CBT development Flashcards
1/6 people have what?
A diagnosable mental health condition
by how much did the number of people diagnosed with anxiety and depression increase in the past 30yrs?
40% - greater for young women and other vulnerable groups (LGBTQ+)
what did the pandemic trigger?
25% increase in prevalence of anxiety and depression worldwide
what are the 2 effective approaches to treating psychological distress?
pharmacological and psychological
how much has pharmacological treatment increased in the past 30yrs?
10-fold increase
how does pharmacological treatment define effectiveness?
symptom relief
The broader criteria for effectiveness in psychological approaches:
increases sense of …
teaches …
… effects (lower …)
no …
no …
Increases sense of personal empowerment.
Teaches skills for life.
Preventive effects – lower relapse rates.
No dependency.
No rebound effect.
Psychological therapy can help people…
understand their … (what is this called?)
support their …
enhance their …
build their …
Understand their problems (psychoeducation).
Support their own recovery.
Enhance their positive wellbeing.
Build their resilience level.
what are the dates for the evolution of CBT?
1960s = first wave; behaviour therapy.
1970s = second wave; added cognitive therapy.
1990s = third wave; several additional approaches
Behaviour therapy views MH conditions as … … … which stems from … (including …)
Views MH conditions as learned maladaptive behaviours which stem from conditioning, classical and operant, including vicarious learning.
what kind of reinforcement schedule does behaviour therapy use?
positive reinforcement schedule; behaviour shaped towards an adaptive behaviour
What does reciprocal inhibition mean?
certain emotions are incompatible with other emotions (at a neurobiological level)
what is an example of a therapeutic technique using reciprocal inhibition?
systematic desensitisation: deep muscular relaxation paired with gradual hierarchy of phobic stimuli
Behaviour therapy for depression is based on the idea that depression results from …
too little environmental reinforcement or too much environmental punishment
who are the two founders of cognitive therapy?
Aaron Beck and Albert Ellis
what is the cognitive rationale?
Importance on what we think - i.e., subjective reality/experience is more important than reality
what does a person’s emotional response to a situation depends on?
a person’s emotional response to a situation depends on their appraisal of that situation
consequences of appraisal differ in what terms?
emotional
what does Beck’s cognitive therapy help us to identify?
Cognitive errors and distortions that lead to unnecessary distress or maladaptive behaviour.
what does Beck’s cognitive therapy try to do with our identified cognitive errors and distortions?
Correct for these biases and unwanted hypotheses.
what kind of approach is cognitive therapy?
Problem solving.
Problem = appraisals distorted.
Solution = help to see things clearly.
What 6 things does cognitive therapy help people become?
More rational.
More reasonable.
More realistic.
More evidence based.
To keep things in perspective.
To be more balanced in their judgement.
what are the 3 types of cognitive distortions?
Irrational thoughts and beliefs.
Illogical reasoning.
Negative judgement biases (e.g., focus on problems and failures).
What 3 words are emphases in Ellis’ irrational beliefs?
Should, ought, must.
How does Beck suggest cognitive beliefs develop?
During childhood and beyond we develop core beliefs about ourselves, other people, the world, and the future.
These are often unrealistic and irrational and have profound effects on how we feel and behave.
What are the aspects of Beck’s cognitive hierarchy?
Core beliefs (schema) -> intermediate beliefs (assumptions) -> automatic thoughts (NATs)
What do NATs come in and how can we use them to identify beliefs?
They come in clusters (variations on the same core belief/schema). Work backwards from these patterns to identify the schema it comes from and challenge them.
What do we do to NATs after identifying them?
Challenge them.
what are Beck’s 8 cognitive distortions? (and examples)
All or nothing thinking.
Magnification/minimisation: something goes wrong we make a big thing of it; something goes right we play it down.
Catastrophising: “I’m going to be lonely forever” after someone is late/doesn’t turn up for a date.
Discounting the positive: focus on things you cannot do rather than those you can; “yeh I can do that but that’s not important”.
Labelling: fail at one thing and jump to labelling yourself as a failure/joke/nobody.
Mind-reading: “I know just what he thinks of me”.
Fortune-telling: “I know just what is going to happen here”.
Emotional reasoning: “when I feel scared it shows the situation is really dangerous”
what cognitive distortion is each of these?
something goes wrong we make a big thing of it; something goes right we play it down.
“I’m going to be lonely forever” after someone is late/doesn’t turn up for a date.
focus on things you cannot do rather than those you can; “yeh I can do that but that’s not important”.
fail at one thing and jump to labelling yourself as a failure/joke/nobody.
“I know just what he thinks of me”.
“I know just what is going to happen here”.
“when I feel scared it shows the situation is really dangerous”
magnification/minimisation
catastrophising
discounting the positive
labelling
mind-reading
fortune-telling
emotional reasoning
CBT aims to help clients understand the relationships between their …, …, and … and to help them develop … and … skills to … and … their cognitive biases, errors, and distortions
thoughts, feelings, and behaviours
cognitive and behavioural skills
identify and correct
what are the 3 elements of delivering CBT?
Psychoeducation, exploration, strategic change (intervention)
what does psychoeducation increase in the client?
emotional literacy and intelligence
what is a big part of exploration?
Collaborative empiricism: client and therapist work together to explore evidence (cognitive bases for emotional issues), to set therapeutic goals, and identify effective therapeutic strategies.
what is collaborative empiricism done in the spirit of?
openness and transparency
what are the 3 types/aspects of data collection?
clinical interview, diaries and thought records, behavioural experiments
what are the 3 parts to a clinical interview?
NATs -> core beliefs (vertical arrow): what assumptions are underlying NATs and can we move to schema to identify why you think them.
Thought-feeling-behaviour links.
Pattern discovery (when, where, who)
what is the spotlight illusion?
think you are the absolute object of everyone’s view all the time and always under judgement
what does pattern discovery help to map out?
the parameters of the various levels of the problem
Exploration -> intervention
NATS -> …
Look for cognitive distortions -> …
Look for false beliefs -> …
Conduct behavioural experiments -> …
identify schema
expose and correct biases
challenge (evidence?)
evaluate outcomes
what do third wave approaches place more emphasis on rather than focusing on the content of thought?
metacognitions: a person’s beliefs about their thoughts
what to third wave approaches try to change?
the person’s relationship to their thoughts, feelings, and behaviour (distance from your thoughts)
what do these abbreviations stand for?
DBT, CFT, MCT, MBSR, ACT
- Dialectical Behaviour Therapy – DBT
- Compassion Focused Therapy – CFT
- Metacognitive Therapy – MCT
- Mindfulness Based Stress Reduction – MBSR
- Acceptance and Commitment Therapy – ACT
ACT is a … and … therapy
directive and experiential
ACT doesn’t try to repair, change, or fix problems but instead helps people to …
respond to distressing events in a mindful way
what does responding to distressing experiences in a mindful way allow the person to do?
live a rich and meaningful life
who was ACT devised by?
Steven Hayes.
Collaborators included Kelly Wilson, Patty Bach & Kirk Strosahl.
who is ACT particularly effective for?
those with chronic pain
ACT…
teaches … skills to reduce the impact of … … and …
encourages people to respond … rather than acting impulsively
aims to reduce … … against things that cannot be changed (and what is this termed?)
aims to reduce … and help people live rich, full, meaningful lives
mindfulness skills, reduce impact of distressing thoughts and feelings
respond in a mindful way
reduce pointless struggling – acceptance
reduce suffering
what is psychological flexibility/what do developed skills enable people to do?
Be present in the here and now, be open to experience, and act in line with their values.
what is the serenity request?
May I have the strength to change the things I can change; the courage to accept the things I cannot change; and the wisdom to know the difference.
what eases suffering and what helps us to make life more rewarding and fulfilling?
Being less impulsive and more mindful (respond rather than react).
Commitment to living in line with our values.
what is the major problem with CBT?
the delivery – resource limitations make it impossible to provide one-to-one counselling/psychological therapy to those who could benefit from it
what can many people benefit from?
standard, low intensity interventions
what is ACTivate Your Life?
ACT based psychoeducation course.
Used across many places/charities.
YouTube, 4x45mins
Translated into BSL.
what does it mean to be mindful?
thinking things through and deciding what you are going to do
what does ACTivate distinguish between regarding the mind?
you are not your mind
what does the mind trigger?
emotional reactions
what is the stage show analogy?
Imagine your thoughts and feelings as if they were aspects of a stage show. There would be a lot of action on stage (because a lot goes on in your mind) and you can see what’s going on because you are the audience – you are not your mind.
what does trying to suppress unwanted thoughts and feelings often lead to?
increase their strength and frequency - increases our distress
what 3 things should you do when you have unwanted thoughts?
notice them, accept them, and let them be
what does the ACT approach to dealing with persistent pain involve? (3 things)
Acceptance of the pain.
Mindfulness.
Commitment to carry on doing the things you enjoy and the things that matter to you/give your life meaning.
every time we use the avoidance strategy it increases our belief that …?
avoidance is necessary/the best thing to do
what 3 things should you do to give yourself the best chance of overcoming needless fear?
Expose yourself to the thing you fear.
Confront the object/situation you dread.
Accept that when you do this you will experience fear and anxiety.
what do we try to avoid during experiential avoidance?
our own distressing emotions
we often confuse what 3 things and reality? What type of mistake is this?
thoughts, images, words
Fusion
how do we combat fusion?
defusion techniques
what is the “they’re talking about me” thought experiment and what does it help you identify?
Helps to identify your values.
Imagine phoning a friend but then hearing them talk to somebody else about you - what would you want to hear them say about you?
