Cognitive Behaviour Therapy (CBT) Flashcards
General overview of CBT
What is CBT?
Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.
What disorders can CBT be used to treat?
It’s most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.
Including:
- bipolar disorder
- borderline personality disorder
- eating disorders – such as anorexia and bulimia
- obsessive compulsive disorder (OCD)
- panic disorder
- phobias
- post-traumatic stress disorder (PTSD)
- psychosis
- schizophrenia
- sleep problems – such as insomnia
- problems related to alcohol misuse
How does CBT works?
CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a negative cycle.
What are the three principles of CBT?
- Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
- Psychological problems are based, in part, on learned patterns of unhelpful behavior.
- People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.
What is the aim of CBT?
CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts.
You’re shown how to change these negative patterns to improve the way you feel.
Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past.
It looks for practical ways to improve your state of mind on a daily basis.
CBT treatment usually involves efforts to change thinking patterns. What four strategies might this include?
- Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
- Gaining a better understanding of the behavior and motivation of others.
- Using problem-solving skills to cope with difficult situations.
- Learning to develop a greater sense of confidence in one’s own abilities.
CBT treatment also usually involves efforts to change behavioral patterns. What three strategies might this include?
- Facing one’s fears instead of avoiding them.
- Using role playing to prepare for potentially problematic interactions with others.
- Learning to calm one’s mind and relax one’s body.
What happens during CBT sessions: Frequency and course treatment?
If CBT is recommended, you’ll usually have a session with a therapist once a week or once every 2 weeks.
The course of treatment usually lasts for between 6 and 20 sessions, with each session lasting 30 to 60 minutes.
What happens during the CBT sessions?
During the sessions, you’ll work with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions.
You and your therapist will analyse these areas to work out if they’re unrealistic or unhelpful, and to determine the effect they have on each other and on you.
Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.
After working out what you can change, your therapist will ask you to practise these changes in your daily life and you’ll discuss how you got on during the next session.
What is the eventual aim of CBT post-treatment?
The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life.
This should help you manage your problems and stop them having a negative impact on your life, even after your course of treatment finishes.
What are some of the advantages of CBT?
It can be completed in a relatively short period of time compared with other talking therapies.
The highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and online.
It teaches you useful and practical strategies that can be used in everyday life, even after the treatment has finished.
It focuses on the person’s capacity to change themselves (their thoughts, feelings and behaviours).
It can be as effective as medicine in treating some mental health problems and may be helpful in cases where medicine alone has not worked
What are some of the disadvantages of CBT?
You need to commit yourself to the process to get the most from it – a therapist can help and advise you, but they need your co-operation.
Attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time.
It may not be suitable for people with more complex mental health needs or learning difficulties.
It involves confronting your emotions and anxieties – you may experience initial periods where you’re anxious or emotionally uncomfortable.
It does not address any wider problems in systems or families that may have a significant impact on someone’s health and wellbeing.
Some critics also argue that while CBT addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.
Things to Consider in Evaluating Patients for CBT?
Diagnosis and Symptom Severity.
Treatment Goals.
Readiness and Motivation.
Cognitive Functioning.
Co-morbid Conditions.
Safety and Risk Assessment.
Medication Use.
Personality and Coping Styles.
What is meant by ‘Diagnosis and Symptom Severity’ when considering evaluating a patient for CBT?
Assess the patient’s primary diagnosis and the severity of their symptoms. CBT is effective for various conditions, including anxiety disorders, depression, PTSD, OCD, and more.
How does a therapist evaluate Diagnosis and Symptom Severity during the session?
Accurate assessment ensures that the client receives appropriate interventions and allows for tracking of progress over time. There are various methods therapists use:
Clinical Interview: This is often the first step in the diagnostic process. The therapist will ask a series of open and closed-ended questions to understand the client’s symptoms, history, and context.
Example: A therapist may ask, “Can you describe what you’re experiencing on the days you feel at your worst?”
Structured Clinical Interviews: These are standardized interviews where the therapist asks a specific set of questions to determine if a client meets the criteria for a particular diagnosis.
Example: The SCID (Structured Clinical Interview for DSM Disorders) is commonly used to diagnose disorders based on DSM criteria.
Self-Report Questionnaires: Clients complete these standardized measures, often rating the frequency or severity of various symptoms.
Example: The PHQ-9 (Patient Health Questionnaire) is a self-report measure used to assess the severity of depressive symptoms.
Behavioral Observations: Therapists can gain a lot of information by observing the client’s behavior, affect, and interactions during the session.
Example: If a client is unable to sit still, is highly distractible, and frequently interrupts the therapist, these behaviors might be indicative of hyperactivity and impulsivity commonly seen in ADHD.
Functional Analysis: This assessment technique examines antecedents, behaviors, and consequences to understand the function or purpose of maladaptive behaviors.
Example: A client may self-harm (behavior) after feeling rejected (antecedent) because it provides temporary relief from emotional pain (consequence).
Feedback from Others: With permission, therapists might gather information from significant others, family members, teachers, or other relevant persons.
Example: For child clients, a therapist might ask parents or teachers about behaviors observed at home or school.
Use of Scales and Metrics: For ongoing assessment of symptom severity, therapists might employ rating scales.
Example: On a scale from 1-10, where 1 is “not anxious at all” and 10 is “the most anxious I’ve ever felt,” how would you rate your anxiety right now?
Regular Review: Periodically revisiting symptoms and challenges allows therapists to track changes over time and adjust treatment accordingly.
Example: At the start of every session, a therapist might ask, “How has your mood been since our last meeting?”
Multimodal Assessments: Incorporating various methods like interviews, observations, physiological measures, and others can give a comprehensive view of the client’s issues.
Example: For a client with suspected panic disorder, the therapist might use a clinical interview, self-report measures, and even monitor physiological responses like heart rate during specific tasks.
Collateral Information: Reviewing past medical records, psychiatric evaluations, or previous therapy notes (with permission) can offer additional insights.
Example: A therapist reviews a client’s previous hospitalization record to gain a deeper understanding of a past severe depressive episode.
