Chapter 1: Basic Theory, Development and Current Status of CBT

Question 1

Cognitive Behavior Therapy

Answer 1

Cookbook approach to therapy: if the client has this problem then use that technique

Question 2

What CBT Entails

Answer 2

Understanding the client, understanding and bringing the two together in a formulation

Question 3

Modern CBT

Answer 3

Not a monolithic structure but a broad movement that is still developing and continues to be full of controversies

Question 4

Beckian Model

Answer 4

Developed by AT Beck in the 1960’s and 1970’s; dominant in the UK for the past 30 years

Question 5

Influences on Modern CBT

Answer 5

Behavior therapy as developed by Wolpe and others in the 1950’s and 1960’s
Cognitie therapy approach developed by AT Beck beginning 1960’s

Question 6

Cognitive Revolution

Answer 6

1970’s

Question 7

Behavior Therapy

Answer 7

Arose as a reaction against the Freudian psychodynamic paradigm that had dominated psychotherapy from the 19th century onwards; strongly influenced by the behaviorist movement in academic psychology which took the view that what went on inside a person’s mind was not directly observable and therefore not amenable to scientific study

Question 8

Why Freudian Psychoanalysis was questioned by Scientific Psychology

Answer 8

Lack of empirical evidence to support either its theory or its effectiveness

Question 9

Behaviorists

Answer 9

Looked for reproducible associations between observable events; particularly between stimuli and responses

Question 10

Stimuli

Answer 10

Features or events in the environment

Question 11

Responses

Answer 11

Observable and measureable reactions from the people and animals being studied

Question 12

Behavior Therapists

Answer 12

Constructed procedures, based on the learning theory, which they believed would help people learn new ways of responding; Task of therapy to establish a new, non-fearfl, response to that stimulus

Question 13

Systematic Desensitization

Answer 13

Treatment for anxiety disorders; asks clients to repeatedly imagine the feared stimulus whilst practising relaxation so that the fearful response would be replaced by a relaxed response

Question 14

Imaginal

Answer 14

Thinking about a mental picture of the feared object

Question 15

In Vivo Exposure

Answer 15

Approaching the feared object

Question 16

Behavioral Therapy

Answer 16

Successful because it had always taken an empirical approach, which soon allowed it to provide solid evidence that it was effective in relieiving anxiety problems
More Economical treatment than traditional Psychotherapy, taking 6-12 sessions

Question 17

Cognitive REvolution

Answer 17

Ways were sought to bring cognitive phenomena into psychology and theapy, whist still trying to maintain an empirical approach that would avoid ungrounded speculation

Question 18

Cognitive Therapy

Answer 18

Developed by Beck et al during the 1950’s and the early 1960s but their ideas become increasingly influential

Question 19

What fueled the Cognitive Revolution

Answer 19

Publication of Beck’s Book on cognitive therapy of depression
Research trials showing that CT was as effective a treatment for depression as anti-depressant medication

Question 20

Cognitive Behavior Therapy

Answer 20

Resulting amalgam of BT and CT growing together and influencing each other

Question 21

Basic Principles and Beliefs of CBT

Answer 21

The Cognitive Model

Event—>Cognition—>Emotion

Question 22

Core Idea of any Therapy calling itself Cognitive

Answer 22

People’s emotional reactions and behavior are strongly influenced by cognitions

Question 23

Cognitions

Answer 23

People’s thoughts, beliefs, and interpretations about themselves or the situations in which they find themselves -fundamentally the meaning they give to the events of their lives

Question 24

Basic Principles of Modern Cognitive Behavior Therapy

Answer 24

The Cognitive Principle
The Behavioral Principle
The Continuum Principle
The "Here and Now Principle"
The Interacting Systems Principle
The Empirical Principle

Question 25

Cognitive Principle

Answer 25

To a greater or lesses degree, people react differently to similar events; it is not just the event that determines emotion:there must be something else; CBT says that the something else is c ognition; different cognitions give rise to different emotions; association between certain kinds of cognition and corresponding emotional states; by helping people change their cognitions, we may be able to help them change the way they feel

Question 26

Behavioral Principle

Answer 26

Inherited from BT that considers behavior (what we do) as crucial in maintaining or in changing psychological states; Behavior can have a strong impact on thought and emotion, and, in articular, that changing what you do is often a powerful way of changing thoughts and emotions

Question 27

Continuum Principle

Answer 27

CBT believes that it is usally more helpful to see mental problems as arising from exaggerated or extreme version of normal process, rather than as pathological states that are qualitatively different from, and inexplicable by, normal states and processes

Question 28

Here and Now Principle

Answer 28

Main focus of therapy is on what is happening in the present and its major concerns are the processes currently maintaining the problem, rather than the processes taht might have led to its development many years ago;

Question 29

Systems which Interact in CBT

Answer 29

Cognition
Affect
Behavior
Physiology

Question 30

Interacting Systems Principle

Answer 30

Systems interact with each other in complex feedback processes and also interact with the environment; kind of analysis helps us to describe problems in more detail, to target specific aspects of a problem and also to consider times when one or more systems are not correlated with the others

Question 31

Environment

Answer 31

Includes not just the obvious physical environment but also the social, family, cultural and econnomic environment;

Question 32

Empirical Principle

Answer 32

CBT believes we should evaluate theories and treatments as rigorously as possible, using scientific evidence rather than just clinical anecdote

Question 33

Levels of Cognition

Answer 33

Negative Automatic Thoughts (NAT)
Core Beliefs
Dysfunctional Assumptions

Question 34

Negative Automatic Thoughts

Answer 34

Described by Beck; Used to Descrie a stream of thoughts that almost all of us can notice if we try to pay attention to them; negatively tinged appraisals or interpretations - meanings we take from what happens around us or within us

Question 35

Characteristics of NAT

Answer 35

One does not have to try to think NAT’s they just happen, automatically and without effort
They are specific thoughts about events or situations
They are, and can easily become, conscious
They may be brief and frequent, and so habitual, they are not heard
They are often plausible and taken as obviously true, especially when emotions are strong
Because of their immediate effect on emotional states, and their accessibility, tackled early on in therapy

Question 36

Core Beliefs

Answer 36

Most of the time, they are not immediately accessible to consciousness
They manifest as general and absolute statements
They are usually learned early on in life as a result of childhood experiences but may develop and change
Generally not tackled directly in short-term therapy for focal problems

Question 37

Dysfunctional Assumptions (DA)

Answer 37

Bridges the gap between core beliefs and NAT’s; take the form of if…then propositions, framed as should or must; represent attempts to live with negative core beliefs

Question 38

Characterics of DA’s

Answer 38

Like core beliefs, not as obvious as NATS and may not be easily verbalised
Conditional statements, taking the form ‘if…then…’ or should/must…otherwise…. statements
Some may be culturally reinforced
What makes them dysfunctional is that they are too rigid or overgeneralized, not flexible enough to cope with the inevitable complications and setbacks of life
Usually tackled later on in therapy, after the client has developed some ability challenging NATs

Question 39

Depression

Answer 39

Characteristic cognitions in depression are the negative cognitive triad

Question 40

Negative Cognitive Triad

Answer 40

Negatively based views of oneself, of the world in general, and of the future

Question 41

Anxiety

Answer 41

General process is a bias towards the overestimation of threat

Question 42

Nature of threat and content of cognitions

Answer 42

Panic - catastrophic misinterpretation of harmless anxiety symptoms as indicating some imment disaster
Health Anxiety -Similar misinterpretation of harmless symptoms as indicating illness, but on a longer time scale
Social Anxiety - Thoughts are about being negatively evaluated by others
OCD - Thoughts are about being responsible for, and/or needing to prevent, some harm to oneself or others

Question 43

Anger

Answer 43

Thoughts are usually about others’ beahvior being unfair, breaking some implicit or explicit rule, or having hostile intent: they ought not to do that, it’s not fair, they’re trying to put me down