CBT

Question 1

How approach can be applied to therapy (CBT)

Answer 1

• Cognitive approach believes our behaviour is influenced by how we think about a situation
• One assumption is behaviour can be explained in terms of internal mental processes
• Perception is an important element within our mental processes, if we perceive ourselves/world negatively it can effect our behaviour - cognitive restructuring can alter this perception
• Schemas (another key assumption) - if we have negative schemas of ourselves, the world and the future = depression (cognitive triad) - CBT helps change these negative schemas.

Question 2

The cognitive approach believes…

Answer 2

psychological disorders stem from irrational and maladaptive thinking patterns. Beck (1967) believed depression is caused by negative schemas of the world.

Question 3

CBT aims to…

Answer 3

Change unwanted or maladaptive thoughts and belief + aims to replace irrational/negative thoughts + schemas with rational healthy ones.

Question 4

CBT uses both cognitive and behavioural techniques..

Answer 4

The cognitive element: The therapist helps the client to identify the negative thoughts that are contributing to problems.
The behavioural element: The therapist helps the client apply their work from the therapy in their real lives (or as a role play)

Question 5

Dysfunctional Thought Diary

Answer 5

• Clients record any negative automatic thoughts associated with these events + rate how much they believe them on a scale of 1-100%
• They then write a rational response to the negative automatic thought.
• Then clients rate how much they believe their rational response (1-100%)
• Finally after re-reading the automatic negative thought + the rational response, clients re-rate their belief in the automatic negative thought.

Question 6

Cognitive Restructuring (“therapy during therapy”)

Answer 6

• Taught to challenge dysfunctional thoughts themselves.
• E.g. taught to question their dysfunctional thoughts: where is the evidence for this being true? Whats the worst that could happen if “X” happens?
• By challenging their own thoughts clients can take control over their behaviour.

Question 7

Pleasant Activity Scheduling (“behavioural activation”)

Answer 7

• Clients are asked to plan for each week, and schedule one pleasant activity for each day that they will engage in.
• Could include things that give a sense of accomplishment (e.g. trying a new gym class) or things that break from the normal routine (e.g. trying something new for lunch)
• Idea is if client is involved in positive activities, it will detract from their negative thought pattern.
• Client asked to keep diary of their daily pleasant activity, noting how they felt + what the specific circumstances were + to set future goals.

Question 8

Effectiveness of CBT - strength (the study)

Answer 8

Jarett et al (1999) found CBT was as effective as some antidepressants drugs when treating 108 patients with severe depression over 10 week trial.

Question 9

Effectiveness of CBT - strength

Answer 9

Empowerment - client has control of their behaviour - methods learnt by client can help them across a number of contexts/situations in the future - recognises a persons free will.
- good for those who cannot cope with deterministic principles in other approaches - why CBT is the most widely used therapy in the NHS.

Question 10

Effectiveness if CBT - weakness - anti-depressant drugs

Answer 10

Hollen et al (1992) found no difference between CBT and anti-depressant drugs when treating 107 patients with severe depression over a 10 week trial.

Question 11

Effectiveness of CBT - weakness with study evidence

Answer 11

Therapist competence - Kuyken and Tsvirikos (2009) claim there is 15% variance in effectiveness due to the therapist’s ability - CBT heavily relies on the therapist being able to plan/structure sessions, review clients activities/homework etc.

Question 12

Effectivness of CBT - weakness

Answer 12

• requires a lot of commitment of the client as they need to be prepared to do tasks away from therapy.

Question 13

Ethics - weakness

Answer 13

Patient blame - CBT works on the assumption that the client is responsible for their faulty/maladaptive thoughts - important factors could be missed e.g. family problems, traumatic life events.
- therefore challenging thoughts may not be enough - aspects of the clients life may need to be changed to help treat them.

Question 14

Ethics weakness

Answer 14

The question of rationality - who decides whats rational/irrational? Therapist may think a client’s thought is irrational, when really its not.

• challenging a person’s core belief system could cause PSYCHOLOGICAL HARM.
• Alloy + Abrahamson (1979) suggest depressive realists tend to see things for what they are and normal people tend to distort things in a positive way. (the sadder but wiser effect)