Cognitive Behavioral Therapy Flashcards
Know Chart of cognitive therapies
See chart
thought stopping
Decreases the frequency, duration and intensity of disturbing thoughts in two steps:
Step 1: A disturbing thought is interrupted
Step 2: A nondisturbing thought is substituted for a disturbing thought
(not that helpful)
Aaron Beck V. Albert Ellis
Aaron Beck: Did studies on Freud’s idea that depression is “anger turned on the self.” He found instead that dreams and thoughts were characterized by a negative processing bias. Tended to think negatively about self, the world, and their futures; tended to notice and amplify the negative, and ignore and minimize the positive. Is supposed to be a rather nice, noncompetitive person. Has even sought treatment from Ellis for his own fear of public speaking.
Albert Ellis: Has been called the “grandfather of cognitive therapy.” Is known for his rather bawdy sense of humor, foul language, and aggressive approach as a therapist. Has had his own tough times, including chronic renal problems since age 9, diabetes since age 40, fear of public speaking, and shyness around women.ellis not on exam–way too rough
Similarities and Differences between REBT and CBT
Similar:
Psychological distress: disturbance in cognitive process
Focus on changing cognitions to produce desired changes in affect and behavior
Focus on the present
Treatment is time-limited, educational, and focused on specific target problems
Different:
REBT: very confrontational (“irrational beliefs”, argumentative)
CBT: kinder, gentler, “test out” maladaptive thoughts
Some influences on the development of REBT and CT
Learning theory (particularly social learning theory)
- highlighted role of relationships in learning
- began to attend to cognitions (instead of Skinner’s black box)
Stoic philosophers
- Epictetus: “People are disturbed not by things, but by the view which they take of things”
- Adler’s focus on basic beliefs and mistaken beliefs
Psychological Problems from Ellis’ Perspective (REBT)
Irrational Beliefs
- Beliefs that are rigid, inconsistent w/ reality, illogical, and often counter to people’s goals
- logical errors in thinking
Absolutist demands underlie all irrational belifs
-Musts, shoulds, and have tos
Psychological problems come from:
- Irrational beliefs based on absolutist demands
- Maladaptive thoughts that stem from irrational beliefs
- ——cause people to blame themselves and others for their unhappiness
- —–which causes psychological problems
- —– i.e. beliefs about events, not events themselves, cause problems
People w/ low frustration tolerance are at risk for problems
Examples of "musturbation" All boil down into these three irrational beliefs 1. I must do well 2. You must treat me well 3. The world must be easy
Psychological problems from Beck’s perspective (CT)
Cognitive Errors
- Systematic errors in reasoning that result from biased information processing
- Often occur automatically, without individual’s awareness (Automatic thoughts)
Cognitive Schemas
- -are the source of cognitive errors
- -important beliefs and assumptions about people, events and the environment
Examples of cognitive errors
- Dichotomous thinking
- Selective abstraction
- Arbitrary Inference (mind reading, negative prediction)
- Overgeneralization
- Labeling/mislabeling
- Magnification/Minimization
Beck’s Cognitive Developmental Model
- Early Childhood Experiences
- Development of schemas, basic beliefs and conditional beliefs
- Critical Incidents
- Activation of schemas, basic beliefs and conditional beliefs
- Automatic thoughts
- —-emotions, behaviors, physiologic responses—-
Phases of therapy in CBT
Phase 1:
Building a trusting relationship
Listing and prioritizing the client’s problems
Educating the client about the theory and the process of therapy
Beginning to identify cognitive errors
Working toward some immediate symptom relief
Phase 2:
Identifying links among cognitive errors, beliefs, emotional reactions and behavior
Helping the client overcome cognitive errors
Main techniques and strategies of CBT
- Be sure to understand client’s idiosyncratic meanings
- Use socratic dialogue to challenge cognitive errors
- —–“the 3 questions” : What is the evidence for this belief? How else could it be interpreted? If it is true, what are the implications?
- Logical analysis of beliefs
- Cost/benefit analyses of beliefs
Homework Techniques of CBT
- Keep a log of information related to one’s automatic thoughts (e.g. dysfunctional thought record)
- Conduct “experiments” to test one’s beliefs
Dealing with cognitive errors: highlighting differences in Ellis Vs. Beck
Ellis- Actively disputes, attacks and attempts to destroy “musts”
-Therapist is the educator who teaches clients how to use principles of logic to live more rationally
-confrontational
-distinctions are not made among different disorders
Beck
-“collaborative empiricism”
—-clients are encouraged to test their beliefs
—-through logical scrutiny
—-and real life experiments
Unique cognitive profiles are identified for different disorders
Dysfunctional beliefs are tested by the client
Cognitive Therapy (Beck)-definition
-referred to irrational, maladaptive cognitions as “automatic thoughts”
Two means of changing distorted cognitions
- The Socratic Method
- Empirical hypothesis testing through homework assignments
Cognitive therapy (Beck) techniques
- Provide relavent information (people usually dont get hurt on escalators)
- Client keeps a thought diary, records automatic thoughts, what situation did it occur in, emotions at the time, logical errors/possible rational alternative thoughts
- Clients learn to generate alternative interpretations
- Clients learn to re-attribute responsibility (is it really my fault if X happens?)
- Decatastrophizing (using socratic method) i.e. what would be the worst that could happen? How likely is that?
- Use of Overt-Behavioral Interventions to indirectly change cognitions (beck)
- Generating activity schedules (hour by hour plan for the day, good if feel no motivation/disorganized/anxious)
- Making mastery and pleasure ratings
- rate activities in activity schedule for mastery and pleasure levels, recognize partial success and reduce dichotomous thinking
- Engaging in graded task assignments
- small, sequential steps, shape behavior
Coping Skills Therapies: definition and the three kinds
- Treats problems by changing both cognitions and overt behaviors.
- Teaches clients a systematic strategy for approaching present and future problems
3 kinds: Self-instructional training, problem solving therapy, stress innoculation therapy
