Stages of Learning Acquisition Generalization and Maintenance of New Skills

C-CT draws liberally from learning theory and emphasizes strategies to promote acquiring, generalizing, and maintaining new responses (Ferster, 1973). Social learning theory (e.g., Bandura, 1977) emphasizes the impor-

TABLE 6.1. Sample Compensatory Skills Learned during Cognitive Therapy

Cognitive model

Behavioral targets

Restructuring via logical analysis

Restructuring via hypothesis testing

Restructuring schémas

Understands that thoughts, feelings, and behaviors can contribute to depression.

Notices how view of self, world, and future influences behavior.

Recognizes and records thoughts, feelings, and other behaviors with a mood shift.

Identifies automatic negative thoughts and completes thought records.

Uses CT skills when a mood shift occurs on a typical day.

Schedules and participates in activities that improve mood.

Applies CT tools to problems in family Applies CT tools to problems with feelings.

Applies CT tools to problems with relationships. Applies CT tools to depressive symptoms.

Applies CT tools to problems at work.

Identifies automatic negative thoughts and completes thought records.

Identifies thinking or logical errors.^ Notices a change in mood after analyzing automatic thoughts. Examines automatic negative thoughts logically and/or rationally.

Looks for alternative explanations when he/she has negative thoughts.

Weighs the evidence for and against negative thoughts. Is able to separate facts from beliefs. Sees the difference between thinking styles when feeling depressed versus not.

Looks at the consequences or advantages/disadvantages of holding certain beliefs.

Changes thinking when it was illogical.

Argues with automatic thoughts.

Identifies automatic negative thoughts and completes thought records.

Tests automatic thoughts or beliefs by setting up experiments.

Looks at how negative thinking affects his/her predictions about the future.

States thoughts in ways that could be tested.

Identifies ways to test thoughts.

Decides how to evaluate the results of his/her test.

Compares the results of experiment to thoughts or predictions.

Asks whether additional tests are necessary to evaluate beliefs.

Results of the tests influence thinking.

Examines underlying assumptions (or schemas) and how they contribute to his/her depression. Identifies automatic negative thoughts and completed thought records.

Identifies underlying assumptions (or schemas) that increase depressive assumptions.

Uses CT skills (e.g., logical analysis or hypothesis testing) to challenge depressive assumptions. Tests alternatives to depressive schemas or assumptions by testing what it would be like to have different beliefs.

Uses CT skills when a mood shift occurs on a typical day.

Note. From larrett and Kraft (1998). Reprinted by permission of the authors.

I 'or example: overgeneralization, negative filtering of information, discounting the positive personalization.jumping to conclusions, mind readings, fortune-telling, catastrophizing, all-or-none thinking, emotional reasoning, excessive use of "should" statements, labeling, minimization, and magnification.

tance of modeling and vicarious learning, guided practice, and attitudes about learning and mastery (i.e., self-efficacy) that help to facilitate these processes in therapy. As such, role plays, homework, and insession responding can aid therapists in assessing where patients' skills fall in the stages of learning.

Specifically, during each session the therapist not only assesses the signs and symptoms of depression and sets goals for the therapy based on symptoms and functioning level, but he/she also evaluates how far the patient has progressed in learning compensatory skills by asking him/herself, whether, the patient learning has reached the acquisition stage. Is more practice needed to grasp the basics? What specific skills have been learned? Can the patient name the skill? Can the patient describe aloud when and how to use the skill or demonstrate its use in session? Can the patient teach a peer to use the skill, proving a rationale for when and how to use it? If the patient has acquired basic skills (based on homework and in-session usage), then how well can he/she generalize the skills to new environments or new problems? How likely is it that the patient will be able to maintain these skills over time? Has he/she learned a sufficient number of skills to be prepared for psychosocial stressors in multiple risk domains? How many "psychosocial challenges" has the patient encountered and successfully used coping skills? How confident and comfortable is the patient in his/her ability to use the skills?

Therapists decide how many skills to teach depending on which interventions their patients learn and use most easily, which interventions and life changes have occurred with symptom reductions during A-CT, and which interventions may promote and enhance "stress inoculation." Therapists help patients identify and name these so-called "critical or key skills" that can be used most effectively and frequently. They design in-session role plays and homework assignments in which critical skills can be practiced (repetitively) in highly probable, high-risk situations occurring in vivo, in session, and in imagination.

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Responses

  • Fulgenzia
    What is maintenance tage of learning?
    9 months ago

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