附录:YOUR TURN! 练习答案
附录
你的轮次!练习答案
第1章
识别情境、思维、感受、生理反应和行为
识别情境、思维、感受、生理反应和行为
情境、思维、感受、生理反应或行为? |
类型 |
熬夜学习 |
情境 |
无论我做什么,没有人喜欢我 |
思维 |
我全身都感到紧张 |
生理反应 |
即使我努力学习,我还是会失败 |
思维 |
我非常开心 |
感受 |
我的老板讨厌我的工作 |
思维 |
我上班迟到了 |
情境 |
思维如何影响感受和行为
下面是图1.4的完成情况。
玛丽亚的思维 |
情境 |
玛丽亚的思维 |
詹妮的思维 |
感受 |
行为 |
生理反应 |
玛丽亚和詹妮参加了一个会议 |
这将是一场灾难。没有人会和我讲话。每个人都会认为我很愚蠢。 |
这是一个结交新朋友的好机会。做一些不同的事情会很有趣。 |
焦虑 |
坐在角落里独自一人 |
胃部不适 |
兴奋 |
识别客户的思维、感受、生理反应和行为
情境:男朋友迟到三十分钟,没有告知她会迟到
-
萨拉的思维:我讨厌这样,他不在乎我;我一文不值;我还能怎么办?;他把我当成理所当然。
-
萨拉的感受:沮丧、生气
-
萨拉的生理反应:紧张
-
萨拉的行为:翻白眼,态度冷淡
玛丽亚的症状维持循环
下面是玛丽亚的症状维持循环的完成情况。
感受 |
情境 |
思维 |
行为 |
生理反应 |
后果 |
焦虑 |
参加一个她不认识任何人的会议 |
这将是一场灾难。没有人会和我讲话。每个人都会认为我很愚蠢。 |
坐在角落里独自一人 |
胃部不适 |
没有人和她讲话;没有机会认识任何人 |
第2章
劳尔的压力源和优势
家庭
困难或压力源 |
优势或韧性领域 |
无信息 |
长期婚姻 |
孩子住在外地 |
妻子鼓励他打保龄球,表明关系亲密 |
与女儿的关系足够亲近,以至于她注意到了他的痛苦并说服他接受治疗 |
|
朋友和社会联系
娱乐和组织
困难或压力源 |
优势或韧性领域 |
无信息 |
过去五年,参加了保龄球联赛 |
工作或学校
困难或压力源 |
优势或韧性领域 |
最近被晋升的机会错过 |
保持了二十年的稳定就业 |
最近的工作评价不佳 |
在要求理解税务的高需求领域工作 |
以前喜欢工作 |
冒险申请晋升 |
有良好的工作评价历史 |
|
健康
困难或压力源 |
优势或韧性领域 |
睡眠困难 |
适度饮酒 |
焦虑 |
健康“良好” |
推迟退休 |
有一些迹象表明财务负责 |
规划退休 |
|
变化
第3章
确定具体、可衡量的目标
评估目标是否一般或具体且可衡量
目标 |
这个目标是一般还是具体且可衡量? |
与老板谈谈加班费 |
具体且可衡量 |
对朋友的要求少一些 |
一般 |
月底前戒烟 |
具体且可衡量 |
更好地照顾健康 |
一般 |
与父母相处得更好 |
一般 |
每周与伴侣进行一次愉快的活动 |
具体且可衡量 |
学习更好的家长管理技巧,以便在八岁的孩子发脾气时使用 |
具体 |
第4章
评估苏珊的家庭作业
苏珊的治疗师说:“我想给你布置一些家庭作业。我觉得如果你能在接下来的一周里和孩子们一起做一些有趣的事情,这会非常有帮助。”
有帮助的家庭作业指南
有帮助的家庭作业指南 |
苏珊的家庭作业是否符合此指南? |
家庭作业是协作开发的 |
不符合,治疗师在最后一刻建议家庭作业,苏珊没有机会提供意见 |
家庭作业具体且明确 |
不符合,没有明确说明苏珊将做什么 |
家庭作业与会话相关 |
符合,苏珊谈到了她因没有和孩子们一起做有趣的事情而产生的感受,并表示她想重新开始 |
家庭作业是可以完成的 |
不确定,因为没有具体任务 |
第5章
区分情境的事实和对情境的想法
情境示例
情境 |
情境的事实 |
客户对情境的想法 |
本该做作业,但我偷懒和朋友出去了 |
客户本该做作业,但出去和朋友玩了 |
我偷懒了 |
老板说我做得很好,但他不是真心的 |
老板说客户做得很好 |
他不是真心的 |
我的孩子五个月大还不会爬 |
客户的孩子不会爬 |
我的孩子不正常 |
丈夫在厨房留下了一大堆脏乱 |
不清楚丈夫做了什么,因此没有事实 |
我的丈夫在厨房留下了一大堆脏乱 |
第6章
识别苏珊对自己的、他人的和未来的看法
- 他没有给安德鲁洗澡。
- 这是一个事实。她丈夫确实没有给安德鲁洗澡。这个想法不是评价,而是事实陈述。
- 无论我做什么,都没有用。
- 他不在乎我和孩子。
- 男人靠不住。
- 我是一个完全不合格的母亲。
- 为什么我必须做家里的所有事情?
- 这是一个问题。我们将更详细地讨论问题。然而,在这个练习中,有一些隐含的想法,你希望帮助客户明确。这是一个关于自己的想法,因为苏珊实际上在说“我必须做家里的所有事情”,但也是一个关于他人的想法,因为隐含的意思是“我的丈夫什么都不做”。
第2章
劳尔的压力源和优势
家庭
困难或压力源 |
优势或韧性领域 |
无信息 |
长期婚姻 |
孩子住在外地 |
妻子鼓励他打保龄球,表明关系亲密 |
与女儿的关系足够亲近,以至于她注意到了他的痛苦并说服他接受治疗 |
|
朋友和社会联系
娱乐和组织
困难或压力源 |
优势或韧性领域 |
无信息 |
过去五年,参加了保龄球联赛 |
工作或学校
困难或压力源 |
优势或韧性领域 |
最近被晋升的机会错过 |
保持了二十年的稳定就业 |
最近的工作评价不佳 |
在要求理解税务的高需求领域工作 |
以前喜欢工作 |
冒险申请晋升 |
有良好的工作评价历史 |
|
健康
困难或压力源 |
优势或韧性领域 |
睡眠困难 |
适度饮酒 |
焦虑 |
健康“良好” |
推迟退休 |
有一些迹象表明财务负责 |
规划退休 |
|
变化
第3章
确定具体、可衡量的目标
评估目标是否一般或具体且可衡量
目标 |
这个目标是一般还是具体且可衡量? |
与老板谈谈加班费 |
具体且可衡量 |
对朋友的要求少一些 |
一般 |
月底前戒烟 |
具体且可衡量 |
更好地照顾健康 |
一般 |
与父母相处得更好 |
一般 |
每周与伴侣进行一次愉快的活动 |
具体且可衡量 |
学习更好的家长管理技巧,以便在八岁的孩子发脾气时使用 |
具体 |
第4章
评估苏珊的家庭作业
苏珊的治疗师说:“我想给你布置一些家庭作业。我觉得如果你能在接下来的一周里和孩子们一起做一些有趣的事情,这会非常有帮助。”
有帮助的家庭作业指南
有帮助的家庭作业指南 |
苏珊的家庭作业是否符合此指南? |
家庭作业是协作开发的 |
不符合,治疗师在最后一刻建议家庭作业,苏珊没有机会提供意见 |
家庭作业具体且明确 |
不符合,没有明确说明苏珊将做什么 |
家庭作业与会话相关 |
符合,苏珊谈到了她因没有和孩子们一起做有趣的事情而产生的感受,并表示她想重新开始 |
家庭作业是可以完成的 |
不确定,因为没有具体任务 |
第5章
区分情境的事实和对情境的想法
情境示例
情境 |
情境的事实 |
客户对情境的想法 |
本该做作业,但我偷懒和朋友出去了 |
客户本该做作业,但出去和朋友玩了 |
我偷懒了 |
老板说我做得很好,但他不是真心的 |
老板说客户做得很好 |
他不是真心的 |
我的孩子五个月大还不会爬 |
客户的孩子不会爬 |
我的孩子不正常 |
丈夫在厨房留下了一大堆脏乱 |
不清楚丈夫做了什么,因此没有事实 |
我的丈夫在厨房留下了一大堆脏乱 |
第6章
识别苏珊对自己的、他人的和未来的看法
- 他没有给安德鲁洗澡。
- 这是一个事实。她丈夫确实没有给安德鲁洗澡。这个想法不是评价,而是事实陈述。
- 无论我做什么,都没有用。
- 他不在乎我和孩子。
- 男人靠不住。
- 我是一个完全不合格的母亲。
- 为什么我必须做家里的所有事情?
- 这是一个问题。我们将更详细地讨论问题。然而,在这个练习中,有一些隐含的想法,你希望帮助客户明确。这是一个关于自己的想法,因为苏珊实际上在说“我必须做家里的所有事情”,但也是一个关于他人的想法,因为隐含的意思是“我的丈夫什么都不做”。
与这些感受相对应的想法是什么?
正确的答案加粗显示。
- 卡梅隆感到愤怒。他可能在想什么?
- 我们队再也不会有机会参加半决赛了。
-
那个家伙是个畜生;他应该受到惩罚;这不公平。 这个想法最有可能导致愤怒,因为它涉及到规则被打破和受到不公平对待。
- 如果我们输了,都是我的错。
- 安妮特感到失望。她可能在想什么?
- 我永远找不到好工作;我的生活完了。
- 他们应该雇用我;他们是白痴!
-
我希望得到这份工作,但至少我是第二选择。 这个想法最有可能导致失望。失望与悲伤有关,但不是强烈的情感。其他想法对于失望来说过于极端。
- 奥利感到内疚。他可能在想什么?
-
我是一个坏朋友;我应该去;我肯定伤了罗伊的感情。 这个想法最有可能导致内疚,因为它涉及到违反道德规范。
- 我的朋友肯定对我很生气。
- 我肯定罗伊不会再想当我的朋友了。
识别认知扭曲
- 如果我没有得到这份工作,我的生活就完了。
- 要成为一名好的治疗师,你必须全力以赴,100%的时间为你的客户提供服务。
- 我确信,没有人会在这次面试失败后愿意雇用我。
- 如果我不能帮助所有的客户,我就是一个不合格的治疗师。
- 我知道我的上一个客户取消了预约,因为她认为我是一个糟糕的治疗师。
- 一位同事告诉我,他怀疑下次小组签到时间是否可以短一些。这是我第一次带领小组时犯的一个严重错误。
第8章
帮助辛西娅得出自己的结论
以下是一些你可以问的问题:
- 你能告诉我你和约翰的关系吗?
- 约翰有哪些方式表现出他关心和尊重你?(如果辛西娅没有提到他们的性关系)在你们的性关系中,约翰有哪些方式表现出他关心和尊重你?
- 迈克和克里斯是如何对待你的?你能给我举一些例子吗?
- 迈克和克里斯有没有说过任何表明他们尊重你的话?你能给我举一些例子吗?
- 当你考虑约翰、迈克和克里斯提供的证据时,它们对你认为男人只对你感兴趣于性这一信念有什么启示?
第10章
理解梅琳的抑郁
梅琳的“理解你的抑郁”工作表
自生活变化或压力源以来增加的活动 |
自生活变化或压力源以来减少的活动 |
我喜欢或能带来快乐或成就感的活动 |
照顾母亲 |
我不喜欢的活动 |
开车去看母亲 |
去看母亲的医生预约(混合:享受作为目的感和与价值观一致,但不喜欢活动) |
|
照顾房子 |
|
看电视 |
|
锻炼 |
停止锻炼 |
与朋友共度时光 |
几乎不再见朋友 |
与家人共度时光 |
|
休闲或爱好 |
|
吸烟、暴饮暴食、酒精或药物使用 |
|
与饮食和睡眠相关的日常习惯 |
|
与母亲在一起时没有朋友 |
与母亲相处的时间更多 |
为安娜制定提升情绪的活动
建议的活动 |
协作开发 |
具体且明确 |
可行 |
自然强化 |
定期例行 |
每周跑三次,每次一小时 |
否 |
是 |
否 |
是,如果她能做到 |
是 |
分析:
每周跑三次,每次一小时。这是一个具体的计划,而且安娜喜欢跑步,所以它自然有强化作用。此外,这也可以成为她的日常习惯的一部分。问题是,这个计划可能不可行。很少有人能够从不锻炼直接过渡到每周跑三次,每次一小时。此外,如果她已经有一段时间没有锻炼了,一小时的跑步可能会对身体造成过大负担。综上所述,这不是一个好的计划。
更有效的计划:
为了制定更有效的计划,你可以先询问安娜她希望在生活中添加什么,以及她希望如何改变下午5点左右的时间安排。如果跑步对安娜有吸引力,重要的是让她慢慢开始。根据安娜多久没有锻炼,可能需要从散步开始,或者结合散步和跑步。
使用分级任务分配
任务 |
具体且明确? |
可行? |
有限时间和具体时间? |
辛西娅:重新整理文件系统 |
否。不清楚什么是系统的文件系统;第一步不明确 |
不确定谁来做这件事,具体做什么;难以判断是否可行 |
没有给出时间限制;辛西娅会工作10分钟还是整天? |
理查德:列出我想做的食物清单 |
是,这是一个具体的任务 |
是,尽管需要检查 |
设定了时间限制,但没有具体说明何时完成任务 |
亚历山德拉:探索工作选项 |
否,不清楚亚历山德拉将如何探索她的工作选项 |
由于任务不明确,难以判断是否可行 |
没有时间限制,也没有具体设定任务时间 |
第11章
制定有效的暴露任务
任务 |
具体且明确? |
客户可以采取的行动? |
在客户的控制范围内? |
结论:这是一个有效的任务吗? |
每天站在大楼电梯前5分钟 |
是 |
是 |
是 |
是 |
查看互联网上与撞到我的汽车相似的照片 |
否。我们不知道他会查看哪些照片。有很多“相似”的汽车 |
是 |
是 |
否,因为不够具体和明确 |
APPENDIX
Answers to
YOUR TURN!
Exercises
Chapter 1
Identify Situations, Thoughts, Feelings,
Physical Reactions, and Behavior
Identify Situations, Thoughts, Feelings, Physical
Reactions, and Behavior
Situation, Thought, Feeling, Physical
Reaction, or Behavior?
Staying up late and studyingSituation
No matter what I do, no one likes me.Thought
I feel tense all over.Physical reaction
Even if I study hard, I will still fail.Thought
I am so happy.Feeling
My boss hates my work.Thought
I am late for work.Situation
How Thoughts Influence Feelings and Behavior
Below is how I completed figure 1.4.
Maria's Thoughts
Situation
Maria and Jane
attend a
conference.
This will be awful.
No one will talk to
me. Everyone will
think I am stupid.
Jane's Thoughts
This is a good
opportunity to
network and meet
new people. It will
be fun to have
something different
to do.
Feelings
Anxious
Behavior
Sits in a corner
by herself
Physical Reactions
Sick stomach
Feelings
Excited
Behavior
Mingles with
other attendees
Physical Reactions
Pleasant
excitement
Identify Clients’ Thoughts, Feelings,
Physical Reactions, and Behavior
Situation: Boyfriend arrived thirty minutes late, did not let her know he would be late
Sara’s Thoughts: I hate it, he doesn’t care about me; I am worthless; what else can I do?; he takes me
for granted.
Sara’s Feelings: Depressed, irritated
Sara’s Physical Reactions: Tense
Sara’s Behavior: Gives dirty looks, acts cold
Maria’s Symptom Maintenance Cycle
Below is how I completed Maria’s symptom maintenance cycle.
Feelings
SituationThoughts
Attend a
conference where
she knows no oneThis will be awful.
No one will talk to
me. Everyone will
think I am stupid.
No one talks to her,
never gets experience
of people liking her
Anxious
Behavior
Sits in a corner by
herself
Physical Reaction
Sick stomach
Consequences
No one talks to her;
does not meet anyone
Chapter 2
Raoul’s Stressors and Strengths
R aoul’s Stressors and Strengths
Family
Difficulties or StressorsStrengths or Areas of Resilience
• No information• Long-term marriage
• Children live out of town• Wife encouraged him to bowl, suggests
caring relationship
• Close enough relationship with
daughter that she noticed his distress
and was able to convince him to go for
therapy
Friends and
Social Contacts• No information• No information
Recreation &
Organizations• No information• Past five years, part of a bowling league
Work or School• Recently passed over for a
promotion• Has maintained steady employment
for twenty years
• Recent poor work evaluation• Works in a demanding area that
requires understanding of taxes
• Previously enjoyed work
• Risked applying for a promotion
• History of good work evaluations
Health
Finances
• Sleep difficulties• Moderate drinking
• Anxiety• Health “good”
• Postponed retirement• Some indication that financially
responsible
• Planning for retirement
Changes
• Financial worries
• No information
Chapter 3
Identify Specific, Measurable Goals
Assess Whether the Goal Is Gener al
or Specific and Measur able
GoalsIs This Goal General or
Specific and Measurable?
Talk to my boss about getting paid for working overtimeSpecific and measurable
Be less demanding of my friendsGeneral
Stop smoking by the end of the monthSpecific and measurable
Take better care of my healthGeneral
Get along better with my parentsGeneral
Do a pleasant activity with my partner on a weekly basisSpecific and measurable
Learn better parent management skills for when my eight-year-
old has a temper tantrumSpecific
Chapter 4
Evaluate Suzanne’s Homework
Suzanne’s therapist says, “I would like to give you some homework. I think it would be really helpful if
you could try to do some fun things with your children this coming week.”
Helpful Homework GuidelinesDoes Suzanne’s Homework Meet This
Guideline?
The homework is developed collaboratively.No, the therapist suggested the homework at the
last minute. There is no opportunity for Suzanne
to have input.
The homework is specific and concrete.No, no clear idea what Suzanne will do.
The homework is related to the session.Yes, Suzanne had been talking about her feelings
related to not doing fun things with her children
and indicated she would like to start again.
The homework is doable.We don’t know, as there is no specific task.
Chapter 5
Separate the Facts about the Situation from
the Thoughts about the Situation
Examples of SituationsFacts about the SituationClient’s Thoughts about
the Situation
Instead of doing homework,
I was lazy and went out with
friends.Instead of doing homework,
client went out with friends.I was lazy.
My boss told me I did a
good job, but he didn’t really
mean it.Boss said client did a good job.He didn’t really mean it.
My child is not normal;
he is not crawling at age
five months.Client’s child is not crawling.My child is not normal.
The huge mess my husband
left in the kitchen.Not clear what the husband
did; therefore, you don’t have
any facts. You would need to
gather facts.My husband left a huge mess
in the kitchen.
Chapter 6
Identify Suzanne’s Thoughts about Self,
Others, and the Future
- He didn’t give Andrew his bath.
This is a fact. It is true that her husband did not give Andrew his bath. This thought is not an evalu-
ation but a statement of fact.
- No matter what I do, it won’t make a difference.
This thought is about the future. She thinks the future will be the same as the present.
- He doesn’t care about me or the kids.
This thought is a judgment about her husband. Therefore, it is about others.
- You can’t count on men.
This is a general rule about men. Therefore, it is about others.
- I’m a completely inadequate mother.
This thought is a negative judgment about herself. Therefore, it is about self.
- Why do I have to do everything in the house?
I ended with a trick question. This is a question. We are going to look at questions in more detail.
However, for this exercise, there are a number of implied thoughts that you would want to help your
client make explicit. It is a thought about self, as Suzanne is really saying, “I have to do everything in
the house,” but it is also a thought about others, as the implication is “My husband does nothing.”
What Thoughts Go with These Feelings?
The correct answer is in bold.
- Cameron is feeling furious. What might he be thinking?
•Our team will never have another chance to play in the semi-finals.
•That guy is an animal; he should be punished; it’s unfair. This thought is most likely to
lead to feeling furious. It is about rules being broken, and being treated unfairly.
•
If we lose, it is all my fault.
- Annette is feeling disappointed. What might she be thinking?
•I will never get a decent job; my life is over.
•They should have hired me; what idiots!
•I had hoped to get the job, but at least I was second choice. This thought is most likely
to lead to disappointment. Disappointment is related to sadness, but it is not a strong feeling.
The other thoughts are too extreme for disappointment.
- Orly is feeling guilty. What might he be thinking?
•
I am a bad friend; I should have gone; I bet I hurt Roy’s feelings. This thought is most
likely to lead to guilt as it is about breaking a moral rule.
•My friend is probably furious at me.
•I bet Roy will not want to be my friend anymore.
Identify the Cognitive Distortion
- If I don’t get this job, my life will be over.
Cognitive distortion: catastrophizing
- To be a good therapist, you have to give it your all and be there 100 percent of the time for your
clients.
Cognitive distortion: shoulds
- I’m sure that no one will ever want to hire me after this last fiasco of a job interview.
Cognitive distortion: overgeneralizing
- If I don’t help all of my clients, I am an inadequate therapist.
Cognitive distortion: polarized thinking
- I know that my last client canceled because she thinks I’m a bad therapist.
Cognitive distortion: personalizing and mind reading
- A colleague told me he wondered if the group check-in should be a bit shorter next time. That
was a terrible mistake I made in the first group.
Cognitive distortion: magnifying; could also be catastrophizing
Chapter 8
Help Cynthia Reach Her Own Conclusions
Below are some questions you could ask.
- Can you tell me about your relationship with John?
- Are there ways that John shows he cares about and respects you? (If Cynthia did not mention
their sexual relationship) In your sexual relationship, are there ways John shows he cares about
and respects you?
- How do Mike and Chris treat you? Can you give me some examples?
- Have Mike and Chris ever made any comments indicating that they respect you? Could you
give me examples?
- When you think of the evidence from John, Mike, and Chris, what does it tell you about your
belief that men are only interested in you for sex?
Chapter 10
Understand Mayleen’s Depression
Mayleen’s Understand Your Depression worksheet
Increased Since Life
Changes or StressorsDecreased Since Life Changes
or Stressors
Activities I enjoy
or that provide
pleasure or
masteryTaking care of motherStopped sculpting
Activities I do not
enjoyDriving to see mother
Going to mother’s doctor’s
appointments (mixed: enjoy as
sense of purpose and consistent
with values, but do not enjoy
activity)
Looking after the house
TV
ExerciseStopped exercise
Spending time
with friendsStopped seeing many friends
Spending time
with family
Leisure or hobbies
Smoking,
overeating, alcohol
or drug use
Routines related to
eating and sleeping
No friends when with mother
More time with mother
Develop Mood-Boosting Activities for Anna
Suggested
ActivityDeveloped
CollaborativelySpecific and
ConcreteDoableNaturally
ReinforcingRegular
Routine
Run three
times a week
for an hourNoYesNoYes, if she
could do itYes
Run three times a week for an hour. This is a concrete plan, and it is naturally reinforcing because
Anna likes to run. It could also be part of a routine. The problem is that it is probably not doable. Very
few people could go from no exercise to running for an hour three times a week. Plus, if she has not
exercised in a while, an hour of running may be physically too much. In conclusion, it is not a good
plan.
A more effective plan: To develop a more effective plan, you would start with asking Anna what she
would like to add to her life and how she would like to change the period of time around 5:00 p.m.
If running was of interest to Anna, it would be important for her to start slowly. Depending on how
long it has been since Anna has exercised, it might make sense to start with walking, or a combina-
tion of walking and running.
Use Graded Task Assignments
TaskSpecific and
Concrete?Doable?Time-Limited and
Specific Time for
Task?
Cynthia:No. Not clear what
the criteria are for a
systematic filing
system; first action is
not clearNot sure who will do
this and what exactly
the person/people will
do; hard to know if it
is doableNo time limit given;
will Cynthia work for
10 minutes or the
whole day?
Yes, this is a specific
task.Yes, though you would
have to checkYes, a time limit was
set, but no specific time
was specified when the
task would be done
No, it is not clear
how Alexandra
would explore her
options for work.Because as task is
unclear, hard to know
if it is doableNo time limit and no
specific time set for task
Reorganizing the
filing system
Richard:
Make a list of food
I want to cook
Alexandra:
Explore options
for work
No specific time for task
Chapter 11
Develop Effective Exposure Tasks
TaskSpecific and
Concrete?Action the
Client Can
Do?In Client’s
Control?Conclusion:
Is This an
Effective Task?
Stand in front of the
elevator in my building
for 5 minutes every dayYesYesYesYes
Look at photos on the
Internet of cars similar to
the one that hit meNo. We do not know
which photos he will
look at. There is a
great range of cars
that are “similar” to
the one that hit the
client.YesYesNo, because
it is not
sufficiently
concrete and
specific