cognitive behavioural approaches Flashcards
when do behaviour models originate from
1950s/60s
what are the three waves of behaviour therapy
- traditional/radical behaviour therapy
- cognitive behaviour therapy
- ‘third wave’ behavioural therapy
what did bandura find
- people who observed others handling snakes were less avoidant than those who had just had systematic desensitisation
what are the goals of behavioural therapy
- change observable and current behaviours
- target symptoms not cause
- goals need to be specific and measurable
what are the characteristics of behavioural therapy
- time-limited - up to 20 weeks
- clients actively involved
- in stages
what are the stages of behavioural therapy
- behavioural assessment - ABC model
- treatment - goals of therapy, treatment with empirical support
- assessment - check on progress
who discovered systematic desensitisation
- joseph wolpe
what does systematic desensitisation involve
- classical conditioning
- reciprocal inhibition
what are the stages of systematic desensitisation
- relaxation training
- construct hierarchy
- gradual exposure using relaxation techniques
what did Egara and Mosimege find
- maths anxiety and achievement in secondary school students
- 120 pps
- 2 groups - SD and control
- compared scores on maths anxiety scale before and after
- treatment group had lower anxiety
what is graded exposure
- in vivo - contact with feared stimulus until fear habituates
- can be self managed
- goes through hierarchy
what did emmelkamp et al 2001 find
- compared in vivo graded exposure to virtual reality
- 33 pps
- exposed to 3 environments for fears
- both groups improved
what is aversion therapy
- simultaneous paring of target stimulus with aversive stimulus
what did bordnick et al find about aversion therapy
- reduced cravings for cocaine
what did saeed et al find about aversion therapy
- ineffective in reducing smoking
what is rational living
- helps to achieve goals
what is irrational living
- prevents from achieving goals
what is the ABC theory
- people create their own emotional disturbances
- A - activating event
- B - belief
- C - consequences
what are rational beliefs
- healthy, productive, adaptive, consistent with social reality
- preferences
a - block goals
b - i prefer to have goals unblocked
c - frustration
what are irrational beliefs
- rigid, dogmatic, unhealthy, maladaptive
- demands, must, shoulds
a - blocks goals
b - i must have goals unblocked
c - anxiety
what is musturbation
- primary demanding beliefs
- i must do well
- awfulizing, damning self
what are secondary demanding beliefs
- miserable about misery
- awfulizing, damning
- consequence becomes another activating event
what are the 2 main categories of neuroses
- ego disturbance - view of self - i must do well - inadequacy
- low frustration tolerance - expectation of external world - others should treat me well, conditions must allow me to get what i want
how did ellis thing we acquired beliefs
- biological tendencies, social learning, choosing irrational cognitions
how did ellis believe we maintain beliefs
- biological tendencies - short range hedonism
- insufficient scientific thinking - lacks flexibility, testing, too absolutist
- emphasizing awful past
- reinforcing consequences
what are the goals of CBT for ellis
- add D and E
- dispute beliefs and change them
what are inelegant change goals in REBT
symptom removal
- new philosophy focused on specific issues
what are elegant change goals in REBT
- new philosophy for life
- anti-musturbatory thinking
- unconditional self, other, and life acceptance
what is the therapeutic process of REBT
- therapist as teacher
- homework tasks
- weekly, 5-50 sessions
- relationships - unconditionally accepting, genuine, empathetic
what are the types of scientific questioning in REBT
- functional
- empirical
- logical
- philosophical
what are cognitive techniques in REBT
- rational coping statements
- cognitive homework - reminder cards
what are emotive techniques in REBT
- rational emotive imagery - imagine the worst A
- role playing - rehearse
- humour - take things less seriously
what are behavioural techniques in REBT
- shame-attacking - repeatedly do something shameful - refuse to feel ashamed and accept
- assignments that challenge demandingness - do feared behaviour
- reinforcement - rewards and penalties
what did Grove et al 20201 find about REBT
- REBT informed group therapy for veterans with PTSD reduced depression and PTSD symptoms
what did Knapp et al 2023 find about REBT
- reduced irrational beliefs and distress and increased self-acceptance for women at risk of exercise addiction
what did misdeni et al 2019 find about REBT
- reduced exam anxiety in school students
what did Ahnmadabedi et al 2024 find about REBT
- increased self control and reduced impulsivity for male prisoners
what did david et al find about REBT
- did a systematic review and meta- analysis
- reviewed 84 studies which included an REBT intervention
- found a medium effect size on most outcomes and irrational beliefs
what are the principles of CT
- information processing critical for survival
- how we feel and behave is based on how we perceive and structure our experiences
- schemas
how do we develop psychological disorders according to CT
- dysfunctional schema leads to systematic bias in info processing
what is systematic bias
shift to rigid, absolutist thinking
what is dichotomous thinking
- evaluating experiences as extremes
what is arbitrary inference
drawing conclusions without evidence
what is magnification/minimalisation
evaluating events as far more or less important than they are
what is selective abstraction
drawing only conclusions based on only a selection of evidence
what is personalisation
evaluating events as related to the self
what is over generalisation
drawing conclusions from one single event
what are automatic thoughts
- involuntary, recurring words or images that occur rapidly at the edge of awareness
- reflect schema content
- psychological disorder - NATs
what is the cognitive triad
- negative thoughts about self
- negative thoughts about the world
- negative thoughts about the future
what are the goals of CBT
- correct faulty info processing - symptom relief, remove systematic bias
- treat beliefs and automatic thoughts
- learn to become own therapist
what is the process of CBT
- initial session - functional and cognitive analysis
- drawing up problem lists
- weekly - 5-16 sessions
- homework
- rogerian therapeutic style
- therapist is co-investigator
- guided discovery
what are the cognitive interventions in CBT
- elicit and identify NATs
- reality test and correct - socratic dialogues
- identify and alter beliefs
what are behavioural interventions in CBT
- rating mastery
- rehearsing behaviour
- hypothesis testing
- assigning graded tests
what are third wave approaches
- complement and extend CBT
- more holistic, less symptom focused - promoting well being
- looks at context and relationship with thoughts
- concepts now widely used, evidenced and considered part of CBT
what is dialectical behaviour therapy
- dialectical - 2 opposite things can be true - accpeting yourself whilst trying to change
- designed for BPD, depression
- based on CBT but adapted to people who feel emotions very intensely
- focus on self acceptance and learning to understand and regulate strong emotions
- effective for eating disorders, BPD and reducing suicide attempts but not depression
what is mindfulness based cognitive therapy
- mindfulness techniques alongside CBT
- learn to recognise thoughts without reacting
- recommended for prevention of relapse of depression
what is acceptance and commitment therapy
- learning to accept and live with our thoughts and feelings rather than changing them
- accept they are just thoughts
- focus on learning individual values and setting goals that align with these values
- used for physical and mental issues
what did NICE systematic review find about CBT
- effectiveness of CBT for depression and anxiety disorders
what did DeRubeis et al find about CBT
placebo vs anti-depressant medication vs CT
- 16 weeks - CT just as effective as anti-depressant medication and more effective than placebo
what did Hollon et al find about CBT
- follow up
- Ct has enduring effect - protect against symptom return
what id Kani et al find about CBT
- CBT for dental phobia
- 5 CBT sessions - 79% patients had dental treatment without sedation
how did Naeem et al adapt CBT
- for use in Pakistan
- more involvement in family members
- explained concepts using relevant folk stories
- translated jargon terms to Urdu equivalents
