Cognitive Behavioural Approaches 3

Question 1

Who is Aaron beck?

Answer 1

-Began research into depression in 1950s
-Beck Institute of Cognitive Therapy and Research
-Developed important tests such as Beck Depression Inventory (BDI)

Question 2

Why are schemas used?

Answer 2

-Fundamental beliefs and assumptions about self, others and goals
-Develop early in life through experiences that we go through
-Either adaptive or maladaptive
-Selection and perception of incoming information

Question 2

What are the basic principles of Beck’s Cognitive therapy?

Answer 2

-Info processing needed for survival
-How we feel and behave is based on our perception of our experiences

Question 3

What can cause psychological distress?

Answer 3

-Evolutionary, biological, environmental and developmental factors all contribute to potential for psychological distress
-Due to schemas, we all set up unique cognitive vulnerabilities which predispose us to distress

Question 4

What is magnification/minimisation?

Answer 4

-Evaluating events as far more or less important than they are

Question 5

What is selective abstraction?

Answer 5

-Drawing conclusions based on only a selection of evidence

Question 6

What is personalisation?

Answer 6

-Evaluating events as related to self

Question 7

What is over-generalisation?

Answer 7

-Drawing conclusions from a single event

Question 8

What is dichotomous thinking?

Answer 8

-Evaluating experiences as extremes

Question 9

What is arbitrary inference?

Answer 9

-Drawing conclusions without evidence

Question 10

Describe what is meant by automatic thoughts

Answer 10

-Involuntary, recurring words or images that occur rapidly at the edge of awareness
-Similar to Freud ‘preconscious’
-Reflects schema content

Question 11

How does the cognitive model link to depression?

Answer 11

-Systematic bias towards negative information in 3 different areas, known as the cognitive triad
-Self - ‘im worthless’
-World - ‘no-one likes me’
-Future - ‘i’ll never amount to anything’
-Depression worsens -> Depressive schema is more activated -> Increases cognitive distortions

Question 12

What are the goals of Beck’s cognitive therapy?

Answer 12

-Correct faulty information-processing
-Symptom relief occurs by removing systematic biases and modifying fundamental beliefs
-Learn to become own therapist

Question 13

What is the process of this type of therapy?

Answer 13

-In-depth initial session; functional and cognitive analysis
-Draw up problem lists
-5-16 sessions which occur weekly
-Homework given

Question 14

What are the 3 different cognitive interventions used in cognitive therapy?

Answer 14

-Elicit and identify NATs
-Reality test and correct NATs
-Identify and alter beliefs

Question 15

Describe what eliciting and identifying NATs mean

Answer 15

-Provide reasons
-Encourage engagement
-Self-monitoring

Question 16

Describe what reality testing and correcting NATs mean

Answer 16

-Socratic dialogues
-Decatastrophizing and decentring
-Forming adaptive responses

Question 17

Describe what altering and identifying beliefs mean

Answer 17

-Socratic dialogues
-Hypothesis testing
-Re-fashioning beliefs

Question 18

What behavioural approaches can be used within cognitive therapy?

Answer 18

-Rating mastery/pleasure
-Rehearsing behaviour
-Assigning graded tasks
-Hypothesis-testing

Question 19

What 3rd wave approaches can be used within cognitive therapy?

Answer 19

-Complement and extend CBT
-More holistic, less symptom focused
-Promoting wellbeing
-Includes values, mindfulness, acceptance
-More widely used

Question 20

Describe the use of Dialectical Behaviour Therapy

Answer 20

-Dialectical - two opposite things can be true
-Designed for treating borderline personality disorder as well as depression, self harm, suicide and eating disorders
-Focus on self-acceptance
-Learning to understand, accept and regulate strong emotions
-Improve interpersonal relationships

Question 21

Describe the use of Mindfulness Based Cognitive Therapy

Answer 21

-Uses mindfulness techniques alongside CBT e.g. meditation, breathing exercises etc.
-Help us to learn, observe and recognise thoughts without reacting to them
-Identify thoughts to challenge and change with CBT techniques
-NICE recommended for prevention of relapse in recurrent depression

Question 22

Describe the use of Acceptance and Commitment Therapy

Answer 22

-Accept and live with our thoughts and feelings rather than changing them
-Focus on learning our individual values and then setting goals that align with these values, helps to ensure the goals are meaningful
-Used for managing physical and mental issues

Question 23

Evaluate CBT using evidence from NICE

Answer 23

-NICE guidelines recommend forms of CBT for; depression, anxiety, phobias, bipolar, bulimia, OCD, PTSD and schizophrenia
-NICE systematic review showed that there is effectiveness of CBT for depression and anxiety (Butler et al., 2006)

Question 24

What did DeRubeis et al (2005) find about the use of CBT for depression?

Answer 24

-RCT: placebo vs antidepressant medication vs CT
-Found that CT was as effective as medication
-Hollon et al (2005) conducted a follow up and found that Ct has enduring effects

Question 25

What did Kani et al (2015) find about the use of CBT for phobias and anxiety?

Answer 25

-Dental phobia
-Following average of 5 CBT sessions
-79% patients had dental treatment without sedation

Question 26

How can gender have an impact on the effectiveness of CBT?

Answer 26

-Suggested that these may occur due to differences in emotional intelligence
-No apparent gender differences in CBT efficacy for depression (Cuijpers et al., 2014)

Question 27

How can culture and ethnicity have an impact on the effectiveness of CBT?

Answer 27

-All developed from similar US perspective, may not map across to other cultures (individualist v collectivist)
-Tang et al (2017) compared White and Asian Americans on an intensive CBT course
-No difference in symptom reduction or depression
-Trends in data suggest difference in anxiety severity (better for Asian Americans)

Question 28

What is the use of culturally adapted CBT?

Answer 28

-Naeem et al (2015) adapted CBT for use in Pakistan
-More involvement of family members in sessions and homework tasks
-Explained concepts using relevant folk stories and examples that align with religious beliefs of population
-Patients reported greater satisfaction with treatment