Class 7: CBFT and Gottman

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CBFT includes many theories

  • behavioral couple and family therapies
  • cognitive=behavioral couple and family therapy
  • integrative behavioral couples therapy
  • Gottman method of couple therapy
  • Mindfulness-based therapies
  • Multicouple and multifamily group therapies
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  • Three waves of cbt:
  • Behavioral
  • Cognitive and social learning
  • Contextual and experiential
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Parent training

  • Regardless of the specific cbft orientation, they all use concepts of reinforcement and consistency to help improve parental efficiency
  • Important aspects of parental training:
    • Teaching compliance and socialization (teach children to comply with parental requests, with broader context of functioning in society)
    • Improving parental requests (should be fewer, plate, statements, specific, well times, and made only once before using a consequence)
    • Monitoring and tracking (parents ask who, where, what, when)
    • Creating a contingent environment (parents use point c harts to develop positive rewards that encouraged desired behavior)
    • Five minute work chore (parents assign a lesser punishment with initial infractions before removing privileges or using harsher punishments)
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  • Overview/ steps to treatment in cbft
  • Assessment
  • Target behaviors and thoughts for change
  • Educate
  • Replace and retrain
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  • Therapeutic relationship in cbft
  • Directive educator and expert
  • Empathy in CBT(with main focus of creating rapport to then be trusted to use interventions)
  • Alliance (active collaboration, empathy, adapt therapeutic style, alleviate distress, elicit feedback at end of session)
  • Written contracts (business-like)
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  • Problem analysis in cbft
  • Focuses on present-day behaviors, emotions, thoughts
  • Focus of tx is to reduce undesirable thoughts, feelings, and behaviors
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  • Functional analysis in cbft
  • Identified the precise context, antecedents, and consequences of the problem behavior
  • Strengths and skills of the relationship
  • Presenting problems
  • Sex and affection
  • Future prospects
  • Social environment
  • Individual functioning
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  • 5 types of cognition that influence how couples emotionally and behaviorally respond to one another
  1. Selective perceptions- focusing on certain events or info to the exclusion of others
  2. Attributions- inferences about causes of + and – aspects of the relationship
  3. Expectancies- predictions about the likelihood of certain events in the relationship; these are often informed by one’s family of origin as well as racial/ ethnic background
  4. Assumptions- basic beliefs or assumptions about the characteristics of the partner and/or relationships
  5. Standards- beliefs about the characteristics that the relationship and each partner “should” have; these are often shaped by one’s family of origin as well as gendered ethnic and racial standards of behavior
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  • Cognitive distortions
  • Beliefs about our family of origin and beliefs about couples/ families in general
  • Arbitrary inference
  • Selective abstraction
  • Overgeneralization
  • Magnification and minimization
  • Personalization
  • Dichotomous thinking
  • Mislabeling
  • Mind reading
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  • Arbitrary inference

cog distortion

  • A belief based on little evidence
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  • Selective abstraction

cog distortion

  • Focusing on one detail while ignoring the context and other obvious details
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  • Overgeneralization
  • cog distortion
  • Generalizing one or 2 incidents to make a broad sweeping judgment about another’s essential character
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  • Magnification and minimization
  • cog distortion
  • Going to either extreme of overemphasizing or underemphasizing based on the facts
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  • Personalization
  • Type of arbitrary influence in which external events are attributed to oneself
  • cog distortion
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  • Mislabeling
  • Assigning a personality trait to someone based on a handful of incidents, often ignoring exceptions
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  • Mind reading
  • Believing you know what the other is thinking or what they’ll do based on assumptions or generalizations
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  • Schema
  • Fundamental source of cognitive distortions and automatic thoughts
  • Long-held basic assumptions about how the world and relationships work and a person’s place in it
  • Can eb about self, about others/relationships, and about life
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  • Interventions in cbft
  • Classical conditioning
  • Operant conditioning
  • Encouragement and compliments
  • Contingency contracting
  • Token economies
  • Quid pro quo
  • Psychoeducation
  • Communication training
  • Homework
  • Challenge irrational beliefs
  • Socratic method
  • Thought record
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Reinforcement frequency

  • Immediacy
  • Consistency
  • Intermittent
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Contingency contracting

  • (a stipulation must be met for the individual to receive a reward)
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Token economies

(reinforces behaviors by allowing individual to build up points that they can apply to privileges, purchases, etc

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Quid pro quo

  • (this for that arrangements; can be helpful for couples negotiating rules. Gottman found that couples who use this tend to have lower levels of marital satisfaction)
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  • Psychoeducation
  • 4 categories: problem oriented, change oriented, bibliotherapy, cinema therapy
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  • Communication training
  • Begin with positive, single subject, specific behavioral prob, describe impact, take responsibility, paraphrase, no verbal abuse
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  • Socratic method
  • Guided discovery or inductive reasoning. Helps encourage clients to questions their own beliefs, cognitive therapists use open ended questions that help clients discover themselves
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Gottman debunked some myths....

  • Communication training helps- better communication usually results in just short term gains
  • Anger is a dangerous emotion- expressing anger actually doesn’t predict divorce but defense and contempt do
  • Quid pro quo error- tit for tat or this for that characterizes unhappy marriages
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Gottman: how couples therapy should be characterized

  • Positive affect experience
  • Primarily dyadic
  • Emotional learning
  • Easy
  • Not idealistic
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Gottman: therapeutic approach

  • Therapist as coach- coach, empowering, etc. no soothing
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  • 4 horseman of the apocalypse

gottman

  • Criticism—statement that implies something is globally wrong with the partner. Women tend to criticize more than men
  • Defensiveness—used to ward off attack, defensiveness claims “I’m innocent”
  • Contempt—single best predictor for divorce, seeing oneself as superior to one’s partner
  • Stonewalling—when listener withdraws from interaction, either [physically or mentally. Men are more likely than women.
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  • Negative affect reciprocity
  • Increased probability that one’s partner’s emotions will be negative immediately following negativity in the other
  • gottman
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  • Repair attempts
  • Refer to when one partner tries to “make nice” and end the conflict, sooth the other, or soften the complain. Distressed couples usually reject repair attempts
  • gottman
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  • Harsh startup
  • Raising an issue using negative affect in the first minute of a conversation
  • Relationships in which women are more likely to use this in the first minute are more likely to end in divorce
  • gottman
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  • Distance and isolation cascade

gottman

  • Happens when problems go unresolved and thus become emotionally disengaged
  • Underlying tension and sadness
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gottman: Typologies of happy marriages

  1. Volatile couples- emotionally expressive (pos and neg emo), [passionate fighting and loving
  2. Validating couples- have moderate emotional expression and strong marital friendships
  3. Conflict-avoiding couples- least emotional expression, minimize problems,
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gottman session format

  • 1. Catch up- check in
  • 2. Preintervention marital interaction- boxing around. Couple interact 6-10 min on diffractal topic
  • 3. Give an intervention- therapist asks couple for an intervention before suggesting one, based on the premise that people tend to be more accepting of their own ideas
  • 4. The spouses make the intervention on their own- couple discusses thoughts on how to improve interactions
  • 5. Got resistance?- therapist to address the source of concerns
  • 5. No resistance?- once there’s a plan for altering the interaction, therapist instructs them to engage in another 6 minute interaction
  • 6. Homework – tasks are assigned based on interactions in session
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  • Love maps

gottman

  • Help develop knowledge of each other by answering questions about friends, potential friends, and important events, worries, etc