Cognitive Behavioral Therapies Flashcards by A HL

Cognitive-Behavior Therapies

CBT is an evidence-based treatment for what disorders

depression
anxiety
bipolar disorder
anorexia & bulimia
schizophrenia
OCD
PTSD
& as an adjunct treatment for chronic pain

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Cognitive-Behavior Therapies

evidence suggest that for patients with rheumatoid arthritis, CBT is useful for what outcomes, especially if provided early in the course of the disease

reducing comorbid depression & anxiety
improving coping skills & self-efficacy
reducing pain intensity & fatigue

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Cognitive-Behavior Therapies

CBT
1) assumption(s)
2) key terms

1) psychological disturbance is due largely to maladaptive cognitive schemas, automatic thoughts, & cognitive distortions
2) key terms:
* cognitive schemas:
* automatic thoughts:
* cognitive distortions:

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Cognitive-Behavior Therapies

a practitioner of CBT might say that this term refers to core beliefs that develop during childhood as a result of experience & certain biological factors such as reactivity to stress

cognitive schemas

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Cognitive-Behavior Therapies

a practitioner of CBT might say this term refers to verbal self-statements or mental images that come to mind spontaneously when triggered by circumstances… [and] intercede between an event or stimulus and the individual’s emotional & behavrioal reactions

automatic thoughts

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Cognitive-Behavior Therapies

a practitioner of CBT might say this term refers to systematic erros in reasoning that often affect thinking when a stressful situation triggers a dysfunctional schema that, in turn, affecfts the content of automatic thoughts

cognitive disortions

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Cognitive-Behavior Therapies

according to Beck, these are enduring, can be maladaptive or adaptive, and are revealed in automatic thoughts

schemas

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Cognitive-Behavior Therapies

according to Beck, different disorders are associated with different… ?

maladaptive schemas (aka cognitive profiles)

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Cognitive-Behavior Therapies

a practitioner of CBT might say these types of thoughts are characterized by a distortion of reality, emotional distress, and/or interference with the pursuit of life goals & can contribute to psychological distress

negative automatic thoughts

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Cognitive-Behavior Therapies

a practitioner of CBT might ask a client, who presents with negative self-talk, to complete this outside of therapy whenever they feel their mood worsening

Dysfunctional Thought Record (DTR)

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Cognitive-Behavior Therapies

list the 6 components of a Dysfunctional Thought Record

the event or situation that lead to an unpleasant emotion
the automatic thoughts that preceded the emotion
the type of emotion
the emotion’s intensity on a sacel from 0 to 100
an alternative rational response to the automatic thought
the outcome (the emotion and any change in behavior elicited by the rational response)

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Cognitive-Behavior Therapies

list the 5 common cognitive distortions according to Beck

1) arbitrary inference
2) selective abstraction
3) dichotomous thinking
4) personalization
5) emotional reasoning

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Cognitive-Behavior Therapies

this is a type of cognitive disortion that involves drawing negative conclusions without any supporting evidence

arbitrary inference

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Cognitive-Behavior Therapies

this is a type of cognitive distortion that involves paying attention to & exaggerating a minor negative detail of a situation while ignoring other aspects of the situation

selective abstraction

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Cognitive-Behavior Therapies

this is a type of cognitive distortion referring to the tendency to classify events as respresenting one of 2 extremes, e.g., as a success or a failure

dichotomous thinking

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Cognitive-Behavior Therapies

this is a type of cognitive disortion that involves concluding that one’s actions caused an external event without evidence for that conclusion

personalization

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Cognitive-Behavior Therapies

this is a type of cognitive distortion that refers to a reliance on one’s emotional state to draw conclusion about oneself, others, and situations

emotional reasoning

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Cognitive-Behavior Therapies

list the 2 primary goals of CBT

1) to correct faulty information processing
2) to help patients modify assumptions that maintain maladaptive beahviors & emotions

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Cognitive-Behavior Therapies

this is an essential feature of CBT and refers to a collaborative therapeutic alliance in which therapist and client become coinvestigators as they examine the evidence to accept, support, reevaluate, or reject the client’s thoughts, assumptions, intentions, & beliefs

collaborative empiricism

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Cognitive-Behavior Therapies

characteristics CBT therapists & types of techniques used

active
structured
use of a variety of cognitive & behavioral techniques

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Cognitive-Behavior Therapies

list 3 cognitive techniques used by practitioners of CBT

1) redefining the problem
2) reattribution
3) decatastrophizing

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Cognitive-Behavior Therapies

list 4 behavioral techniques used by practitioners of CBT

1) activity scheduling
2) behavioral rehearsal
3) exposure therapy
4) guided imagery

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Cognitive-Behavior Therapies

this technique/feature of CBT involves asking the client questions that are designed to clarify & define the client’s problems, identify the thoughts & assumptions that underlie those problems, & evaluate the consequences of maintaining maladaptive thoughts & assumptions

Socractic dialogue

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Cognitive-Behavior Therapies

Rational Emotive Behavior Therapy (REBT)
1) assumptions
2) key terms & concepts

1) psychological disturbances are irrational beliefs, which tend to be “absolute (or dogmatic) and are expressed in the form of “must’s,” “should’s,” “‘ought’s,” “have to’s,” etc. … and lead to negative emotions that largely interfere with goal pursuit & attainment
2) key terms & concepts
* irrational beliefs
* A-B-C-D-E model

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# **Cognitive-Behavior Therapies** describe Ellis' A-B-C-D-E model of REBT

1) **A**ctivating event 2) irrational **B**elief about that event 3) emotional or behavioral **C**onsequence of that belief 4) the therapist's use of techniques that **D**ispute the client's irrational belief 5) the **E**ffect of these techniques, which is the replacement of the irrational belief with a more rational one

# **Cognitive-Behavior Therapies** list 4 techniques used by practitioners of REBT

* **active disputation** of irrational beliefs * rational-emotive **imagery** * systematic **desensitization** * **skills** training

# **Cognitive-Behavior Therapies** research suggests that REBT is an effective treatment for what disorders

* depression * anxiety * conduct problems * anger

# **Cognitive-Behavior Therapies** this cognitive-behavioral approach, initially developed to teach problem-solving skills to children with high levels of impulsivity, consists of 5 stages: cognitive modeling stage, overt external guidance stage, over self-guidance stage, faded overt guidance stage, and covert self-instruction stage

self-instructional training

# **Cognitive-Behavior Therapies** during this stage of self-instructional training, **children observe a model perform a task** while the model verbalizes instructions aloud

cognitive modeling stage

# **Cognitive-Behavior Therapies** during this stage of self-instructional training, children perform the same task while the model verbalizes the instructions

overt external guidance stage

# **Cognitive-Behavior Therapies** during this stage of self-instructional training, children perform the task while verbalizing the instructions aloud themselves

overt self-guidance stage

# **Cognitive-Behavior Therapies** during this stage of self-instructional training, children perform the task while whispering the instructions

faded overt guidance stage

# **Cognitive-Behavior Therapies** during this stage of self-instructional training, children perform the task while **repeating the instructions subvocally**

covert self-instruction stage

# **Cognitive-Behavior Therapies** according to self-instructional training, the instructions used throughout the 5 stages address these 4 skills

1) **idenfiying** the nature of the task 2) **focusing attention** on the task & behaviors needed to complete it 3) providing **self-reinforcement** that sustains appropriate behavior 4) **evaluating** performance & **correcting** errors

# **Cognitive-Behavior Therapies** this cognitive-behavioral therapy focuses on improving the ability of clients to deal better with ongoing & future stressful situations by **teaching them effective coping skills** and consists of 3 phases: conceptualization/education phase, skills acquisition & consolidation phase, & follow-through phase

stress inoculation training

# **Cognitive-Behavior Therapies** during this phase of stress inoculation training, clients are **provided with information** about stress and its effects and are **encouraged** to view stressful situations as "problems-to-be-solved"

conceptualization/education

# **Cognitive-Behavior Therapies** during this phase of stress inoculation training, clients **learn a variety of cognitive & behavioral coping skills** which may include relaxation, self-instruction, & problem-solving

skills acquisition & consolidation phase

# **Cognitive-Behavior Therapies** during this phase of stress inoculation training, clients **use newly acquired coping skills**, first in imagined & role-playing situations and then in real life situations

follow-through phase

# **Cognitive-Behavior Therapies** **Acceptance & Commitment Therapy** 1) assumptions 2) key terms & concepts

1) **psychological pain** is both universal and normal and is part of what makes us human and **psychological inflexibility** causes psychological problems and is characterized by "**rigid dominance** of psychological reactions over chosen values & contingencies in guiding action" 2) **key terms & concepts** * clean vs. dry pain * experiential acceptance * cognitive defusion * awareness of self-as-context * values-based actions * committed action

# **Cognitive-Behavior Therapies** according to ACT, this type of pain refers to natural levels of physical & psychological discomfort that are inevitable and cannot be controlled

clean pain (aka clean discomfort)

# **Cognitive-Behavior Therapies** according to ACT, this type of pain refers to the emotional suffering that's caused by attempts to control or resist the other type of pain

dirty pain (aka dirty discomfort)

# **Cognitive-Behavior Therapies** list the main goal of ACT

to **increase psychological flexibility**, which involves addressing 6 core processes that **foster acceptance, mindfulness, commitment, and behavior change** & counter the processes that contribute to psychological inflexibility

# **Cognitive-Behavior Therapies** list the 6 core processes that foster acceptance, mindfulness, commitment, & behavior change

1) experiential acceptance 2) cognitive defusion 3) being present 4) awareness of self-as-context 5) values based actions 6) committed action ## Footnote **experience being cogntively aware (and) committed (to) values (and) actions**

# **Cognitive-Behavior Therapies** this core process of ACT is "the active and aware embrace of private experiences withouth unnecessary attempts to change their frequency or form

experiential acceptance ## Footnote **counters experiential avoidance**

# **Cognitive-Behavior Therapies** this core process of ACT is the **ability to distance oneself** from one's thoughts & feelings and view them as **experiences rather than reality**

cognitive defusion ## Footnote **counters cognitive fusion**

# **Cognitive-Behavior Therapies** this core process of ACT involves being in contact with whatever is happening in the present moment

being present ## Footnote **counters attentional rigidity to the past and future**

# **Cognitive-Behavior Therapies** this core process of ACT is the ability to view oneself as the **context in which one's thoughts & feelings occur** rather than as the thought & feelings themselves

awareness of self-as-context ## Footnote **counters attachment to the conceptualized self**

# **Cognitive-Behavior Therapies** this core process of ACT depend on the ability to use one's freely chosen values to guide one's behaviors

values-based actions ## Footnote **counters unclear, compliant, or avoidant motives**

# **Cognitive-Behavior Therapies** this core process of ACT refers to a commitment to continue to act in ways consistent with one's values in the future, even when faced with obstacles

committed action ## Footnote **counters inaction, impulsivity, and avoidant persistence**

# **Cognitive-Behavior Therapies** list 3 ACT interventions that target the 6 core processes

* metaphors * mindfulness strategies * experiential exercises

# **Cognitive-Behavior Therapies** ACT is considered an evidence-based treatment for what disorders

* chronic pain * psychosis * depression * anxiety * OCD

# **Cognitive-Behavior Therapies** these interventions refers to "moment-to-moment awareness of one's experience without judgment" and has been incorporated into several therapeutic approachs, including ACT and DBT

mindfulness-based interventions

# **Cognitive-Behavior Therapies** list 2 types of mindfulness-based therapeutic approaches

1) mindfulness-based stress reduction 2) mindfulness-based cognitive therapy

# **Cognitive-Behavior Therapies** this mindfulness-based therapeutic approach helps people cope with stress, pain, and illness and consists of an 8-session group program that focuses on teaching participants several mindfulness meditation practices, including awareness of breathing, yoga, & walking meditation

mindfulness-based stress reduction (MBSR)

# **Cognitive-Behavior Therapies** this mindfulness-based approach combines elements of CBT and adopts the primary goal of enabling clients to become self-aware, so they can learn to de-center from distressing thoughts, feelings, bodily sensations, & behvaiors.

mindfulness-based cognitive therapy (MBCT)

# **Cognitive-Behavior Therapies** list 3 interventions commonly used in MBCT

* psychoeducation * mindfulness meditation practices * cognitive-behavioral techniques

# **Cognitive-Behavior Therapies** a frequently cited systematic review & meta-analysis of mindfulness-based interventions, Gu et al. (2015), found the following...

1) consistent & strong support for **decreased emotional & cognitive reactivity** as the change mechanism 2) moderate support for **increased mindfulness** & **decreased rumination/worry** 3) insufficient support for increased self-compassion & psychological flexibility

# **Cognitive-Behavior Therapies** this cognitive-behavioral therapy for suicide prevention approach was designed to prevent repeat suicide attempts by adults who recently attempted suicide

Wenzel, Brown, & Beck's (2009) cognitive therapy for suicide prevention (CT-SP)

# **Cognitive-Behavior Therapies** this cognitive-behavioral therapy for suicide prevention approach developed for **active-duty members of the military** & incorporates many of the elements of CT-SP

Bryan & Rudd's (2018) **brief cognitive-behavioral therapy** for suicide prevention (BCBT)

# **Cognitive-Behavior Therapies** list the 3 foci in Bryan & Rudd's (2018) brief cognitive-behavioral therapy for suicide prevention (BCBT)

1) **emotion** regulation 2) **cognitive** flexibility 3) **relapse** prevention

# **Cognitive-Behavior Therapies** this cognitive-behavioral therapy for suicide prevention approach was developed for **adolescents** who recently attempted suicide & **combines elements of CBT and DBT**

Stanley et al.'s (2009) cognitive-behavioral therapy for suicide prevention (CBT-SP)

# **Cognitive-Behavior Therapies** this phase of Stanley et al.'s (2009) CBT-SP approach consists of chain analysis (identification of events that led to the suicide attempt, safety planning, psychoeducation, addressing reasons for living, & case conceptualization

acute phase

# **Cognitive-Behavior Therapies** this phase of Stanley et al.'s (2009) CBT-SP approach focuses on generalizing & consolidating behavioral and cognitive skills & relapse prevention

continuation phase

# **Cognitive-Behavior Therapies** list the 6 steps included in Stanley and Brown's (2012) safety planning intervention

1) warning signs 2) internal coping strategies (e.g., going for a walk, reading a book) 3) using social contacts as a means of distraction or support 4) contacting family or friends who may help resolve the crisis 5) contacting mental health professionals or agencies 6) reducing access to lethal means

# **Cognitive-Behavior Therapies** evidence suggests that CBT therapies are an effective means of suicide prevention that reduce these 4 clinical concerns, regardless of these 3 factors

**clinical concerns** 1) suicidal ideation 2) suicide attempts 3) feelings of hopelessness 4) sxs of depression **factors** 1) a person's gender 2) severity of suicide 3) number of suicide attempts