2nd Wave: Cognitive interventions Flashcards
Hayes (2004)
Behaviourism didn’t adequately account for the role of cognition or emotional symptoms
What is CT according to Beck (1993)
the application of the cognitive model to a particular disorder
designed to modify the dysfunctional beliefs and faulty info processing characteristics of each disorder
the mechanisms of change for CT is changing the content of thoughts and way people process info
What is CT according to Clarke and Beck (2010)
CT is a structured skills-based therapy
focuses on modifying faulty thoughts, evaluations, attributions, beliefs and processes on biases that characterise anxiety and depression
Who is the ABC model by and what does it suggest?
Beck (1976) and Ellis (1962)
An individuals thoughts/beliefs/assumptions mediate the relationship between an event and its consequences
What did Shakespeare say?
For there is nothing either good or bad but thinking makes it so
What did Ellis and Beck recognise
recognised the key role that cognitions play in psychological problems
who is the Cognitive Model of Depression by and what does it include?
Clarke and Beck (2010)
Schemas
Common Cognitive distortions
how these cognitive distortions maintain depression
what are Schemas in the Cognitive Model of Depression?
deepest level of cognitions
internal model of self+world
developed in childhood
inferred from persistant repetitive themes in thoughts, images and recurring patterns of biased information processing
readily activated by a range of stimuli and once activated dominate information processing
What are common cognitive distortions in the cognitive model of depression?
biased information processing/unhelpful styles of thinking
selective abstraction
- not an active choice - core schemas choose how you attend the environment
- seek out negative environmental stimuli - may not notice positive
Mind reading
- no evidence for it
- mind just supplies thought
assuming you know what the other is thinking
How do cognitions maintain depression in the cognitive model of depression?
combination of schemas and NATs Cognitive Triad (Beck) - NATs about self, future and world
Craske (2010)
view thoughts as hypotheses which can be tested. challenged and changes
What did Craske (2010) say about cognitive restructuring?
set of techniques for identifying maladaptive thoughts and beliefs and replacing them with more evidence-based thoughts and beliefs
What are thought records and what are they used for?
cognitive restructuring
records that therapy can be based on
adapting and recognising unhelpful thoughts
outcome column - how much you believe the thought
process that needs practicing
Mills et al (2009)
ABC model with congitive restructuring on end
D = disputing automatic thoughts
- look for evidence to support/disprove
E= alternative explanation
- rational alternative explanations to automatic thoughts
Butler et al (2006)
- moderate to large effect sizes in RCT of and in favour for CBT across a range of diagnoses
- depression, GAD, SAD and OCD
but
- few studies compared CBT with other established treatments
Hofmann et al (2012)
Review of 106 representative meta-analysis across a range of diagnoses
- strongest support for CBT for anxiety, bulimia, anger control problems and general stress
- evidence for efficacy of CBT in depression and Bipolar was mixed
- evidence for efficacy of CBT for addiction varied from low to medium size
NICE guidlines
Recommend CBT for more MH problems than any other therapy
Westbrook and Kirk (2005)
less clear is CBT is more effective than other interventions
only 50% who have CBT significantly benefited
Vittengle, Clark Dunn and Jarret (2007)
Meta analysis of studies investigating relapse in CBT for depression
29% relapsed within 1yr
54% relapsed within 2yrs
but still better than relapse following discontinuation of anti-depressant medication
Hollon and Beck (2004)
Changes in belief is the primary mechanism of change in CT
Hollon and DeRubeis (2004)
changes in cognition during CBT predict changes in symptoms
Jarrett et al (2007)
when using CBT for depression cognitive context changes but those changes in thought don’t predict outcomes
symptoms get better and following that they get better cognitions
Jacobson et al and Dimidjian et al
Adding cognitive element of CBT to BA doesn’t improve outcomes for depression
Kazdin (2007)
changes in symptoms often occur earlier on in CBT before cognitive strategies are used
shows you don’t have to directly address negative thoughts to improve cognitions
