Cognitive behavioural therapy Flashcards
Figure who described operant conditioning
B. F. Skinner
Type of response to a behaviour which reduces the frequency of the behaviour
Punishment
Type of response to a behaviour which increases the frequency of the behaviour
Reinforcement
Type of conditioning where something pleasant is imagined to increase the target behaviour e.g. imagining spending your paycheck to stay at work
Covert reinforcement
Type of conditioning where something unpleasant is imagined to decrease the target behaviour, e.g. imagining having lung cancer to stop smoking
Covert punishment
Technique in conditioning where gradually closer approximations towards the target behaviour are rewarded
Shaping
Technique in conditioning where a behaviour is broken into a sequence of events and each segment is reinforced
Chaining
Idea that in conditioning the emotional response to a stimulus increases if the stimulus is experienced often for short periods of time
Incubation
Figure who described learned helplesness
Seligman
Idea that when someone cannot escape from a negative stimulus, they stop trying to escape
Learned helplesness
The idea that one stimulus can lead to a behaviour because of the association between the two in the past, and that someone can avoid the behaviour by avoiding the initial stimulus
Stimulus control/cue-exposure control
Example of stimulus control
Someone has always associated going to their local pub with drinking alcohol - they avoid drinking alcohol by avoiding being near their local pub
The idea that repeated exposure to a stimulus decreases the resulting behaviour
Habituation
The idea that repeated exposure to a stimulus increases the resulting behaviour
Sensitisation
Developed systemic desensitisation therapy
Wolpe
Two behavioural principles that systemic desensitisation therapy relies on
Counter conditioning
Reciprocal inhibition
Idea that if an anxiety provoking stimulus and a relaxed state occur at the same time then the anxiety reduces
Reciprocal inhibition
Three steps within systemic desensitisation
Relaxation training
Making a hierarchy of anxieties
Desensitisation of the stimulus
Example of a hierarchy of anxieties
Someone who is scared of wasps -
Look at a picture of a wasp
Watch a video of a wasp
Walk through a park where wasps might be present
Stay in an outside space close by to a wasp
Stay in an enclosed room with a wasp in
Relaxation technique where people relax different muscle groups in a specific order
Progressive relaxation
Technique where someone directs their attention to a specific body part while carrying out a relaxation exercise
Autogenic training
Technique where someone deliberately tenses parts of their body to avoid fainting
Applied tension
Example phobia where applied tension is used
Phobia of needles/blood
Type of therapy technique where the patient is exposed to the anxiety at the top of their hierarchy without any graded exposure
Flooding
Type of therapy technique which uses imagined flooding rather than real life
Implosion
Type of therapy used in tic disorders where the patient is asked to purposefully carry out the tic at specified time intervals
Massed negative practice
Conditions which habit reversal training is used for
OCD
Tic disorders
Components of habit reversal training
Awareness training - thinking what situations trigger an unwanted response
Competing response training - performing an opposite response to the unwanted response e.g. if the patient normally clenches their fist deliberately relaxing the hands
Contingency management - positive reinforcement for doing the competing behaviour not the unwanted behaviour
Relaxation training
Generalisation training once one component is mastered
Therapy technique where patients observe a therapist’s response and start doing a new behaviour by imitating the therapist’s response when they are ready
Modelling
Therapy which uses the idea that the autonomic nervous system functions can be altered by experiencing feedback about them
Biofeedback
Examples of biofeedback
Wearing sensor bands around the chest which measure respiratory rate and then focussing on decreasing the respiratory rate when tachypnoeic
Wearing a sensor that detects blood pressure and when it is reading high carrying out relaxation techniques
Three forms of social skills training
Basic model
Social problem solving model
Cognitive remediation model
Type of social skills training where complex social situations are broken down into individual steps which are practiced through role playing then practiced in real life
Basic model
Type of social skills training which looks at improving information processing so that the patient can then improve their social skills
Social problem solving model
Type of social skills training which tries to improve more basic functions such as attention or planning, with the idea that when these are improved the improvements can be applied to social situations
Cognitive remediation model
Key figures involved in the development of social skills training
Bellack and Mueser
ABC model of functional analysis
Antecedents - identifying the trigger for a behaviour
Behaviour - identifying the exact behaviour
Consequences - identifying the consequences of the behaviour and why the behaviour continues
Example of ABC functional analysis
A - the patient is shouted at
B - the patient screams and cries and becomes very distressed
C - the patient is comforted and given attention, which also reinforces the behaviour to happen again
Measure of a behaviour which looks at how often is occurs
Repeatability
Measure of a behaviour which looks at how long each behaviour lasts
Temporal extent
Measure of a behaviour which looks at when the behaviour occurs
Temporal locus
Measure of a behaviour which looks at the time gap between the antecedent stimulus and the resulting behaviour
Response latency
Measure of a behaviour which looks at the amount of time between two occurrences of the behaviour
Inter response time
Key figure behind cognitive therapy and cognitive behavioural therapy
Aaron Beck
Three types of cognitive dysfunctions which are described in cognitive behavioural therapy
Negative automatic thoughts/cognitive distortions
Conditional assumptions
Core beliefs/schemas
Type of cognitive dysfunction where someone has an automatic negative thought in response to a situation e.g. if they are meeting a friend automatically thinking that the friend doesn’t really want to see them
Negative automatic thoughts/cognitive distortions
Type of cognitive dysfunction which are rules someone makes for themselves in life e.g. I should always be helpful
Conditional assumptions
Type of cognitive dysfunction which are people’s beliefs about themselves e.g. I am lazy
Core beliefs/schemas
Types of cognitive distortions
Minimisation
Magnification
Over generalising
Selective abstraction
Personalisation
Arbitrary inference
Dichotomous thinking
Catastrophisation
Example of minimisation
Thinking you only passed an exam because the questions were easier than normal
Example of maximisation
You are down to the final two but don’t get a job, thinking you are useless and nobody will employ you
Example of over generalising
You fall out with a friend and think none of your friends like you
Example of selective abstraction
You fail one exam and focus on this rather than the other exams you passed
Example of personalisation
Your dance class is cancelled and you think this happened because of you
Example of arbitrary inference
You break up with someone at Christmas and think the next Christmas you will also break up with soemone
Example of dichotomous thinking
Thinking you will either be accepted to buy a a house and your life will come together, or you won’t be able to buy the house and your life will be a failure
Example of catastrophisation
If you receive bad feedback at work, thinking that you will be fired, you will have no money and then you will lose your house
Type of cognition where someone can only see one solution to a problem where actually multiple solutions might exist - can be thinking which increases the risk of suicide where someone thinks it is the only way out of their issues
Cognitive constiction/one way exit
Type of cognition where someone thinks their thoughts are as powerful as their actions
Thought omnipotence
Cognitions seen in depression
Negative view of self (worthlessness)
Negative view of the world/present (helplessness)
Negative view of the future (hopelessness)
Cognition seen in panic disorder
Catastrophising physiological experiences e.g. having chest pain during a panic attack and thinking they are having a heart attack
Cognition seen in paranoid personality disorder
Negative external attribution bias - thinking bad things happen because of them rather than because of external factors
Cognitions seen in OCD
Thought omnipotence
Thinking that alternative actions can compensate for other thoughts/actions e.g. thinking about their family dying, then tapping their hands five times to stop this happening
Things which maintain cognitive distortions
Avoidance/escape behaviour
Safety behaviours
Attentional deployment
Rumination
Rationale behind avoidance/escape behaviours maintaining cognitive distortions
The patient leaves or avoids a situation which causes them to believe they cannot cope with the situation in the future
Rationale behind safety behaviours maintaining cognitive disrtortions
The patient engages in certain safety behaviours during times of high stress, which leads them to think they can only cope with that stressful situation if they employ that particular safety behaviour
Rationale behind attentional deployment maintaining cognitive distortions
Patients pay particular attention to certain body parts and start noticing small sensations that they otherwise wouldn’t notice, this then worsens their anxieties about those symptoms
Rationale behind rumination maintaining cognitive distortions
The thing being ruminated about becomes more feared and the patient thinks of it as more likely than it is
Example of escape behaviour maintaining a cognitive distortion
Someone has a panic attack in a busy shop and leaves. They then think they can’t cope with busy shops and stop going shopping at busy times
Example of a safety behaviour maintaining a cognitive distortion
Someone has a phobia of dogs. They encounter a dog and count out loud until the dog is past. They then think they can only walk past dogs if they count out loud.
Example of attentional deployment maintaining a cognitive distortion
Someone has panic attacks and is scared of the associated palpitations. They pay particular attention to their pulse and feel an occasional benign skipped beat. This causes them to think they are experiencing palpitations, panic and then develop true palpitations.
Example of rumination maintaining a cognitive distortion
Someone is scared of being in a car in case they are in a car accident. They ruminate over this and begin thinking it is quite likely they will be in a car accident, because they are spending so much time thinking about it. This worsens their fear of being in a car.
Technique used in CBT where the patient is questioned to allow them to reframe their thinking independently, without the therapist doing this directly
Guided discovery
Method of behavioural experiments in CBT
Hypothesis is made e.g. when I have a panic attack I will not come to physical harm even if I don’t curl up in a ball
Hypothesis is tested by not curling up in a ball during a panic attack
If the hypothesis is true then this disproves that the catastrophic thinking is always true and the patient can start working on using alternate strategies
Method of thought stopping, behavioural technique used in CBT for OCD
The patient shouts stop, or applies a negative stimulus e.g. tapping their hand when they are experiencing an obsessional thought
Method of though postponement, behavioural technique used in CBT for OCD
The patient does not allow themselves to think a particular obsessional thought until a certain time
Method of exposure and response prevention, behavioural technique used in CBT for OCD
Obsession provoking situations are carried out and the patient does not act out the related compulsion they normally would
Inverted pyramid technique used in CBT for health anxiety
The patient estimates the number of people who have a particular symptom at any one time, then the number who have it for more than a day, then the number who consult their doctor, then the number who have tests, then the number who are found to have a serious problem, then the number who are not successfully treated
Method of selective physical attention experiments for CBT for health anxiety
The patient asked to focus on a body part which is not anxiety provoking for them
Afterwards they note the physical sensations they noticed
They often notice minor symptoms they would not normally notice
This reinforces the consequences of symptom monitoring
Two models of CBT used for psychosis
Stress-vulnerability model
Continuum model
Focus of the stress-vulnerability model of CBT for psychosis
Looks at specific triggers which can trigger or worsen psychotic symptoms and find ways to deal with these
Focus of the continuum model of CBT for psychosis
Aim of symptom relief from delusions and looks at the similarity/differences between normal thoughts and delusional thoughts, encouraging the patient to think about evidence that contradicts a delusion
Primary treatment tool used in the stress-vulnerability model of CBT for psychosis
Coping strategy enhancement - looks at affective, behavioural or cognitive strategies to cope with triggers
Examples of affective strategies used in coping strategy enhancement
Sleep
Relaxation
Examples of behavioural strategies used in coping strategy enhancement
Exercise
Leaving the situation
Examples of cognitive strategies used in coping strategy enhancement
Distraction
Challenging negative voices
Psychiatric disorder associated with the cognitive element of catastrophic misinterpretation of physiological experiences
Panic disorder
Psychiatric disorder associated with the cognitive element of thinking an alternate or substitute action can undo another thought or action
OCD
Psychiatric disorder associated with the cognitive element of a negative global external attributional bias
Paranoid personality disorder
Psychiatric problem associated with the cognitive elements of hopelessness and cognitive constriction
Suicidality
Therapy type associated with Socratic questioning, which aims to elicit false beliefs
Cognitive therapy
Type of therapy built around collaborative empiricism - collaboration between the client and the therapist
Cognitive therapy
