CBT - Depression Flashcards

1
Q

Describe the First Wave: Behaviour Therapy

A

First “empirically based” therapy… based on behavioural research how we “learn” to behave and react emotionally (behavioural learning theory –classical, operant)

The Behavioural View
A - antecedent
B - behaviour
C - consequence

Classical/Pavlovian Conditioning: (poor Little Albert)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Second Wave: Cognitive Behaviour Therapy

A

Empirical study of how thinking (cognitions) affected emotions and behaviour.

It is not the situation = emotion, but rather the way in which the situation is interpreted.

Interpretation = emotion

Interpretation of a specific situation mediates emotional response.

A (Activating Event)&raquo_space;> B (Belief)&raquo_space;> C (consequence)

The way we think affects the way we feel and act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Third wave CBT (e.g., ACT, mindfulness, DBT)Third wave CBT (e.g., ACT, mindfulness, DBT)

A

Acknowledges the importance of behaviour
Still acknowledge the importance of cognition
Still empirically based

Trying not to just change what we think but how we think.
more emphasis reacting to thoughts in a new ways
placing them in context, rather than getting caught in arguing with the content of negative thoughts.
Borrowing from eastern traditions e.g.,mindfulness
Incorporating more explicit work on values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Operant Conditioning

how is it KEY TO ANXIETY:

A

Behaviours become more or less likely to occur as a result of the consequences of the behaviours.

Positive and Negative Reinforcement: increase frequency of behavior.

  • receiving pay is positive reinforcement for working
  • avoiding traffic is negative reinforcement for going to work early

Punishment and Extinction: decrease the frequency of behaviour.

  • Punishment: Actively applying a stimulus that decreases likelihood of behavior
  • Extinction: Non-reinforcement of response leading to a decrease in the behaviour

KEY TO ANXIETY: Negative Reinforcement: Anxiety.. (phone checking)

TREATMENT: Extinction… (lack of expected response)
and negative feedback loops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Beck’s Cognitive Model that indicates that depression may come form early experience?

What are the symptoms of this cycle?

A
Early experience 
>>> Dysfunctional Assumptions 
>>> Critical Incident 
>>> Assumptions activated
 >>> Negative Automatic Thoughts
(+++Cognitive Triad and assumptons) 

Symptoms Include: Behavioural, Motivational, Affective, Cognitive, Somatic

the cognitive appraisal of internal or external
stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the parts of Beck’s cognitive model that become the target of CBT?

A

Schemas and Core beliefs: Filters / lens;
Often inflexible; Self, others, world

Rules and Assumptions: (“should”);
Beliefs apply across situations;

If ….. Then…..

Automatic thoughts (or images): 
Unplanned –not as a result of thinking or introspection; The most accessible thoughts; Specific to the situation 
* can be difficult to articulate for the client
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Beck’s Theory of Depression- the cognitive triad

A

cognitive triad negative view of self, the world, and the future

Self - I am a Failure

World - people judge you according to your success

Future - things will get worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ANT (Automatics negative thoughts)

A

cognitive errors –faulty thinking accompanied by negative and unrealistic faulty thinking accompanied by negative and unrealistic representations of reality

Schemas ; pattern of maladaptive thoughts and beliefs pattern of maladaptive thoughts and beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Depression and Attributions

A

Negative events interpreted as:
Internal, stable and global

Positive events interpreted as:
External, unstable and specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some Behavioural Aspects of Depression

A

Depression is maintained because there are benefits for depressed behaviours

◦Avoidance of stressful tasks

◦Defer responsibility to others

◦Individual with depression has withdrawn from behaviours and activities that used to provide pleasure and success

◦Therefore receives less reward for autonomous behavior

◦Poor coping skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the research say about CBT for depression?

A

◦The single most investigated psychosocial treatment for depression.

◦16-20 sessions delivered over 12-16 weeks

◦Over numerous studies, CT is shown to be of equivalent efficacy to antidepressants, and superior to pill-placebo.

◦This finding holds even when dosage is allowed to vary at discretion of prescribing physician.

What works: 
◦Behavioral activation 
◦Automatic thought identification, evaluation, and restructuring
◦Deeper level schema work
◦Relapse prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some things that CBT TREATMENT includes?

What does treatment for depression include?

A
Thought monitoring 
Cog restricting (ABC model) 
Experience (CBT) 
Problem solving skills 
Behavioural activation 
Pleasant event schedule 

establishment of the therapeutic relationship
behavioral change strategies
cognitive restructuring
the modification of core beliefs and schemas
The prevention of relapse and recurrence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some strategies for Modifying Automatic Negative Thoughts

A

Generating rational alternatives

Decatastrophising (what’s the worst that could happen, will it matter in 5 years)

Identifying cog errors

Prob solving

Foster acceptance

Focus on utility of thought

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Behavioural Activation? Examples?

A

A procedure that engages a client in one or two actions that can alter how they feel (lift their mood)

Provide psychoeducation about behavioural model of depression (negative cycle of depression)

Select actions (e.g., going for a walk, do something with a friend, go shopping for ingredients and cook a nice meal) that are realistic for client

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Activity Scheduling? What are some examples? And why does it help?

A

People with depression tend to under report experiences that are positive or enjoyable, and focus heavily on events that were not positive (remember cognitive profile of people with depression)

monitoring and maybe schedule

RATE ACTIVITIES pleasure and mastery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Three main propositions in CT are

A
  • the access hypothesis (it is possible for individuals to become aware of the content and processing of their thinking)
  • the mediation hypothesis (the way in which individuals think about themselves and their circumstances impacts subsequent emotional and behavioral responses)
  • the change hypothesis (by modifying
    cognitive and behavioral responses, an individual can become more functional and
    adaptive).