23. Cognitive-Behavioural Therapies Flashcards
Use methods derived from behaviourist and cognitive approaches to learning.
Cognitive behavioural therapists
Early approaches viewed symptoms as ___ ____ ____ ____ that could be changed by applying behaviourist principles of learning.
maladaptive learned behaviour patterns
Although many therapists continue to practice behaviour therapy (treatment based primarily on behaviourist learning principles), most who make use of learning principles today are cognitive-behavioural in the orientation, using methods derived from ____ and ____ approaches to learning.
behaviourist and cognitive
Cognitive behavioural therapies are typically ____.
short-term
The focus is on the individual’s ____ behaviour and cognitions, not on childhood experiences or inferred motives.
present
They suggest specific ways patients should change their ____ and ____, assign homework and structure sessions with questions and strategies.
thinking and behaviour
Cognitive behavioural therapists begin with a careful ____ ____, examining the stimuli or thoughts that proceed it or are associated with a symptom.
BEHAVIOURAL ANALYSIS
They then tailor ____ to address problematic behaviours, cognitions and emotional responses.
procedures
One of the most widely used cognitive behavioural techniques is ____ ____, in which the patient gradually confronts a phobic stimulus mentally while in a state that inhibits anxiety.
Systematic desensitisation
To ____ irrational fear responses, the patient must confront the feared stimulus. This is the aim of systematic desensitisation, which takes place in four steps.
extinguish
(1) The therapist teaches the patient ____ ____, such as tensing and then relaxing muscle groups throughout the body or breathing from the diaphragm.
relaxation techniques
(2) The therapist questions the patient about his fears and uses this information to construct a ____ of ____ ____ ____ from scenes that provoke mild anxiety to those that induce intense fear.
hierarchy of feared imagined stimuli
(3) The patient relaxes, using the techniques he has learned, and is then instructed to ____ vividly the first (i.e. least threatening) scene in the hierarchy.
imagine
(4) The therapist encourages the patient to ____ his fears in real life and monitors his progress as he does so, desensitising additional scenes as needed to eliminate anxiety and avoidance.
confront
Has been used to treat a long list of anxiety related disorders, including phobias, impotence, nightmares, obsessive compulsive disorders, social anxiety and even fears of death.
Desensitisation
____ techniques presented patients with the actual phobic stimulus in real life, rather than having them merely imagine it.
Exposure
Exposure techniques for simple phobias are some of the ____ ____ treatments devised for any disorder.
most successful
The patient confronts the phobic stimulus all at once.
FLOODING
The theory behind flooding is that ____ ____ to the conditions stimulus eventually desensitises the patient through extinction or related mechanisms.
inescapable exposure
Flooding prevents the person from escaping the onset of the ____ ____.
conditioned stimulus
From a more ____ ____, when faced with inescapable exposure, patients eventually recognise that the situation is not really catastrophic and tahr they have the self efficacy to confront it.
cognitive perspective
A procedure in which the patient is gradually exposed to the phobic stimulus.
GRADED EXPOSURE
Technological advances have altered the ways in which some therapists use graded exposure. Now, therapists can use ____ ____ _____ ____ to treat phobias. Patients are exposed to virtual images of the feared stimulus, as opposed to the actual stimulus.
VIRTUAL REALITY EXPOSURE THERAPY
A key component of all exposure techniques is ____ ____ – preventing the patient from producing responses that allow avoidance of the feared stimulus. Avoidance can be quite subtle.
RESPONSE PREVENTION
In ____ ____, behaviour is controlled by its consequences. Therapies based on operant conditioning therefore use reinforcement and punishment to modify unwanted behaviour.
Operant conditioning
Operant procedures are used in virtually all the ____ ____ and are used unsystematically by all therapists, whether or not they are aware of it, as they reward is certain kinds of behaviour and discourage others.
psychiatric hospitals
Operant techniques can be particularly effective in working with ____ and their ____ because parents often intuitively apply rewards and punishments in ineffective or counter-productive ways.
children and their parents
Skilfully managing contingencies of ____ can bring unwanted behaviours under control.
reinforcement
The recognition that people learn not only through their own experiences but also by observing the behaviour of others led psychologist to develop ____ procedures in psychotherapy.
modelling
The therapist models the desired behaviour and gradually induces the patient to participate in it.
PARTICIPATORY MODELLING
Another cognitive behavioural technique, involves teaching the behaviours necessary to accomplish relevant goals.
Skills training
Skills are a form of ____ ____ and are typically carried out automatically.
procedural knowledge
Acquiring new skills, however, usually requires that the individual focus conscious awareness on and practicing a set of procedures until they gradually become ____.
routine
Involves teaching new skills to people with specific interpersonal deficits, such as social awkwardness or lack of assertiveness.
SOCIAL SKILLS TRAINING
Following assessment, treatment usually begins with direct teaching of skills or ____ ____ on film, on videotape or in person.
modelling behaviour
The next stage is ____ of the new skills – practising gestures, imagining responses, role-playing various scenarios and so forth – which is followed by feedback and renewed practice.
rehearsal
Whereas most cognitive behavioural techniques try to altar behaviour, ____ ____ focuses on changing dysfunctional cognitions that underlie psychological disorders.
Cognitive therapy
The things individuals spontaneously say to themselves and the assumptions they make.
AUTOMATIC THOUGHTS
By questioning the patient’s ____ and ____ and asking her to identify the data underlying them, the therapist engages the patient in hypothesis testing.
assumptions and beliefs
Proposed that what people think and say to themselves about the situation affects the way to respond to it.
Albert Ellis
Ellis proposed the ___ ____ of ____, where A refers to activating conditions, B to belief systems and C to emotional consequences.
ABC THEORY OF PSYCHOPATHOLOGY
Ellis’ ____ ____ ____ attempts to address the belief systems that mediate between activating conditions and maladaptive emotional reactions.
RATIONAL-EMOTIVE BEHAVIOURAL THERAPY
Beck’s ____ ____ targets cognitive distortions.
COGNITIVE THERAPY
