CBT Flashcards
Methods of Bx Assessment
Bxl interview Direct self-report Self-recording Bxl checklist Systematic naturalistic observation Simulated observation Role-playing Physiological measurement
Multimethod vs. Multimodal
Multimethod uses more than one of the 8 methods
Multimodal tries to get information about different modes or dimensions of bs
Methods of Cognitive Assessment
Thoughts and internal dialogue Beliefs Attributions Cognitive distortions Imagery Self-efficacy expectations Cognitive style
The ABC Model
The specific antecedents and consequences that cause an individual to perform a behavior.
The Process of Behavior Therapy
Clarify problem Formulate goals of tx Designate a target bx Identify maintaining conditions Design a tx plan to change the conditions Implement plan Evaluate success of plan Follow-up assesssment
Stimulus Control
Changing the maintaining antecedents of behavior
Used in obesity and insomnia
Use cues that elicit target behavior
Change antecedents and cues that elect undesirable bx
Contingency Management
Using the consequences of behavior to change that behavior through reinforcement (positive or negative)
Used in alcohol treatment, ABA therapy
Behavioral Activation
Lewinsohn: depression is due to lack of response contingent positive reinforcement
Engage in planned activation strategies that lead to sense of mastery
Response Cost
Remove a valued item or privilege as a consequence of undesirable bx (negative punishment)
Sunday Box
Token economies
Motivating client to perform desirable bxs.
Anna State Hospital token economy
Effective during treatment, but generalization is not guaranteed
“Harry” film
Relaxation Training
Used for medical problems (pain, heart problems)
Psychological problems (anxiety, panic, PTSD, insomnia)
Progressive muscle relaxation, applied relaxation
Brief/Graduated Exposure Therapy
For maladaptive anxiety
Systematic desensitization and In vivo desensitization
Systematic desensitization
Client imagines greater anxiety provoking situations while doing relaxation techniques
teaches competing response (relaxation)
Constructs a hierarchy of scenes (needs time to develop)
Desensitize
Works because of repeated safe exposure, in a gradual manner, while engaging in a competing response
In vivo desensitization/In vivo exposure
Might use relaxation Use hierarchy Option to terminate if uncomfortable Interoceptive exposure for panic More effective than SD Generalizes better than SD Can monitor avoidance Costly
Virtual Reality Exposure
significant reduction in PTSD symptoms in veterans
VRE is better than imaginal exposure and no better than in vivo
Panic Control Treatment
Diaphragmatic breathing Progressive muscle relaxation Cognitive restructuring Interoceptive exposure PCT led to greater change than treatment as usual
Prolonged/Intense Exposure (flooding)
Doesn’t promote relaxation because it is a form of avoidance.
No hierarchy. People learn that anxiety is not going to hurt them.
Imagine scene as if it is actually occurring
Continue involvement even if anxious
Anxiety will increase and should pay attention
Used for phobias, OCD, PTSD, anorexia, PD, body dysmorphia
80% improvement compared to controls (phobias)
PE is highly effective for PTSD and gains are maintained over time (Foa)
EMDR
rebalances information processing system
Works better than nothing, but not better than CBT or BT
Unified Protocol
Psychoeducation and tx rationale
Motivational enhancement
Present-focused emotional awareness
Used across anxiety/mood disorders
Classical Conditioning
a learning process that occurs when two stimuli are repeatedly paired; a response that is at first elicited by the second stimulus is eventually elicited by the first stimulus alone.
Operant Conditioning
Operant conditioning (sometimes referred to as instrumental conditioning) is a method of learning that occurs through rewards and punishments for behavior. Through operant conditioning, an association is made between a behavior and a consequence for that behavior
3 levels of cognition
Automatic thoughts
Cognitive distortions
Negative Cognitive Triad
Cognitive interventions
Socratic dialogue
Columbo technique
Problem-solving
Homeworks and evidence gathering
Leads to more improvement, better outcomes when combined with meds vs. meds alone
Behavioral Interventions
Behavioral activation Graded task assignment Behavioral experiment Role-playing Relaxation training
Rational Emotive Behavior Therapy
Identifying thoughts based on irrational beliefs, challenging those beliefs, and replacing them with rational thoughts.
Only modest empirical support
May not work with substance use clients or paraphiliacs
Modeling/Social Learning
Learning through observation
Used for social skills training in schizophrenia or people with social phobia
Self-instructional training
Cognitive coping skills Teaching people to talk to themselves Used with impulsive kids, developmentally disabled, schizophrenics. Not the strongest evidence for efficacy Cognitive modeling Cognitive participant modeling Overt self-instructions Fading overt self-instructions Covert-self instruction
Stress inoculation training
Clients learn coping skills to deal with stress and practicing them in situations Education Coping skills acquisition Application Used for anxiety, anger, and pain Good evidence for PTSD
Problem-solving therapy
Generates many possible effective solutions
Helps choose the best ones
Implements and evaluates the chosen solution
Treats immediate problem and prepares to cope with future ones.
Used with depression, anxiety, eating disorders, caregivers
More effective than wait-list but only trending effective with active comparisons
Reduces depression significantly in older adults
Might be better for people with biases against therapy
Relapse prevention
Procedures used to handle inevitable setbacks that occur in coping with real-life stressors.
Identify high risk situations
Learn coping skills (assertiveness, relaxation, social communication)
Practice coping skills
Creating a lifestyle balance (activity scheduling)
Used in substance related disorders and tx packages
5 core themes of third generation therapies
Expanded view of psychological health Broad view of acceptable outcomes Acceptance Mindfulness Creating a life worth living
DBT
balance of radical acceptance with validation and change
1) stabilize client and achieve bxl control
2) replace quiet desperation with non-traumatic emotional experiencing
3) achieve ordinary happiness and unhappiness
4) resolve sense of incompleteness and achieve joy
Better to use the whole training. Used for people with borderline personality disorder
ACT
Accept life as it is and mindfully accept your distressing thoughts and feelings. Identify core values and commit to bx that furthers them
Experiential acceptance Cognitive defusion Self as context Contact with present moment Values Committed action
In those with social anxiety disorder, CBT and ACT were effective. ACT showed greater anxiety reduction post and follow up compared to CBT
MBSR
Mindfulness of breath
Body scan
Mindful yoga
Walking meditation
Evidence for mindfulness
moderate effect sizes for anxiety, depression, and pain
Lowe evidence of improved distress or QoL, weight, sleep, substance use
MBCT
helping to disengage and disidentify from depressing thoughts.
Might be better for people with multiple depression relapses
Used with chronic depression and bipolar
Equally as effective as medication
Applications for Health Psychology
Treatment of Medical Disorders
Adherence to Medical Regimens
Coping with Medical Procedures and Illness
Prevention of Illness
Studies using Contingency Management
Petry (2000) fishbowl procedure with alcoholics. “Good job” “small slips” “big slips”
Lewinsohn behavioral activation for depression. Dimidijan (2006) BA comparable to meds.
