Chapter 10 - CBT (FIVE)

Question 1

hi

Answer 1

• Cognitive behavioural interventions have been proven effective through research, evidence based
• the most empirically validated treatment for most problems
• Twice as good at preventing relapse compared to medication (changes brain chemistry)
• more effective than medication alone
• reduces the reliance on external interventions
• Cognitive Behavioural Interventions fit with the developmental stage of adolescence.

Question 2

hi

Answer 2

• Cognitive Behavioural Interventions are helpful for internalizing (e.g., depression, anxiety) behaviours
• Cognitive Behavioural Interventions are helpful for externalizing (e.g., aggression) behaviours

Question 3

What were the three waves in cognitive behavioral theories?

Answer 3

1st-Behavior focused
2nd-Cognitive focused
3rd-Mindfullness

Question 4

What element accounts for 75% of client change?

Answer 4

Therapeutic Alliance

• essential for success
• better alliance = better outcome

Question 5

How does CBT address client’s feelings?

Answer 5

• help clients differentiate and develop language for the different feelings they have
• goal is to recognize the reason behind their symptoms before they escalate
• ex. body clues; strong body feelings are often signs that we are experiencing a strong emotion
• methods: progressive muscle relaxation, drawing etc

Question 6

How does CBT address client’s thoughts?

Answer 6

• help client recognize connection b/w their thoughts and feelings
• you can’t stop yourself from thinking
• your thoughts are influenced by other thoughts, feelings, and behaviours
• we are not aware of all of our thoughts
• once we become aware of them, we have the ability to change them

Question 7

Give examples of thought -> emotions-> behavior links

Answer 7

1. Something is unfair (‘shoulds’ about others)=Anger=Lashing Out
2. Danger/Threats to self=Anxiety=Avoidance
3. Happy =Positive future/Hope
4. Loss=Sadness=Withdrawal

Question 8

define: opposite action

Answer 8

-changing behavior to change feelings/thoughts
-ex. Anger, want to:Lash out, instead: Be a little nice
Sadness, want to: Withdraw, instead: Do something social/active
Anxiety, want to: Avoid, instead: Face fears

Question 9

Unhelpful Thinking Patterns

Answer 9

1. All or Nothing Thinking/Overgeneralization
2. Negative Filter
   -discounting the good things that have
   happened or that you have done for some reason or
   another, makes positive invisible
3. Personalization vs. Blaming
   -blaming yourself for everything that goes wrong or taking responsibility for something that wasn’t completely your fault OR blaming other people for something you are responsible for
4. Magnification or Catastrophizing and Minimizing
   -blowing things out or proportion, inappropriately
   minimizing something to make it seem less important
   -ex. magnifying other’s positive qualities and
   minimizing your own, creating distress and discouragement
5. Labelling
   -assigning labels to ourselves and others, ex. making global statements based on one specific example
   -creates discouragement related to self and anger towards others
6. Jumping to conclusions (Fortune Telling/Mind Reading)
   -imagining we know what others are thinking, and/or predicting the future
   -can lead to feel anxious, assuming the worst about other’s perceptions and the future

Question 10

What are the three steps in the ‘stopping the snowball’ drill?

Answer 10

Step 1: Explore Worst Case Scenario
-Rate intensity of anxiety
Step 2: Explore Best Case Scenario
-Rate intensity of anxiety and compare scenarios
Step 3: Explore Most Likely Scenario
-Check on anxiety

Question 11

What are the main causes of unhelpful thinking? and how does CBT address this?

Answer 11

• internalized oppression and other false messages
• core beliefs (schemas), triggering events/experiences
• leads to negative automatic thoughts: immediate, first, quick thoughts that go through our mind in response to a situation, go on to affect emotions and behaviors
• can go unnoticed and unquestioned
• learning to monitor thoughts is a essential first step in cognitive behavioral interventions, aka regular thought monitoring

Question 12

2 steps in the ‘root strategy’ for banishing harmful core beliefs

Answer 12

1. Ask what questions
   - What was the hardest part of that?
   - What was the most upsetting part?
   - What does that mean to you?
   - If that is true, what does that say about you?
   - What is the worst part of that?
2. Evaluate usefulness of beliefs
   - What proof do you have that this belief is still true?
   - How much do you still believe this?
   - How helpful is it to continue to believe this?
   - What is a more accurate belief?

Question 13

11 Elements of Socratic Questioning

Answer 13

1. Getting people to clarify their thinking
   e.g., ‘Why do you say that?’, ‘Could you explain further?’
2. Challenging clients about assumptions
   e.g., ‘Is this always the case?’, ‘Why do you think that this assumption holds here?’
3. Evidence as a basis for argument
   e.g., ‘Why do you say that?’, ‘Is there reason to doubt this evidence?’
4. Alternative viewpoints and perspectives
   e.g., ‘What is the counter-argument?’, ‘Can/did anyone see this another way?’
5. Implications and consequences
   e.g., ‘But if…happened, what else would result?’, ‘How does…affect…?’
6. Question the question
   e.g., ‘Why do you think that I asked that question?’, ‘Why was that question important?’, ‘Which of your questions turned out to be the most useful?’
7. Revealing the issue: ‘What evidence supports this idea?
   And what evidence is against its being true?’
8. Conceiving reasonable alternatives: ‘What might be
   another explanation or viewpoint of the situation? Why else did it happen?’
9. Examining various potential consequences: ‘What are
   worst, best, bearable and most realistic outcomes?’
10. Evaluate those consequences: ‘What’s the effect of thinking or believing this? What could be the effect of thinking differently and no longer holding onto this belief?’
    11 .Distancing: ‘Imagine a specific friend/family member in the same situation or if they viewed the situation this way,
    what would I tell them?’

Question 14

Define: SMART goals

Answer 14

Specific
Measurable
Attainable
Relevant
Time-based goals

Question 15

6 Steps in CBT

Answer 15

1. Explore the concern
2. Establish the goal area
3. Brainstorm ideas for solutions
4. Evaluate advantages and disadvantages
5. Choose an option and make a plan
6. Test it