Cognitive Therapy : Cognitive Behavioural Therapy (CBT)

Question 1

What does Cognitive Behavioural Therapy (CBT) aim to do to people with mental health disorders?

Answer 1

Challenge negative thoughts and replace them with healthy thinking

Question 2

What techniques does CBT use to help the client identify negative thought processes?

Answer 2

Through techniques such as role play and homework

Question 3

What attitude must the client take both inside and outside of their sessions?

Answer 3

An active role

Question 4

What does CBT begin with?

Answer 4

An initial assessment

Question 5

What happens in the initial assessment of CBT?

Answer 5

The client and therapist discuss the problems the client needs help with

Question 6

What do the client and patient create at the start of CBT therapy?

Answer 6

Set goals for their sessions and a plan of action on how to achieve these

Question 7

What are the 3 main components of CBT?

Answer 7

• Dysfunctional thought diary
• Cognitive restructuring
• Pleasant activity scheduling

Question 8

Where is a dysfunctional thought diary used?

Answer 8

At home and in the session

Question 9

What happens in a dysfunctional thought diary at home?

Answer 9

• As homework, clients keep a record of their dysfunctional thoughts
• This involves recording any events that may lead to those automatic negative emotions
• They then have to rate how much they believe the emotion is true

Question 10

What happens with the dysfunctional thought diary within the therapy session?

Answer 10

• Clients write a rational response and rate the belief of this
• The client then re-rates their original automatic negative thought

Question 11

What does cognitive restructuring involve?

Answer 11

Identifying and changing the clients negative thinking patterns

Question 12

How does cognitive restructuring work?

Answer 12

By the therapist offering counterstatements that challenges the belief of the client, therefore leading the client to realise that they do not think rationally

Question 13

What does pleasant activity scheduling involve?

Answer 13

Clients are told to plan a pleasant activity for themselves over a period of time.

Question 14

What should the pleasant activity do to the client? (PAS)

Answer 14

Should make the client feel positive

Question 15

How can pleasant activity scheduling make the client feel positive? (3 points)

Answer 15

• Feeling a sense of accomplishment
• Breaking normal routine
• Feel fun and engaging

Question 16

What must the client do with their pleasant activity scheduling?

Answer 16

Keep a record of the activities done and how they felt after/during doing them.

Question 17

What happens over time to the clients thinking in pleasant activity scheduling? (Outcome)

Answer 17

The client will move further away from the negative thinking and behaviour

Question 18

What are the 3 cognitive assumptions?

Answer 18

• Internal mental processes
• Schemas
• Computer analogy

Question 19

What are the 4 internal mental processes?

Answer 19

Perception
Attention
Memory
Language

Question 20

Define schema

Answer 20

Organised packets of information that are sorted in our long-term memory

Question 21

Why do schemas develop as we get older?

Answer 21

We learn new information through experience

Question 22

Why is the brain said to be like a computer?

Answer 22

The computer analogy represents how we take in and store information and retrieve this

Question 23

How many of the cognitive assumptions can be applied to CBT?

Answer 23

3 (all of them)

Question 24

How does the internal mental processes assumption connect to CBT?

Answer 24

CBT targets IMP through:
Dysfunctional thought diary - identification of irrational thought processes
Cognitive restructuring - change negative perception. Present evidence to show that thought process is irrational

Question 25

What is the cognitive triad?

Answer 25

Negative views about the world Negative views about one's self Negative views about the future All are connected

Question 26

How do schemas relate to CBT?

Answer 26

The cognitive triad represents a negative schema that people with MH disorders hold. CBT challenges the negative schema and present evidence against them, to help the patient respond in a more positive way

Question 27

How does the computer analogy relate to CBT?

Answer 27

The therapist attempts to change the way that the clients cognitive processes work, which can be compared to the software of a computer

Question 28

What do we need to consider when evaluating therapy? (2 points)

Answer 28

- Effectiveness (supporting or refuting research, comparison to other therapies) - Ethics (ethical guidelines eg. PCDRIP)

Question 29

What research supports CBT? (2 points)

Answer 29

Jarret et al (1999) found CBT was as effective as some anti-depressant drugs when treating patients with severe depression Hollon et al (1992) found no difference in CBT when compared to another anti-depressant drug

Question 30

What can we conclude from research to support about the effectiveness of CBT? (3 points)

Answer 30

- That CBT and drug therapy are effective in treating depression - Neither one offers a superior treatment - Therefore a combination therapy is often recommended for patients

Question 30

How does individual differences affect the effectiveness of CBT? (3 points)

Answer 30

- CBT requires a lot of motivation from the client so they have to be **willing** to change. - CBT wont be effective on clients who find it difficult to change their negative beliefs. - CBT will also not be effective if the client has many environmental triggers in their life

Question 31

Why does empowerment positively affect the effectiveness of CBT?

Answer 31

CBT makes the client feel empowered because they can make their own choices. This has made it become popular as people have more control over their recovery

Question 32

What are the 2 main ethical problems with CBT?

Answer 32

- Patient blame - Psychological harm

Question 33

Why is patient blame an ethical weakness in CBT?

Answer 33

The client may be led to believe that the faulty processing is their fault when actually other factors may be causing that.

Question 34

Why is psychological harm an ethical issue for CBT?

Answer 34

Rational vs irrational thinking is subjective. In therapy, the therapist supports a client's irrational thoughts, which could lead to the client's self esteem being damaged

Question 35

What are 3 additional ethical issues, not including patient blame and psychological harm?

Answer 35

- Waiting times - Choice of therapy - Equal access to therapy

Question 36

Why is waiting times an ethical issue in CBT? (3 points)

Answer 36

One in 10 have been waiting **over a year** for CBT Over half have been waiting **3 months +** Around 13% are still waiting for their first psychological assessment

Question 37

Why is choice of therapy an ethical issue? (4 points)

Answer 37

58% of people weren't offered choice in what therapy they received 3/4 of people didn't have a choice in **where** they received treatment 1/2 felt that the number of sessions weren't enough 11% said they had to pay for their treatment as it wasn't available with the NHS

Question 38

Why is equal access an ethical issue?

Answer 38

40% of people had to request psychological therapies rather than being offered them 10% of people weren't offered a therapy after being assessed

Question 39

What are the strengths of CBT? (4 points)

Answer 39

- Can be effective in treating some mental health disorders and can help when medication hasn't worked - Can finish course faster than other therapies - Can be provided in different formats, including in groups - Skills learnt in CBT are useful in everyday life

Question 40

What are the weaknesses of CBT? (5 points)

Answer 40

- Needs strong commitment from the client to be successful - Can take up a lot of the client's personal time - May not be suitable for clients with complex mental health disorders - Can cause more anxiousness initially as it involves confronting your emotions - CBT is said to only address current problems and not the underlying cause

Question 41

How would you conclude an evaluation answer on CBT?

Answer 41

- Research support is mixed and has no difference in effectiveness from drug therapy. - Ethical issues show it may not be suitable to everyone