From a CBT perspective, psychological wellness is comprised of a number of characteristics and capabilities, including a person’s possessing: (1) a broad behavioral repertoire that can be used effectively to solve problems, to relate well to others, and to respond in differential ways that will be positively reinforced across many different situations; (2) cognitive flexibility, objectivity, astute observational skills, and hopefulness, along with a sense of self-efficacy; and (3) good emotional selfregulation, while still possessing an appropriate range of affect and a capacity for joy. 112
The primary goal of Cognitive-Behavioral assessment is “to agree on a formulation and treatment plan with the client” (Kirk, 1989, p. 15). 112
A common strategy for doing this type of assessment is to begin with behaviors and then address cognitions. (중략) Problematic behaviors and affects can be identified by analyzing a specific situation looking for antecedents, specific behaviors, and consequences and if there is an ongoing pattern of impaired functioning. 113
“What was your interpretation of the situation?” and “What did it mean to you?” can be useful in the elicitation of the client’s automatic thinking and intermediate beliefs. This inquiry is essential because it “begins to tap into automatic thoughts and deeper, more long-standing core beliefs” (Ledley, Marx, & Heimber, 2005, p. 42). (중략) In addition, probing the client’s earlier experiences can be useful in identifying core maladaptive beliefs and schemas. 113
Accordingly, the practitioner might early in treatment make the predictive interpretation that this might occur, but that it does not indicate failure, and that it can be therapeutically processed. 127
the practitioner who believes the client can profit from continued therapy needs to point out—at the beginning of therapy and thereafter—that until the client’s underlying maladaptive pattern is sufficiently changed, similar issues and concerns will inevitably arise in the future (treatment obstacles). 131
패턴(inflexible, ineffective manner of perceiving, thinking, acting. 촉발인 -> 패턴 -> 현재 어려움)을 설명하는 Predisposition으로서 maladaptive behaviors와 maladaptive beliefs를 생각해야 하며, 스스로가 문제시 여기는 행동이 야기된 상황에서 그 상황을 어떻게 바라보는지를 탐색하는 것이 자동적 사고와 조건화된 신념을 식별하는 데 도움이 됨을 배웁니다. 이러한 임상적 공식화에 기반하여 치료가 어떻게 진행될지 예측한 후, 필요하다면 내담자와 이를 조기에 나눔으로써 치료적 동맹을 강화할 수 있습니다.
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