Cognitive Approach - Therapy: Cognitive Behavioural Therapy (CBT)

Question 1

What are the aims of cognitive therapies

Answer 1

Altering maladaptive thought

Question 2

What’s the negative cognitive triad

Answer 2

• proposed by Aaron Beck: depressed people in particular, develop a pattern of negative thinking
• they have unrealistic thoughts about: the self, the world, the future
  —> Beck’s theory has been used to inform techniques used in CBT = helps client change pessimistic views

Question 3

What is the Aim of CBT

Answer 3

Challenge the negative thoughts and replace them with constructive positive thinking that will lead to healthy behaviour
—> therapist makes these thoughts conscious and then challenges them = client sees there’s no basis for these thoughts

Question 4

Does CBT use cognitive or behaviourist techniques in order to help clients

Answer 4

Both

Question 5

What are the 3 main elements to CBT

Answer 5

1) cognitive element
—> therapist works with client to help identify the negative thoughts
2) Behavioural element
—> encourages client to engage in reality testing
3) Both therapist + client play an active role

Question 6

What are the main components of CBT

Answer 6

• Dysfunctional thought diary
• Cognitive restructuring
• pleasant activity scheduling

Question 7

How does a dysfunctional thought diary work

Answer 7

• record the events that lead to unpleasant emotions
• record the automatic negative thoughts associated with these events, then rate how much they believe these thoughts 1-100%
• then write a rational response, then rate belief in response 1-100%
• Finally, re-rate the belief in the automatic thoughts 1-100%

Question 8

How does cognitive restructuring work

Answer 8

• Client + therapist work together = identifying and changing negative thinking patterns (done collaboratively)
• challenge dysfunctional automatic thoughts through Socratic questioning techniques
• by challenging dysfunctional thoughts and replacing them with constructive ones = clients can try out new ways of behaving

Question 9

How ones the pleasant activity planner work

Answer 9

• clients plan a pleasant activity for them to practice in every day
• it should be a break from regular routine or give a sense of achievement
  —> therefore induces positive emotions because it detracts from negative thinking patterns (this is an examples of behavioural activation)
  —> helps them to move towards positive solutions and away from negative thinking patterns

Question 10

How does CBT link to schemas

Answer 10

• negative schemas are also a cause of mental illness
  —> therefore CBT aims to change these negative schemas

Question 11

What internal mental processes is CBT concerned with

Answer 11

• thinking (maladaptive thoughts)
• attention (pay attention to negative aspects of a situation)
• memory (recalling unhappy events rather than happy ones)

Question 12

Why is the problem with CBT saying that client’s poor mental health is a result of maladaptive thinking

Answer 12

• damages their self-esteem by saying its only their fault (psychological harm)
  —> maladaptive thinking could be caused by other problems like abuse, not always their own fault

—however—> it means that they’re in control, its possible to change

Question 13

Why is CBT effective

Answer 13

• Supporting evidence from Jarret et al (1999)
• its long lasting = effective
• Removes cause

Question 14

Why is CBT not effective

Answer 14

• Research evidence against: Hollon et al (1992)
• Not appropriate from all
• Therapist incompetence
• Doesn’t remove the cause

Question 15

Explain the supporting evidence for why CBT is effective

Answer 15

• Jarret et al (1999)
  —> treated 108 patients with severe depression over a 10 week trial
  —> CBT proved to be just as effective as some antidepressant drugs

Question 16

Explain why the long lasting effects of CBT makes it effective

Answer 16

• patients recognise they have the free will to develop their own coping strategies, can use over and over again in the future
• very popular to alternative therapies —> especially to those who couldn’t cope with the determinist principles of other therapies
• CBT has become the most widely used therapy by clinical psychologists working in the NHS

Question 17

How does removing the cause in CBT prove that its effective
+ the argument for why it doesn’t actually and therefore CBT = doesn’t remove the cause

Answer 17

• it gets rid of maladaptive thoughts —> getting rid of depression
  HOWEVER
• ignores other causes, such as if mental health is bad due to: abusive relationships, finances, etc
• therefore changing thoughts won’t fix it

Question 18

Explain the research evidence that proves why CBT isn’t effective

Answer 18

• Hollon et al (1992)
• found no difference in CBT when compared with a slightly different kind of antidepressant drug in a sample of 107 patients over a 10-week trial
• proves that CBT isn’t superior to all antidepressants

Question 19

Explain why CBT not being appropriate for all proves why CBT isn’t effective

Answer 19

• its less suited for those with increased levels of irrational beliefs that are rigid and resistant to change
• its also less suited in high stress situations that can’t be resolved by therapy (Simons et al. (1995)

Question 20

Explain why therapist competence proves that CBT is not effective

Answer 20

• Kuyken and Tsiurikos (2009)
• claims that as much as 15% of the variance in outcomes of CBT effectiveness maybe attributable to therapist competence
• therapist competence manifests through the ability structure sessions/plan and review assignments/etc…

Question 21

Suggest an appropriate conclusion for why CBT is/isn’t effective

Answer 21

• In conclusion CBT can be an effective therapy
• for some people, proven to be as effective as drug therapy, reduces symptoms and the cause of these symptoms in a way that empowers patients to be able to implement these techniques long-term
• However
• not as effective for everybody, especially in situations where the key cause of their problems is not cognitive and is only effective if the therapist is competent enough.
• otherwise: some antidepressants are actually more effective