CBT

Question 1

What are common factors most associated with good outcomes in psychotherapy?

Answer 1

Therapeutic relationship
Empathy
Collaboration
Collecting and giving feedback
Positive regard and affirmation
Goal consensus

Question 2

Who is the founder of CBT? When?

Answer 2

Aaron Beck, early 1960s

Question 3

In context of depression, how is CBT indicated according to CANMAT guidelines?

Answer 3

1st line for acute treatment
1st line for maintenance treatment

2nd line for acute treatment for telephone-delivered CBT

Question 4

In context of bipolar disorder, how is it indicated according to CANMAT guidelines 2018?

Answer 4

2nd line for depressive phase

2nd line for maintenance phase

Question 5

In context of specific phobia, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 5

1st line, gold standard
Better than medication
Exposure-based treatment

Question 6

In context of panic disorder, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 6

1st line, CBT with interoceptive exposure

Acute phase combo > CBT alone

Question 7

In context of social anxiety disorder, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 7

1st line

Meds = CBT

Question 8

In context of GAD, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 8

1st line
Meds = CBT
No improvement with combo

Question 9

In context of OCD, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 9

1st line
CBT with exposure response prevention
CBT = or > meds

Question 10

In context of PTSD, how is CBT indicated according to Canadian Anxiety Guidelines 2014?

Answer 10

TF-CBT, including CBT with exposure

Question 11

In context of schizophrenia, how is CBT indicated according to Canadian Schizophrenia Guidelines 2017?

Answer 11

For all patients who have residual symptoms despite medication treatment

Can be initial, acute, or recovery phase

Question 12

What is systematic desensitization?

Answer 12

A person overcomes maladaptive anxiety by approaching the feared situation gradually in a state of relaxation that inhibits anxiety.
Also called reciprocal inhibition.
Usually in imagined situations.

Question 13

What are the steps of systematic desensitization?

Answer 13

1. Relaxation training
2. Hierarchy construction
3. Desensitization of stimulus

Question 14

What is flooding?

Answer 14

Patient placed in situation they fear the MOST, not necessarily applying relaxation methods.
Trying to achieve: Extinction

Question 15

What is interoceptive exposure?

Answer 15

Trying to recreate unpleasant bodily sensations in panic disorder

Question 16

What is exposure response prevention?

Answer 16

For exposure to produce extinction, avoidance behaviours that reduce fear must be prevented.

Question 17

What is contingency management?

Answer 17

Patients are rewarded [or punished] according to a formalized
set of pre-arranged [contracted] rules.

May be used in SUD.

Question 18

What are some other behavioural interventions?

Answer 18

Relaxation training
Behavioural activation
Pleasurable events scheduling
Graded task assignment
Problem-solving therapy
Social skills training
Assertive skills training
Communication skills training
Habit reversal (trichotillomania, tic disorder)

Question 19

What is Beck’s Cognitive Triad?

Answer 19

1. Self (is worthless)
2. World (is unfair)
3. Future (is hopeless)

Question 20

What are the propositions that CBT Theory is based on?

Answer 20

1. Access hypothesis (thoughts are accessible and modifiable)
2. Mediation hypothesis (our thoughts mediate our feelings and behaviour)
3. Change hypothesis (we can change our thinking)

Question 21

What is the cognitive hierarchy?

Answer 21

Core beliefs -> Intermediate beliefs -> situations -> automatic thoughts -> reactions

Question 22

Who is appropriate for CBT?

Answer 22

1. Accessibility of automatic thoughts
2. Awareness and differentiation of emotions
3. Acceptance of personal responsibility for change
4. Compatibility with cognitive rationale
5. Alliance potential: in session evidence
6. Alliance potential: out of session evidence including previous therapy
7. Chronicity of problems
8. Security operations
9. Focality
10. General optimism regarding therapy

Question 23

What are the 12 therapeutic factors of group therapy?

Answer 23

1. Instillation of Hope: Members recognize other member’s improvement and develop optimism for their own improvement.
2. Universality: Members realize that they are not alone in their feelings, impulses, thoughts, and problems.
3. Imparting information: Education and advice provided by the group members and therapist.
4. Altruism: Members boost their self-esteem and sense of value and significance by helping other group members.
5. Corrective recapitulation of primary family experience: the opportunity to re-enact family dynamics within the safety and corrective manner of a group setting
6. Development of socializing techniques: provides an environment for group members to have social development, tolerance, empathy, and other interpersonal skills.
7. Imitative behavior: group members expand their own knowledge and skills by observing other member’s self-exploration, working through, and personal development
8. Interpersonal learning:
   Input: members gain personal insight about their interpersonal impact through feedback provided by other members
   Output: members provide an environment that allows members to interact in a more adaptive manner and practice new skills.
9. Cohesiveness: gives members a sense of trust, acceptance, belonging, and security.
10. Catharsis: members release strong feelings or suppressed emotions about past or present experiences
11. Existential factors: members accept responsibility for their life decisions – by living ‘existentially’, members learn how to accept responsibility without escaping from them.
12. Self-understanding: members gain insight into psychological motivation underlying behaviour and emotional reactions