Week 3 Counselling

Front 1

Explain cognitive therapy

Back 1

• Developed in 1960s by Aaron Beck fortreatment of depression
• Assumption that distorted thinkinginfluences mood & behaviour
• Distorted thinking is common to allpsychological disturbance
• Realistic evaluation & modificationof distorted thinking will improve symptoms
  

Front 2

Explain the cognitive model

Back 2

1. Situation (observe ambiguous non-verbal cue)
2. thought (she thinks I'm an idiot)
3. feeling (anxiety)
4. Behaviour (avoidance/not expressing opinions)

Front 3

Explain the biases in info

Back 3

• Depression: negative viewof self, world & future (cognitive triad)
• Anxiety: overestimation of physical orpsychological danger
• Panic disorder: catastrophicinterpretation of physiological experiences
• Paranoia: attribution of bias to others
• Suicidal ideation: hopelessness regardingfuture & deficiencies in problem solving

Front 4

Describe cognitive distortions (1)

Back 4

• All-or-nothing Thinking: dichotomous,black-or-white thinking¤“If I don’t get a HD, I have failed”¨
• Selective Abstraction: selectivelychoosing facts to support negative/positive thinking = athlete focuses on 1 loss in otherwisesuccessful career, which reinforces sense of incompetence
• Mind-reading: weknow what others think of us -> “I know she thinks I’m an idiot”¨
• Negative prediction: negativeprediction of future in the absence of supporting evidence¤“I just know that if I go, I’ll have abad time”
• Catastrophising: exaggeratethe consequences of a future event into something fearful -> “If I don’t get a HD, I’ll die”
  

Front 5

Describe cognitive distortions (2)

Back 5

• Overgeneralisation: makinga rule based on a few negative events -> “I forgot my keys again...I can neverremember anything”
• Labelling & mislabelling: negative viewof self created by labelling based on a few mistakes: -> rather than “I felt awkward talking toSarah”, “I am a complete loser” (overgeneralisation at the identity level)
• Magnification/minimisation:magnify imperfections, minimise good points
  -> “my jeans are a little tight. I am so fat& disgusting” (mag)
  -> “I did really well on that assignment.Total fluke”(min)
• Personalisation:taking an event unrelated to oneself & making it meaningful -> “Another red light. Why does nothing evergo right for me?”
  

Front 6

Explain automatic thoughts

Back 6

• Quick, evaluative thoughts
• The outcome of cognitive distortions
• Not the result of reasoned deliberation
• May be outside full conscious awareness
• Tend to uncritically accept them as true
• Subsequently affect emotion &behaviour ¤AT “People won’t like me”
  ¤Emotion: Anxiety
  ¤Behaviour: Avoidance (stay home)

Front 7

Explain core beliefs

Back 7

• The breeding ground for distortions &automatic thoughts
• Fundamental beliefs about oneself, theworld & others that are unquestioningly accepted as absolute truths
• Global, rigid, overgeneralised: “I’mstupid”, “I'm unlovable”
• Again, often outside conscious awareness
• Stem from early experiences (thus,predisposing factors)
• Current experiences (i.e. Precipitatingfactors) trigger them¨
  

Front 8

Explain the development of beliefs/schemas

Back 8

• Often centre around competence &self-worth
• Sufficient caregiver love & support =lovable & competent
• Negative early experiences
  ¤Chronic, harsh criticism: I’m incompetent¤Pervasive neglect, punishment: I’m notok’/I’m not worth attention
  ¤Traumatic experiences: the world is adangerous place; people will hurt me; I’m not safe

Front 9

describe the cognitive model in terms of schemas

Back 9

• Behaving in belief/schema consistent waysreinforces belief/schema
• Does not allow for a disconfirmingexperience (e.g. Expressing different opinion & not being rejected)
  

Front 10

Explain the process of cognitive conceptualisation

Back 10

1. relevant early experiences
2. core beliefs/schemas
3. situation/critical incident
4. automatic thought
5. emotion
6. behaviour

Front 11

Cognitive conceptualisation factors

Back 11

• Predisposing factors:
  ¤Early childhood experiences which lead tothe development of core beliefs/schemas
  ¤Explain how automatic thoughts aregenerated by schemas
• Precipitating Factors:
  ¤A critical incident/situation whichtriggers the core belief/schema
• Perpetuating Factors:
  ¤Ongoing cognitive distortions, acceptanceof NAT as truth – perpetuate core belief/schema
  ¤Lack of experiences to disconfirm corebelief
  

Front 12

Explain schemas

Back 12

• Schema = broad organising principle formaking sense of experience
• Early Maladaptive Schemas (EMS):¤Pervasive theme or pattern
  ¤Consists of congruent memories, emotions,thoughts, physiological sensations – about self & others
  ¤Develop early in life (through toadolescence), due to unmet emotional needs
  ¤Were originally adaptive in some way
  ¤Become maladaptive – people behave inself-defeating ways in response to schemas
  

Front 13

What are unmet core emotional needs?

Back 13

• Believed to be universal, individualdifference in relative importance of needs
  1. Secure attachment to othersnInc safety, nurturance & acceptance
  2. Autonomy, competence, sense ofself/identity
  3. Freedom to express valid needs &emotions
  4. Spontaneity & play
  5. Realistic limits & self-control

Front 14

What are the five schema domains and 18 schemas?

Back 14

• Disconnection and rejection:
  - abandonment/instability - mistrust/abuse - emotional deprivation - defectiveness/shame - social isolation
• impaired autonomy & performance
  - dependency/incompetence - vulnerability to harm - emneshment - failure
• impaired limits
  - entitlement/grandiosity - lack of self control/self-discipline
• other directedness
  - subjugation - self-sacrifice - approval seeking
• over-vigilance & inhibitions
  - negativity/pessimism - emotional inhibition - unrelenting standards - punitiveness

Front 15

Explain the maladaptive schemas (1) - disconnection and rejection

Back 15

• Disconnection & rejection: beliefthat needs for safety, nurturance, care, belonging & acceptance will not bemet
  
• Family of origin: unstable, abusive,cold, rejecting, or isolated
• Adulthood: difficulty forming secure &satisfying relationships
  

Front 16

Explain the maladaptive schemas (2) - Impaired autonomy and performance

Back 16

• Impaired autonomy &performance: cannotfunction independently, will not manage responsibilities, will always fail
• FO: overprotective parents who dideverything, or failed to provide adequate direction (no reinforcement). Bothextremes undermine development of self-confidence
• Adulthood: difficulty creating ownidentity/sense of self, set goals & develop skills
  

Front 17

Explain the maladaptive schemas (3) - Impaired limits

Back 17

• difficulties controlling own behaviour,self-discipline, respecting others, being cooperative. May seem selfish,irresponsible
• FO: indulgent & permissive, notrequired to follow the rules or consider others, sense of superiority
• Adulthood: entitlement, rules only applyto others, demanding, lack empathy, exaggerated sense of superiority,frustration intolerance prevents goal attainment
  

Front 18

Explain the maladaptive schemas (4) - other directedness

Back 18

• putting others’ needs before own to gainapproval, maintain r’ships oremotional connection or avoid retaliation.
• FO: conditional acceptance; had tosuppress own needs, aspects of themselves to receive love or avoid punishment.Parents’ needs (or social acceptance/status) valued more than needs of child
• Adulthood: may lack awareness of ownneeds; self-sacrificing, excessive people pleaser, approval/recognitionseeking, suppress emotions
  

Front 19

Explain the maladaptive schemas (5) - over-vigilance & inhibitions

Back 19

• Over-vigilance &inhibitions: mustsuppress own spontaneous feelings, meet high & rigidexpectations/unrelenting standards at expense of self
  
• FO: repressed, strict, grim, punishing,self-control/denial emphasised over pleasure/play
• Adulthood: sacrifice self-expression,relaxation/health, r’ships tomeet goals, pessimism, worry, hypervigilance to harm, highly strung,perfectionistic
  

Front 20

Schema Therapy: what are the three maladaptive coping styles?

Back 20

1. Overcompensation
2. avoidance
3. surrender

Front 21

Schema Therapy: explain the overcompensation coping style

Back 21

think, feel & behave as if theopposite were true

¤Failure schema: become an over-achiever¤Emotional Deprivation: become emotionallydemanding

Front 22

Schema Therapy: explain the avoidance coping style

Back 22

arrange lives so schema is neveractivated¤Failure schema: avoid challengescompletely
- EmotionalDeprivation: avoid intimate relationships

Front 23

Schema Therapy: explain the surrender coping style

Back 23

accept that the schema is true &behave congruently
¤Failure schema: do tasks in half-heartedway; don’t really try
¤Emotional Deprivation: select emotionallydepriving partners; never ask for own needs to be met

Front 24

describe the schema therapy conceptualisation

Back 24

1. early experiences & core unmet needs (predisposing factors)
2. schemas
3. activation schema (precipitating factor)
4. coping style

Front 25

unfinished

Back 25

bhh