Dysfunctional Thought Record DTR or Automatic Thought Record

The classic psychodrama techniques of role reversal, doubling, self-presentation, interview in role reversal, mirroring, future projection, surplus reality, empty chair, and other action techniques (Moreno, 1934; Blatner 1996; Kellerman, 1992) can be applied directly to situations indicated in the DTRs. During the initial didactic sessions, we found that it is extremely helpful to teach the group members how to complete a DTR. It is important to introduce the DTR as a self-reflection strategy for recognition of automatic thoughts that occur within and outside the therapy sessions and for improving problemsolving and mood-regulation skills.

Automatic Thoughts (ATs)

Automatic thoughts usually contain one or more cognitive distortions (Greenberger & Padaskey, 1995). The auxiliary ego and the therapist may help the protagonist discover the possible cognitive distortion in the protagonist's stated AT. For example, for an identified "all-or-nothing" cognitive distortion, the therapist develops a scenario to explore the distortion in an action format to get an in-

depth, concrete explanation of the protagonist's thought processes. Additional auxiliary egos or the self-presentation technique are used to represent the many conflicting selves to facilitate working through the cognitive distortion.

Downward Arrow Technique

The downward arrow technique consists of challenging the protagonist by repeatedly asking the questions: "If that were true, why would it be so upsetting?" and "Being upset means what to you?" The technique can be used during any stage of psychodrama to explore a deeper understanding of the core beliefs/schemas underlying an AT.

The Case Conceptualization Technique

This technique is applied as an ongoing therapeutic tool. After three or four sessions, the therapist explains and teaches the main ideas behind the technique to group members and asks them to complete the case conceptualization form on an ongoing basis as the group progresses. A member discusses his or her completed form with the group on an assigned day.

Case conceptualization may help the group member reflect on their various rules, conditional assumptions, beliefs, and means of coping. It is also a good way of introducing the cognitive triad to group members who characterize their situations to reflect themes of loss, emptiness, and failure. Beck (1995) referred to such bias as the negative triad, viewing oneself ("I am worthless"), one's world ("Nothing is fair"), and one's future ("My life will never improve") in a negative manner. This view is usually distorted and the purpose of designing a case formulation is to challenge the patient's views of self, the world, and the future.

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