A Primer on CBT

ROBERT M. NEWELL, PH.D.

FORENSIC AND CLINICAL PSYCHOLOGY

Specializing in Behavioral Healthcare for Children &

Adolescents, Families, Couples, and Adults.

HOME

TREATMENT

SERVICES

A PRIMER ON COGNITIVE BEHAVIORAL THERAPY

What upsets people is not things themselves

but their judgments about the things.

--Epictetus

There are many different ways to conceptualize and understand why people do what they do. No single model or theory of psychology offers a complete and comprehensive explanation for human behavior—it is far too complex a phenomenon. However, one useful model used by research scientists is called the “biopsychosocial model.” In its essence, the biopsychosocial model views any human behavior as being caused and/or maintained by a complex interaction of variables in three domains—biological, psychological, and environmental. Stated a little differently, according to the biopsychosocial model, any human behavior can be viewed as being both caused and/or maintained by an interaction between biological, psychological, and environmental factors.

For example, a child who is experiencing school problems can be viewed as being caused by an interaction between biological factors (e.g., a learning disability; basis temperament), psychological factors (e.g., depression; emotional developmental delay; non compliant behavior), and social or environmental context (e.g., problems achieving an accurate diagnosis; classroom setting; distressed family situation). It is important to understand that these biological, psychological, and environmental factors have a bi-directional or reciprocal influence on each other in terms of both causing and maintaining dysfunctional behavior. This process of reciprocal influence can be extremely pernicious and degenerative.

Although each of these biological, psychological, and environmental factors plays a role in both causing and maintaining an individual’s current problems in functioning, they do not play an equal role in any one individual, and they often play a different role in different people. That is, certain variables have a greater influence in either causing or maintaining a respective problem vis-à-vis other factors. For example, a child or adolescent with a learning disability (a biological factor) and resulting low sense of self-efficacy (a psychological factor) have played a strong role in causing his school failure, as opposed his school failure being caused by environmental factors such as poor parenting or an inadequate learning environment. In addition, the distressed family situation that has existed over the past couple of years (i.e., environmental factor) likely has created a context that has exacerbated the negative influence of other factors. However, at this time, it is a child’s oppositional behavior and other psychological factors that are playing the most influential role in terms of maintaining his current dysfunctional behavior.

The next point is that the factors that are responsible for causing or creating the dysfunctional behavior may not be the same factors that currently are responsible for maintaining the dysfunctional behavior. Also, the relative influence of a respective factor, or the relative influence of the reciprocal interaction between factors, often changes over time as the psychological condition follows a developmental course. So, although a child’s problems initially were caused by a convergence of certain biological and psychological factors, his current problems are now being maintained due to the influence of other factors.

Perhaps the most important point in all of this from a treatment perspective is that the factors that currently serve to maintain the dysfunctional behavior may best be addressed and remediated by targeting other factors. Remember, the biological, psychological, and environmental factors are interrelated and have a reciprocal influence on each other. Thus, an intervention that targets one aspect of functioning can serve to modify other factors through the process of bi-directional and reciprocal influence. That is, just as the biological, psychological, and environmental factors interact with each other to produce a negative effect, they also can interact with each other to produce a positive effect.

So, although a child’s problems can be attributed to a reciprocal influence of biological, psychological, and environmental factors, this treatment plan is designed to target specific (psychological) factors as a pathway to influencing and modifying other factors that are contributing to his problems. As a starting point, we are going to focus on some specific psychological factors (i.e., how a child thinks, feels, and behaves), but the pathway by which these factors will be modified is by modifying certain environmental factors. It is a well-established psychological principle that contingencies (i.e., rewards and punishments) in the environment play an important role in influencing and determining human behavior.

BACK

DR. ROBERT M. NEWELL

Telephone: 509-910-0329

Email: mail@drrobertnewell.com

Website: www.drrobertnewell.com