Cognitive Behavioural Therapy Flashcards
(47 cards)
1
Q
What is Psychotherapy?
A
- An engagement between two people (therapist and patient/client)
- Focused on bringing about positive change within the client via the therapeutic alliance
2
Q
Core therapeutic approaches
A
Psychoanalysis, Person-centered therapy & CBT
3
Q
What is Psychoanalysis?
A
Relies on analytic processes to access unconscious conflicts that cause neurotic anxiety that manifest as repression, projection, or displacement behaviours
↳ Neurotic anxiety: Phobias, panic, OCD etc;
↳ Unconscious conflicts: Often believed to be formed at childhood
4
Q
Psychoanalytic Theorist
A
Freud, Jung, Alder, Bion, Klien etc;
5
Q
Analytic processes of psychoanalysis
A
- Free-Association → Get people to say random words to provide access to the unconscious
- Rorschach Test → Inkblot tests, people are asked to look at a inkblot and say what they see
6
Q
Issues with psychoanalysis
A
- Very little evidence for Psychoanalysis
- Has not been therapeutically & clinically proved
7
Q
Person-centered therapy
A
Relies on unconditional positive regard, empathy, and congruence in the therapeutic relationship to confront incongruence, which manifests as denial, fantasy, or overcompensation.
8
Q
Theorists of person-centred therapy
A
Rogers, Maslow, etc.
9
Q
Aims of Person-centred therapy aims
A
- Incongruence → When your perceived self and ideal self are separate
- Moving towards congruence → When your perceived self and ideal self are moving towards each other
10
Q
What is CBT?
A
Cognitive behavioural therapy (CBT): Relies on problem-solving to change unhelpful cognitions (thoughts) and underlying maladaptive behaviours.
11
Q
Theorists of CBT
A
Beck & Ellis
12
Q
The aims of CBT
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- CBT aims to help our clients dissect and analyse their original thought to help them determine what has made them act or feel in a specific way
- The goal is to change the emotional and behavioural response. until it becomes automatic
13
Q
Cognitive aspect of CBT
A
Changing the clients thoughts and beliefs, which becomes cemented. These childhood thoughts and beliefs are looked at from adult eyes
14
Q
Behavioural aspect of CBT
A
Change behaviours that are not consistent with a client’s life goals.
15
Q
What is the central principle of CBT?
A
That our thoughts are central to the regulation of behaviour.
16
Q
What is the role of CBT?
A
- To teach the individual to treat their beliefs as hypotheses and not facts
- To try out alternative ways of looking at the situation of their concern
- To have different responses to it based on these new ways of thinking.
17
Q
What type of approach does CBT follow?
A
Active, directive, collaborative, time-limited, present-oriented, structured, and has strong empirical basis.
18
Q
Theorists of CBT and brief description
A
Beck’s early work was centred around the role of unhelpful information processing for those with depression and anxiety
19
Q
Beck’s ABC Model of CBT
A
- A = Activating Event (Anti-cedent) ↳ Something occurs - B = Beliefs/thoughts ↳ Pulls on particular belief structures - C = Consequence → Emotional and/or behavioural - A → B → C
20
Q
Case study using ABC Model
A
Person 1 gets gastric bypass surgery and they can’t eat specific foods
- A: Attending a birthday party where cake is served
- B: I should not eat cake, cake is bad → I should not be overweight, being fat is awful → If I overeat, I ruin my diet → I might as well eat more
- C:
- Emotional
↳ Guilt
↳ Anxious & Depressed - Behavioural
↳ Eats 3 pieces of cake → Neglects healthy eating for a week
- Emotional
21
Q
Theoretical concept behind CBT’s cognitive perspective
A
Individuals’ core beliefs around the self, the world, and relationships with others originate in childhood (Schema); forms emotional disturbance affecting all levels of information processing in adulthood
22
Q
Goal of CBT
A
- To challenge cognitive distortions by identifying automatic negative thoughts (ANTS)
- To restructure their understanding of their irrational/self-defeating beliefs at the core of their schema
23
Q
Impact of Cognitive distortions
A
Cognitive distortions → ANTs → Creates irrational/self-defeating beliefs which reach the core schema
24
Q
Cognitive Distortions
A
- Black/white
↳ Either/or thinking with very limited nuance - Filtering
↳ Selective with information which they choose to focus on - Catastrophising
↳ Imagining the worst-case scenario - Overgeneralising
↳ E.g. ‘I always mess up…’ - Labelling
↳ ‘(I’m a loser!’ vs. ‘I made a mistake.’) - Selective abstraction
↳ Focusing on one negative detail of the situation, rather than looking at the whole picture
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Irrational/Self-defeating Beliefs
- **Being liked/loved:** I must always be loved and approved by the significant people in my life.
- **Being competent**: I must always, in all situations, demonstrate competence, and I must be both talented and competent in some important area of my life.
- **Having one’s own way:** I must have my way, and my plans must always work out.
- **Being hurt:** People who do anything wrong, especially those who harm me, are evil and should be blamed and punished.
- **Being danger-free:** If anything or any situation is challenging in any way, I must be anxious and upset about it. I should not have to face challenging/threatening/harmful situations
- **Being problemless:** Things should never go wrong in life and if, by chance, they do, there should be quick and easy solutions.
- **Being a victim:** Other people and outside forces are responsible for any misery I experience.
- **Tyranny of the past:** What I did in the past, and especially what happened to me in the past, determines how I act and feel today.
- **Avoiding:** It is easier to avoid facing life’s difficulties than to develop coping techniques; making demands of myself should not be necessary.
- **Passivity:** I should be able to be happy by avoiding, being passive, uncommitted, and by just existing.
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Importance of identifying irrational/self-defeating beliefs
- Should latch onto particular things people say to make sense of their thought pattern to ask if those are the cognitive distortions taking place
- Stories and the way people share their narratives demonstrate their underlying schemas
27
Applying CBT to change thinking
1. Identify the negative thought.
↳ Help the people recognise their own issue by asking them questions so they can have their own breakthrough
2. Look for evidence surrounding the thought:
- What are the facts?
- What has happened before?
- What would you say to a friend?
- What else might be true?
3. Come up with a realistic thought based on the evidence
28
Application of CBT to change thinking
1. Activating Event: Meeting new people in this unit
2. Negative Thought: “They will think I’m boring”
3. Evidence: “Someone in Year 7 said I was not interesting”
↳ Peer opinions really matter in year 7
↳ That one person’s opinion really matters → Can infiltrate their sense of self
4. Challenge: “My other friends don’t find me boring”, “my new colleagues may be happy to meet someone else”, “I do have some interests and opinions”
5. Realistic Thought: “They may not think I’m boring and could be happy to make a friend
29
What cognitive profile is linked to anxiety, depression and anger?
- Anxiety (physical and/or social threat)
- Depression (loss/failure)
- Anger (hostile intent/revenge)
30
What does CBT do?
1. Situation
↳ Activating event
2. Thoughts
↳ Based on your cognitive distortions
3. ANTs
↳ Challenged through cognitive restructuring
4. Elicts a different emotional and behavioural response
31
Who is Watson?
- Founder of behaviourism
| - Provided foundation for classical conditioning and operant conditioning
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What is classical Conditioning?
- When a neutral stimulus that has no meaning, is paited with a meaning. With enough pairings the neutral stimulus would have absorbed the characteristics that now means it elicits a response that it shouldn’t
- Founded by Pavlov
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What are the steps in exposure therapy
1. Determine problem and particular circumstances that elicit the conditioned fear response.
2. Construct hierarchy of situations inducing feared response.
3.
1. Imaginal – therapist guides client to conjure up scenes that gradually increase anxiety.
2. In vivo – (In person) gradual exposure to actual feared stimulus.
3. Flooding – forced and prolonged exposure to feared stimulus.
↳ Go HARD and FAST
Note: Check-up on the client with this, to avoid the occurance of bad things happening
4. Repeated exposure to gradual anxiety-evoking stimuli whilst learning to tolerate and eventually be comfortable with stimuli.
↳ Slowly escalate the stimulus with nothing bad happening
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Application of Exposure Therapy
Phobias, traumas (PTSD), anxiety
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What is Systematic De-sensitisation?
- Developed by Joseph Wolpe (1958)
- Aims to reduce phobic clients’ anxiety responses through counterconditioning whereby a relaxation-response is elicited (through rehearsal) during an anxiety provoking event.
36
Systematic Desensitation procedure
1. Help the client build an anxiety hierarchy (a ranked list of anxiety-arousing stimuli);
2. Train client in deep muscle relaxation and cognitive restructuring;
3. Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus
37
Systematic Desensitation procedure
1. Help the client build an anxiety hierarchy (a ranked list of anxiety-arousing stimuli);
2. Train client in deep muscle relaxation and cognitive restructuring;
3. Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus
38
Idea behind Systematic Desensitation
- The body can’t be both anxious and relaxed at the same time
- When experiencing a phobic response → Mind and body is stressed
- When you have a emotional response, do a muscle relaxation exercise at the same time → Do this consistently
↳ Physiological trick with the body
↳ Have the phobic stimulus → There’s no phobic response
↳ Similar to classical conditioning
39
What is Operant condiditoning?
- Theorists: Skinner & Thorndike
- Idea that we repeat behaviour that generates a good outcome, and avoid behaviours that generates a bad outcome
- This occurs through positive/negative reinforcement and positive/negative punishment
40
Positive reinforcement
- A stimulus is delivered which increases response due to pleasant outcome.
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Negative Reinforcement
A stimulus is removed to increases response due to pleasant outcome.
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Positive punishment
- A stimulus is delivered decreases response due to unpleasant outcome
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Negative punishment
A stimulus is removed which decreases response due to unpleasant outcome
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Applications of operant conditioning
- Parenting: Clear rules, Attention, Rewards, Consequences, Modelling, Consistency
- Animal Training: Attention, Rewards, Shaping, Consequences, Consistency
- Self-Management: Self-directed change, Monitoring, Goal setting, Self - reinforcement
45
Aversion therapy
- Where an aversive stimulus is paired with a stimulus that elicits an undesirable response
- Used with substance abuse, sexual “deviance”, smoking, shoplifting, gambling, stuttering, and overeating
46
Observational learning
- Discovered by Bandura
- Social-cognitive-behavioural approach to learning through modelling, behavioural rehearsal, and shaping.
- Vicarious learning: where a model is rewarded or punished for a behaviour and this shapes your own (desired) behaviour.
47
Applications of observational learning
- Social Skills Training: Establish skill level, teach, show, and practice
- Assertiveness: What is assertive, what is not, and practice
- Dealing with Teasing and Bullying: Doing something different, comebacks, and practice
- Stress Management: Diet, time management, prioritising social support, and community participation
- Problem Solving
- Unhelpful Coping Strategies and Suicidal Feelings: Selfmedicating, withdrawal and inactivity
