Chapter 5: Measurement in CBT

Question 1

Why measure in CBT

Answer 1

View treatment as an experiment in which thoughts, feelings, and behavior, and the relationships between them, can be investigated during assessment and treatment - like any experiment need to measure

Question 2

Assessment

Answer 2

Ask the client to collect data about the problem, to fine-tune what he reports in the assessment interview

Question 3

Main Goals of Collecting Data

Answer 3

Helps with initial Formulation by looking at triggers and relationships for TFB

The baseline against which the problem can be compared and measure frequency and severity

Allow eval of impact of interventions pre and post

Question 4

Regular Measures

Answer 4

Allow both client and therapist to evaluate the impact of interventions; gather data at the end of treatment so overall progress can be assessed

Question 5

Reasons it is helpful to gather data to supplement information derived from interviews

Answer 5

Regular measures allow you to obtain a baseline and then use that to assess effects of future intervention

Observations of behaviors, thoughts, and feelings made at the time they occur are more reliable than retrospective estimates

Direct observations by the client in real life can have therapeutic effects in themselves by increasing awareness

Once they have improved, many clients lose awareness of how disabling the problem was initially; Baseline measures help client to assess his progress more accurately

If the intervention does not have impact, measurement can help therapist and client to figure out why

Question 6

Reactivity of Measurement

Answer 6

Process of monitoring can have a positive or negative effect on what is being measured eg initially increase anxiety as awareness increases or reduce smoking by ID triggers

Question 7

Useful and Accurate Measures

Answer 7

Simple
Consider measures in more than one system (eg behavior, emotion, thought)
Specific, clearly defined targets
Provide clear and simple instructions
Use sensitive and meaningful measures
Provide aids to recording/discreet
Train Client to use the measure
Collect data as soon as possible after the event
Pay attention to the monitoring

Question 8

Sort of Information to Collect

Answer 8

Frequency Counts (number of times thoughts, urges, behaviors) - if lots just one hour period each day
Duration of time of event/experience
Self-ratings for internal experiences such as on 0-10 scale
Diaries - train client to use and get feedback on it
Questionnaires

Question 9

Other sources of Information using same type of measures

Answer 9

Informants
Live observations of behavior at time occurs
Physiological Data

Question 10

Problems When Using Measurements

Answer 10

Client does not appreciate its potential value
Client cannot read or write
Poor reliability or validity of a questionnaire
Doesnt understand measure
Doesnt measure accurately