Cognitive Behavioural Therapy Flashcards
What are the key components of assessment before CBT?
▪️ Open questions establishing problem (incl onset, perpetuating and relieving factors)
▪️ History
▪️ Assess risk
▪️ Data from measures
▪️ Engagement and rapport
▪️ Expectations of therapy
▪️ Goals
What is formulation?
▪️ Conceptualisation/theory of what can explain how and why the problem is occurring
▪️ Guides and personalises intervention
▪️ Continual process throughout treatment
▪️ Collaborative
(Biopsychosocial and the 4 Ps!)
What might be examples of triggering and maintaining factors?
▪️ Events and schema
▪️ Triggers
▪️ Behaviours (e.g., avoidance)
▪️ Cognitive processes (distortions)
▪️ Physiology (e.g., arousal, poor sleep, autonomic)
▪️ Social factors
What is the cognitive approach to panic?
Trigger stimulus starts vicious circle of:
▪️ Perceived threat
▪️ Apprehension
▪️ Body sensations
▪️ Interpretation of sensations as catastrophic
How might a CBT model explain maintenance of persistent physical symptoms?
Hot cross bun model of interactions between:
▪️ Emotions (distress, anxiety)
▪️ Cognitive processes (excessive attention on symptoms)
▪️ Persistent physical symptoms and physiological processes (e.g., autonomic arousal, HPA dysfunction)
▪️ Behaviours (avoidance, checking, withdrawal)
Exacerbated by social factors including medical uncertainty, stigma, family, work etc
What is the typical structure of a CBT session?
▪️ Set an agenda
▪️ Questions (e.g., how have you been)
▪️ Problem and solution focused (review formulation?)
▪️ Set new homework (e.g., behavioural experiments)
KEY = COLLABORATION AND FLEXIBILITY
How can Socratic questioning be used in CBT?
Guide patients to discovery and gain insight into their own problems, making links between events, interpretations, and emotions
Goals set in CBT should…
▪️ NOT be ideal states (e.g., never sad)
▪️ Be SMART: specific, measurable, attainable, realistic, timed
What are the benefits of behavioural experiments?
▪️ Powerful and objective way to explore beliefs and assumptions
▪️ Used to test belief, prediction, or appraisal
▪️ Find out more about problem and test hypotheses
What are grounding/distraction/refocusing strategies?
Techniques designed to ‘ground’ someone into their immediate environment, distancing themselves from the stress or distress that triggered physical symptoms
What is the window of tolerance?
The comfort zone between hypo aroused and hyper aroused
Aim to widen window for increased flexibility
How can arousal awareness help in CBT?
▪️ Identify different emotional states and physical arousal
▪️ Identify anxious predictions occurring in these states
▪️ Recognise tendency to fuse with catastrophic predictions
▪️ Identify unhelpful responses
What techniques/homeworks can be useful in CBT?
▪️ Goal-setting
▪️ Behavioural experiments and graded exposure
▪️ Grounding techniques
▪️ Arousal awareness
▪️ Episode records
▪️ Relaxation
▪️ Pacing of fatigue
▪️ Stress management
What are the two types of relaxation techniques you could use in CBT?
▪️ Mindful breathing
▪️ Progressive muscle relaxation
