10. CBT: specific intervention techniques Flashcards
identifying + evaluating automatic thoughts, identifying + challenging cognitive distortions, behavioural experiments, other CBT techniques
when should you ask a client about their automatic thoughts?
which contexts?
- notice a change in emotion
- notice a change in mind/body
- feel the urge to engage in a dysfunctional way (ED, substance abuse)
what forms do automatic thoughts take?
verbal, visual, both
what’s a common issue with automatic thoughts?
they’re usually embedded within a broader statement or it’s phrased as a question
fill in the blank:
people use _ to describe their automatic thoughts
people use feelings to describe their automatic thoughts
“i don’t feel like i’m good enough”
what question can you ask to identify a clients’ automatic thought?
what was going through my mind just then?
3 types of automatic thoughts; name them!
- distorted
- accurate but distorted conclusion
- accurate but unhelpful
automatic thoughts
what is a distorted thought?
thought that occurs despite objective evidence to the contrary
“I am going to fail this exam” despite being an A student
example of thought being accurate, but conclusion being distorted
“I didn’t meet the deadline; thus, I am a horrible student”
example of thought being accurate, but unhelpful
“It is going to take me hours to finish this assignment. I will be up all night!”
which kind of automatic thought is easiest to deal with, and why?
disortorted thoughts, because you already have objective evidence to show to client
6 methods of thought re-structuring
what’s the first line approach to automatic thoughts?
make the client review evidence for and against the thought
remember to recognize their thoughts, not to dismiss them
6 methods of thought re-structuring
explain the worst case, best case, most realistic case. why do we use this?
what dx is this method best for?
- what’s the worst that could happen?
- what’s the best thing that could happen?
- if this happened, how would i cope?
best for anxiety dx
demonstrate extremes; usually recognize that middle is most realistic
6 methods of thought re-structuring
client has a realistic thought. what questions help with the responses to their thoughts?
what are the effects of believing vs not believing your thought?
how do you behave in response to the thought?
6 methods of thought re-structuring
- reviewing evidence for and against thought
- worst, best, realistic case
- pros and cons of having thought
- distancing self from thought
- problem solving
- assessing outcome of automatic thought eval process
6 methods of thought re-structuring
distancing self from thought – how do you implement this technique?
what’s the purpose of the technique?
3rd wave CBT
what would you tell a friend/family member in this situation?
purpose: you’re kinder to others than yourself
6 methods of thought re-structuring
problem solving: what questions do you ask client?
what can you do in this situation?
what could you do differently next time?
CBT thought record
what are the 7 components of the thought record?
not sure if we’ll need to know this, but at least have a general idea
- situation
- emotion
- negative automatic thought (find the hot thought)
- evidence supporting it (objective)
- evidence that doesn’t support it
- alternative thought (don’t dismiss client)
- emotion (now)
name all types of cognitive distortions
yeah all of them. there are 10. good luck xoxo
- all or nothing
- mental filter
- jumping to conclusions
- emotional reasoning
- labelling
- overgeneralizing
- disqualifying the positive
- magnification (catastrophizing) or minimization
- should & must
- personalization
cognitive distortions
what’s all or nothing?
what do we do to address it?
black & white thinking
identify extremes and explore stages between them
cognitive distortions
what’s mental filter?
what do we do to address it?
only paying attention to certain types of evidence
pay attention to all instances (good + bad)
cognitive distortions
what’s jumping to conclusions?
2 types
- mind reading (imagining we know what people are thinking)
- fortune telling (predicting the future)
cognitive distortions
what’s emotional reasoning?
assuming that because we feel a certain way what we think must be true
cognitive distortions
what’s labelling?
assigning labels to ourselves or other people
cognitive distortions
what’s overgeneralizing?
seeing a pattern based on a single event
being overly broad in the conclusions we draw
cognitive distortions
what’s disqualifying the positive?
discounting the good things that have happened or that you’ve done
“that doesn’t count”
cognitive distortions
what’s magnification + minimization?
blowing things out of proportion
inappropriately shrinking something to make it seem less important
cognitive distortions
whats should & must?
using critical words like “should”, “must”, “ought” can make us feel guilty or like we’ve already failed
cognitive distortions
what’s personalization?
blaming yourself or taking responsibility for somrthing that wasn’t completely your fault // blaming others for something that was your fault
in the context of CBT interventions
what’s an example of a behavioural experiment?
planned experiential activities undertaken to test validity of patient’s beliefs and construct more adaptive beliefs
going out to order a coffee!
in the context of CBT interventions: behavioural experiments
what’s hypothesis testing vs discovery?
hyp: i have an idea, let’s test it
discovery: no idea of how things would work out, data generation
in the context of CBT interventions: behavioural experiments
what’s active vs observational?
active: you’re actively doing something
observational: see how other people interact
4 rules to plan behavioural experiments
- can be spontaneous
- want client to push themselves but avoid setbacks (can’t predict other people’s reactions)
- design experiment so you learn something either way
- prep for challenges ahead of time
what’s the difference between active engagement and “going through the motions”?
they have to be an active participant, otherwise they might discount it because of external factors
after the exp:
what to address during the debrief?
4 questions
- what happened?
- how did the outcome fit with predictions?
- what did you learn?
- what would you diff next time based on results?
other CBT techniques
what is advantages/disadvantages analysis? how is it different than the pros and cons of cognitive restructuring?
weighing pros + cons, but rating the importance of each option – not all options are perceived the same by each person
other CBT techniques
what’s refocusing? why would we use this? how would we do it?
deliberately refocus attention on task at hand
because thinkin in circles won’t work for everyone lol (felt)
acknowledgement that thinking about thinking isn’t great
label automatic thought as a thought
other CBT techniques
what’s a graded task assignment?
- breaking down goal into smaller pieces
- focussing on one step at a time
other CBT techniques
what’s the pie technique?
making a pie chart of stuff
useful for setting goals or determining relative possibility
other CBT techniques
what’s self comparisons and credit lists?
are you comparing yourself to you at your best or your worst?
teaching client to give themselves credit when it’s due
