Chapter 1 of the book ‘Learning Cognitive-Behaviour Therapy’ - Wright, Basco, & Thase

Question 1

CBT is a commonsense approach based on 2 principles:

Answer 1

1. Our cognitions have a controlling influence on our emotions and behaviour
2. How we act or behave can strongly affect our thought patterns and emotions

Question 2

Cognitive behavioral model - levels of processing

Answer 2

• consciousness
• automatic thoughts
• schemas:

Question 3

Cognitive behavioral model - consciousness

Answer 3

the highest level of cognition,
is a state of awareness in which decisions can
be made on rational basis.

allows us to link past memories with present experiences, monitor and assess interactions with the environment and control and
plan future actions.

Question 4

Cognitive behavioral model - automatic thoughts

Answer 4

cognitions that stream rapidly through our minds when we
are in the midst of situations

we are aware of them but they are not subjected to careful rational analysis, it is just below the surface of consciousness (preconscious)

• Persons with depression or anxiety can experience floods of automatic thoughts that are maladaptive or distorted.

Question 5

Cognitive behavioral model - schemas

Answer 5

=Basic templates or rules for information processing that underlie the more superficial layer of automatic thoughts.
* shaped in early childhood.
* needed to manage the large amounts of information that is encountered each day and to make timely and appropriate decisions.

Question 6

There are 3 main groups of schemas

Answer 6

1) Simple schemas
2) intermediary beliefs and assumptions
3) Core beliefs about the self

Question 7

Simple schemas

Answer 7

= rules about the physical nature of the environment, practical management of everyday activities, or laws of nature
* may have little or no effect on psychopathology ‘A good education pays off’

Question 8

Schemas - intermediary beliefs and assumptions

Answer 8

= conditional rules such as if-then statements that influence self-esteem and emotional regulation ‘I must be perfect to be accepted’

Question 9

Schemas - Core beliefs about the self

Answer 9

global and absolute rules for interpreting environmental information related to self-esteem ‘I can trust others’

Question 10

cognitive errors - what’s the goal in CBT?

Answer 10

Patients should generally realize that people make cognitive errors

Question 11

6 main categories of cognitive errors

Answer 11

DOPAMI

D) dichotomous/absolutistic/all-or-nothing:
O) overgeneralization
P) Personalization
A) Arbitrary inference
M) magnification and minimization
I) ignoring the evidence/the mental filter/selective abstraction

Question 12

ignoring the evidence/the mental filter/selective abstraction

Answer 12

= drawing a conclusion after only looking at a small portion of the available information and ignoring other data, in order to confirm the person’s biased view of the situation

Question 13

Arbitrary inference:

Answer 13

a conclusion is reached in the face of contradictory evidence or in the absence of evidence (thinking the change to fall is way higher than it is)

Question 14

overgeneralization:

Answer 14

a conclusion is made about one or more isolated incidents and then is extended illogically to cover broad areas of functioning (I can’t do anything right)

Question 15

magnification and minimization:

Answer 15

the significance of an attribute, event, or sensation is exaggerated of minimized (sweating  I will die)

Question 16

Personalization:

Answer 16

external events are related to oneself when there is little or no basis for doing so, it is excessive responsibility or blame that is taken of negative events

Question 17

dichotomous/absolutistic/all-or-nothing

Answer 17

judgements about oneself, personal experiences or others are places into one of two categories (I have nothing, they have everything)

Question 18

Attributional style in depressions

Answer 18

1) internal versus external (taking excessive blame for negative events),
2) global versus specific (thinking that negative events have far-reaching, global, all-encompassing implications)
3) and fixed versus changeable (thinking negative events are unchangeable)

> . Attributions can be distorted in depression an CBT methods can be helpful in reversing this type of biased cognitive processing.

Question 19

feedback - depressed patients

Answer 19

*Depressed patients underestimate the amount of positive feedback that is given.
*They Expend less effort on tasks after they have been told that they perform poorly.
*Nondepressed persons hear more positive feedback than is actually given or downplay the significance of negative feedback (positive self-serving bias)

Question 20

Thinking style in anxiety disorders

Answer 20

*There is a heightened level of attention to information in the environment about potential threat
*view triggers for their fear as being unrealistically dangerous or likely to cause harm.

Question 21

Key methods of cognitive behaviour therapy (CBT)

Answer 21

• Problem-oriented
• Individualized case conceptualization
• Collaborative-empirical therapeutic relationship
• Socratic questioning
• Use of structuring, psychoeducation, rehearsal to enhance learning
• Eliciting and modifying automatic thoughts
• Uncovering and changing schemas
• Behavioural methods to reverse patterns of helplessness, self-defeating behaviour and avoidance
• Building CBT skills to help prevent relapse

Question 22

Therapeutic relationship in CBT

Answer 22

• high degree of collaboration
• use of action-oriented interventions.
• Patient and therapist work together
• collaborate on developing a healthier style of thinking, building coping skills and reversing unproductive patterns of behaviour.
• The therapist is active, structures the sessions, gives feedback and coaches their patients on how to use CBT methods.
• Patients get responsibilities: they set the agenda etc.

Question 23

Cognitive restructuring

Answer 23

• Identifying automatic thoughts and schemas in therapy sessions
• teach patients skills for changing cognitions and have patients perform a series of homework exercises designed to extend therapy lessons to real-world situations.