Fluency Flashcards

Question

CBT in action sequence: Assess

Answer 1

1. Antecedents (situations/events) –> Feelings—Thoughts–Actions –> Consequences 2. Create a list of the negative emotions, negative thoughts, and maladaptive behaviors Primary strategies: - Guided discovery - OARS - Downward Arrow - “If this were true, why would it be upsetting? What would it mean to you/for you? What would it say about you? About the type of person you are?

Answer 2

After summarizing.. Inquire: Am I getting it? Are you feeling heard and understood? What grade do I get for listening and understanding?

Answer 3

You’ve talked about some things that are very powerful, personal, and important. Let me ask you, is this a good time to work on how you’re feeling or would it be important that I provide more listening & support? Do you want some help beyond my listening and providing support? NO – It sounds like you don’t want any help with X, Y, and Z, and I’m fine with that. I’m wondering if there’s anything else that we could talk about or other areas of your life that might be helpful to talk about… YES = continue on

Answer 4

1. Positive reframing 2. Identify cognitive distortions 3. Cognitive restructuring 4. Double standard technique 5. Positive-negative role reversal

Answer 5

1. To daily life 2. Home practice or exercises 3. Coping card 4. Activity scheduling 5. Behavioral experiment to test a negative prediction/belief 6. Goal-directed behavior plan

Answer 6

1. All or nothing- view things in absolute, black or white categories 2. Overgeneralization- view a negative event as a never ending pattern, “this always happens!” 3. Mental filter- dwell on the negatives and ignore the positives 4. Discounting the positives- you insist that positive qualities don’t count or miss positive interpretations 5. Jumping to conclusions- jump to conclusions not warranted by facts –> mind reading: you assume that people are reacting negatively to you & fortune telling: you predict that things will turn out badly 6. Magnification or minimization- you blow negative out of proportion and blow off positives 7. Emotional reasoning- you reason from your feelings, “I feel like an idiot, so I must really be one” 8. Should statements- you use shoulds, shouldn’ts, musts, oughts, and tos 9. Labeling- instead of saying, “I made a mistake” you say “I’m a jerk” or “I’m a loser” 10. Blaming- You find fault instead of solving the problem –> Self blame: You blame yourself for something you weren’t really responsible for & other blame: you blame others entirely and overlook ways you contributed to the problem

Answer 7

What are some benefits/advantages of the negative thoughts/feelings? What do these feelings/thoughts show about you, about your deepest core values, that is beautiful, awesome, or positive? Establish a goal of decreasing the impact of negative thoughts, not elimination of them entirely

Answer 8

- Client plays themself - Therapist plays role of loved one or clone Steps: 1: Clarify roles 2: Therapist summarizes situation and offers automatic negative thoughts 3: Ask client if they agree with that conclusion (the negative thoughts) 4: Client responds 5: Therapist reflects and encourages elaboration of counter thoughts over several conversational turns 6: Therapist summarizes counter argument, says it’s helpful, and asks client if they really believe the counter argument 7: Identify counter as applying to client

Answer 9

Talking back to negative thoughts - Negative voice vs Positive voice Implementation: (1) Clarify roles (2) Client as negative voice offers automatic negative thought(s) (3) Therapist as positive voice responds (4) Ask client who won (positive or negative) and size of win (small, medium, large) (5) Ask client if what was said was true/important/believable (6) Role-reversal (therapist as negative voice and client as positive voice) until client wins big

Answer 10

1. Present moment awareness/dominating concept of past and future 2. Values clarity/lack of values clarity 3. Committed action/persistent inaction, impulsivity, or avoidance 4. Self-as-context/self-as-content 5. Cognitive defusion/fusion 6. Acceptance/experiential avoidance

Answer 11

1. What are your values? 2. What are the barriers, what stands in the way of you living more fully toward your values?

Answer 12

Introduce concept of values (freely chosen, person-specific, way of being) Emphasize that values are what the client wants to be about Distinguish values from goals & activities Reiterate values as anchors for behavior Identify several values that can serve as anchors for activation

Answer 13

"As humans we yearn to be oriented to the hear and now. It can be difficult at times, however, to participate fully in life experiences. In other words, to be here now. Strategy: 5 senses Practice shifting attention across the senses: Notice 5 things the patient can see, 4 they can feel, 3 they can hear, 2 they can smell/taste, and 1 believable positive self-statement they can make

Answer 14

"When we're so wrapped up in these uncomfortable sensations, it can be really difficult to engage in ways that we find meaningful"... Strategy: Sensations seeking Identify a prominent sensation and observe, breathe into, expand around, objectify (give it a size, shape, color, texture, movement), allow (hold it like a newborn) and normalize as product of a working nervous system. Explore it like a scientist.

Answer 15

"When we become too attached to the thoughts that come to us, they can really get in our way. That said, it is really difficult to stop these thoughts all together. Instead, it might be more helpful to create space for these thoughts or to observe them at a distance" Strategy: Semantic Satiation Say a word aloud repeatedly with increasing rapidity for 20-30 seconds to experience the fading away of conventional functions. Begin with “lemon” then a personally relevant word (e.g., “addict”)

Answer 16

When you are noticing these troubling thoughts, notice that there is a "you" noticing them. When these thoughts are repetitive and negative, it can be easy to forget about that observing self. That self has been a constant for all of the ups and downs in your life. It is easy to lose sight of this. To emphasize the observing self... Strategy: Leaves on the stream Take a moment to close your eyes and imagine that you are sitting by a stream. It is Autumn, and the leaves are falling from the trees, floating downstream. As a thought arises, imagine taking it and gently placing it on a leaf, allowing it to float away. As the thoughts inevitably arise, continue to do so. Notice what it feels like to see these thoughts come and go.

Answer 17

1. Decrease life threatening behaviors (suicide, self harm, homicidal urges) 2. Decrease therapy interfering behaviors (any client or therapist behaviors that potentially disrupt the therapeutic relationship, such as attendance, lateness, noncompliance, or lying) 3. Decrease quality of life interfering behaviors 4. Increase behavioral skills

Answer 18

Temperature, Intense exercise, Progressive relaxation, Paced breathing (3-5; e.g., holding ice, hot/cold shower, snap rubber band on wrist)

Answer 19

For interpersonal effectiveness: -Describe the situation -Express your feelings about it -Assert what you want (or say no, might necessitate “broken record”) -Reinforce the other & why it’s in their interest to give you what you want -(Be) Mindful -Appear confident -Negotiate

Answer 20

For interpersonal effectiveness: Assertiveness is HARD Honest-Appropriate-Respectful-Direct

Answer 21

For interpersonal effectiveness: (Be) Gentle (Act) Interested in the other person Validate the other person’s point of view (Use an) Easy manner

Answer 22

For interpersonal effectiveness: (Be) Fair (Be) Assertive (Not overly Apologetic or Aggressive) Stick to your values (Be) Truthful

Answer 23

Empathy/Active Listening: 1. Disarming technique – find some truth in what other person is saying 2. Reflection – paraphrase the other’s main ideas (thought empathy) and acknowledge their feelings (feeling empathy) 3. Inquire – ask gentle questions, be curious and non- defensive, to learn what person is thinking and feeling Acknowledgement/Assertiveness: 4. Use “I” statements to express yourself non-defensively and tactfully i. I realize I’ve ignored your feelings” (not “You don’t talk to me”) ii. “I feel upset” (not “You’re making me angry”). iii. “I want to be closer” (not “You push me away”) Respect: 5. Stroking - Affirm – find some genuine positives to say to the other person, even in the heat of battle or if frustrated

Answer 24

Recognize - Arousal/Energy/Intensity/Strength (high/strong---low/weak) & valence (pos---neg) Understand - Antecedents, vulnerability, and maintenance factors – Where did it come from? What’s feeding/fueling it? Label - Give the emotion a name – if I can name it, I can claim it, tame it, or reframe it Express - Share how you are feeling with others. Use “I” statements – “I’m feeling” Regulate o Mindfulness awareness o Relaxation o Cognitive restructuring or defusion o Opposite action (act different than you feel) o Distraction o Self-soothing o Time-out o Half smile and willing hands posture o TIPP skills

Fluency Flashcards

(48 cards)