Self Management and Cognitive Behavior Therapy

Alusine M. Kanu, D.A.

            This article llustrates and evaluates self-management therapies and cognitive therapy as treatment methods.  The approach in presentation will include a comparison and contrast of treatment methods.  Without question, even though both methods are useful, Cognitive Behavior Therapy is the most studied intervention for treatment.

            There are many varieties of self-control strategies.  Other terms for self-control strategies are behavioral self-control strategies, behavioral self-control training, cognitive self-regulation and self-management techniques.  In recent years, the term “self-management” has replaced “self-control” because self-control implies changing behavior through sheer will power.  Self-management, on the other hand, involves becoming aware of the natural processes that affect a particular behavior and consciously altering those processes, resulting in the desired change.

            The goal of self-management therapy is to reduce behavioral deficiencies or behavioral excesses.  Behavioral deficiencies occur when an individual does not engage in a positive desirable behavior frequently enough.  The result is a missed future benefit.  Behavioral excesses occur when an individual engages in negative, undesirable behavior too often. This results in negative future consequence.

            Self-management strategies help individuals to become aware of their own patterns of behavior and to alter those patterns (usually by creating artificial rewards or punishments) so that the behavior will be more or less likely to occur.  A self-control program, environmental strategies, behavioral strategies, and cognitive strategies are all ways to enable managing the self.

  • Self-control programs include:
  1. Make a commitment—Plan
  2. Identify the problem and alternative solutions
  3. Make revisions as necessary
  4. Think before acting
  • Environmental Strategies include:
  1. Changing the group of people with whom one socializes
  2. Avoiding situations or settings where an undesirable behavior is more likely to occur
  3. Changing the time of day for participating in a desirable behavior to a time when one will be more productive or successful
  • Cognitive strategies in self-management involve changing one’s thoughts or beliefs about a particular behavior.
  1. Using self-instructions to cue oneself about what to do and how to do it.
  2. Using self-praise to commend oneself for engaging in a desirable behavior.
  3. Thinking about the benefits for reaching one’s goal
  4. Imagining oneself successful in achieving a goal or using imagery to distract oneself from engaging in an undesirable behavior.
  5. Substitution positive self-statements for unproductive, negative self-statements

   Ways to help counselees in applying ways of coping with environment, behavior control and cognitive strategies are participating in group sessions, hearing a lecture on a specific strategy, relapse prevention, participating in role plays or rehearsal of the strategy, homework assignment, and mastering one strategy before attempting another.

            A way to approach cognitive therapy is to increase understanding that everyone experiences temporary mental lapses resulting in negative emotions, anxiety, depression, or unreasonable thinking.  Typically, people develop an acceptable level of self-control.  However, some individuals do not comprehend, recognize, or have the capability to function on a rational level without learning new coping or thinking skills.

            A scientifically proven form of cognitive therapy involves identifying distorted, maladaptive patterns of thinking and behaviors and replacing them with a pragmatic, problem-solving way of thinking an acting.  Cognitive therapy helps the clients to change so that issues do not rule one’s life.  The cognitive behavior therapy model emphasizes thought processes with advantages of short-term instruction, with emphasis on getting better, rather than feeling better.  Cognitive behavior therapy is cross cultural and is structured.  Cognitive behavior therapy can be researched, and it is adaptive.

            Cognitive therapy seeks to help the patient overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses.  This involves helping patients develop skills for modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors.  The premise, in Beck’s words, is that cognitive therapy is “the way we perceive situations influences how we feel emotionally,” and so by changing thoughts, then behaviors will also change.

            Cognitive behavior modification involves the concepts that an individual’s behavior is mediated by cognitive events; a change in mediating events results in a change in behavior, and an individual is an active participant in learning (Helflin, 1998).

            Cognitive behavioral therapy in its applications to youth populations uses active, performance-based procedures, as well as cognitive interventions to produce changes in thinking, feeling and behavior by developing a constructive world view and a problem-solving attitude.  Factors that are relevant in conducting cognitive behavior therapy with youth are

  1. Recognition of how young clients come to treatment
  2. Use of age-appropriate modes of delivery
  3. Sensitivity to the client’s cognitive and affective development
  4. Awareness of social context in which the youth is embedded
  5. Clarity about the therapist’s role

A comparison of self-management and cognitive therapy can be made with descriptions of the roles of the help-giver, treatment methods and directions to future research in both evaluative treatments.  There are multiple components of strategies that work with various disorders.  Cognitive behavior therapy uses multiple components and procedures.  Which treatment works with what disorder requires multiple approaches.

            Both self-management and cognitive therapy involve intervention for treatment with behavioral tasks, cognitive strategies, specific plans, working individually in groups, task instruction, performance feedback and interpersonal skills.  To effectively evaluate using self-management and cognitive therapy, there should be analysis of life experiences, helping clients to understand the nature of self-talk as self-fulfilling and should be optimistic.  Clients can also be helped in understanding using automatic thoughts, how one deals with irrational ideas and beliefs, cognitive distortions, and pessimistic thinking.

            Models and curriculum of self-management and cognitive behavior therapy are both learning processes with influences of the contingencies and models in the environment.  Cognitive behavior therapy involves mediating processing factors.  The variations can be non interactions with the linear approach, or interactive, elaborated, or self-instruction.

            Further comparisons show that cognitive behavior therapy offers the client a rationale for the approach and techniques used.  The focus is on the person’s functioning in the present time through exploring interrelatonships between thoughts, feelings, beliefs, attitudes, goals of behavior.  Self-management is more behavioral.  It involves self-reinforcement, self-management roots in behavioral explanation.  Self-management must be in relation to the context and consequences.  Both cognitive behavior therapy and self-management involve homework.  For self-management programs to work there should be mediation of readiness and going through stages in readiness.  Both cognitive behavioral therapy and self-management can be offered by guiding treatment.

            Future research on both “self-management and cognitive therapy should reflect on the nature and magnitude of improvement by assessing clinical significance for improvement” (Kendall, p. 89).  There are issues in assessment, role of parents, and family in treatment, mediators of positive outcomes, place of medications, therapeutic factors that may contribute to outcome and the effects of treatment on target disorder.

            Multiple components should be used for long-term self-management and cognitive therapy. Additional interactions and desired outcomes should include cognitive restructuring, problem solving, self-regulation, affective education, relaxation training, modeling, role playing and public speaking.  The posture of the therapist who does self-management and the cognitive therapist should include guiding, directing, and coor-dinating.  The therapists can be consultants by providing the opportunity for clients to try a skill or behavior by providing supportive experiences and weighing the merits and demerits of new tried skills.

            Therapists in both self-management and cognitive therapy are diagnosticians.  Their roles include gathering and integrating information from a variety of sources.  The third major role is for therapists to be educators by helping clients to recognize problems, think of alternatives, enact plans, and to make sense of events and outcomes.

            This article has, with some exploration, discussed self-management and cognitive therapy as treatment methods.  The intended goals are to integrate conscious and unconscious processes of treatment methods by discussing ways by which people regulate their thoughts, emotions, attention, behavior, and impulses.  Self-regulation shapes and is shaped by sound relationships with question.  Cognitive therapy is the best form of treatment because of predictive outcomes.  Both can be utilized in therapy depending on the disorder.

References 

Beck, J. S (1995). Cognitive Therapy Basics and Beyond.The Guilford Press. New York.

Heflin, L.J. et al. (1998). Intervention for children and youth with autism: Prudent choices in a world of exaggerated claims and empty promises.  Focus on Autism and Other Development Disabilities, 13, pp. 194-211.

Kendall, P. (2003).  Cognitive theory and Research, 27(1), pp. 89-104.