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This article is part of our introductory series on cognitive-behaviour therapy.
The CBT model typically uses a schematic, commonly referred to as the A-B-C model of emotional and behavioural disturbance.
(A) in the model typically refers to the Activating Event or adverse situation with which the individual is confronted. This could be a difficult interpersonal interaction, a stressful situation at work, a physical sensation, thought or emotional reaction.
(B) refers to the thoughts or Beliefs that one then responds to the activating event with, which is then seen as responsible for initiating or maintaining
(C) the emotional and behavioural Consequences to these beliefs.
The three examples below illustrate the model using a typical scenario with panic disorder, OCD and depression.
EXAMPLE 1: PANIC DISORDER | ||
(A) | (B) | (C) |
| Driving on the N1 in the car. Slight increase in body temperature + the thought - “what if I have a panic attack”. | "I have to control this anxiety.” “I’m not in control of myself.” “I will have an accident.” | Increased anxiety & panic Pull car over Use of tranquilizer Avoid driving on the N1 |
EXAMPLE 2: OCD | ||
(A) | (B) | (C) |
| Sitting in the kitchen with a loved one, close to a large knife and the thought “what if I stab my wife” pops into my head | “This is an abnormal thought that I shouldn’t be having.” “This thought makes me dangerous.” “Thinking this increases the chance of acting on it.” | Anxiety Guilt Shame Escape from room Prayer to get rid of the thought. |
EXAMPLE 3: DEPRESSION | ||
(A) | (B) | (C) |
| Recently rejected by a boyfriend. Feeling sad and disappointed | “I should have been able to prevent this if I was good enough.” “If I was a worthwhile partner then this wouldn’t have happened.” “I’m unlovable.” “I can’t handle feeling this way.” “I’m never going to find someone.” | Depressed Socially withdrawn Ruminating about why this happened. |
The schematic would often include a second section with typical questions aimed at cognitive restructuring or Cognitive Disputation (D) that assists clients in evaluating the helpfulness of their beliefs and then provides them with an opportunity for developing new Effective Beliefs (E) that would then lead to more Functional Emotional or Behavioural Reactions (F).
Written by Bradley Drake and Jaco Rossouw, Centre for Cognitive-Behaviour Therapy, Cape Town, South-Africa. For further details visit: www.cognitive-behaviour-therapy.co.za. (September 2011)
