Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
What is the basic assumption of CBT? |
That people contribute to their own psychological problems by how they interpret events and situations |
|
|
What 4 things reciprocally influence behaviour? |
Thoughts, feelings, physiological processes and consequences of behaviour |
|
|
The A-B-C-D-E Model |
A - Activating event B - Beliefs about A C - Consequences of Beliefs (emotions & behaviours or lack thereof) D - Disputing beliefs about the Activating event E - Effect of the Disputation |
|
|
When is the past important in CBT? |
- The client wants to explore it - When working on present doesn't relieve symptoms - When therapist judges that it's important to understand where maladaptive core beliefs originated |
|
|
Why is CBT educative? |
To teach the client how to do it for themselves out of session. This improves relapse prevention |
|
|
What are the three levels of cognitive processing? |
- Consciousness - Automatic thoughts - Schema/core beliefs |
|
|
What are the 6 common cognitive errors? |
Arbitrary inference Magnification and minimisation Selective abstraction Overgeneralisation Absolutistic thinking Personalisation |
|
|
Explain Selective Abstraction |
Drawing a conclusion after only looking at some of the available information. While salient data are ignored to confirm a biased view. |
|
|
Explain Arbitrary Inference |
A conclusion is reached despite contradictory evidence. I.e. Fear of public spaces for fear of terrorist attack, while knowing probability of attack is very low |
|
|
Explain Overgeneralisation |
Conclusion is made about 1 or 2 isolated incidents and then is illogically generalised to broad areas of functioning I.e. Undesirable grade on 1 assignment = I can't do anything right, I'm a failure |
|
|
Explain Magnification and Minimisation |
The significance of an attribute, events or sensation is either exaggerated or minimised. I.e. Like in panic disorder |
|
|
Explain Personalisation |
Relating external events to oneself with little or no basis for doing so Taking excessive responsibility or blame for negative events I.e, Firing people due to GFC and thinking "it's all my fault, I should've seen it coming" |
|
|
Explain Absolutistic thinking |
Categorising judgements about yourself, personal experiences or others into 2 categories. Either all good, or all bad, total success or total failure. I.e. My marriage is terrible, her's is perfect |
|
|
What is a schema? And what are the 3 main groups of schemas? |
Basic rules that underlie automatic thoughts, enduring principles of thinking. 1. Simple schemas - little effect on psychopathology, about environment/everyday living 2. Intermediary beliefs and assumptions - if/then statements effect self esteem & emotion regulation "If I work hard, i'll succeed" 3. Core beliefs about the self - global & absolute "I'm worthless" |
|
|
Explain what Automatic Thoughts are |
Stream of thinking, part of general thinking Pop up spontaneously but are predictable once core beliefs are identified Usually brief, client more aware of emotion than the thought |
|
|
What are the two categories of automatic thoughts? And describe each type |
Validity and Utility - AT can be invalid, or valid (accurate) but conclusion drawn from it is distorted, or valid but unhelpful |
|
|
What is a hot cognition? |
A noticeable shift in the client that tells you they are feeling strong emotions and can be a chance to explore automatic thoughts. |
|
|
List and describe 3 methods of identifying automatic thoughts |
Guided discovery - ask questions that stimulate emotion, be specific & focused (on recent events), dig deeper and show empathy Thought Monitoring - shows impact of thoughts on emotion Imagery - helps client elaborate on AT by revisiting past event, important to explain method, intensify image as scene is described |
|
|
Explain the steps in evaluating automatic thoughts |
1. Confirm it's worth exploring by determining degree of belief and distress 2. Ask more questions about the thought/s 3. Use the AT to reinforce the cognitive model - use Socratic questioning & downwards arrow technique to uncover core beliefs 4. Help client evaluate validity & utility of AT - evidence for and against |
|
|
What is listed in a thought change record? |
Situation, ATs, emotions, rational response, outcome |
|
|
Generating rational alternatives |
1. Be open minded - think like a detective 2. Think like your old self 3. Brianstorm - explore all options regardless of their utility 4. Learn from others by observing and asking |
|
|
Examining the evidence |
List evidence of and against an AT/CB then use the list to to change the AT to be consistent with newfound evidence |
|
|
What is cognitive rehearsal? |
Client prepares for events & rehearsing adaptive cognitions - - Think through situation in advance - ID possible ATs and behaviours - Modify ATs - Rehearse adaptive ATs & behaviours in one's mind - Implement the new strategy |
|
|
Assessing effectiveness of evaluation of ATs |
If evaluation was successful - move on If it wasn't - - Other more central ATs are unidentified - Evaluation was implausible, superficial or inadequate - Client didn't explain their evidence supporting AT well enough - AT is also a core belief |
|
|
What 7 domains are included in a case conceptualisation/formulation? |
Diagnosis/Symptoms Formative influences Biological, genetic & medical factors Interpersonal/Situational issues Automatic thoughts, emotions & behaviours Underlying schemas Strengths/Assets |
|
|
Explain the 4 P model |
Predisposing - increase probability of eventual dev. of disorder Precipitating - Triggers for disorder onset Perpetuating - maintaining factors (I.e. avoidance) Protective - strengths/assets (internal or external) Based on Diathesis-Stress Model |
|
|
What is the principle value of the case formulation? |
To guide and structure the course of therapy/treatment plan |
|
|
What else does the case formulation aim to do in terms of the treatment plan? |
- Ties all symptoms/problems together in meaningful way that's relevant to formulation - Help therapist focus on most salient/pressing issues - Can help predict how client may think, feel & react in specific situations - Can be used to evaluate treatment success/failure using the accuracy/inaccuracy of formulation |
|
|
Mood Disorders - What is the key to understanding depression? |
Understanding a client's core beliefs |
|
|
Mood Disorders - What are the three attributes of negative core beliefs? |
They are global, overgeneralised and absolute |
|
|
Mood Disorders - How does the therapist begin to work with core beliefs? |
- Mentally hypothesises what the core belief is based on ATs - Presents hypothesis to client - Educates client about core beliefs generally and about specific CBs - Evaluates and modifies CB with the client using CBT model |
|
|
Mood Disorders - Name three ways of identifying Core Beliefs |
- Spotting patterns of automatic thoughts - Conducting a life history review - Downwards arrow technique |
|
|
Mood Disorders - Explain the downwards arrow technique |
- Identifies CBs/schemas from ATs - 'If that thought you have about yourself is true, what does that mean about you?' - Only attempt with good therapeutic alliance - Uses 'If-then' questions that progressively reveal deeper levels of cognitive processing |
|
|
Mood Disorders - Explain the process of spotting patterns of ATs |
- Recognise a theme in therapy - Review thought records - Get client to review own thought records as homework |
|
|
Mood Disorders - Explain the process of conducting a life history review and why is it important? |
Identify the formative influences in the development of the CB - - Ask about influential people & life shaping experiences - What CBs may have been shaped by these experiences? - What interests, jobs, sports/activities are important to client? - Cultural/social influences & Education Because predisposing & precipitating factors are key to understanding CBs |
|
|
Mood Disorders - What are the different categories of core beliefs? Give 2 examples of each |
Helpless - I am a failure, I am weak Unlovable - I am unworthy, I am bad |
|
|
Mood Disorders - Psychoeducation about Core Beliefs - What is important that the client understands about their CB? |
- It's an idea, not a truth - Despite feeling it strongly to be true, it can be mostly untrue - It's an idea that can be tested - It's rooted in childhood events - It's maintained by their own operation - Client & therapist can work together to change it |
|
|
Mood Disorders - Name the methods of Modifying Core Beliefs |
- How would you like things to be? - Examining the evidence - Core belief worksheet to modify CBs & strengthen new CBs - Continuum |
|
|
Mood Disorders - Explain 'How would you like it to be?' |
- Ifyou weren’t depressed, how would you like to be/ think about yourself? - Expanddetail – how would you look / feel / behave if this was true? Does anyone personify this new belief? Imagery - If cannotaccess new belief, shifting perspective helps: how do you see others youadmire? Would you like to be likethis? If you were, would youstill be worthless? |
|
|
Mood Disorders - Explain 'Examining the evidence' |
CB to be tested: I'm unlovable Task/s: Ask 3 colleagues to have coffee w me Prediction: They'll all say no What actually happened: 2 were busy, 1 said yes Conclusion: My CB is not always true Balanced CB: Not everyone will like me, but I am likeable to some people |
|
|
Mood Disorders - Explain 'Continuum' |
- CBs are often absolute, continuum method reduces absolutist thinking - Should be done repeatedly over weeks/months - Establish rating of maladaptive CB, what behaviours define this? Rate themselves on these behaviours to show they are not 100% unlovable or a failure etc. |
|
|
Mood Disorders - What types of deficits can clients have with problem solving? |
Performance - have prob. solv. skills but can't use them Skills - understand nature of problem, but cannot think of ways to solve it |
|
|
Mood Disorders - What are the causes of performance deficits in problem solving? |
- Cognitive impairment: stimulus control/reduce distractions - Emotional overload: relaxation techniques, exercise - Cognitive distortions: cognitive restructuring methods - Avoidance: activity scheduling & graded task assignments - Social Factors: assessing advantages/disadv. of others' suggestions - Practical problems: brainstorm idea with client to overcome these obstacles |
|
|
Mood Disorders - How can we help clients overcome skills deficits in problem solving? |
- Pick a target - Define problem accurately - Brainstorm solutions with client (encourage creativity) - Select most reasonable solution - Implement the plan - Evaluate outcome & repeat steps if needed |
|
|
Children - When adapting CBT for children, what must you keep in mind? |
- Child's developmental level - Family system - Method of intervention administration |
|
|
Why is BT more effective in younger children hat CT? |
Because, developmentally they are unable to make the connection between cognition, emotion and behaviour. Because CBT requires meta cognition (thinking about thinking) |
|
|
Which of Piaget's stages allows for more complex mental processes and logical reasoning? |
Concrete Operational Stage (7-8 years) |
|
|
Children - What are the aims and steps involved in assessment of children? |
Aims: providea detailed description of the presenting problems that's consistent with a CBT formulation. - provide info about the child’ssocial context, strengths and weaknesses |
|
|
Children - What is involved in goal setting with children? |
Incollaboration with the child and family, the therapist conducts a detailedanalysis of the presenting complaints to generate more specific target problems (i.e.,more activity) |
|
|
Children - What is involved in formulation with children? |
- Thetherapist endeavours to identify the cognitive distortions - Theformulation should also reflect the role of external factors, such as familydifficulties or peer problems, on the young person’s view of themselves and theworld. |
|
|
What are 4 ways of adapting CBT for use with children? |
- Materials need to be changed to suit developmental level - Abstract concepts/strategies translated into simple examples and metaphors - Use of art, games or play - Fewer verbal and more visual techniques |
|
|
Name 6 specific examples of CBT interventions for children |
- 'Thought invaders': encouraged to destroy their thoughts - 'Turn down' annoying song: shows thought stopping (use imagery) - 'Thought detective': identify, test & evaluate their thoughts & behaviour - Anger Volcano: anger build up and how to stop eruption - Dolls, puppets & toys for playing & thinking about others thoughts - Cartoons & thought bubbles to explore different ways of thinking |
|
|
Why is it important to include parents in a child's treatment process? |
- They could be contributing to the problem (avoidant behaviours) - Increases impact of treatment - They can help monitor, prompt & reinforce new skills between sessions - Encourage the child to complete therapy homework - Can provide extra info to therapist |
|
|
Children - What is involved in treating anxiety in children? |
- Psycho-education of parents - Cognitive restructuring: detective/realistic thinking (children/teens) - Progressive Muscle Relaxation - Graded exposure - Parent management |
|
|
Children - What are the two main cognitive biases displayed in anxious people? |
- Overestimating the likelihood ofunpleasant events happening - Underestimating their ability to cope if the event were to happen - Anxious person could have one or both of these symptoms |
|
|
Children - What is involved in treating depression in children? |
- Psycho-education of parents - Problem solving: brainstorm ways to help deal with external precipitating problems - Activity scheduling - Cognitive restructuring of maladaptive cognitions: identify positive thought & emotions, educate re 'hot thoughts' (AT), use of examine evidence, what if? (downwards arrow) - HTFR: Happening, thought feeling, response |
|
|
Children - Explain behaviour modification |
Based on operant conditioning Reinforcement - encourages desired behaviour - Pos. reinforce: $ for good marks - Neg. reinforce: remove something neg. when child does something good Punishment - discourages unwanted behaviour - Pos. punish: add something bad - Neg. punish: remove something good Extinction - eliminates incentive for unwanted behaviour by withholding expected response (time out) |
|
|
Children - Explain the five steps of teaching social skills to children |
1. Info & discussion: why skill is important (use pics, role-play & videos) 2. Modelling: demonstrate target skill (use group therapy) 3. Behavioural rehearsal: practice in session 4. Training outside therapy: set relevant homework tasks & use behaviour modification to encourage child 5. Monitoring of child's progress |
|
|
When does anxiety become a problem? |
Whenthe normal response is exaggerated and occurs in the absence of a real threat |
|
|
Anxiety - Maintaining Processes |
Anxiety is perpetuated by how we feel, what we think & what we do. I.e. Physiological response, think we can't cope, use avoidance tactics |
|
|
Anxiety - What are the 6 maintaining processes that are central to anxiety? |
1. Safety-seeking behaviours - avoidance, compulsions, misattribute success to these behaviours 2. Focus of attention - towards or away from threat cues 3. Spontaneous imagery - mental images enhance sense of threat (imagine plane crashing not just turbulence) 4. Emotional reasoning - If I feel anxious, there must be a legitimate threat 5. Memory processes - selective, negative recall of threat situations, 6. Interpretation of reactions to a threat event - "Must be going crazy" = heightened anxiety |
|
|
Anxiety treatment approaches - Psycho-education |
- Highlights interconnection between thoughts, feelings and behaviours - Difference between normal & pathological anxiety - Anxiety is result of faulty thinking, difficulty controlling physiological reactions & avoidance/maintenance behaviours - Informs client how this can be addressed - INSTILS HOPE |
|
|
Anxiety treatment approaches - Cognitive Restructuring (general) |
- Identify, evaluate & change faulty thinking - Situation specific (ATs) then core beliefs (schemas) - Questioning the evidence - Labelling the distortion - Generating rational responses (socratically) |
|
|
Anxiety treatment approaches - Cognitive Restructuring - Cost-benefit analysis |
- Select a belief/behaviour to be modified - Client is helped to list the advantagesand then the disadvantages of holding a particular belief or engaging in aparticular behaviour (spend equal time on both sides) |
|
|
Anxiety treatment approaches - Cognitive Restructuring - Pie charts |
- A way of exploring a range of possible explanations for events (i.e. headaches = brain tumour) - Therapist helps list alternative explanations |
|
|
Anxiety treatment approaches - Cognitive Restructuring - Education |
- Info that corrects clients' faulty knowledge/lack of understanding can help modify belief in thoughts and core beliefs - Can be presented in written material (bibliotherapy) or verbally (usually presented in direct way) |
|
|
Anxiety treatment approaches - Cognitive Restructuring - Point and counter-point |
- Client and therapist alternate roles of presenting negative AT and counter-evidence/arguments - Therapist begins by articulating one of the client's key negative ATs & client argues against it - Once client starts to struggle, roles are reversed - Highlights absurdity of thinking - Requires good therapeutic alliance |
|
|
Anxiety treatment approaches - Cognitive Restructuring - Core beliefs |
- Social Phobia AT: People will think I'm boring CB: I'm boring/inadequate - Panic Disorder AT: If I become anxious, I could die CB: I'm vulnerable - GAD AT: If I worry, I won't be able to cope CB: I can't cope (worrying helps me cope) |
|
|
Anxiety treatment approaches - Relaxation |
- Empowers clients with skills & tools to control physiological manifestations of anxiety - Diaphragmatic breathing - Progressive muscle relaxation |
|
|
Anxiety treatment approaches - Exposure |
- To feared external or internal stimuli - Can be graded, intense, brief or prolonged - Leads to anxiety response gradually fading - Helps clients habituate & change their thinking - Systematic desensitisation |
