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Thread: what is CBT?

  1. #1
    Sweetum is offline Sapphire level (2000+ posts)
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    Default what is CBT?

    I have seen several posts here on BBB regarding CBT. I am not 100% sure what it is, specifically
    - is it used for Autism?
    - how is it different from ABA?
    - who recommends it?
    - who provides the treatment/therapy?
    - what are things that come under the realm of CBT?

    thanks.

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    Others wil, have more comprehensive answers. But I will give it a go to start the ball rolling.

    CBT=Cognitvie Behavioral Therapy

    It is well supported by research as a treatment for anxiety. To the extent an autistic person has anxiety (the two often co-exist, I believe) it would be appropriate. My ver rudimentary understanding is that it helps by improving self-talk, sort of "I think I can, I think I can". But others will have a better understanding than I do, for sure.

    It might be of some use in social skills? Not sure.

    I don't believe it would be of much help for many of the challenges of autism (for example, I don't think it would be used to help with elopement).

    I do not think it would be a substitute for ABA. I just don't think it is global enough in reach. I think Floortime is the most widely known alternative to ABA.

    Catherine

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    Gena's Avatar
    Gena is offline Emerald level (3000+ posts)
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    Cognitive Behavior Therapy (CBT) is based on the idea that what we think (cognition), what we feel (emotion) and what we do (behavior) are all connected. Specifically, it holds that our thoughts determine our emotions and behavior. So, if you can change how/what a person thinks about something (a situation, a person, an event, etc.), that person's emotions and behavior will change.

    A lot of therapies and techniques that have been developed for working with autistic individuals use principles of CBT, even though they might not ever use that term explicitly. Such programs are designed to help autistic individuals learn to recognize and regulate their emotions, cope with sensory issues, and improve social interaction, and increase communication.

    A few of these techniques/programs include:
    The Incredible 5 Point Scale
    The ALERT Program (aka "How Does Your Engine Run?")
    The Social Thinking Curriculum
    Social Stories
    The Hidden Curriculum
    Social Skills Autopsy (Note: it's not as morbid as it sounds.)
    Power Cards
    The Way to A

    Some of these are more appropriate for specific age groups. For very young children, Social Stories are good. Many respond positively to "How Does Your Engine Run?" or to Power Cards. The Social Thinking Curriculum has stages for every age group, starting with very young children and continuing though adulthood. The 5 Point Scale is easy to use, and for a child who does not yet have number sense, can be reduced to a three point scale of small, medium, and large.

    CBT differs in ABA in what it teaches and how it teaches. In ABA the goal is to change the child's behavior (I'm going to say "child" here, because IME it's unusual to use ABA with an adult) and teaching new behaviors. But it doesn't encourage the child to think about his own behavior. Any analysis of what motivations and rewards might drive the behavior is done by the therapist; the child generally is not asked to give input about his own thoughts or feelings.

    Many of the above programs were developed by educators, SLPs, and/or developmental specialists. This is probably why they do not explicitly use the term CBT, although the principles are there. These strategies can be integrated into classrooms and therapy settings, as well as home.

    As with everything else, some techniques are better for some kids and others for other kids. We use some of the above strategies with good success, and others backfired on us (sometimes humorously, in retrospect). And some we are continuing to use with slow progress.
    Gena

    DS, age 11 and always amazing

    “Autistics are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It's that you're destroying the peg." - Paul Collins, Not Even Wrong

  4. #4
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    egoldber is offline Black Diamond level (25,000+ posts)
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    As PP have said, CBT is most commonly used to treat anxiety disorders of various types.

    http://www.nacbt.org/whatiscbt.htm

    It differs from more traditional "talk" psychotherapy in that is goal focused and (usually) of short duration. It doesn't attempt to get at the why's of the anxiety. Instead it teaches you to recognize the anxiety for what it is (a particular thought process) and to teach you ways to shift your mind out of the anxious mindset into a more desired response.

    It has an excellent history and there are several "curricula" that therapists can use depending on the age of the person and the type of anxiety. Unlike with many other types of therapy, there is usually homework for the participant and doing the homework is a key part of the process.
    Beth, mom to older DD (8/01) and younger DD (10/06) and always missing Leah (4/22 - 5/1/05)

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    Sweetum is offline Sapphire level (2000+ posts)
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    Thank you, all, for the information. I am particularly interested in whether it is an affective methodology to use with a child with Autism whose social anxiety is very high. And strangely, I have used some of these already! like social stories, we always use these to make things more expected and reduce anxiety about a new situation. I have heard of the 5 point scale (in the context of theory of mind teaching), social thinking and the ALERT program, but never realized that they are derivatives of CBT.
    The reason I set out to understand it a bit more is because I am wondering if some of the behaviors that ABA is trying to address (aggression, perseveration) can be addressed through CBT. While both are sometimes rooted in anxiety, they aren't always. So, that makes it tricky, I guess. But if you have thoughts and know of CBT addressing these, I'd like to know more.
    Thanks for the link, off to read more.

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