CBT Model Flashcards
Basic Idea of CBT Model
→ combines principles from cognitive and behavioural psychology
→ it is not the situation itself, but how we interpret the situation
- Challenges established thought patterns
- Break learned and conditional behaviours that are maladaptive
Beck’s Level of Cognition
Core Beliefs → intermediate beliefs and assumptions → automatic thoughts and images
When an activating event triggers a core belief then we process information through the lenses of that core belief in a biased manner
Core Beliefs (Beck)
- Beliefs about self, others and the future
- If these are thought of negatively then it becomes Beck’s triad of negative beliefs
- Absolute, inflexible and generalised
- Lovability, helplessness and adequacy
- Develops from messages received early in life and during stressful moments
Intermediate Beliefs and Assumptions (Beck)
- Rigid, conditional rules for living
- Impossible standards, do not take into account events and challenges that get in the way of our lives
- If-then conditional statements and rules
Automatic Thoughts/Images (Beck)
- Spontaneous
- Distorted and consistent with core belief
- Distortion in thinking (cognitive distortions)
- Black and white thinking
- Overgeneralization
- Catastrophizing
- Disqualifying the poitive
Cognitive Distortions
- Black and white thinking
- Overgeneralization
- Catastrophizing
- Disqualifying the positive
Learning Theory
Classical conditioning
- E.G specific phobia of dogs
- Fear response in absence of actual threat
Operant conditioning
Social Learning Theory
People learn from one another via observation, imitation and modelling
Formulation (as Longitudinal or Cross-sectional)
formulation: conceptualising how the clients difficulties have developed and are maintained
- hypothesise the causes, precipitants and maintaining factors of the clients condition
May involve a longitudinal perspective
- Early experiences trigger similar thoughts/behaviours
May be cross-sectional
- Padesky and Mooney
- Focus on the immediate, here and now
- Illustrates how thoughts, emotions, physical sensations and behaviour all interact and affect each other
CBT
Practical, action-oriented, short-term (5 to 20 sessions), emphasis on present rather than early childhood, understand how thinking, emotions and behaviour are linked and strategies for reducing symptoms and building skills
Key Elements of CBT
Assessment
- Client’s background
- Current difficulties
Strengths
Formulation
Psychoeducation
- Psychological principles and knowledge to gain understanding
- Links thoughts, feelings, physical sensations and behaviour
- CBT - structure, process, evidence base
- Goals are specific, measurable, achievable, realistic, relevant, time-limited
Cognitive Techniques used in CBT
- focus
- cognitive restructuring
- socratic questioning
- behavioural experiments
Focus (Cognitive CBT Technique)
- Target dysfunctional beliefs and thoughts
- Monitor thoughts and emotions with thought diaries or thought records
Cognitive Restructuring (Cognitive CBT Technique)
- Challenge automatic thoughts by considering evidence for and against them
- Generate balanced alternative appraisal
Socratic Questioning (Cognitive CBT Technique)
- Systematic questioning to arrive at ‘the truth’
- Guided discovery, to foster critical thinking
- What is another way to look at it, why do you think I ask that question
Behavioural Experiments (Cognitive CBT Technique)
- test assumptions and beliefs
Behavioural Techniques used in CBT
- behavioural activation
- contingency management
- exposure
Behavioural Activation (Behavioural CBT Technique)
- Increase client activity
- Reinforce situations that improve mood and functioning
- Important for consistent depressed mood within a vicious cycle
Contingency Management (Behavioural CBT Technique)
- Operant conditioning aims to reinforce desirable behaviours and decrease those that are undesirable
- Particularly useful for young adolescents
Exposure (Behavioural CBT Technique)
- Break escape pattern that maintains a fear
- Social anxiety, panic disorder, OCD, PTSD
Types
- In vivo (real life exposure - fearful situations)
- Imaginal (imagine a situation where they are afraid)
- Interoceptive (confronting feared bodily symptoms such as increased heart rate)
Additional Skills used in CBT
- Problem solving
- Assertiveness training
- Relaxation techniques
- Use a combination of strategies in practice
“Homework” used in CBT
- practice between sessions, better outcomes than those who do not
Collaborative Empiricism
- therapeutic relationship
- active and directive therapist
Limitations to Homework
- Commitment, specifically homework tasks
- Underlying causes of mental health are not addressed
- Focus on individual,
meaning wider problems, systems and family are not addressed - Standard CBT not effective for more complex presentations
CBT: Third-wave interventions
- Focus on relationships to thoughts and emotions rather than content
- Mindfulness, emotions, acceptance, relationships, values, meta-cognition
E.g
- Acceptance and commitment therapy
- Dialectical behavioural therapy
- Schema therapy
- Mindfulness-based cognitive therapy
- Meta-cognitive therapy
