CBT Flashcards
Activity scheduling
(aka behavioral activation) Working with clients to schedule activities that increase the rate of naturally occurring positive reinforcement. Used for depression especially
Behavior therapy
The therapeutic application of scientific behaviorism (holds the premise that psychology is an objective, natural science and therefore is the study of observable and measurable human behavior; the study of the mind is unscientific)
Behavioral activation
The idea that changing behaviors will improve symptoms.
Classical v. operant conditioning
Classical conditioning involves an association or linking of one environmental stimulus with another. Operant conditioning is a form of behavior modification that involves manipulation of behavioral antecedents and consequences; rooted in learning. (“Behavior is a function of its consequences)
Exposure therapy
Clients are best treated by exposure to the very thing they want to avoid. Can be done in vivo, virtual reality, or imaginal
Mowrer’s Two Factor Theory of Learning
fear of a stimulus is learned through classical conditioning, and avoiding that stimulus (negative reinforcement) relieves that fear so the fear is maintained through operant conditioning.
Massed v. spaced exposure
A single prolonged session v. a series of shorter sessions
Virtual reality exposure
Particularly for acrophobia, flight phobia, spider phobia, and other anxiety disorders.
Interoceptive exposure
Target exposure stimuli are internal physical cues or somatic sensations. (Heart racing, out of breath, etc.)
Response and ritual prevention
Involves therapists guiding and supporting clients to not engage in an avoidance response. (Not washing hands for an OCD person.)
Participant modeling
Social learning- watching someone else tackle a feared situation
Functional Behavioral Analysis
Formal assessment of behavior contingencies: behavioral ABC’s: antecedents, behavior, consequences
Reinforcement v. punishment
Reinforcement is when a stimulus is applied that increases the likelihood of a behavior or an aversive stimulus is removed that increases the likelihood of a behavior; punishment is when a a stimulus is applied that reduces the likelihood of the behavior it follows or when the removal of a stimulus decreases the likelihood of the behavior it follows. Reinforcing a behavior makes it more likely to happen again; punishing a behavior makes it less likely to happen again.
Self-monitoring
Clients observe and record their own behaviors
Automatic thoughts
Arise from cognitive distortions (faulty assumptions and misconceptions), triggered by external or internal events.
Cognitive distortions
Faulty assumptions and misconceptions (catastrophizing, polarized thinking, mind reading, labeling, personalization)
Core beliefs or schemas
beneath automatic thoughts; view of self, world and others
Modeling
When individuals learn indirectly, from watching or listening to the experiences of others. (observational or vicarious learning)
Problem list
Includes client concerns in simple, descriptive, concrete terms
Psychoeducation
Focuses on information about client diagnosis, treatment process, prognosis, and intervention strategies.
Self-efficacy
The conviction that one can successfully execute the behavior required to produce an outcome. Can be improved through incentives, knowledge and skills, positive feedback, and successful performance accomplishment.
Social Learning Theory
A theoretical extension of operant and classical conditioning. Includes stimulus-influence components (classical conditioning) and consequence-influence components (operant conditioning), but also adds a cognitive meditational component. Its two main components are observational learning and person-stimulus reciprocity.
Socratic questioning
Used to inspire introspection and uncover a client’s method of reasoning.
Thought record
A system for clients to record the following after experiencing a strong emotional response: date and time, situation that elicited the emotional response, behaviors the client engaged in, emotions that were elicited, associated thoughts that occurred during the situation
CBT characteristics
Brief or time sensitive, structured, present-oriented, involves teaching and learning, and seeks to change BOTH dysfunctional thinking and maladaptive behavior.
Stimulus generalization
Extension of fear response
Stimulus discrimination
New stimuli do not elicit fear
Extinction
Gradual elimination of conditioned response
Counter conditioning
The pairing of a positive (and often incompatible) stimulus with a stimulus that elicits a negative or undesirable response (e.g., fear)
Spontaneous recovery
When an extinct conditioned response reappears spontaneously
Behavioral theory of psychopathology
Maladaptive behavior is learned, and can be unlearned or replaced by new learning; can involve a skill deficit
Cognitive appraisal theory
“People are not disturbed by things, but by the view which they take of them.”
Beck’s Cognitive Theory
- Cognition is at the core of human suffering.
- The therapist’s job is to help clients modify distress-producing thoughts.
- self-schema includes negative or inaccurate beliefs
- Modify cognitions through cognitive therapy using an approach of collaboration, not confrontation
Beck’s view of psychopathology
Psychopathology is an exaggeration of normal cognitive biases; cognitive distortions of fault assumptions
Ellis’ view of psychopathology
Psychopathology is a function of irrational beliefs
Beck’s Negative Triad
“I am unworthy” (I suck)
“The world is falling apart” (The whole world sucks)
“Nothing will ever get better” (Everything will always suck)
Meichenbaum’s view of psychpathology
A result of dysfunctional inner speech
Goals associated with CBT assessment
- Arriving at a diagnosis which best describes client symptoms
- Developing a tentative cognitive-behavioral treatment formulation that can be used for treatment planning.
CBT Assessment strategies
- Collaborative interviewing
- Setting an agenda
- The problem list
- Self-rating scales
- Self-monitoring (client homework)
- Case formulation
Types of behavioral “heavy” interventions
- Behavioral activation
- Token economies/contingency management
- Exposure
- Skills Training
Relaxation training
counter-conditioning treatment
Systematic desensitization
An exposure treatment in which avoidance behavior can be negatively reinforced through operant conditioning
Cognitive “heavy” interventions
- Identifying thoughts
- Coping statements
- Socratic questioning
- Cognitive Restructuring
Vertical Descent
aka Downward Arrow is about uncovering core beliefs: “What would it mean to you if you did have cancer?”
Cognitive Restructuring
Getting the client to rethink and revise maladaptive interpretations (examining the evidence, considering alternatives)
How do behavioral and cognitive theory explain the role of the therapist and their primary tasks in helping the client?
Develop a collaborative and educational relationship with clients. Set an agenda, identify a problem list, use self rating scales and procedures, develop a case formulation, and provide psychoeducation. Explore and identify clients’ automatic thoughts and core beliefs.
What are some of the specific therapy skills used in CBT and their rationales?
- Vigorous and forceful disputing: clients offer a forceful and rational counterattack against their irrational beliefs
- Generating alternative interpretations
- Psychoeducation
- Guess the underlying thoughts
- Vertical descent technique (Socratic questioning)
- Use monitoring procedures
- Thinking in shades of grey/graduated thinking
What are the strengths of CBT?
- CBT is the most widely accepted and respected approach available
- Effective across a wide range of mental disorders and client
- Good fit with the medical model (amenable to manualization)
What are the limitations of CBT?
- Efficacy evidence focuses on immediate effects and it’s difficult to determine longer-term effects.
- Can be viewed as “blaming” clients for their symptoms because it is so individually focused and doesn’t take cultural or diversity factors into account
