Cognitive Behavioural Approaches 3 Flashcards
Who is Aaron beck?
-Began research into depression in 1950s
-Beck Institute of Cognitive Therapy and Research
-Developed important tests such as Beck Depression Inventory (BDI)
Why are schemas used?
-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
What are the basic principles of Beck’s Cognitive therapy?
-Info processing needed for survival
-How we feel and behave is based on our perception of our experiences
What can cause psychological distress?
-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
What is magnification/minimisation?
-Evaluating events as far more or less important than they are
What is selective abstraction?
-Drawing conclusions based on only a selection of evidence
What is personalisation?
-Evaluating events as related to self
What is over-generalisation?
-Drawing conclusions from a single event
What is dichotomous thinking?
-Evaluating experiences as extremes
What is arbitrary inference?
-Drawing conclusions without evidence
Describe what is meant by automatic thoughts
-Involuntary, recurring words or images that occur rapidly at the edge of awareness
-Similar to Freud ‘preconscious’
-Reflects schema content
How does the cognitive model link to depression?
-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
What are the goals of Beck’s cognitive therapy?
-Correct faulty information-processing
-Symptom relief occurs by removing systematic biases and modifying fundamental beliefs
-Learn to become own therapist
What is the process of this type of therapy?
-In-depth initial session; functional and cognitive analysis
-Draw up problem lists
-5-16 sessions which occur weekly
-Homework given
What are the 3 different cognitive interventions used in cognitive therapy?
-Elicit and identify NATs
-Reality test and correct NATs
-Identify and alter beliefs
Describe what eliciting and identifying NATs mean
-Provide reasons
-Encourage engagement
-Self-monitoring
Describe what reality testing and correcting NATs mean
-Socratic dialogues
-Decatastrophizing and decentring
-Forming adaptive responses
Describe what altering and identifying beliefs mean
-Socratic dialogues
-Hypothesis testing
-Re-fashioning beliefs
What behavioural approaches can be used within cognitive therapy?
-Rating mastery/pleasure
-Rehearsing behaviour
-Assigning graded tasks
-Hypothesis-testing
What 3rd wave approaches can be used within cognitive therapy?
-Complement and extend CBT
-More holistic, less symptom focused
-Promoting wellbeing
-Includes values, mindfulness, acceptance
-More widely used
Describe the use of Dialectical Behaviour Therapy
-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
Describe the use of Mindfulness Based Cognitive Therapy
-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
Describe the use of Acceptance and Commitment Therapy
-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
Evaluate CBT using evidence from NICE
-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)
What did DeRubeis et al (2005) find about the use of CBT for depression?
-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
What did Kani et al (2015) find about the use of CBT for phobias and anxiety?
-Dental phobia
-Following average of 5 CBT sessions
-79% patients had dental treatment without sedation
How can gender have an impact on the effectiveness of CBT?
-Suggested that these may occur due to differences in emotional intelligence
-No apparent gender differences in CBT efficacy for depression (Cuijpers et al., 2014)
How can culture and ethnicity have an impact on the effectiveness of CBT?
-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)
What is the use of culturally adapted CBT?
-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
