Beck Ch 2 + 3

Question 1

What are the 3 situations in which the focus of CBT would shift from present focused to focus on the past?

Answer 1

1. When the client expresses a strong desire to do so,
2. When work directed toward current problems and future aspirations
   produces insufficient change, or
3. When you judge that it’s important for you and clients to understand how and when their key dysfunctional ideas and behavioral coping strategies originated and became maintained.

Question 2

What model is CBT based on?

Answer 2

The cognitive model

Question 3

What does the cognitive model hypothesize?

Answer 3

It hypothesizes that people’s emotions, behaviors, and physiology are influenced by their perception of events (both external and internal).

It’s not a situation in and of itself that determines what people feel and do but rather how individuals construe a situation

Question 4

How can you train yourself to notice automatic thoughts?

Answer 4

Ask yourself: “What was just going through my mind?”

When:
* you begin to feel dysphoric,
* you feel inclined to behave in a dysfunctional way (or to avoid
behaving in an adaptive way)
* you notice changes in your body or mind that distress you (e.g., shortness of breath or racing thoughts)

Question 5

What are automatic thoughts rooted in?

Answer 5

Beliefs

Question 6

What are core beliefs

Answer 6

Enduring understandings so fundamental and deep that we often do not articulate them, even to ourselves

Individuals regard these ideas as absolute truths—just the way things “are”

Question 7

What are the three categories that negative beliefs usually fall in?

Answer 7

1. Helplessness (being ineffective—in getting things done, self- protection, and/or measuring up to others);
2. Unlovability (having personal qualities resulting in an inability to get or maintain love and intimacy from others); and
3. Worthlessness (being an immoral sinner or dangerous to others).

Question 8

What is a Schema (is Piagetian terms)

Answer 8

A hypothesized mental structure that organizes information.

Question 9

What makes maladaptive schemas difficult to change?

Answer 9

Negative data that supports the schema reinforces it, but positive data that goes against the core belief is either discounted or not noticed at all. See figure 3.3. on p 34

Question 10

When clients are depressed, what happens to core beliefs?

Answer 10

They tend to be negative, extreme, global, rigid, and overgeneralized.

Question 11

What are intermediate beliefs?

Answer 11

Attitudes, rules, and assumptions

Question 12

Give an example of an intermediate belief that is an attitude:

Answer 12

It’s terrible to fail.

Question 13

Give an example of an intermediate belief that is an assumption:

Answer 13

If I try to do something difficult, I’ll fail. If I avoid doing it, I’ll be ok.

Question 14

Give an example of an intermediate belief that is a rule:

Answer 14

I should give up if a challenge seems too great

Question 15

What is the diathesis–stress model?

Answer 15

Existing vulnerabilities exposed to relevant stressor results in disorder

Question 16

The Strengths‐Based Cognitive Conceptualization Diagram depicts (among other things) the relationship among what 4 things?

Answer 16

1. Important life events and adaptive core beliefs
2. Adaptive core beliefs and the meaning of the client’s automatic thoughts
3. Adaptive core beliefs, related intermediate beliefs, and adaptive coping strategies
4. Situations, adaptive automatic thoughts, and adaptive beahviours

Question 17

What is the purpose of the The Strengths-Based Cognitive Conceptualization Diagram?

Answer 17

Helps you pay attention to and organize the client’s patterns of helpful cognitions and behaviour

Question 18

What does the Traditional cognitive conceptualization do?

Answer 18

The traditional (i.e., problem-based) organizes the maladaptive information you collect about clients

Question 19

The Traditional Cognitive Conceptualization Diagram depicts (among other things) the relationship among what 4 things?

Answer 19

1. Important life events and core beliefs
2. Core beliefs and the meaning of client’s automatic thoughts
3. Core beliefs, intermediate beliefs, and dysfunctional coping strategies
4. Trigger situations, automatic thoughts, and reactions

Question 20

When do you share your conceptualization with clients?

Answer 20

You share your partial conceptualization with clients verbally at every session as you summarize their experiences in the form of the cognitive model

NOTE: says this on page 49. Confusing because later on (page 52) it says that at some point, usually the middle part of therapy, you will share the information from both the top and bottom of the conceptualization. I’m confused about what the “partial” part is that is being shared in every session. Is it the top or bottom? but unclear from the text.

Question 21

When might the traditional cognitive conceptualization diagram mislead you?

Answer 21

The completed diagram will mislead you if you choose situations in which the themes of clients’ automatic thoughts are not part of an overall pattern.

Question 22

How do you fill the bottom half of the traditional cognitive conceptualization?

Answer 22

1) Start with 3 typical current situations related to the presenting problems in which clients became upset or behaved in an unhelpful way.

2) Fill in the key automatic thoughts and the subsequent emotion, relevant behavior (if any), and physiological reac- tion

Question 23

What should you do in your conceptualization if a client has more than one theme in their automatic thoughts?

Answer 23

Make sure to include situations that reflect those themes

Question 24

To complete the top box of the diagram, ask yourself (and the client):

Answer 24

1. How did the core belief originate and become maintained?
2. What life events (often including those in childhood and adolescence, if any are relevant) did the client experience that might
   be related to developing and maintaining the beliefs?
3. Next ask yourself, “What are the client’s most important intermediate beliefs: rules, attitudes, and conditional assumptions?” Unhelpful rules often start with “I should” or “I shouldn’t,” and unhelpful attitudes often start with “It’s bad to.”

Question 25

How should you consider your hypotheses? How should you indicate this in your diagram?

Answer 25

Consider tentative until confirmed by the client, present them as tentative to client

Indicate tentative hypotheses with a ? in the diagram

Question 26

Whenever you present your conceptualization, what should you do?

Answer 26

Ask the client for confirmation, disconfirmation, or modification of each part

Question 27

What must be present before presenting the conceptualization?

Answer 27

Clients must be intellectually and emotionally ready

Question 28

When should you wait to present a conceptualization?

Answer 28

If a client isn’t yet intellectually and emotionally ready

If they do not have a sound therapeutic relationship or who don’t fully grasp the cognitive model or accept it

Question 29

What type of explanations should clinicians use?

Answer 29

using the most parsimonious explanations

Question 30

What should you use questions marks for in the diagram?

Answer 30

To mark things that you have inferred, hypotheses that are unconfirmed by the client