CBT & Depression

Question 1

What are the aims of CBT?

Answer 1

1. Identify thinking that causes problematic feelings + behaviour
2. Question patients -ve thinking/feeling to enable +ve change in thought processes
3. Identify unwanted behaviour patterns
4. Plan goals to achieve the change sought + step-step process for goal achievement

Question 2

What is the main purpose of CBT?

Answer 2

To look at how a patient thinks and feels and to find out how this influences there behaviour if the behaviour is problematic with the goal being to achieve +ve change in behaviour which has been counterproductive to an individuals functioning

Question 3

Why might dysfunctional thoughts arise?

Answer 3

1. “Shoulds”
2. Catastrophising
3. Filtering
4. Polarisation
5. Over-generalisation
6. Personalisation
7. Mind-reading
8. Heaven’s reward

Question 4

What are “shoulds”?

Answer 4

A set of expectations concerning one’s own behaviour and behaviour of others

Question 5

What is catastrophising?

Answer 5

Expecting the worst and interpreting situations as evidence of looming disaster

Question 6

What is filtering?

Answer 6

Focusing on -ve aspects of a situation and ignoring the +ves

Question 7

What is polarisation?

Answer 7

An insistence on an extreme view - people + circumstances must be categorised with no “shades of grey”

Question 8

What is over-generalisation?

Answer 8

Reaching conclusions from a single incident or a limited range of events

Question 9

What is personalisation?

Answer 9

Tending to assume that people are -vely referring to oneself; always comparing oneself (usually unfavourably) with others

Question 10

What is mind-reading?

Answer 10

Assuming that you know what others are thinking without asking them

Question 11

What is heaven’s reward?

Answer 11

Expecting that pain and sacrifice will be rewarded - feeling dismayed when this does not happen

Question 12

What is the CBT process?

Answer 12

1. Problem identification - what is the concern?
2. Goal selection - what does the patient want to change?
3. What options are possible for the patient?
4. Consideration of consequences - what might happen?
5. PoA - what does the patient decide to do?
6. Implementation - putting the plan into action
7. Evaluation - was the plan successful?

Question 13

What conditions can CBT be beneficial for?

Answer 13

Depression
Anxiety/panic attacks
Addictions e.g. pathological gambling
OCD
Drug/alcohol problems
EDs
Phobias
Chronic fatigue syndrome

Question 14

What are the benefits of CBT?

Answer 14

• Can be used instead of/in conjunction with medication
• Structure means it can be provided in different formats i.e. 1-1, groups, online/apps, self-help books
• Teaches practical strategies that can be used in everyday life after treatment has finished
• Can be completed in shorter time scale than other talking therapies

Question 15

What are the disadvantages of CBT?

Answer 15

• May not be suitable for complex mental health needs or learning difficulties
• Short-term so not enough time to cover all problems with some patients
• Confronting emotions/anxieties can be difficult in early stages so patient needs to be ready to pursue change
• Focuses on individuals capacity to change w/o addressing wider problem in systems or families which can impact on mental health + well-being
• Hard work

Question 16

What are the CBT techniques?

Answer 16

Challenging irrational beliefs
Reframing/replacing them with alternative rational thoughts
Thought stopping
Graded exposure
Assertiveness
Social skills training 
Problem solving training
Relaxation techniques

Question 17

What is Rational Emotive Behaviour Therapy (REBT)?

Answer 17

A form of CBT that involves the ABCD approach:
A = activating event
B = belief about event
C = consequences of event
D = disputing the belief/anticipated consequences of event

Question 18

What are alternative counselling approaches?

Answer 18

Psychodynamic therapy
Humanistic approach
Systemic approach
Transactional analysis
Integrative approach

Question 19

What is psychodynamic therapy?

Answer 19

Focuses on psychological changes to help the patient

Question 20

What is humanistic approach?

Answer 20

Focuses on the ideation that non-judgemental acceptance is helpful enough

Question 21

What is a systemic approach?

Answer 21

Focuses on systems that we all belong to and how they press in on us

Question 22

What is transactional analysis?

Answer 22

Focuses on how you interact with others and games people play

Question 23

What is an integrative approach?

Answer 23

Uses approaches all ranges of therapies depending on individuals needs

Question 24

What is an acute stress response?

Answer 24

Psychological condition arising IMMEDIATELY in response to a terrifying or traumatic event, or witnessing a traumatic event that induces a strong emotional response within the individual

Question 25

What is post-traumatic stress disorder (PTSD)?

Answer 25

Anxiety disorder that develops as a long-term effect of a very stressful, frightening or distressing events -someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt

Question 26

What is normal grief?

Answer 26

The typical sequence of a bereavement reaction is considered to be: initial shock (with numbness and disbelief); denial and searching; depression, apathy or despair; guilt, anger or blame and finally acceptance

Question 27

What is abnormal grief?

Answer 27

Warning signs include idealisation of the dead person, denial of the death, self-neglect, prolonged functional impairment, impulses for sudden radical changes, a sense of intense and stereotypical bereavement reactions, or the use of drugs or alcohol or displaying antisocial behaviour - tends to last for more than 6mnths

Question 28

What is motivational interviewing?

Answer 28

Counselling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behaviour - practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes

Question 29

What is solution-focused (brief) therapy (SFBT)?

Answer 29

Goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients’ responses to a series of precisely constructed questions

Question 30

What is abnormal grief called?

Answer 30

Prolonged grief disorder (PGD) OR Persistent Complex Bereavement Disorder (POBD)