Cognitive-Behavior Modification Approach by Meichenbaum

Instructor: Karin Gonzalez

Karin has taught middle and high school Health and has a master's degree in social work.

In a series of therapy sessions, psychologist Donald Meichenbaum helps a woman transform the traumatic and sad story of her life by shedding light on its positive aspects. In this lesson, you will learn how Meichenbaum turns a sad story to a positive one with cognitive-behavioral modification.

What Is Cognitive-Behavioral Modification?

Tormented with guilt and shame over being the victim of several years of rape in her early teens, Amanda consistently believes and tells herself she is unworthy and dirty. She has a history of abusive relationships and tends to stay in them because she feels undeserving of anything better. Amanda's therapist assists her in turning the shameful story of her life to one of resilience and strength.

Cognitive-behavioral modification (CBM) is an approach to cognitive-behavioral therapy that focuses on changing negative self-talk and life narrative to positive self-talk. The premise of this approach to therapy is that negative self-talk can reflect in a person's behaviors. Taking the example of Amanda, she did not respect herself, so neither did the men that she dated.

The goal of of CBM is to change a person's narrative or life story from negative to positive. This is done by focusing on the client's strengths and resilience. CBM also helps clients forgive themselves for misdoings in the past and move forward with hope and positivity for the future. With a favorable change of perspective and life narrative, a client's actions and behaviors will expectantly follow suit.

Positive thoughts about the self are key to positive behaviors according to Cognitive Behavioral Modification.
Positive affirmations

In the case of Amanda, after a few months of therapy, she genuinely starts to believe that she is a respectable and lovable woman who deserves the same in a relationship. Not surprisingly, a year later, Amanda is with a man who cherishes, loves, and respects her.

Who Is Donald Meichenbaum (1940-)?

Growing up in New York City, Meichenbaum was puzzled by the question of how a group of humans could stoop to the level brutality and barbarity that the Nazis did during the Holocaust, when they killed millions of innocent Jews and others. His fascination with this era of human on human evil was what led him to want to study the human mind.

Meichenbaum received his college degree from City College in New York and his graduate degree from the University of Illinois. He received his doctorate in Clinical Psychology. Dr. Meichenbaum was Professor Emeritus at the University of Waterloo in Ontario, Canada, for 33 years.

Meichenbaum is known for his book, Cognitive-behavioral Modification: An Integrative Approach, which he published in 1977 at the tail end of the cognitive revolution. CBM empowered clients to take charge of their own negative self-talk and beliefs. It put clients in the driver seat to changing their own behaviors, simply by changing their inner dialogue. This revolutionary therapeutic approach continues to be a powerful and effective tool for therapists today. In fact, Meichenbaum was voted one of the top 10 influential psychotherapists of the 20th century. In a 2002 interview, Meichenbaum stated that he was not fully retired and instead works as research director and founding member of The Melissa Institute for Violence Prevention in Miami, Florida.

Process of Cognitive Behavioral Modification

Cognitive behavioral modification follows a general procedure entailing three main steps. CBM is a form of self-instructional therapy, meaning that clients can do much of the work and learn about themselves on their own time. Let's look at how the therapist approaches CBM counseling with Vince, who has a severe phobia of public speaking.

Observing Negative Self-Talk

After hearing Vince tell the story of his fear of speaking in public, his therapist asked him to keep a journal of his negative thoughts over the course of a week. At the end of the week, Vince read his journal to his therapist. Some of his recorded thoughts were:

  • 'I'm the worst public speaker ever.'
  • 'I'm going to embarrass myself in front of everyone.'
  • 'Nobody likes hearing me speak.'
  • 'I'm going to vomit in front of everyone because I'm so nervous.'

Journaling is a great way for clients to observe their own thoughts and feelings when they are not in therapy.

Vince becomes aware of his negative self-talk. A client's awareness of their negative self-talk and narrative is imperative for CBM to work. It is also necessary in order to move onto the next phase of treatment: changing negative self-talk.

Changing Negative Self-Talk to Positive

Vince is surprised with his journal entries over the past week. He didn't realize all of the self-defeating and negative thoughts that ran through his mind on a consistent basis regarding his fear of public speaking.

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