Wk 3 - CT

Question 1

What is the key assumption of cognitive therapy?

Answer 1

Reality is constructed by the self. All experiences are mediated by our perceptions. How we see a situation will make that situation a reality.
Focus on how Thoughts -> Feelings

Question 2

What are some of the proposed strengths of CBT?

Answer 2

1) scientific in approach; empirical

2) practical and problem-focused

Question 3

What is considered as health and dysfunction is cognitive therapy?

Answer 3

Functional vs Dysfunctional Thinking Patterns

• Validity (is it valid?)
• Utility (is it useful?)

Health

• functional thinking patterns
• use less primal mode processing but more constructive mode of processing
• accurate view of oneself and the world

Question 4

How do core beliefs become established in your life?

Answer 4

Early experiences shape our schemas, and these schemas are maintained because they are self-fulfilling. We do things and react in ways that confirm our expectations. This maintains our core beliefs, and feelings associated with the core beliefs.

Question 5

Thoughts are processed at 3 levels. What are they?

Answer 5

Automatic/Preconscious: related to survival
Conscious: usual thinking
Metacognitive: thoughts about thoughts

Question 6

Briefly Describe the Cognitive Model.

Answer 6

Early Relevant History –> Core Beliefs –> Intermediate Beliefs/Assumptions/Rules –> Triggering Event –> Maintaining Cycle (automatic thoughts, behaviors, emotions, physiology)

Question 7

Describe Core beliefs.

Answer 7

• stems from early history
• most difficult to change (hence shouldn’t start here)
• refer to content of beliefs inside your schema.

Question 8

Describe intermediate beliefs/assumptions/rules

Answer 8

Rules put in place in order not to reveal your ‘core belief’ to the world. These assumptions emerge as a response to cope with negative core beliefs.

Question 9

How should we dertmine if automatic thoughts are adaptive or not?

Answer 9

Validity and Utility
isit valid
isit useful

Question 10

What does the hot cross bun formulation show us?

Answer 10

shows us how our automatic thoughts are linked to our emotions, physiology and behavior. which works in a vicious cycle to reinforce our automatic thoughts.

Question 11

How do we evaluate a validity of a thought?

Answer 11

1) content accuracy - are these thoughts about the situation, others, or the self objective?
2) prediction accuracy - do these thoughts have reasonable conclusions?

Question 12

How do we evaluate the utility of a thought?

Answer 12

Is it useful.
Does this thought lead to dysfunctional, extreme responses?
Does this thought affect your motivation for functional responses?

Question 13

Name the 10 different types of cognitive distortions.

Answer 13

1) black and white thinking/all or nothing
2) overgeneralizing
3) mental filter
4) disqualifying the positives
5) emotional reasoning
6) should/must
7) labelling
8) personalisation
9) jumping to conclusions
10) magnification/ catastrophizing

Question 14

What is overgeneralising?

Answer 14

Making a broad conclusion just based on a single event.

Question 15

What is mental filter?

Answer 15

Only paying attention to certain types of evidence

Question 16

What is disqualifying the positives?

Answer 16

discounting the good things that has happened

Question 17

What is emotional reasoning?

Answer 17

Assuming that because we feel a certain way, what we think must be true

Question 18

What is personalisation?

Answer 18

Blaming yourself or taking responsibility for something that wasn’t completely your fault.

Question 19

What are the 2 types of jumping into conclusions?

Answer 19

mind reading - imagining we know what others are thinking

fortune telling - predicting the future

Question 20

What are typical cognitive distortions for individuals with depression? Cognitive Triad

Answer 20

Self - lack of self-worth, negative, global, personalized meaning to events
World - rejection from others
Future - sense of hopelessness

Question 21

What are some gambling-related cognitive distortions?

Answer 21

1) interpretive control - past wins are due to my ability, past losses are due to uncontrollable circumstances
2) illusion of control - I possess the knowledge, skill, or luck necessary to alter fortuity in gambling games
3) predictive control - belief about randomness and a personal ability to forecast wins
4) gambling -related expectancies - that pleasure can be derived from gambling

Question 22

What would a systemic therapist say to a cognitive therapist?

Answer 22

• too much blame on the client

- you are ignoring how beliefs are culturally embedded. you are pathologizing what may be culturally appropriate.

Question 23

What should we do in the initial stages of Cognitive Therapy?

Answer 23

1) Build Rapport
2) Set Therapy Goals
3) Socialize client to the model (psychoeducation)
- explain to clients why we are so interested in thoughts.
- explain the model. thoughts are related to emotions, behaviors, physiology
- every box in the diagram becomes a target for therapy

Question 24

What are the 3 intervention phases found in CBT?

Answer 24

1) Behavioral work (especially behavioral activation for depression)
2) Target Automatic Thoughts
3) Move on to Intermediate and then core beliefs

Question 25

What is the general structure of a CBT session?

Answer 25

1) Mood Check; Catch Up 2) Review homework - thought records - behavioral experiments 3) Set Agenda (123) - Agenda items usually targeting one of the boxes

Question 26

Describe the 7 columns in a thought record.

Answer 26

1) Situation/Trigger 2) Emotions/Body Sensations (Rate 0-100) 3) Unhelpful Thoughts 4) Facts that Support the Thought 5) Facts that DO NOT Support the unhelpful thought 6) Alternative, more realistic, balanced perspective 7) Outcome (re-rate emotion)

Question 27

How should you identify underlying automatic thoughts?

Answer 27

The thought must be able to explain why the client is feeling so anxious. Cannot be 'too low' on the hierarchy. Ask 'what's the meaning of that for you?' Should be something that have implications for the self eg. 'people will think I am aggressive', 'people will think I am a failure'

Question 28

What is Socratic questioning mainly used for?

Answer 28

Used for cognitive change. Examining distorted thoughts and beliefs and modifying them

Question 29

Name some Socratic questioning questions.

Answer 29

- What is the evidence for and against it? - Could these thoughts be based on your feelings? - Is the thought black and white? or is reality more complicated? - Might other people see this differently? - Might these thought be exaggerated?

Question 30

During socratic questioning, what are some good things that you can do as a therapist? (5)

Answer 30

1) offer counterevidence, especially evidence that is not as salient 2) can try acting blur to offer a curious perspective. non-blaming stance 3) remember to validate the client's emotions. once client is more calm, therapist goes back to cognitive restructuring. 4) therapist must keep firmly to agenda 5) take note of power dynamics

Question 31

What is the technique downward arrowing used for?

Answer 31

For discovering core beliefs. Moving up from automatic thoughts to core beliefs.

Question 32

What are some questions you can ask in downward arrowing?

Answer 32

- why do you think this upsets you so much? - what is the worst part about it? - what does that say about you as a person? - what does this mean to you

Question 33

What are the 3 key types of core beliefs?

Answer 33

- self: 'I am ...' - others: 'They are ...' - the world: 'the world is'

Question 34

Describe what behavioral experiments are for and how to do it.

Answer 34

Behavioral experiments are about testing a thought in order to challenge its validity. Clients will be asked to predict outcomes in a situation, and experiment facing the situation, and determine if their initial beliefs were rational or not. Behavioral experiments are meant to strengthen alternative more adaptive thoughts through experiential learning so that the thought is understood on an emotional level. With the new experience and new knowledge acquired, thoughts and emotions will adjust to something more adaptive.

Question 35

What are the 5 columns on a behavioral experiment record sheet?

Answer 35

1) Target Cognition 2) Experiment 3) Predictions 4) Outcome 5) What I learned

Question 36

What are some kinds of behavioral experiments you can try?

Answer 36

- facing a situation you will otherwise avoid - dropping precautions - behaving in a new way - surveying family members

Question 37

What are 2 advantages of CBT?

Answer 37

1) technique for cognitive change is very focused; methodological; structured 2) short-term 3) present focused intervention

Question 38

What is a disadvantage of CBT?

Answer 38

1) better for clients who are more reflective. less helpful for clients who are unable or unwilling to work with thoughts (eg. learning disabilities)

Question 39

What are some characteristics of automatic thoughts?

Answer 39

- usually quite brief and spontaneous, clients more aware of the EMOTION they feel as a result of thoughts rather than the thoughts themselves - people usually accept their automatic thoughts as true without much reflection and evaluation - can be evaluated according to their validity and utility - may be in verbal or visual form

Question 40

Each schema we hold is based on ____ _____ about the world. If we hold faulty ___ ___ about something, we are going to activate faulty schemas that affect ______.

Answer 40

- core beliefs | - behavior

Question 41

What are core beliefs?

Answer 41

- basic beliefs that tend to be overgeneralised and absolute - usually self-referent - hardest to modify

Question 42

What are intermediate beliefs?

Answer 42

- assumptions and rules | - "should" and "must" beliefs, as well as conditional beliefs (eg. if i dont ___, then i am____)

Question 43

What are the 3 major mode categories?

Answer 43

1) primal (threat, loss, victim, self-enhancement) 2) constructive (serve to increase life resources available to the individual. eg. capacity for intimacy, personal mastery, independence) 3) minor

Question 44

What are the 3 negative core self-beliefs?

Answer 44

helplessness, unlovability, worthlessnesss

Question 45

Do cognitive techniques ask clients to think positively?

Answer 45

NO. its not about thinking positively but to think more 'realistically'

Question 46

Describe activity scheduling? (used in depression)

Answer 46

When clients have low motivation (eg. depression), it is helpful to create a daily schedule to follow between therapy sessions. Establish baseline with a record of daily activities first. After reviewing the data, the client and counselor can work together to fill in the blocks of an activity chart (timetable format). Client will rate daily activities on a scale of 1-10 for mastery and pleasure.

Question 47

When clients are having difficulty identifying their Automatic Thoughts, what can the counselor do?

Answer 47

Imagery/Role playing to vividly conjure up the problem situation. this will likely evoke the emotions associated with the problem situation. they should also help clients identify cognition associated with the feelings.

Question 48

What are some cultural advantages of CT?

Answer 48

1) structure and clarity may appeal to minority clients (Eg. chinese cultures). 2) emphasis on individual control 3) collaborative nature of CT relationship promotes egalitarianism

Question 49

What are some cultural disadvantages of CT?

Answer 49

this intervention would not immunize the client from social pressures (eg. cultural pressures, prejudice, and discrimination). can be quite blaming.