CBT Lecture Flashcards
1
Q
What is CBT?
A
- Two schools of thought to make functional whole - cognitive and behavioural
- Cognitive derived from psychodynamic therapy
- Behavioural therapy from Pavlov, Skinner
- Present moment focus - present and what maintains the problem
2
Q
What is behavioural therapy?
A
- Behaviourism predicts and influences behaviour
- Respondent - learn from experience, conditioned learning eg food poisoning then avoid food
- Operant learning - learning by positive or negative reinforcement, eg police/guide dogs, trained via treats
- Good to treat simple phobias eg spider phobia - use exposure
3
Q
What is cognitive therapy?
A
- Developed by A Beck
- Seen as thoughts functioning on 4 levels - unconscious, pre, concsious and meta-conscious
- Focus on available thoughts
- Use socratic questioning - stimulate learning by guiding
- Don’t psychoanalyse
- Eg imagine see friend and they don’t say hello - examine thoughts
4
Q
Basic CBT formulation - hot cross bun
A
- Maintenance cycle
- See how problem is being maintained
- Behaviours can make thoughts worse, emotions worse
5
Q
What are safety behaviours?
A
- Designed to prevent feared outcomes or avoid/reduce distress
- Often disproportionate to actual risk
- Covert or overt
- Covert - can’t see, neutralise intrusive thoughts internally
- Feel only thing that is keeping them safe
6
Q
Principles of CBT
A
- Based on ever-evolving formulation of patients problems
- Sound therapeutic alliance
- Emphasise collaboration and active participation
- Goal orientated and problem focus
- Emphasizes present
- Time limited
- Structured sessions
- Teaches patient - to allow them to do it in world
7
Q
What is schema?
A
- Mental concept
- Pattern of behaviour based on previous experiences
- Cognitive structures that when activated directly influence persons pereceptions, interpretations and memories
- eg waiting room schema - have memory and know what to do
8
Q
Damaging safety behaviours
A
9
Q
What is formulation?
A
- Look at early experiences
- –> These inform core beliefs
- –> Core beliefs develop about self, others and world
- –> These form rules for living - eg please others, be perfect
- –> Find critical incident - often rule break eg lose job, divorce, activate negative core beliefs
- –> Negative automatic thoughts –> body sensations, emotions, behaviours
10
Q
OCD maintenance cycle
A
- Trigger causes intrusive thought –> belief about thought eg bad mother
- –> distress with urge to act
- –> Behaviour follows urge and belief about thought - ritual or avoidance (compulsion)
- –> Temporary relief
- –> repeat cycles
-
Behaviour confims meaning, strengthens initial thought, gives power.
11
Q
What is exposure and response prevention?
A
- Treatment for OCD
- Exposing to intrusive thought and anxiety
- Response prevention - resist compulsions, tolerate stress
- Lasts 1hr - gives time to calm down with panic, learn that is not harming them
12
Q
Contextual formulation
A
13
Q
What is triad of PTSD?
A
- Re-experiencing
- Avoidance
- Persistent arousal
14
Q
Complex PTSD triad
A
- Emotional dysregulation
- Negative self appraisal
- Difficulty in relationships
15
Q
Factors influencing therapetic outcome
A
- Outside factors - needs to be right time of life, motivated and prioritise
- Therapeutic relationship
- Hope
- Model - schema
16
Q
CBT vs psychodynamic therapy
A
- Psychodynamic therapy - focuses more on unconscious mind and free association, unstructured sessions, focuses on present but explores where this has come from
- CBT - structured, focus sessions, focus more on present, do explore some previous experiences but more present focused
17
Q
How to decide therapy suitable for?
A
- If functioning is ok, small element of previous experiences influencing now - CBT probably best
- If more non-specific symptoms and affecting wide areas of life or previous had CBT and not worked - psychodynamic therapy, more complex underlying cause
- Also depends on person - if solution focused - prefer CBT, if exploratory and want to know why - psychoanalytic psychotherapy
- Also psychoanalytic therapy - makes worse before get better
