Cognitive behaviour thearpy Flashcards
What does the cognitive approach believe about negative thought processes?
Negative thought process are the cause of dysfunctional behaviour and emotional distress
What is the main aim of cognitive behaviour therapy?
To help an individual to identify negative and irrational thoughts and replace these with more ways of thinking. This should lead to more functional behaviour and positive emotional responses
How long does CBT take place?
Over 20 one hour sessions with a therapist but the duration of CBT is flexible and tailored around the needs of the client
What happens during the first phase of CBT
During the first part of CBT, as part of the initial assessment of the client’s issues, it is common practice for a client to be asked to complete a self-report questionnaire. Questionnaires such as the Beck Depression Inventory (BDI) can indicate how a client is feeling
What is an initial process of CBT?
Involves the client and the therapist working collaboratively to identify the client’s self-defeating beliefs (e.g. ‘I must be excellent at everything otherwise I am worthless’) they are challenged by the therapist by questioning the client as to why not excelling at everything makes them worthless
What is case conceptualisation?
-The client needs to understand the nature of CBT
-The therapist creates a list of problems experienced by
the client using self-report and questioning
-Set initial goals and a treatment plan
What is skill acquisition and application?
-Work with the client on intervention techniques including
teaching new skills
-Ongoing evaluation and assessment of success of
techniques and skills
-Set goals and targets
-Refine intervention techniques
What is ending and follow-up?
-Final assessment of progress using self-report and
questioning
-Discuss ending treatment and maintenance of changes
-End treatment- Client and therapist agree when this is
appropriate
-Top-up sessions can take place three to six months after
treatment
What happens during the skills acquisition phase?
The therapist uses techniques such as questioning designed to challenge maladaptive thoughts, and relaxation techniques such as breathing and guided imagery to relive stress in anxious clients
What is questioning in CBT?
Questioning can be used to challenge the client’s irrational beliefs. For instance, if a client says ‘nobody likes me’ then a therapist may ask why they think like that or ask them what evidence they have that this is the case.
What is breathing in CBT?
The type of relaxation technique taught to the client may depend on personal preference. Stressed clients can be taught to identify tension in certain muscle groups and to recognise the different feelings between tense and relaxed muscles
What is guided imagery in CBT?
Sine clients prefer guided imagery as a relaxation tool, with the therapist acting as the guide. The created image can be relevant to the client’s issue. For example, a client with a fear of public speaking could be asked to give a successful speech.
What is the importance of the relationship with the client and therapist?
The three phases show the flexibility of CBT and the importance of ongoing assessment and progress, which then allows for review of goals and targets with the development of new skills and techniques. Although CBT is structured and goal directed its success id also dependant upon the relationship between the client and the therapist. If the client trusts the therapist and is able to work with them as an equal the therapy is more likely to have a positive outcome
What is the effectiveness of CBT?
A study by DeRubeis et al (2005) demonstrates the effectiveness of CBT in treating depression. The researchers studied three groups of participants who all suffered from depression. Group 1 were treated using CBT, group 2 were given anti-depressants and 3 acted as a placebo. After 8 weeks 43% of the CBT group had improved with only 25% of the placebo group improving. The greatest improvement was the antidepressant group where 50% showed signs of improvement. however, conclusions drawn from this need to be taken with caution as it only showed what happened after eight weeks. CBT has been shown effective when applied to the treatment of mood disorders. However, the active nature of CBT means that it will not be suitable for all clients with this disorder.
What are the ethical considerations of CBT?
The relationship between the client and the CBT practitioner may raise negative ethical issues. CBT states the importance of equality in the relationship between the client and the therapist is good ethical practice. The therapist is in a position of power over the client and is considered an ‘expert’ in the clients issues. The focus on teaching and learning of skills in CBT may also raise ethical issues because the therapist could be seen as the teacher and the client as their pupil, again, leading to an imbalance of power.
