CBT

Question 1

Cognitive Behavioral Therapy

Answer 1

Umbrella term for a variety of approaches, but all share a common model about psychological symptoms and therapeutic change:
Cognitions/beliefs affect mood and behavior; INACCURATE or DISTORTED cognitions/beliefs can lead to psychological dysfunction

Question 2

CBT: What factors cause change/improve symptoms?

Answer 2

since symptoms are caused by distorted or inaccurate thoughts/beliefs, change occurs by identifying and altering these inaccurate beliefs through a set of validated cognitive and behavioral interventions

Question 3

CBT, in summary…

Answer 3

If you
Identify the distorted/inaccurate beliefs that
produce & maintain the symptoms, and
Alter these beliefs through cognitive and behaviorally-based interventions
o Then the symptoms of depression should lessen, or even disappear.

Question 4

Some characteristics of CBT

Answer 4

Directive (vs. nondirective), but Collaborative o Structured (may use standardized manuals)
Case example clip
o Time limited
o Immediate problem-focused
Less insight-oriented, less focus on initial (i.e.,
early childhood) causes of symptoms
o Use of homework (self monitoring) o Ongoing formal symptom monitoring

Question 5

CBT: Initial sessions:

Answer 5

Assessment
Initial interventions
Case formulation
Setting of treatment goals

Question 6

Cognitive Restructuring

Answer 6

identifying the negative automatic thoughts
becoming more aware of NATs as they happen
ultimately change the habitual dysfunctional thought patterns

Question 7

Cognitive restructuring process

Answer 7

Client asked to described situation in which they became upset
o Identify which emotion (mad, sad, scared)
o Rate the intensity of the emotion
o Write down all thoughts that occurred just before and during the distress
o With therapist’s assistance, identify the thoughts likely related to the distress, and challenge them in one or more ways

Question 8

Burns’ cognitive-based techniques

Answer 8

1. Identify the distortions
2. Examine the evidence
3. The double standard method
4. The experimental technique
5. Thinking in shades of gray
6. The survey method
7. Define terms
8. The semantic method
9. Re-attribution
10. Cost-Benefit analysis

Question 9

Checklist of Cognitive Distortions

Answer 9

o All-or-nothing thinking o Overgeneralization
o Mental Filter
o Discounting the Positives
o Jumping to conclusions
o Magnification or minimization o Emotional Reasoning
o “Should” Statements
o Labeling
o Personalization and Blame

Question 10

Behaviorally-based techniques

Answer 10

Scheduling Pleasant Events
Controlled/Slow Breathing
Graded Exposure with Response Prevention
Structured Problem-Solving

Question 11

CBT: Relapse Prevention

Answer 11

Schema-focused Treatment

Question 12

Characteristics of “early maladaptive schema”

Answer 12

Experienced as a priori truths
Self-perpetuating and resistant to change
Dysfunctional
Tied to high level of affect when activated

Question 13

Components of SFT

Answer 13

Assessment & Education (increase awareness of schema & modes, origin, triggers)
Changing schemas and modes (“healthy adult” mode)

Question 14

Panic Disorder

Answer 14

an acquired fear of certain bodily sensations, especially those elicited by autonomic arousal

Question 15

Agoraphobia

Answer 15

a behavioral response to the anticipation of such sensations or their crescendo into a full blown panic attack

Question 16

Cognitive Model of Panic: Possible predisposing factors

Answer 16

Genetic and temperamental factors (e.g.,
neuroticism/”negative affectivity”)
Perception that anxiety is harmful – “anxiety sensitivity”
– increases likelihood of fear reaction to bodily sensations
Parental modeling
Increased sensitivity to bodily sensations
History of childhood respiratory illness, abuse/trauma

Question 17

CBT interventions for Panic Disorder

Answer 17

o Education
o Cognitive Restructuring
o Controlled/Slow Breathing
o Relaxation Training
o Interoceptive Exposure (Controlled induction of feared body sensation)

Question 18

CBT Treatment Protocol Panic Disorder

Answer 18

Sessions 1: Assessment and initial education

Session 2 and 3

• Introduction of breathing control, hyperventilation in session, education about physiology of overbreathing
• Introduction of cognitive restructuring
• Hierarchy for in vivo exposure begun

Sessions 4 – 9

• Extension of cognitive restructuring and breathing control practice
• move to exposure in naturalistic environments
• Interoceptive exposure applications and homework

Sessions 10-12

• Extension & processing of in vivo exposure, therapist feedback on cognitions, further use of IE during in vivo exposure
• Termination and plans for continuing in vivo exposure