Cognitive-Behavioural Therapies Flashcards
How does CBT explain problems?
psychological disturbance is due largely to maladaptive cognitive schemas, automatic thoughts, and cognitive distortions
What are cognitive schemas in CBT?
- core beliefs that develop during childhood as the result of experience and certain biological factors
- enduring
- can be maladaptive or adaptive
- revealed in automatic thoughts
- different disorders are associated with different maladaptive schemas (aka cognitive profiles)
What are automatic thoughts in CBT?
- verbal self-statements or mental images that come to mind spontaneously when triggered by circumstances and come between an event/stimulus and the individual’s emotional and behavioral reactions
- can be positive or negative
What are the features of negative automatic thoughts?
- distortion of reality
- emotional distress
- interference with the pursuit of life goals
How are thought records used in CBT?
- when the client feels their mood worsening they record:
- the event or situation that led to an unpleasant emotion
- automatic thoughts that preceded the emotion
- the type of emotion and its intensity on a scale from 0 to 100
- an alternative rational response to the automatic thought
- the outcome (the emotion and any change in behavior elicited by the rational response)
What are cognitive distortions in CBT?
systematic errors in reasoning that often affect thinking when a stressful situation triggers a dysfunctional schema that, in turn, affects the content of automatic thoughts
What are the 5 main types of cognitive distortions in CBT?
- arbitrary inference
- selective abstraction
- dichotomous thinking
- personalization
- emotional reasoning
What is arbitrary interference?
drawing negative conclusions without any supporting evidence
What is selective abstraction?
paying attention to and exaggerating a minor negative detail of a situation while ignoring other aspects of the situation
What is dichotomous thinking?
the tendency to classify events as representing one of two extremes – for example, as a success or a failure
What is personalization?
concluding that one’s actions caused an external event without evidence for that conclusion
What is emotional reasoning?
reliance on one’s emotional state to draw conclusions about oneself, others, and situations
What are the 2 primary goals of CBT?
- correct faulty information processing
2. help patients modify assumptions that maintain maladaptive behaviors and emotions
What are some (7) of the cognitive and behavioural techniques used in CBT?
- redefining the problem
- reattribution
- decatastrophizing
- activity scheduling
- behavioral rehearsal
- exposure therapy
- guided imagery
What is collaborative empiricism in CBT?
a collaborative therapeutic alliance between the therapist and client in which they become coinvestigators as they examine the evidence to accept, support, reevaluate, or reject the client’s thoughts, assumptions, intentions, and beliefs
What is socratic dialogue in CBT?
asking the client questions that are designed to clarify and define the client’s problems, identify the thoughts and assumptions that underlie those problems, and evaluate the consequences of maintaining maladaptive thoughts and assumptions
How does Ellis’s Rational Emotive Behaviour Therapy (REBT) explain problems?
psychological disturbances are the result of irrational beliefs (e.g. should’s, must’s, have to’s) which lead to negative emotions that interfere with goal pursuit and attainment
What is the A-B-C-D-E model in REBT?
A - Activating event
B - irrational Belief about event
C - emotional or behavioural Consequence of belief
D - techniques to Dispute irrational belief
E - Effect of techniques
What are four of the techniques used in Rational Emotive Behaviour Therapy?
- rational-emotive imagery
- active disputation of irrational beliefs
- systematic desensitization
- skills training
R.A.S.S.
What problems is Rational Emotive Behaviour Therapy (REBT) used for?
- depression
- anxiety
- conduct problems
- anger
- others
What was Self-Instructional Training developed for?
Self-instructional training was initially developed by Meichenbaum to teach problem-solving skills to children with high levels of impulsivity
What are the 5 stages of Self-Instructional Training?
- Cognitive modeling stage
- Overt external guidance stage
- Overt self-guidance stage
- Faded overt guidance stage
- Covert self-instruction stage
What happens in the cognitive modeling stage of Self-Instructional Training?
children observe a model perform a task while the model verbalizes instructions aloud
What happens in the overt external guidance stage of Self-Instructional Training?
children perform the same task while the model verbalizes the instructions
What happens in the overt self-guidance stage of Self-Instructional Training?
children perform the task while verbalizing the instructions aloud themselves
What happens in the faded overt guidance stage of Self-Instructional Training?
children perform the task while whispering the instructions
What happens in the covert self-instruction stage of Self-Instructional Training?
children perform the task while repeating the instructions subvocally
In Self-Instructional Training, what 4 skills do the instructions address?
- identifying the nature of the task
- focusing attention on the task and the behaviors needed to complete it
- providing self-reinforcement that sustains appropriate behavior
- evaluating performance and correcting errors
What is the goal of Stress Inoculation Training?
improving the ability of clients to deal better with ongoing and future stressful situations by teaching them effective coping skills
What are the 3 phases of Stress Inoculation Training?
- conceptualization/education phase
- skills acquisition and consolidation phase
- application and follow-through phase
What happens in the conceptualization/education phase of Stress Inoculation Training?
clients are provided with information about stress and its effects and are encouraged to view stressful situations as “problems-to-be-solved”
What happens in the skills acquisition and consolidation phase of Stress Inoculation Training?
clients learn a variety of cognitive and behavioral coping skills which may include relaxation, self-instruction, and problem-solving
What happens in the application and follow-through phase of Stress Inoculation Training?
clients use newly acquired coping skills, first in imagined and role-playing situations and then in real life situations
What is the main assumption underlying ACT?
psychological pain is both universal and normal and is part of what makes us human
How does ACT explain problems?
psychological inflexibility causes psychological problems and is characterized by a rigid dominance of psychological reactions over chosen values and contingencies in guiding action
How is “clean pain” defined in ACT?
refers to natural levels of physical and psychological discomfort that are inevitable and cannot be controlled (aka clean discomfort)
How is “dirty pain” defined in ACT?
the emotional suffering that’s caused by attempts to control or resist clean pain (aka dirty discomfort)
What is the main goal of ACT?
increase psychological flexibility and counter the processes that contribute to psychological inflexibility
What are the 6 core processes in ACT?
- experiential acceptance
- cognitive defusion
- being present
- awareness of self-as-context
- values-based actions
- committed action
What is experiential acceptance in ACT?
counters experiential avoidance and is the active and aware embrace of private experiences without unnecessary attempts to change their frequency or form
What is cognitive defusion in ACT?
counters cognitive fusion and is the ability to distance oneself from one’s thoughts and feelings and view them as experiences rather than reality
What is being present in ACT?
counters attentional rigidity to the past and future and involves being in contact with whatever is happening in the present moment
What is awareness of self-as-context in ACT?
counters attachment to the conceptualized self and is the ability to view oneself as the context in which one’s thoughts and feelings occur rather than as the thoughts and feelings themselves
What is values-based actions in ACT?
counter unclear, compliant, or avoidant motives and depend on the ability to use one’s freely chosen values to guide one’s behaviors
What is committed action in ACT?
counters inaction, impulsivity, and avoidant persistence and refers to a commitment to continue to act in ways consistent with one’s values in the future, even when faced with obstacles
What is Mindfulness-Based Stress Reduction (MBSR)?
it’s used to help people cope with stress, pain, and illness and consists of an eight-session group program that focuses on teaching participants several mindfulness meditation practices (e.g. awareness of breathing, yoga, and sitting and walking meditation)
What is primary goal of Mindfulness-Based Cognitive Therapy?
enable clients to become self-aware, so they can learn to de-centre from distressing thoughts, feelings, bodily sensations and behaviours
What techniques does Mindfulness-Based Cognitive Therapy use?
- combines elements of MBSR and CBT
- psychoeducation
- mindfulness meditation practices
- cognitive-behavioral techniques
- usually consists of an eight-session group program
What does the evidence say abou mindfulness-based interventions?
effective for treating both psychological disorders and physical/medical conditions but are more effective for psychological disorders, especially depression, anxiety, and stress
What are the mechanisms responsible for the effectiveness of mindfulness-based interventions?
- no clear consensus
- proposed mechanisms include:
- attention regulation
- emotion regulation
- body awareness (awareness of one’s internal states)
- decentering (the ability to separate oneself from one’s thoughts and emotions)
What are the 3 versions of Cognitive-Behavioral Therapy for Suicide Prevention?
- Wenzel, Brown & Beck’s cognitive therapy for suicide prevention (CT-SP)
- Bryan & Rudd’s brief cognitive-behavioural therapy for suicide prevention (BCBT)
- Stanley et al’s cognitive-behavioral therapy for suicide prevention (CBT-SP)
What population was Wenzel, Brown & Beck’s cognitive therapy for suicide prevention (CT-SP) designed for?
designed to prevent repeat suicide attempts by adults who recently attempted suicide
What population was Bryan and Rudd’s (2018) brief cognitive-behavioral therapy for suicide prevention (BCBT) developed for?
active-duty members of the military
What population was Stanley et al.’s (2009) cognitive-behavioral therapy for suicide prevention (CBT-SP) developed for?
adolescents
What are the primary targets of CT-SP and BCBT?
- emotion regulation
- cognitive flexibility
- relapse prevention
What happens in the first phase of CT-SP and BCBT?
- establishing rapport
- conducting a suicide risk assessment
- identifying treatment goals and a treatment plan
- creating a safety plan
- teaching crisis management skills and emotion regulation skills
What happens in the second phase of CT-SP and BCBT?
- identifying and challenging the client’s maladaptive beliefs and self-statements that contribute to suicidal behaviors
- providing skills training that targets cognitive flexibility
What happens in the third phase of CT-SP and BCBT?
- skill consolidation
- relapse prevention
