQ+iCV4nGZ8rL&dwP-hAU3mFY7qJ%cvO)gzS1lEX6pI!auN(fyR0jDW5oH#9sL*exrK%cvO-hAT2lEX7qJ$buN(gzS1kDW5oI!atM*exR0jCV4nG#9sL&dwP-iBU3mFY7rK%cvO)gAT2lEX6pJ$buN(fyR1kDW5oH#atM*exQ+jCV4nGZ8sL&dwP-hAU3mFY7qJ%cvO)gzS2lEX6pI!auN(fyR0jDW5oH#9sM*exQ+iBV4nGZ8rK%dwP-hAT2mFY7qJ$bvO)gzS1kDX6pI!atM(fyR0jCV5oH#9sL&exQ+iBU3mGZ8rK%cvP-hAT2lEY7qJ$buN)gzS1kDW5pI!atM*eyR0jCV4nH#9sL&dwP+iBU3mFY8rK%cvO)hAT2lEX6qJ$buN(fyS1kDW5oH!atM*exQ0jCV4nGZ8sL&dwP-hBU3mFY7qK%cvO)gzT2lEX6pI!buN(fyR0kDW5oH#9tM*exQ+iCV4nGZ8rK&dwP-hAT3mFY7qJ$cvO)gzS1kEX6pI!atN(fyR0jCW5oH#9sL*exQ+iBU3nGZ8rK%cwP-hAT2lFY7qJ$buO)gzS1kDW6pI!atM*fyR0jCV4oH#9sL&dwQ+iBU3mFZ8rK%cvO-hAT2lEX7qJ$buN(fzS1kDW5oI!atM*exR0jCV4nGZ9sL&dwP-iBU3mFY7rK%cvO)gAT2lEX6pI$buN(fyR1kDW5oH#atM