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24 Cards in this Set

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The Cognitive Model

- It's not an event itself that causes emotions and behaviour, but instead the interpretation/thought of the event

ABC Framework

- Activating event: Bird poos on you
- Beliefs: "I'm so unlucky!" OR "This is a sign of good luck"
- Consequences: Depressed, give up go home OR Excited, buy lottery ticket

Cognitive Behaviour Therapy

- Ellis & Beck: cognitive responses to events, not events themselves determines mood
- Emotional disorders/mental health problems a consequence of faulty/irrational thinking
- Uses cognitive and behavioural techniques to deal with unhelpful thoughts
- Teaches people to control psychological process

CBT Session

1. Working collaboratively with therapist, equal power sharing
2. Talk about current problems, set own goals
3. Asked questions about problem (i.e. thoughts, feelings, experiences, behaviours, mental imagery, memories)
4. Work with therapist to develop 'formulation'
5. Test out new ways of thinking and behaving
6. Learn to manage more independently or fully recover after therapy
7. Consider 'booster' sessions in future

Basic CBT Interventions

- Psychoeducation
- Behavioural Activation
- Behavioural Experiments
- Cognitive Restructuring

Psychoeducation

- Explaining effects of thinking on mood and physiology (adrenaline, sleep disturbance etc.)
- Explaining role of cognitive biases (over-generalisation, selective attention)
- Provide information about how person is thinking

Behavioural Activation

- Basic CBT intervention
- Involves client scheduling activities
- Complete diary measure of activity
- Increase activities that promote mastery and enjoyment
- Manage mood by managing behaviours

Cognitive Restructuring

- Aims to directly change appraisals made about situations
- Clients 'think about thinking'
- Therapist encourages rational thought, questioning of accuracy, is it normal?
- Thought diary: unhelpful belief, emotions, evidence for and against, develop reasonable alternative

Behavioural Experiments

1. Identify problematic belief
2. Devise situation to test belief
3. Identify prediction
4. Do experiment and identify outcome
5. What has been learned? Compare outcome with original prediction

Butler et al. (2006)

- Review of 16 meta-analysis of CBT, 332 studies, nearly 10k participants
- Highly effective across a range of disorders
- Large effect sizes

Tolin (2010)

- Meta-analysis of CBT vs. other therapies
- 26 studies, N = 1981
- CBT larger effects than psychodynamic therapy, but not interpersonal or supportive therapy
- CBT superiority specific to anxiety and depression

Hollon & Ponniah (2010)

- CBT has higher long-term enduring effects than medication

Potential Mechanisms of CBT

- Changing dysfunctional beliefs
- Differentially accessing new information
- 'Decentering'
- Attentional control
- Emotional processing
- Therapeutic relationship

The Accommodation Model

- CBT works by modifying structures in memory that give rise to negative beliefs
- Client directly alters content of underlying schemas
- Beck et al. (1979)

The Activation-Deactivation Model

- CBT does not change content of structures in memory (schema)
- New information brought to clients attention in therapy is stored in new positive schemas
- Therapy helps client learn to deactivate negative memories/thoughts and activate positive schemas
- Barber & DeRubeis (1989)

Retrieval Competition Account

- Draws on activation-deactivation model
- CBT increases accessibility of positive memories/schema
- Brewin (2006)

Decentering

- Observing ones thoughts and feelings as temporary features of mind
- Documented within CBT as mechanism of change (Beck, 1979)
- Mindfulness based CBT

Fresco et al. (2007)

- CBT responders showed greater increases in decentering ability than medication responders
- Ability predicted low relapse at 18 months

Attentional Control

- Having voluntary control over where you place attention and how you divide it
- Key part of interventions for anxiety disorders
- Attentional training leads to improvements in depression and anxiety symptoms (Papageorgiou & Wells, 2000)

Emotional Processing

- Applies across therapies
- Encourages exposure to difficult emotional states
- Promotes flexible use of emotions and integration of emotional memories into autobiographical memory (Conway, 2001)

Enhancing Control

- Proposed as mediator of change in therapy since 1940's
- Study of panic patients inhaling CO2 enriched air, potential control over air reduced panic attacks (Sanderson et al., 1985)

2nd Wave CBT

- Traditional CBT focusses upon changing the content of negative thoughts and beliefs

3rd Wave CBT

- Newer forms of CBT focus on changing the process people use to relate to negative thoughts
- Overcome the avoidance of negative thoughts
- Acceptance of the experience of these mental events, natural products of the mind, noticing thoughts rather than treating them as true or false

Arch & Craske (2008)

- 2nd and 3rd Wave CBT have overlapping techniques
- Exposure to emotional material
- Reappraising involves accepting thought/feeling as normal
- Decentering always part of CBT
- Both involve enhancing control