Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu



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Medical psychology.book (1)

 
to 
cope with difficult situations successfully by breaking out of dysfunctio-
nal patterns of response.
Today cognitive behavior
 
therapy is widely used with children and 
adolescents, especially for disorders involving anxiety, depression, or 
problems with social skills. 
The therapist then works to change erro-
neous beliefs and perceptions by instruction, modeling, and giving the 
child a chance to rehearse new attitudes and responses and practice 
them in real-life situations.
Cognitive behavioral therapy has worked 
especially well, often in combination with medication, for children and 
adolescents suffering from depression. It can help free depressed chil-
dren from the pervasive feelings of helplessness and hopelessness that 
are supported by selfdefeating beliefs. Children in treatment are assign-
ned to monitor their thoughts, and the therapist points out ways that the-
se thoughts (such as “nothing is any fun” or “I never do anything right”) 
misrepresent or distort reality. Other therapeutic techniques may include 
the completion of graded task assignments, and the deliberate schedu-
ling of pleasurable activities. 


139 
Cognitive behavioral therapy is also used for children with conduct 
disorder, which is characterized by aggressive, antisocial actions, inclu-
ding hurting animals and other children, setting fires, lying, and theft. 
Through a cognitive behavioral approach (which generally works better 
with adolescents than with younger children because of the levels of 
thinking and control involved), young people with this disorder are 
taught ways to handle anger
 
and resolve conflicts peacefully. Through 
instruction, modeling, role playing, and other techniques, they learn to 
react to events in socially appropriate, nonviolent ways. Other childhood 
conditions for which cognitive behavior therapy has been effective in-
clude generalized anxiety disorder and attention deficit/hyperactivity 
disorder. It can help children with ADHD become more controlled and 
less impulsive; often, they are taught to memorize and internalize the 
following set of behavior guidelines: “
Stop—Listen— Look—Think—
Act.” 
The treatment is based on the principle that maladaptive behavior 
(ineffective, selfdefeating behavior) is triggered by inappropriate or 
irrational thinking patterns, called 
automatic thoughts.
Instead of reac-
ting to the reality of a situation, an individual automatically reacts to his 
or her own distorted viewpoint of the situation. 
Cognitive therapy
focu-
ses on changing these thought patterns (also known as cognitive distor-
tions), by examining the rationality and validity of the assumptions 
behind them. This process is termed cognitive restructuring. Cognitive 
therapy is a treatment option for a number of mental disorders, including 
agoraphobia, Alzheimer’s disease, anxiety or panic disorder, attention 
deficit-hyperactivity disorder (ADHD), eating disorders, mood disor-
ders, obsessive-compulsive disorder (OCD), personality disorders, post-
traumatic stress disorder (PTSD), psychotic disorders, schizophrenia, 
social phobia, and substance abuse disorders. It can be useful in helping 
individuals with anger
 
management problems, and has been reported to 
be effective in treating insomnia. It is also frequently prescribed as an 
adjunct, or complementary, therapy for patients suffering from back 
pain, cancer, rheumatoid arthritis, and other chronic pain conditions.
Cognitive therapy
is usually administered in an outpatient setting 
(clinic or doctor’s office) by a therapist trained or certified in cognitive 
therapy techniques. Therapy may be in either individual or group ses-
sions, and the course of treatment is short compared to traditional psy-
chotherapy
 
(often 12 sessions or less).


140 
Therapists are psychologists (Ph.D. or M.A. degree), clinical social 
workers (M.S.W., D.S.W., or L.S.W. degree), counselors (M.A. or M.S. 
degree), or psychiatrists (M.D. trained in psychiatry). Therapists use 
several different techniques in the course of cognitive therapy to help 
patients examine thoughts and behaviors.

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