Wednesday 25 April 2012


7 Habits of Highly Effective CBT Therapists:
By: Meir Stolear (2010)

Introduction:
 Stephen R. Covey (1989) Model for 7 Habits of Highly Effective People:
Definition: Habits are made from the interaction of three elements, which are: knowledge, skills and desires.
Knowledge (i.e. theoretical paradigm, model) - what is to be done and why.
Skills (i.e. practical abilities) - how to do it.
Desires (not to be confused with demands) - want to do it.
 * Effective habits are internalised core beliefs (personal principles) combined with patterns of behaviour.
* Effectiveness: An aim to maximise one's long-term benefit, personal empowerment, effective problem solving, maximising opportunities, learning, and the ability to integrate ideas and principles.
* The Maturity factor: Effective habits improve with lifetime experiences (i.e. maturity). In our lives we are progressively moving ourselves from dependency (need to be looked after) to independence (me, me, me; the importance of being me) and finally into interdependence (team work). 
* Factors that are needed for mature effective habits are: awareness of ecological, social, biological and other factors, that interact and govern life on earth (knowledge). Learnt new skills (time) and rational drive to what can be achieved (not to be confused with what must be achieved; irrational).

Effective habits framework:
Habit 1: proactive self-awareness, imagination, conscience and independent will;
Habit 2: goal setting;
Habit 3: organisation and prioritising.

These habits aim to move the person from dependency to independence, from self-mastery to character growth.

Habit 4: win-win;
Habit 5: understand and be understood;
Habit 6: synergy, habits integration.
These habits aim to help the person to move out of the independent state into creating the foundation for interdependence (i.e. team work).

Habit 7: Sharpen the Saw, Renewal.
This habit is about preserving and renewing your assets in four dimensions, which are: physical state, social and emotional state, spiritual state and mental state


7 Habits of Highly Effective CBT/REBT Therapists;
Putting Covey model into practice.

Effective Habit 1): Become self-aware. REBT theory teaches us that we are complex human beings. We are not our moods, our behaviour, our professions, etc., but are what we believe we are. Our self-beliefs will guide our moods and actions accordingly. We have the freedom to choose what kind of therapist we wish to become (better later than never). We aim to be emotionally and behaviourally responsible about our roles as CBT therapists. We do not blame our clients for the failures of our work with them, nor assume that the success of our work was only thanks to us. We learn to act as independent effective CBT therapists by understanding our strengths and weaknesses.

Effective Habit 2): Goal setting. Create rational goals to achieve, as effective CBT therapists. Have your goals in the forefront of your mind and ask no one to do it for you (help is welcome). Consider the entirety of factors that could help you to achieve your goals and work out what could block your goals. Start acting as soon as you are clear about what you are aiming for.

Effective Habit 3): Organisation and action. Set an independent and rational timetable for training, work experiences and supervision. Work with one CBT model long enough for you to become an expert before aiming to learn other modalities.

Effective Habit 4): Win-Win. Create an organisation and priority in the way you manage your career. Your clinical, administration and learning (including supervision) hours need to be well balanced to avoid unhealthy stress or other unhealthy negative emotions that can block your professional goals.

Effective Habit 5): Understand other people and be understood by other people. Formulating your client’s problems is an effective therapeutic tool, aiming to help you and your client to find solutions to the client's problems. However, if you have failed to understand the client correctly and not modified your formulation accordingly, your work with your client may have no real therapeutic effect. Doing formulation is team work and is to be done over the duration of the therapy, not only in the first few sessions. Moreover, to be an effective therapist the client needs to understand you. Therefore, it is better to avoid technical language and be in tune with your client's language and intellect.

Effective Habit 6): Synergy, habits integration. Here you are aiming at working together with your client as a team, for the common therapeutic goals. Here you are using all your first five habits together, as needed. As and when you are meeting a new client, you are most likely to experience a low level of trust in yourself and in your client. Your aims are to gain your client's  trust and to learn to trust him/her (good use of supervision can help with this). The success level of your work with your clients is heavily dependent on two factors, and these are: trust and co-operation. Your teamwork success with your clients can be carefully monitored (again by using your supervision well). In order to do this you need to identify three stages in your therapeutic alliances, which are: stage 1) defensive (learning to know one another); 2) respectful (learning to compromise); and 3) synergistic (achieving the therapeutic goals together).

Effective Habit 7): Sharpen the Saw - Renewal. This habit is all about self-preservation and self-renewing. REBT theory teaches us that if you are not compassionate and caring towards yourself you are less likely to be effective in your caring of other people. Albert Ellis, in his many books, advocated as an ideal putting oneself first and looking after loved ones a close second. That is to say, effective therapists need to be able to look after themselves, in order to be able to help their clients. Covey identified four dimensions for self-caring (compassion), which are: 1) your physical state (looking after the health of your body); your social and emotional states (leaving time to enjoy yourself socially and emotionally); your spiritual state (looking after your own values, life commitments, etc.)  and your mental state (staying rational and fulfilling your own mental needs, such as learning, writing, doing art, etc.). Combining the seven habits with the other six habits will help you to be an effective CBT therapist.

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