Chap 10 CBT CS

As the oldest of three children, Carol (who is 29) berates herself for her family’s tension and dissension. Her father is depressed most of the time (which Carol feels responsible for); her mother feels overburdened and ineffectual (Carol feels she contributes to this); and both her sisters are doing poorly in school and having other personal problems (Carol also assumes responsibility for this). Somehow she is convinced that if she were different and did what she should do, most of these problems would greatly diminish. Assume, as you listen to her, that you hear her saying some of the following things:

“My father looks to me to be the strong one in the family. I must be strong if I’m to gain his approval, which I feel I must”

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“Since my mother is overworked, I should take on more of the responsibility for taking care of my younger sisters. I ought to be able to talk with them and help them with their problems.”

“My sisters both expect me to do their chores for them, to help them at school, and to live up to the image they have of me. I ought to meet their ideals, and it would be absolutely horrible of me to fail in this regard. Then if they grow up with problems, I’ll have only myself to blame for the rest of my life.”
1. Rank the following in order of importance, from the perspective of rational emotive behavior therapy:

____ providing Carol with support and understanding

____ creating a warm and personal relationship with her

____ telling her that she should not think the way she does

____ confronting her with her irrational assumptions

____ asking her to question the origin of her beliefs

____ asking her what she most wants to change

____ teaching her how to identify her own faulty thinking and how to dispute it

____ providing her with reassurance

2. One of the things a rational emotive behavior therapist would do is teach Carol that her thinking and her evaluation of events are causing her problems (feelings of inadequacy, anxiety, and insecurity). What do you hear her saying to herself that is irrational?

3. As a rational emotive behavior therapist you would want to help her undermine her self-destructive thinking, once she had identified disturbance-creating beliefs. Check the therapeutic techniques that you might be inclined to use:

____ active teaching methods

____ readings

____ relaxation exercises

____ fantasy exercises in which she relives past experiences

____ specific homework assignments

____ therapist interpretation

____ free-association exercises

____ a journal of events, thoughts, feelings, and outcomes

____ behavioral rehearsal

____ writing her autobiography

____ writing a “letter” to her sisters and parents

____ methods of disputing irrational beliefs

4. If Carol seems to hang on to the idea that she must have the approval of her father in order to feel adequate as a person, what direction might you take?

5. Apply the technique of rational-emotive imagery in Carol’s case. How would you help her imagine herself thinking, feeling, and behaving in the way she would ideally like to?

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