CBT Flashcards
CBT
- A type of psychotherapy that has flourished since development that has flourished since development in the 1960s:
- Beck: cognitive therapy
- Ellis: rational emotive behaviour therapy
· Now widely practiced in mental health care around the world
- Recommended by national institute for health and clinical excellence (NICE) as a first line treatment for depression, anxiety, trauma, eating disorders, schizophrenia, etc.
CBT 2
· Based on the principle that - “its not what happens to you but the view of it you take that matters”
· Mental health problems can be understood in terms of unhelpful or unrealistic beliefs (or schema) which effect how we make sense of the world – this in turn influences our emotional reaction to events
- CBT aims to break the cycle of patterns of unhelpful thinking and build a new more constructive or adaptive way of making sense of the world – with fewer negative health consequences
the cognitive model - you feel the way you think
· The meaning you attach to an event influences your emotional response to that event
- Different people attach different meanings to the same event.
CBT ABC model
· Activating event
· Beliefs
· Consequences - emotional, physical, behavioural
- It’s not what happens but the view we take of it that matters…
is it the thought that counts?
· Cognitive models posits that thoughts are not the cause’ of mental health problems, but an integral part of emotional distress - Beck, 1991
· Cognitive model posits that cognitive change is central to the change process in effective psychotherapy - Clark and Steer, 1996
· Evidence supporting this cognitive account of emotional distress
- People with depression/anxiety report more negative thoughts
- some evidence of content specificity
- Rehearsal of negative self-statements leads to negative mood in both clinical and non-clinical research participants
- reverse is true for positive self-statements – although not for all people
- Reduction of negative thoughts and thinking processes alleviates emotional distress
- both in the lab, and in CBT
- see Clark & Steer, 1996; Clark & Beck, 2010 for review of studies
its a bit more complicated than ABC
· Our beliefs about an activating event do influence our responses to it…
- But what we do also effects what we think and how we feel, and might even effect the situation itself
CBT 3
· Acknowledges the interconnectedness
- But, emphasises the importance of our thoughts on how we feel and what we do
where do the thoughts come from
· We all hold beliefs, attitudes and assumptions about the world which influence our thoughts and thinking processes.
- Our immediate cognitions are influenced by our beliefs, attitudes or assumptions learnt from our life experiences and their interaction with our unique bundle of genetics and personality.
core beliefs
· When activated ‘Core’ beliefs (schema) generate congruent thought content and attentional processes, and direct our interpretation of events.
- Where unrealistic or maladaptive beliefs, attitudes or assumptions have been learnt - this may lead to patterns of thinking that produce emotional distress (e.g., depression, anxiety, etc).
Beck’s negative cognitive triad
· Depression is characterised by a negative cognitive triad – a biased view of oneself, of the world in general, and of the future (e.g., I am unworthy/loveable, people don’t care about me, I am destined to be alone)
- May be triggered by experiences of loss or rejection
what evidence is there for this model?
· “Hundreds of experimental, correlational and prospective studies have supported major tenets of the cross-sectional cognitive model, with moderate support also accruing for cognitive vulnerability” (Clark & Beck, 2010, p. 418)
· Evidence of the effectiveness of therapies that target a change in cognition also support this model.
- However, evidence is open to critical evaluation, and in places inconclusive.
cognitive therapy
· First described as an approach for depression by Aaron. T. Beck (1967)
· Therapy helps the client to think and act more in a more realistic and adaptive way
- Developed by many others over the last 50 years applied to many types of mental health problem
CBT 4
· Helps people to become aware of unhelpful patterns of thinking associated with current problems
- Make the link between how they think, feel and do
· Helps them to evaluate how valid or helpful their beliefs are
- What is the evidence for these beliefs?
· Helps them to build a new repertoire of more realistic and adaptive ideas about themselves and their world
- Is there any evidence for alternative ideas?
what does CBt look like in practice?
· Active
· Collaborative
· Scientific
· Focused on hear-and-now problems
· Works towards specific goals
· Time-limited
- Structured
what does CBT look like in practice 2
· Traditionally - one-to-one therapy (8-20 sessions)
· But also, briefer therapies, group therapy and self-help therapies are often used.
· Offering a cognitive account of emotional distress
- Use of thought records to help identify patterns of thinking associated with painful emotional experiences.
· Collecting and weighting up evidence for unhelpful beliefs
- Generate alternative ideas and testing them out with behavioural experiments
