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PSYU2201 Counselling Principles and Approaches > Cognitive Behavioural Therapy > Flashcards

Cognitive Behavioural Therapy Flashcards

1
Q

What is Psychotherapy?

A
  • An engagement between two people (therapist and patient/client)
  • Focused on bringing about positive change within the client via the therapeutic alliance
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2
Q

Core therapeutic approaches

A

Psychoanalysis, Person-centered therapy & CBT

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3
Q

What is Psychoanalysis?

A

Relies on analytic processes to access unconscious conflicts that cause neurotic anxiety that manifest as repression, projection, or displacement behaviours
↳ Neurotic anxiety: Phobias, panic, OCD etc;
↳ Unconscious conflicts: Often believed to be formed at childhood

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4
Q

Psychoanalytic Theorist

A

Freud, Jung, Alder, Bion, Klien etc;

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5
Q

Analytic processes of psychoanalysis

A
  • Free-Association → Get people to say random words to provide access to the unconscious
  • Rorschach Test → Inkblot tests, people are asked to look at a inkblot and say what they see
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6
Q

Issues with psychoanalysis

A
  • Very little evidence for Psychoanalysis

- Has not been therapeutically & clinically proved

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7
Q

Person-centered therapy

A

Relies on unconditional positive regard, empathy, and congruence in the therapeutic relationship to confront incongruence, which manifests as denial, fantasy, or overcompensation.

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8
Q

Theorists of person-centred therapy

A

Rogers, Maslow, etc.

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9
Q

Aims of Person-centred therapy aims

A
  • Incongruence → When your perceived self and ideal self are separate
  • Moving towards congruence → When your perceived self and ideal self are moving towards each other
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10
Q

What is CBT?

A

Cognitive behavioural therapy (CBT): Relies on problem-solving to change unhelpful cognitions (thoughts) and underlying maladaptive behaviours.

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11
Q

Theorists of CBT

A

Beck & Ellis

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12
Q

The aims of CBT

A
  • CBT aims to help our clients dissect and analyse their original thought to help them determine what has made them act or feel in a specific way
  • The goal is to change the emotional and behavioural response. until it becomes automatic
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13
Q

Cognitive aspect of CBT

A

Changing the clients thoughts and beliefs, which becomes cemented. These childhood thoughts and beliefs are looked at from adult eyes

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14
Q

Behavioural aspect of CBT

A

Change behaviours that are not consistent with a client’s life goals.

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15
Q

What is the central principle of CBT?

A

That our thoughts are central to the regulation of behaviour.

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16
Q

What is the role of CBT?

A
  • To teach the individual to treat their beliefs as hypotheses and not facts
  • To try out alternative ways of looking at the situation of their concern
  • To have different responses to it based on these new ways of thinking.
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17
Q

What type of approach does CBT follow?

A

Active, directive, collaborative, time-limited, present-oriented, structured, and has strong empirical basis.

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18
Q

Theorists of CBT and brief description

A

Beck’s early work was centred around the role of unhelpful information processing for those with depression and anxiety

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19
Q

Beck’s ABC Model of CBT

A 
- A =  Activating Event (Anti-cedent)
 ↳ Something occurs
- B = Beliefs/thoughts
 ↳ Pulls on particular belief structures
- C = Consequence → Emotional and/or behavioural
- A → B → C
20
Q

Case study using ABC Model

A

Person 1 gets gastric bypass surgery and they can’t eat specific foods

  • A: Attending a birthday party where cake is served
  • B: I should not eat cake, cake is bad → I should not be overweight, being fat is awful → If I overeat, I ruin my diet → I might as well eat more
  • C:
    • Emotional
      ↳ Guilt
      ↳ Anxious & Depressed
    • Behavioural
      ↳ Eats 3 pieces of cake → Neglects healthy eating for a week
21
Q

Theoretical concept behind CBT’s cognitive perspective

A

Individuals’ core beliefs around the self, the world, and relationships with others originate in childhood (Schema); forms emotional disturbance affecting all levels of information processing in adulthood

22
Q

Goal of CBT

A
  • To challenge cognitive distortions by identifying automatic negative thoughts (ANTS)
  • To restructure their understanding of their irrational/self-defeating beliefs at the core of their schema
23
Q

Impact of Cognitive distortions

A

Cognitive distortions → ANTs → Creates irrational/self-defeating beliefs which reach the core schema

24
Q

Cognitive Distortions

A
  • Black/white
    ↳ Either/or thinking with very limited nuance
  • Filtering
    ↳ Selective with information which they choose to focus on
  • Catastrophising
    ↳ Imagining the worst-case scenario
  • Overgeneralising
    ↳ E.g. ‘I always mess up…’
  • Labelling
    ↳ ‘(I’m a loser!’ vs. ‘I made a mistake.’)
  • Selective abstraction
    ↳ Focusing on one negative detail of the situation, rather than looking at the whole picture
25
Q

Irrational/Self-defeating Beliefs

A
  • Being liked/loved: I must always be loved and approved by the significant people in my life.
  • Being competent: I must always, in all situations, demonstrate competence, and I must be both talented and competent in some important area of my life.
  • Having one’s own way: I must have my way, and my plans must always work out.
  • Being hurt: People who do anything wrong, especially those who harm me, are evil and should be blamed and punished.
  • Being danger-free: If anything or any situation is challenging in any way, I must be anxious and upset about it. I should not have to face challenging/threatening/harmful situations
  • Being problemless: Things should never go wrong in life and if, by chance, they do, there should be quick and easy solutions.
  • Being a victim: Other people and outside forces are responsible for any misery I experience.
  • Tyranny of the past: What I did in the past, and especially what happened to me in the past, determines how I act and feel today.
  • Avoiding: It is easier to avoid facing life’s difficulties than to develop coping techniques; making demands of myself should not be necessary.
  • Passivity: I should be able to be happy by avoiding, being passive, uncommitted, and by just existing.
26
Q

Importance of identifying irrational/self-defeating beliefs

A
  • Should latch onto particular things people say to make sense of their thought pattern to ask if those are the cognitive distortions taking place
  • Stories and the way people share their narratives demonstrate their underlying schemas
27
Q

Applying CBT to change thinking

A
  1. Identify the negative thought.
    ↳ Help the people recognise their own issue by asking them questions so they can have their own breakthrough
  2. Look for evidence surrounding the thought:
    • What are the facts?
    • What has happened before?
    • What would you say to a friend?
    • What else might be true?
  3. Come up with a realistic thought based on the evidence
28
Q

Application of CBT to change thinking

A
  1. Activating Event: Meeting new people in this unit
  2. Negative Thought: “They will think I’m boring”
  3. Evidence: “Someone in Year 7 said I was not interesting”
    ↳ Peer opinions really matter in year 7
    ↳ That one person’s opinion really matters → Can infiltrate their sense of self
  4. Challenge: “My other friends don’t find me boring”, “my new colleagues may be happy to meet someone else”, “I do have some interests and opinions”
  5. Realistic Thought: “They may not think I’m boring and could be happy to make a friend
29
Q

What cognitive profile is linked to anxiety, depression and anger?

A
  • Anxiety (physical and/or social threat)
  • Depression (loss/failure)
  • Anger (hostile intent/revenge)
30
Q

What does CBT do?

A
  1. Situation
    ↳ Activating event
  2. Thoughts
    ↳ Based on your cognitive distortions
  3. ANTs
    ↳ Challenged through cognitive restructuring
  4. Elicts a different emotional and behavioural response
31
Q

Who is Watson?

A
  • Founder of behaviourism

- Provided foundation for classical conditioning and operant conditioning

32
Q

What is classical Conditioning?

A
  • When a neutral stimulus that has no meaning, is paited with a meaning. With enough pairings the neutral stimulus would have absorbed the characteristics that now means it elicits a response that it shouldn’t
  • Founded by Pavlov
33
Q

What are the steps in exposure therapy

A
  1. Determine problem and particular circumstances that elicit the conditioned fear response.
  2. Construct hierarchy of situations inducing feared response.
    1. Imaginal – therapist guides client to conjure up scenes that gradually increase anxiety.
    2. In vivo – (In person) gradual exposure to actual feared stimulus.
    3. Flooding – forced and prolonged exposure to feared stimulus.
      ↳ Go HARD and FAST
    Note: Check-up on the client with this, to avoid the occurance of bad things happening
  4. Repeated exposure to gradual anxiety-evoking stimuli whilst learning to tolerate and eventually be comfortable with stimuli.
    ↳ Slowly escalate the stimulus with nothing bad happening
34
Q

Application of Exposure Therapy

A

Phobias, traumas (PTSD), anxiety

35
Q

What is Systematic De-sensitisation?

A
  • Developed by Joseph Wolpe (1958)
  • Aims to reduce phobic clients’ anxiety responses through counterconditioning whereby a relaxation-response is elicited (through rehearsal) during an anxiety provoking event.
36
Q

Systematic Desensitation procedure

A
  1. Help the client build an anxiety hierarchy (a ranked list of anxiety-arousing stimuli);
  2. Train client in deep muscle relaxation and cognitive restructuring;
  3. Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus
37
Q

Systematic Desensitation procedure

A
  1. Help the client build an anxiety hierarchy (a ranked list of anxiety-arousing stimuli);
  2. Train client in deep muscle relaxation and cognitive restructuring;
  3. Client tries to work through the hierarchy, learning to remain relaxed while imagining each stimulus
38
Q

Idea behind Systematic Desensitation

A
  • The body can’t be both anxious and relaxed at the same time
  • When experiencing a phobic response → Mind and body is stressed
  • When you have a emotional response, do a muscle relaxation exercise at the same time → Do this consistently
    ↳ Physiological trick with the body
    ↳ Have the phobic stimulus → There’s no phobic response
    ↳ Similar to classical conditioning
39
Q

What is Operant condiditoning?

A
  • Theorists: Skinner & Thorndike
  • Idea that we repeat behaviour that generates a good outcome, and avoid behaviours that generates a bad outcome
  • This occurs through positive/negative reinforcement and positive/negative punishment
40
Q

Positive reinforcement

A
  • A stimulus is delivered which increases response due to pleasant outcome.
41
Q

Negative Reinforcement

A

A stimulus is removed to increases response due to pleasant outcome.

42
Q

Positive punishment

A
  • A stimulus is delivered decreases response due to unpleasant outcome
43
Q

Negative punishment

A

A stimulus is removed which decreases response due to unpleasant outcome

44
Q

Applications of operant conditioning

A
  • Parenting: Clear rules, Attention, Rewards, Consequences, Modelling, Consistency
  • Animal Training: Attention, Rewards, Shaping, Consequences, Consistency
  • Self-Management: Self-directed change, Monitoring, Goal setting, Self - reinforcement
45
Q

Aversion therapy

A
  • Where an aversive stimulus is paired with a stimulus that elicits an undesirable response
  • Used with substance abuse, sexual “deviance”, smoking, shoplifting, gambling, stuttering, and overeating
46
Q

Observational learning

A
  • Discovered by Bandura
  • Social-cognitive-behavioural approach to learning through modelling, behavioural rehearsal, and shaping.
  • Vicarious learning: where a model is rewarded or punished for a behaviour and this shapes your own (desired) behaviour.
47
Q

Applications of observational learning

A
  • Social Skills Training: Establish skill level, teach, show, and practice
  • Assertiveness: What is assertive, what is not, and practice
  • Dealing with Teasing and Bullying: Doing something different, comebacks, and practice
  • Stress Management: Diet, time management, prioritising social support, and community participation
  • Problem Solving
  • Unhelpful Coping Strategies and Suicidal Feelings: Selfmedicating, withdrawal and inactivity

PSYU2201 Counselling Principles and Approaches (2 decks)

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