8. Cognitive therapy Flashcards
Three basic features of constructivism:
- Proactive cognition: human knowledge and experience are characterized by proactive participation
- Morphogenic nuclear structure: peoples central, core or nuclear processes dictate the surface forms
- Self-organizing development: protect and perpetuate our integrity and develop via structural differentiations selected out of trial and error
Beck
Research to validate psychoanalytic theory, disappointed
Discovered that teaching clients to examine and test their negative ideas, they improved
Cognitive Therapy of Depression
Ellis
Psychoanalyst that noticed slow progression in his clients. Patients improved quickly when they changed their way of thinking.
Rational Emotive Therapy
Later: Rational Emotive Behaviour Therapy (REBT)
Obectives of REBT
- Consciousness-raising (challenge to give evidence about their beliefs)
- Contingency management (contract to follow with the homework, clients reevaluate their particular consequences)
Doubt the meaning we give to things, discuss our thoughts, develop new thoughts with a more valid and viable function.
Techniques:
Guided discovery
Socratic dialogue
- guided questioning to challenge mistaken conclusions
- cooperative argumentative dialogue, stimulate critical thinking
- Short, focused questions with a goal
- Attend to the mood
- Do not interpret and do not argue or contradict
Key aspects:
- attentive
- appropriate questions without putting words in their mouth
- not tell the patient how to think
- help them draw conslusions
- calmly guide the dialogue, helping them identify general patterns
Techniques:
Challenge the evidence
Ask what evidence they have in favour and against
Powerful for cognitive restructuring
Techniques:
Triple column technique
Helps them become aware of logical mistakes
- situation (that causes emotional distress)
- interpretation (automatic thoughts)
- error (cognitive distortions)
Techniques:
Hypothesis testing
Thoughts turned into hypotheses that can be tested.
Systematic record of predictions over several weeks and verification of whether they have been met or not.
New data added, to reduce the impact of catastrophic predictions.
Techniques:
Behavioural experiments
Cognitions to verify, evaluate degree of belief in them. Experiment to confirm cognition. Possible problems, results and what you learns. Degree of belief again. Whats next?
- Checking for thoughts
- data-gathering surveys
- Discovery
- Activity based
- Observational
Techniques:
Responsibility pie chart
Identify area where sense of responsibility is distorted. Rate the strength of belief.
Make a list of all the possible causes and make pie chart starting on teh bottom of the list.
Re-rate belief
ABC technique for irrational beliefs
+D, E and F
A- activating event
B- Beliefs
C- Consequence (emotional+behavioural)
D- Dispute the irrational thought
E- Effect of dispute+ new thought
F- record the new Feeling
Techniques:
Arriving to core/irrational beliefs: The downward arrow technique
Facilitate cognitive restructuring
1. Identify surface level thoughts
2. Inquire with purpose (questions to get beliefs one level deeper): laddering
Do not try to access core beliefs too early in treatment. Insight is not the goal, information is the goal.
Techniques:
Practice GRID technique
Way in which person make sense of their experience using their own terms. Organize view of self and others.
Identify significant people (between 10 and 20), choose according to roles. Include current and ideal self.
Obtain constructs, similarities and diferences between people. (at least 10 constructs)
Score, which construct applied to each person (1-7 likert)
Techniques: New
Midfulness-based cognitive therapy (MBCT)
For patients in remission to prevent relapse.
- Focal attention: directing attention to a chosen object
- Open monitoring: no explicit focus on objects
Metacognition
Metacognitive insight: describe experience of one’s thoughts, emotions and sensations
Limitations of cognitive therapy
- Misuse of therapist power by imposing ideas
- Clients might have trouble with confrontational style
- Too technique oriented
- What is the cause of the improved thinking, behavioural techniques of cognitive techniques?
