2nd Wave: Cognitive interventions

Question 1

Hayes (2004)

Answer 1

Behaviourism didn’t adequately account for the role of cognition or emotional symptoms

Question 2

What is CT according to Beck (1993)

Answer 2

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

Question 3

What is CT according to Clarke and Beck (2010)

Answer 3

CT is a structured skills-based therapy

focuses on modifying faulty thoughts, evaluations, attributions, beliefs and processes on biases that characterise anxiety and depression

Question 4

Who is the ABC model by and what does it suggest?

Answer 4

Beck (1976) and Ellis (1962)

An individuals thoughts/beliefs/assumptions mediate the relationship between an event and its consequences

Question 5

What did Shakespeare say?

Answer 5

For there is nothing either good or bad but thinking makes it so

Question 6

What did Ellis and Beck recognise

Answer 6

recognised the key role that cognitions play in psychological problems

Question 7

who is the Cognitive Model of Depression by and what does it include?

Answer 7

Clarke and Beck (2010)
Schemas
Common Cognitive distortions
how these cognitive distortions maintain depression

Question 8

what are Schemas in the Cognitive Model of Depression?

Answer 8

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

Question 9

What are common cognitive distortions in the cognitive model of depression?

Answer 9

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

Question 10

How do cognitions maintain depression in the cognitive model of depression?

Answer 10

combination of schemas and NATs
Cognitive Triad (Beck) - NATs about self, future and world

Question 11

Craske (2010)

Answer 11

view thoughts as hypotheses which can be tested. challenged and changes

Question 12

What did Craske (2010) say about cognitive restructuring?

Answer 12

set of techniques for identifying maladaptive thoughts and beliefs and replacing them with more evidence-based thoughts and beliefs

Question 13

What are thought records and what are they used for?

Answer 13

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

Question 14

Mills et al (2009)

Answer 14

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

Question 15

Butler et al (2006)

Answer 15

• 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

Question 16

Hofmann et al (2012)

Answer 16

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

Question 17

NICE guidlines

Answer 17

Recommend CBT for more MH problems than any other therapy

Question 18

Westbrook and Kirk (2005)

Answer 18

less clear is CBT is more effective than other interventions
only 50% who have CBT significantly benefited

Question 19

Vittengle, Clark Dunn and Jarret (2007)

Answer 19

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

Question 20

Hollon and Beck (2004)

Answer 20

Changes in belief is the primary mechanism of change in CT

Question 21

Hollon and DeRubeis (2004)

Answer 21

changes in cognition during CBT predict changes in symptoms

Question 22

Jarrett et al (2007)

Answer 22

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

Question 23

Jacobson et al and Dimidjian et al

Answer 23

Adding cognitive element of CBT to BA doesn’t improve outcomes for depression

Question 24

Kazdin (2007)

Answer 24

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