9. CBT assessment + formulation

Question 1

5 main elements of the CBT assessment

Answer 1

1. assessing current problem
2. identify triggers + modifying factors (antecendent)
3. consequences as a result of current problems
4. maintaining processes
5. past history + problem development

Question 2

CBT assessment

what exactly are you searching for when assessing a current problem?

Answer 2

• asking structured questions to obtain detailed info
• asking client to detail a recent occasion when problem sx were experienced “what exactly is happening?”
• break the problems into the internal systems model (cognition, emotion, behaviour, physiology)

Question 3

CBT assessment

what’s a trigger?

Answer 3

what factors make problem more or less likely to occur

Question 4

CBT assessment

what is a modifier?

Answer 4

contextual factors that impact how severe the problem is when it occurs

AKA a moderator

Question 5

fill in the blank

consequences often give clues about _ processes

Answer 5

consequences often give clues about maintaining processes

Question 6

give an example of a modifier in this situation:

you walk by a bar - you are more likely to drink

what’s a moderator of you deciding whether or not you should drink?

Answer 6

whether your friends are there, would you be alone? etc

Question 7

CBT assessment

what are maintaining processes?

Answer 7

vicious cycles that keep the problem going

Question 8

what are some examples of maintaining processes?

Answer 8

• escape + avoidance behaviours (negative reinforcement)
• reduction in activity
• short term rewards

Question 9

what’s a circumstance in which a short-term reward would be positively reinforcing?

Answer 9

substance abuse

Question 10

CBT assessment

what are vulnerability factors?

past and problem development

what’s another term that could similarly be defined?

Answer 10

things that set the stage for a problem to develop but are neither necessary not sufficient

diathesis

Question 11

list the cognitive model

Answer 11

situation/event
l
automatic thought
l
reaction (emot, behav, phys)

Question 12

why do we use the simple thought record?

Answer 12

• because all the info we get is introspective, good way to identify current feelings + initial reactions
• helps identify patterns
• prepares client for CBT – intro to tx

Question 13

what elements compose the expanded cognitive model?

Answer 13

core beliefs
intermediate beliefs
automatic thoughts

Question 14

what are some characteristics of core beliefs to look out for?

Answer 14

they’re:
* global
* rigid
* generalized

Question 15

what’s an intermediate belief?

Answer 15

attitudes, rules, assumptions
fall between core beliefs + automatic thoughts

Question 16

intermediate belief

how to distinguish a/n:
* attitude
* rule
* assumption

this one isn’t very important but i put it anyway – feel free to skip it

Answer 16

• attitude: general belief about outcomes, no specifics
• rule: “should”
• assumption: if…then

Question 17

3 types of core beliefs

Answer 17

1. incompetence
2. unlovable
3. worthless

Question 18

core beliefs

beck originally had 2 core beliefs. which ones were they?

Answer 18

incompetence + unlovable

Question 19

beck later added a 3rd core belief, which one is it? which clientele had it the most?

Answer 19

worthless - seen in people with depression suffering with suicidal ideation

worthless can encompass helpless + unlovable

Question 20

what is the downward arrow technique used for?

Answer 20

identifying intermediate + core beliefs

Question 21

what is the downward arrow technique? what questions arise from this technique?

what’s its composition?

Answer 21

asking client about meaning of key automatic thoughts that you suspect stem from core beliefs:

if the thought is true…

• what does it mean?
• what’s the worst part of the situation?
• what’s so bad about it?
• what does that mean about you?

Question 22

what are some important components that outline CBT formulation?

Answer 22

• road map to therapy
• hypothesis refined by incoming data provided by client
• presentation of formulation to client to see if it “rings true” – diagrams

Question 23

there are a lot, if you get over 4 it’s fine i think

questions to ask yourself while formulating CBT

most of these are common sense, so you should be fine ma belle!

Answer 23

• how did pt develop the dx? (vulnerabilities, risk factors)
• what are significant life events/experiences?
• what are pt basic beliefs about themselves, the world, others?
• what are pt attitudes, rules, assumptions?
• what strategies has pt used to cope with beliefs?
• what automatic thoughts, images, and behaviours maintain dx?
• how did beliefs interact with life events to make pt vulnerable to disorder?
• what’s going on in pt life rn and what’s their perceptions? what’s maintaining?

Question 24

what is beck’s cognitive triad?

Answer 24

patient’s basic beliefs about
* themselves
* the world
* others