Cognitive Behavioral Therapy

Question 1

Any therapy that is based on the belief….

Answer 1

that our thoughts and/or behaviors are directly connected to how we feel. Dysfunctional or inaccurate thinking leads to dysfunctional emotions or behaviors. Changing thoughts = changing how we feel and what we do

Question 2

2 assumptions

Answer 2

client is capable of becoming aware of own thoughts/behaviors and of changing them; sometimes the thoughts are distorted or fail to reflect reality accurately

Question 3

Goal is

Answer 3

to help client become aware of thought distortions, which are causing distress, and of behavioral patterns that reinforce it, and to correct them.

Question 4

Role of therapist

Answer 4

work with client to solve present day problems by helping them identify distorted thinking that causes emotional discomfort.

Question 5

Little emphasis…

Answer 5

on historical root of problems. Issues in past are only relevant if influencing current thinking.

Question 6

Scientific method approach….

Answer 6

understanding and testing thoughts/behaviors.

Question 7

Characteristics

Answer 7

collaborative relationship between client and therapist; homework between sessions; tends to be short duration; assertiveness exercises; role playing.

Question 8

Best for…

Answer 8

clients who are comfortable with self-exploration and a scientific approach; helpful to clients suffering from depression, anxiety, panic, and obsessive-compulsive disorder.

Question 9

Self-report symptom inventories

Answer 9

assess baseline functioning & therapeutic progress; gives insight into way client thinks and behaves & important areas of need; depression & anxiety inventories

Question 10

Problem lists

Answer 10

identifying psychological, social, occupational, and financial difficulties faced by clients; elicit 5 - 10 using open-ended questions; symptom frequency, intensity, and functional impact; as specific as possible

Question 11

Assessing cognitions

Answer 11

how does client perceive him/herself, others and the future

Question 12

ABC model (behavioral component of therapy)

Answer 12

Antecedents, Behavior, Consequences - examine behavior (symptoms) in a larger context; behaviors are largely determined by antecedents (events that come before behavior/thought/mood, might trigger a specific reaction) and consequences (events that follow behavior/thought/mood, and direct person to either continue or discontinue behavior)

Question 13

Antecedents

Answer 13

before behavior; typically elicit emotional and physiological responses; can increase or decrease an behavior - can be affective (an emotion), somatic (physiological); behavioral (an act), cognitive (a thought), contextual (situational), relational (interpersonal)

Question 14

Behaviors

Answer 14

anything the client does, feels, or thinks immediately after the antecedent; can include affective component (feelings or mood), somatic component (bodily sensation), behavioral component (what person does or doesn’t do), and cognitive component (thoughts or beliefs)

Question 15

Consequences

Answer 15

positive consequences increase chances that a behavior will be repeated, either through experience of something pleasant or the removal of something negative; negative consequences decrease the occurrence of a behavior, either by the presence of something noxious or the absence of something desired; short-term and long-term consequences; same components as antecedents

Question 16

4 layers of cognitive dysfunction

Answer 16

1. automatic thoughts - brief stream of thought about ourselves or others, apply to specific situations/events, occur quickly, often unaware, can be distorted reflections of a situation; 2. intermediate beliefs - assumption, attitude or rule a person follows that typically apply across situations (about him/herself, others, future, world), often stated as conditional rules - if x, then y; 3. core beliefs - significant beliefs about ourselves that drive dysfunctional rules and automatic thoughts, e.g. I am unlovable, either interpersonal or achievement related, start as child and solidify as a result of one’s perceptions of experiences (store evidence that support them, reject evidence to contradict them); targeting automatic thoughts may also change underlying beliefs; 4. schemas - cognitive structures in the mind that integrate the core beliefs

Question 17

situation-thought-feeling triangle

Answer 17

most people believe situations/events cause their feelings; cognitive model suggest that it is the thoughts we have about situations that give rise to emotions.

Question 18

Identifying automatic thoughts

Answer 18

Questioning - what was going through your mind at that moment? or what is going through your mind right now (when noticing nonverbal cues of emotion change)? Take client back - ask to describe specific situation in more details, using imagery

Question 19

11 cognitive distortions or thinking errors

Answer 19

1. all or nothing thinking - one extreme or another 2. catastrophizing - predicting only negative outcomes for the future 3. disqualifying or discounting the positive - good things that happen don’t count 4. emotional reasoning - feelings overrule facts to the contrary 5. labeling - giving a label without finding out more about it 6. magnification/minimization - emphasizing the negative/downplaying the positive in a situation 7. mental filter/tunnel vision - seeing only the negatives of a situation 8. mind reading - believing you know what others are thinking 9. overgeneralization - overall negative conclusion about current situation 10. personalization - thinking negative behavior of others has something to do with you 11. should & must statements - concrete idea how people should behave

Question 20

Dysfunctional thought record

Answer 20

particular situation - identify thoughts & distortions, rate believability - identify feelings, rate intensity (socratic questioning to identify thoughts/feelings and any hot thoughts, open-ended, non-judgmental) - evidence that thought is true - evidence that thought is not true (if true, what is worst/best thing that could happen; what would I tell a loved one if they had these thoughts?) - alternative (more balanced) way of thinking about the situation, rate believability of new thought and rate original mood with new thought

Question 21

behavioral activation or increasing pleasant activities

Answer 21

1. re-introducing prior pleasant activities 2. introducing new pleasant activities 3. active coping - some form of behavior/action to alleviate/reduce life stressor but not pleasant activity, usually involves accomplishing something or overcoming avoidance

Question 22

Problem solving

Answer 22

when the root of an issue is a changeable situation, and the thoughts associated with the situation may be accurate

Question 23

SOLVED

Answer 23

S - select a problem that client wants to solve; O - open your mind to all solutions (what advice would you give someone else with this problem, examine ways you’ve handled a similar situation; consult with close friend or relative); L - list potential pros and cons of each potential solution; V - verify best solution; E - enact the plan & carry out the solution (break into steps); D - decide if the plan worked

Question 24

Relaxation

Answer 24

alleviate stress, anxiety, worry, tension; generate increased self-efficacy, perceived control over stress, and improved coping; can focus on physical sensations or changes in thoughts; progressive muscle relaxation, deep breathing, imagery

Question 25

Beck’s cognitive triad to trigger depression

Answer 25

negative view of self + mental filter/tunnel vision + catastrophizing