Category Archives: Counseling and Psychotherapy Theory and Practice

Happiness Lecture 10 — Social PPT Video

Hi All,

This is a video that accompanies COUNSELING 195 – The Art and Science of Happiness. Due to social distancing, I’m putting my lectures online, and the Moodle shell at the University of Montana rejected the file for being too large, so I’m trying this.

The audio is wonky, but the video focuses on components of the social dimension of well-being and happiness.

Be safe. Be well. Be distant, but stay connected!

John

 

Free Video Links for Online Teaching

JSF Travel

This past week I’ve been grateful for the many professionals and organizations (including my publisher, John Wiley & Sons) who are providing free guidance and materials to help with the transition from face-to-face teaching to online instruction. In an effort to contribute back in a small way, I’m posting 10 counseling- and psychotherapy-related videos that can be integrated into online teaching. These videos are free and posted on my YouTube channel. The links are all below with a brief description of the video content.

Some of these videos are rough cuts and all of them are far from perfect demonstrations; that’s partly the point. Although many of the videos show reasonably good counseling skills and interesting assessment processes and therapeutic interventions, none of the videos are scripted, and so there’s plenty of room for review, analysis, critique, and discussion. You can show them as efforts to do CBT, SFBT, Motivational Interviewing, administration of a mental status examination, etc., and prompt students to describe how they would do these sessions even better.

These videos are meant to stimulate learning. In an ideal world, I would include a list of discussion questions, but I’ll leave that to you. If you like, please feel free to use these videos for educational purposes. Here’s the annotated list with video links:

  1. Counseling demonstrations with a 12-year-old.
    1. Opening a counseling session: https://www.youtube.com/watch?v=rHHrMC8t6vY
    2. The three-step emotional change trick: https://www.youtube.com/watch?v=ITWhMYANC5c
    3. John SF demonstrates the What’s Good About You? informal assessment technique: https://www.youtube.com/watch?v=MUhmLQUg_g8
    4. Closing a session: https://www.youtube.com/watch?v=GpuH80tf2jM
  2. Demo of assessment for anger management with a solution-focused spin with a 20-year-old client: https://www.youtube.com/watch?v=noE2wMMNLY4
  3. Demo of motivational interviewing with a 30-year-old client: https://www.youtube.com/watch?v=rtN7kEk0Sv4
  4. Demo of the affect bridge technique with an 18-year-old: https://www.youtube.com/watch?v=fEtiGuc914E
  5. Demo of CBT for social anxiety with a graduate student: https://www.youtube.com/watch?v=jfVeeGJHFjA
  6. Demo of an MSE with a 20-year-old: https://www.youtube.com/watch?v=adwOxj1o7po
  7. A lecture vignette of a demonstration of psychoanalytic ego defense mechanisms: https://studio.youtube.com/video/E818UlgHMXY/edit
  8. The University of Montana Department of Counseling does a spoof video of The Office: https://www.youtube.com/watch?v=eM8-I8_1CqQ

Good luck with the transition to online teaching and stay healthy!

John S-F

Happiness Homework: Savor Now, Feel Better Later

Captain America

We all know how to savor chocolate or wine or the cheesecake that tastes like you’ve made it to heaven. When it comes to gustatory experiences, savoring is natural.

Funny thing, savoring successes, beautiful scenery, a poem you hear on the radio, and other potentially positive life experiences often (but not always) feels less natural. That’s too bad, because researchers have repeatedly found that taking a moment to savor the moment in the midst of a busy day can increase happiness and decrease depression. We should try to remember to savor more often.

For this week the plan is for you to pick one savoring assignment from a menu of research-based savoring activities (below). Each of these activities has research support; doing any of them might make you feel significantly more happiness or less depression. Here are your options:

  • Engage in mutual reminiscence. Mutual reminiscence happens when you get together with someone and intentionally pull up and talk about fun, positive, or meaningful memories. I was with my dad last week and did a bit of this and it was nice. Now I have memories of us remembering our shared positive memories.
  • Make a list of positive memories. After making the list, transport yourself to reminisce on one of the memories. You can do this one by yourself. Retrieve the memory. Play it back in your mind. Explore it. Feel it. Let your brain elaborate on the details.
  • Celebrate good news longer than you would. This is easy. You need to track/observe for a positive message or news in your life that feels good. Then, let your mind linger on it. Notice how you feel. What parts of the news are especially meaningful and pleasant to you? Extend and celebrate the good news.
  • Notice and observe beauty. This activity is mostly visual, but you can listen for beautiful sounds too. Let yourself see color, patterns, and nuanced beauty in nature or in art. Linger with that visual and let its pleasant effects be in your eyes, brain, and body. Notice and feel those sensations and thoughts.

As usual, write a short report to Dan and me about your experiences and put it in the appropriate Moodle bin. This report doesn’t need to be long—unless writing it is a pleasant experience for you—in which case, you can linger and write longer.

Happiness Homework: Week 4 — Thought Monitoring

Goldilocks and Bears

Active Learning Assignment 6 – Thought Monitoring

Humans are thinking beings. You can try arguing the opposite, but that would require thinking.

Sometime around 1637, René Descartes said it this way,

“Cogito, ergo sum.”

The English translation,

“I think, therefore I am.”

Cool stuff.

After several decades of studying psychological theory, I’m finally ready to make my own fancy Cartesian philosophical statement about human thinking. It’s less succinct than Descartes, because, well, I’m not Descartes. Here we go. First, in Latin (because even though I only typed the words into the Google Latin translator, using Latin makes me sound smarter).

“Cogito ergo sum ego possit cogitare et in tempore angustiae triumphi.”

Now, in English.

“I think therefore I am able to think myself into trouble or triumph.”

Inevitably, the more we think, the more we’re able to create personal misery. Alternatively, as we know all too well from political or romantic or employment or online relationships, we humans are also quite capable of rationalizing behaviors and describing ourselves in ways that makes us feel and sound better than we are in reality. We easily and naturally think our way toward trouble and triumph.

One popular contemporary term that speaks to miserable and unhelpful thinking is “overthinking.” Overthinking refers to excessive analysis around actions or decision-making. Overthinking is usually considered a less-than-optimal style that sometimes leads to paralysis by analysis.

Unfortunately, although life is better when we avoid overthinking, “underthinking” (although it hasn’t caught on), is equally bad. Underthinking results in impulsive and thoughtless behaviors and decisions.

As if life wasn’t already hard enough, like Goldilocks, now we have to avoid overthinking and underthinking, and find just the right amount of thinking.

All this brings us to our current happiness assignment.

  1. Using the six-column model demonstrated in class (on Feb 4), track the relationships between your situational triggers, thoughts, emotions, and behaviors. One or two examples is sufficient.
  2. Write one paragraph about anything you learned about how your thoughts and behaviors affect your emotions (for the better or for the worse).
  3. Come to the lab on Thursday (Feb 6) ready to discuss anything you may have discovered about how your thoughts and behaviors affect your emotions.

Just in case you need it, here’s a longer description of how to do the six-column technique: https://johnsommersflanagan.com/2014/02/18/how-to-use-the-six-column-cbt-technique/

Good luck and may the happiness be with you.

Four Questions to Help Keep Your Focus on the Positive

Brain Image

Everyone agrees that the human brain is amazing. Perhaps the most amazing quality of human brains is the ability to shift focus. In an instant and at will, you can shift your focus from a current life conundrum, to the big toe on your left foot, to your dreams for the future, and to a memory from 1st grade. You can explore all these things—at least superficially—and then move on to the meaning of existence and the possibility of life on Mars all in less than one minute. In fact, as you were reading this, I’ll bet you were able to touch on all those thoughts.

Although shifting attention can feel random, it’s a power that most of us should learn to use more intentionally.

We’re using several methods for helping students intentionally harness their attentional focus in the Art and Science of Happiness course at the University of Montana. One method involves homework. Another method involves in-class and happiness lab activities. A third method (and the one featured here), is intentional and regular use of self-reflection. To accomplish this, we ask students to answer four reflection questions every two weeks.

Here are the questions, along with a small sampling of anonymized student responses:

  1. Over the past two weeks, what lecture content stood out to you as most important to you in your life?
  • “The sleep lecture and what you can do to sleep better, and what causes nightmares and night terrors”
  • “Happiness doesn’t have to ALWAYS be present in order to be happy.”
  • “I really enjoyed the lecture about the three steps to cure nightmares.”
  1. Over the past two weeks, what classroom or lab activities do you recall as most important to you in your life?
  • “All of them have been influential . . . and hope to continue these assignments into the future.”
  • “Having a happy song playing at the beginning of class is such a great way to start class.”
  • “The hand-pushing activity about how we should go into a situation with a plan.”
  1. Over the past two weeks, what positive changes have you noticed in yourself or in your life?
  • “After doing the 3 good things activity at night I felt relaxed and in a better mood.”
  • “I’m working on my sleep schedule which has felt good.”
  • “I found the sleeping tips to be really helpful in my own life and help me to improve my sleep.”
  1. Over the past two weeks, what activities, interactions, or thoughts have you experienced (outside of class) that were especially meaningful to you?
  • “Finding something inspirational.”
  • “More positive outlook on life.”
  • “I experienced being able to change my thoughts on a negative day by looking at three good things and able to remember that even on bad days there are still good things to remember.”

As I look over the students’ responses to these questions and the homework assignments, I feel like I’m catching some positive psychology contagion. I’m grateful to be able to teach this course and inspired by the students’ efforts to apply positive psychology principles to their lives.

Happiness Homework — Week 3: University of Montana

Stone Smirk

This week we’ve only got one active learning assignment (see below). That’s probably because there’s a Moodle quiz later in the week and, of course, there are things for students to watch and listen to, like these:

  1. Listen: Science vs. Podcast – All Aboard the Snooze Cruise https://gimletmedia.com/shows/science-vs/o2hx57
  2. WATCH: Hacking your brain for happiness by James Doty: https://www.youtube.com/watch?v=q4TJEA_ZRys
  3. Listen: The Practically Perfect Parenting Podcast, Episode: Teens and Depression — https://podcasts.apple.com/us/podcast/teens-depression/id1170841304?i=1000383659996

And here’s the active learning homework for the week!

Active Learning Assignment 5 – Your Favorite Relaxation Method

As you likely recall from the Thursday, January 23 lecture, in 1975, Herbert Benson of Harvard University published a book titled, The Relaxation Response. Benson wrote that for humans to achieve the relaxation response, they needed four components:

  1. A quiet place.
  2. A comfortable position.
  3. A mental device.
  4. A passive attitude.

For this assignment, your job is to identify and practice your favorite relaxation method. The good news is that you don’t really need a quiet place and a comfortable position (although they help, they’re not essential). But you do need a mental device and a passive attitude.

Unfortunately, as it turns out, for some people, the act of trying to relax creates anxiety. This is a puzzling paradox. Why would trying to relax trigger anxiety?

The intent to relax can trigger anxiety in several different ways. For some, if you try to relax, you can also trigger worries about not being able to relax. This is a relatively natural byproduct of self-consciousness. If this is the case for you, take it slowly. Self-awareness can trigger self-consciousness and self-consciousness can trigger anxiety . . . but time and practice can overcome these obstacles.

For others, a history of trauma or physical discomfort can be activated. This is similar to self-consciousness because the turning of your attention to your body inevitably makes you more aware of your body and this awareness can draw you into old, emotionally or physically painful memories. If this is the case for you, again, take it slowly. Also, manage your expectations, and get support as needed. Support could come in the form of specific comforting and soothing cues (even physical cues), an outside support person, or a professional counselor or psychotherapist.

Trauma and anxiety are common human challenges. Although trauma and anxiety can be terribly emotionally disturbing and disruptive, the core treatment for these problems usually involves one or more forms of exposure and can be traced back to Mary Cover Jones. You can read more about Mary Cover Jones and her amazing work on my blog: https://johnsommersflanagan.com/2018/06/04/the-secret-self-regulation-cure-seriously-this-time/

Okay, that’s enough of my jibber-jabbering. Here’s your assignment:

  1. Try integrating your favorite relaxation method (no drugs please) into your daily life. You can do it for a minute here and there, or 20 minutes all at once.
  2. Write me a paragraph or two about how it went. Include reflections on (a) what helped you relax more? and (b) what got into the way of you relaxing (obstacles)?
  3. Write me a paragraph about how you might try to do more relaxing in the future—including how you will deal with those pesky obstacles.

Thanks for reading and have a fantastic Sunday.

 

 

 

Happiness Homework: Week 2 — University of Montana

Peg and John Singing at Pat's Wedding

Yesterday the happiness class focused on the context of happiness and happiness habits. On my powerpoint slides, I managed to reverse the numerator and denominator of Bono’s happiness equation, resulting in my abject humiliation in front of the class. This led to my personally disclosing my most humiliating experience ever, thereby demonstrating how contextual experiences in the here-and-now can trigger memories that can then either magnify or minimize an experience of happiness or unhappiness in the moment. I’ll spare you the details of my historical humiliations, and instead, direct you toward this week’s happiness homework assignments.

By now, students have read chapters one and two in Tim Bono’s book, “When Likes Aren’t Enough: A crash course in the science of happiness.” Additionally, they listened to a Hidden Brain podcast on Creatures of Habit: https://www.npr.org/transcripts/787160734, and watched a short Forest Bathing video: https://www.youtube.com/watch?v=W0MEFNyLPag

The two take-home assignments of the week are described below:

Active Learning Assignment 3 – Three Happy Places

More often than we might think, our environment, setting, or context directly influences our mood and sense of well-being. This is most obvious when we’re in settings or environments that we find aversive.

To start this assignment, reflect briefly on environments, settings, or contexts that you find aversive. For example, some people find cloudy days, rain, smoky skies (or rooms), or particular temperatures aversive or uncomfortable. Other people might find churches, gyms, or libraries aversive.

Now, consider the opposite: What environments, settings, or contexts do you find pleasurable, comforting, or energizing? As you may have noticed in the short “Forest bathing” video, there’s evidence that, in general, more time in the outdoors is linked to increased feelings of well-being. For this assignment, don’t worry about what “should” be your happy place. . . but if the outdoors is a happy place for you, be sure to include it.

After reading and reflecting on the above, write a few words (short answers) in response to the following prompts:

  1. List three settings that usually trigger negativity or discomfort in you.
  2. List three settings that usually trigger happiness and wellbeing in you (and be specific). These are your happy places
  3. What can you do to prepare for or cope with challenging settings that usually cause you discomfort? (Other than avoiding them)
  4. What can you do to increase the frequency of time you spend in environments that contribute to your feelings of wellness?
  5. What can you do to create places or spaces in your mind that you can use (anywhere and anytime) to increase your sense of comfort and wellness in the moment?

Active Learning Assignment 4 – Three Good Things

Perhaps the most basic and well-known evidence-based happiness assignment is Martin Seligman’s Three Good Things activity.

Here’s Seligman’s description: Write down, for one week, before you go to sleep, three things that went well for you during the day, and then reflect on why they went well.

Just in case you want to hear it from the horse’s mouth, here’s a one-minute video of Seligman describing the activity: https://www.youtube.com/watch?v=ZOGAp9dw8Ac

For this assignment, you should do the Three Good Things activity for a week, as prescribed by Seligman. Dan and I don’t need to see all 21 good things from your whole week, but we would like you to share the following with us:

  1. Three ESPECIALLY good things from the week (think of these of as your Good Things Highlights). We’re very excited to hear about these.
  2. The most common (summarized) explanations for why these 21 good things happened. We’re very interested in what’s happening (or what you’re doing) to create the good things in your day-to-day lives.

 

 

Happiness Homework: Week One – University of Montana

IMG_3098

In the friendly confines of a psychological laboratory, happiness is created rather easily. In the real world, happiness is more elusive.

Whether researchers have college students hold pens with their teeth or write down three good things or express gratitude, mood is boosted. In the real world, sometimes you have to force yourself to smile, and even still, you may not experience happiness.

You might wonder, do the small behaviors that improve mood in the lab result in sustained positive moods into the future? Martin Seligman, the contemporary psychologist most closely linked to the positive psychology movement (and author of Authentic Happiness and Flourishing) says yes. Although I’m less sure about this than Dr. Seligman, I am sure that many small behaviors over time—the sorts of behaviors that become positive habits (or positive routines)—can, for many, result in improved moods sustained over time.

Instead of assuming that everything Martin Seligman or other researchers say is true, in our University of Montana happiness class (COUN 195: The Art and Science of Happiness) we’re all about directly testing evidence-based happiness strategies. Part of the reason we’re testing these strategies is because we’re replicating nomothetic scientific findings in idiographic contexts. The true originator of positive psychology, Alfred Adler, would be happy about this. That’s because Adler believed we can never know if group scientific findings generalize to individuals, until we try them out with individuals.

In the spirit of positive psychology, and in an effort to develop and maintain healthy habits in college students, I’m giving small weekly homework assignments in the UM happiness class. Sometimes these assignments are verbatim (or nearly so) from published scientific research. Other times they’re assignments that Dan Salois (my TA) and I have created just for the class. This week’s assignments are home cooking.

I’m including these assignments on my blog so you can follow along with the class and experience different approaches to creating positive moods and psychological wellness. These assignments aren’t stand-alone miracles; they’re brief and simple behaviors purposely designed to elicit positive emotions and prompt you (and the happiness students) to reflect on the nature of positive emotions and wellness-oriented behaviors. They might work as intended, or they might not. I hope they work.

You have two assignments for this week.

Active Learning Assignment 1 – Happy Songs in Your Life

Music in general, and songs in particular, can trigger happiness, sadness, other emotions, and life memories. Sometimes our emotional responses to music are all about the music. Other times, our emotional responses are about the personal links, associations, or memories that songs trigger. For example, when I listen to “Joy to the World” by Three Dog Night, I’m transported back to positive memories I had playing 9th grade basketball. The song, “Put the Lime in the Coconut” will forever take me back to a car accident that happened with my sister in 1973. It’s not unusual for us to turn to music to help regulate our emotions or to heighten particular feelings.

For this assignment, do the following:

  1. Select a song that has triggers positive emotions for you.
  2. Listen to the song twice in a row and just let the song do its work. You can do this with a friend or by yourself. Don’t WATCH the song. If it’s a music video, shut your eyes and listen.
  3. After you’ve listened twice and let the positive feelings come, respond to the following prompts, and then upload your responses to Moodle.
    1. Write the name of the song and the musical artist (so we know the song).
    2. What emotion does the song bring up?
    3. What’s your best guess (hypothesis) for why the song brings up those particular emotions? (Share the lyrics or the links to life events that make the song emotionally important to you).
    4. Do you usually listen to that song to intentionally create a particular emotional state, or do you wait for the song to randomly pop into your life?
    5. Optional: share the song with someone and tell that person why the song triggers positive emotions for you.

Active Learning Assignment 2 – Witness Something Inspiring

Inspiring things are constantly happening in the world.

Martin Luther King Day is coming. Martin Luther King was a source of great inspiration for many. Over this coming long weekend you could watch a video recording of King’s “I have a dream” speech and feel inspired. You could also go on the internet and find something inspiring on social medial. But instead, just for fun (and for this assignment), we want you to watch for and observe something inspiring that’s happening in the real world.

The inspiring event that you notice may be small or it may be big. The key part of this assignment is that it involves intentionally watching for that which will inspire. Keep all your sensory modalities open for inspiration. Then, write Dan a short note (about 200 to 300 words) describing what you experienced. Your note should include:

  1. What it was like to intentionally pay attention to things that might inspire you.
  2. A description of what you observed.
  3. Reactions you had to the inspirational event.
  4. Anything else you want to add.

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Try these assignments for yourself (or not). If it strikes your fancy, you can post your reactions on this blog (or not).

I hope the remainder of your Martin Luther King weekend is fantastic.

Why I’m Angry about our Happiness Class at the University of Montana

JSF Creates Happiness

Last week, a friend of ours stopped to visit. She asked how our prep for the happiness class at UM was going. We said fine. She asked how we felt about the online comments that were critical of our new happiness class. Not having read any critical comments, I shrugged. She elaborated, “You know, people said that having a happiness class at UM is one of the things wrong with UM and higher education.”

Instantly, a small wave of anger rose up in my chest. I may have offered up a sarcastic retort or two. As is usually best, I’ll spare you the details of retorts. After she left, I ruminated a bit. I imagined a range of fantastic scenarios during which I experienced gratification from confronting our critics. These too, are best left to everyone’s imagination.

Eventually, I settled into a better place. I decided that the ironic conclusion is that I need to get more information about our new happiness class out there. One super-popular phenomenon right now—maybe especially in the age of the internet—has to do with people commenting on things, despite not having all the facts. I do it myself. Sometimes I critique things that I don’t know much about. Having an opinion is easy. Having an informed opinion is harder. Being partially informed generally makes critiquing others easier. I decided that, given my behavior, I shouldn’t complain too much when people disparage our happiness class, even though they don’t have all the facts.

This brought me to a calmer place. Instead of venting anger, I’m channeling my anger into the proliferation of information.

To start, for critics of our happiness course at UM, I have a few questions, some of which may still have an angry edge.

  1. What do you know about the origins of the positive psychology movement? Were you in San Francisco at the American Psychological Association conference in 1998, when Martin E. P. Seligman officially launched the strengths in psychology movement? I was. Using my best academic jargon, being in the room when Seligman changed the course of modern psychology was pretty cool stuff.
  2. Do you know why Seligman launched the positive psychology movement? Do you have any sense of what he was studying before he pivoted toward strengths and positive psychology? Ever heard of learned helplessness?
  3. Did you know there’s an academic Journal of Positive Psychology? Have you read any JPP research articles? How about the Journal of Happiness Studies? Been doing any reading there? If not, you might want to consider enrolling in a class in happiness. You’re too late to get into ours, but there’s a ton of online and in-person stuff out there from Yale, Berkeley, Harvard, and other institutions, although I prefer the University of Montana.
  4. What do you suppose Aristotle thought about happiness? Have you heard of eudaimonia? Do you understand what Aristotle meant by eudaimonia or anything pertaining to his concept of the golden mean? If not, you might want to consider a happiness class . . . or a Google search. The golden mean is very important to understanding virtue, and virtue, well, having virtue is virtuous, which is a good thing.
  5. Are you aware of the rates of depression, suicidality, anxiety, and unhappiness in college students? Are you aware that in published research studies there are at least a dozen specific experiential activities that have scientific evidence supporting their use to increase happiness? Can you name any? Have you tried any? How are you feeling? If you’re so damn grumpy that you spend your time posting negativity on social media, you should definitely consider a happiness class. One interesting tidbit of research information that I’ll share in our happiness class is the fact that the number of hateful Twitter words used in specific counties in the U.S. are significantly correlated with increased coronary heart disease events in those same counties. Does that mean offering up nasty posts or tweets will increase your risk of death from a heart attack? Maybe. Maybe not. As I’m sure you know, the basic scientific rule that correlation does not imply causation means that there may be much more to the story. You might have to take a happiness class to learn whether intentionally posting fewer nasty comments online could increase your longevity.

Inspired by critiques of the existence of our happiness class (thank you, thank you so much!), I’ve decided to increase the frequency of my happiness posts and updates. Look for much more here on specific happiness assignments from our University of Montana Happiness Class. You can follow along. Unfortunately, the class is pretty much full-up now, but there will be more opportunities to take University of Montana happiness classes this summer and during the next academic year.

Below, I’ve included the description of the course from the syllabus:

COURSE CONTENT AND DESCRIPTION: Over the past 20 years, research on happiness has flourished. Due to the natural interest that most Americans have for happiness, research findings (and unfounded rumors) have been widely distributed worldwide. Every day, happiness is promoted via online blogs, newspaper and magazine articles, Twitter posts, Instagram videos, TikTok, and through many other media and social media venues. Ironically, instead of increases in national happiness, most epidemiological research indicates that all across the U.S., children, adolescents, adults, and seniors are experiencing less happiness, more depression, and higher suicide rates. To help sort out scientific reality from unsubstantiated rumors, in this course, we will describe, discuss, and experience the art and science of happiness. What this means is that we will define happiness, read a popular happiness book, examine scientific research studies, try out research experiments in class, engage in extended happiness lab assignments, and use published instruments to measure our own happiness and well-being. Overall, we will focus on how happiness and well-being are manifest in the physical, cognitive, emotional, interpersonal, spiritual, behavioral, and contextual/cultural dimensions of our lives.

Have a happy weekend . . . and watch for upcoming happiness assignments.

Integrating Multicultural Sensitivity into CBT

Woman Statue

A question and brief discussion on Twitter about integrating multicultural competence into CBT inspired me to look back and see what the heck we wrote for that section in our theories text. In the Twitter discussion, we agreed that Pam Hays’s work on CBT and multicultural content is good.

Here’s what I found in our theories text. Obviously it’s a short section and limited, but there are a few interesting points and a citation or two.

Cultural and Diversity Considerations in CBT

CBT focuses on symptoms as manifest within individuals. This position can be (and is) sometimes viewed as disregarding important culture, gender, and sexual diversity issues. For most cognitive-behavioral therapists, culture, gender, and sexuality aren’t primary factors that drive successful outcomes.

This position is a two-edged sword. In the featured case (in Chapter 8), Richard is a white male living a life squarely in the middle of the dominant culture. The therapist was committed to Richard’s well-being. If the client had been an Asian Indian or a bisexual or a woman experiencing domestic abuse the cognitive-behavioral therapist would have been equally committed to the client’s well-being. This is the positive side of CBT being less diversity-oriented.

The negative side is that CBT can be viewed and experienced as blaming clients for their symptoms, when the symptoms may be a function of diversity bias. D. Dobson and K. S. Dobson (2009) articulated the potential for clients to experience blame,

By virtue of looking for distorted thoughts, cognitive-behavioral therapists are more likely than other therapists to find them. Furthermore, some clients do react to the terms distorted, irrational, or dysfunctional thinking. We have heard clients say something to the effect—” Not only do I feel bad, but now I’ve learned that my thoughts are all wrong.” (p. 252)

Awareness of the possibility of client blaming is crucial. For example, what if Richard were a Black American male? And what if his therapist noticed that Richard’s thought record included numerous personalization examples? If so, instead of concluding that Richard is displaying oversensitivity and paranoid cognitions, his therapist should explore the possibility of microaggressions in Richard’s daily life.

The term microaggression was coined by Chester Pierce (1978). Microaggressions were originally defined as “the everyday subtle and often automatic ‘put-downs’ and insults directed toward Black Americans” but now this is expanded so they “can be expressed toward any marginalized group in our society” (Sue, 2010, p. 5).

Microaggressions are typically unconscious. For example, we had a female client come to us in great distress because her vocational instructor had told her “You’re pretty strong for a girl.” Although the vocational instructor defended his “compliment,” the young woman clearly didn’t experience the statement as a compliment. In this circumstance if a therapist is insensitive to culture and gender issues, the young woman might feel blamed for having irrational thoughts and overreactive behaviors. Sue (2010) recommends that mental health professionals exercise vigilance to address microaggression issues inside and outside of counseling. One way in which cognitive behavioral practitioners have addressed the potential for committing microaggressions against sexually diverse clients is by using LGBTQ affirmative CBT (Pachankis, Hatzenbuehler, Rendina, Safren, & Parsons, 2015).

Returning to racial/cultural microaggressions, let’s briefly pretend that Richard is a 6′7′′ Black American male. In his thought record he notes:

Situation: Walking into the local grocery store. Young female makes eye contact with me and then quickly turns around and goes back and locks her car.

Thoughts: She thinks I’m going to steal her car.

Emotions: Anger.

Behavior: I act rude toward her and toward other white people I see in the store.

If the Black American version of Richard has a therapist who looks at this thought record and then talks with Richard about the distorted thinking style of mind-reading (“Richard, you didn’t really know what she was thinking, did you?”) this therapist is showing cultural insensitivity and will likely be fired by Richard. This is an example of one of the many growing edges CBT should address with respect to women and minority clients.

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As always, your reactions to this content are welcome.