Cognitive Behavioural Therapy Flashcards
1. Understand what automatic negative thoughts are and the techniques used to identify and change them 2. Understand how contemporary, third wave CBT differs from second wave CBT 3. Be able to summarise what is known about the effectiveness of CBT 4. Know some examples of how CBT has been applied in the African and South African context
1
Q
What is CBT an integration of?
A
- CBT is an integration of behaviour therapy and cognitive therapy.
2
Q
What is the focus of Second Wave CBT?
A
- Second wave CBT focuses on working collaboratively with the client to identify and modify autonomic negative thoughts (ANTs)
3
Q
What are ANTs and how do they arise?
A
- Autonomic negative thoughts arise spontaneously in the moment, without us reflecting or weighing them up; we don’t give them the same consideration as other thoughts because we just assume them to be true.
- We do not consciously control them and often aren’t consciously aware of them- just of how they make us feel (often intense negative emotions like anxiety, shame, anger, guilt, despair)
- Thoughts and feelings are intimately connected.
4
Q
How can someone become aware of their ANTs?
A
- When you notice a strong negative feeling, pay attention to what thoughts come to mind in that situation.
5
Q
What is the theory behind ANTs and why they impact our mental health?
A
- CBT therapists argue that it’s not always just the situation itself, but rather the unhelpful or inaccurate way we think about or make meaning about the situation that creates distressing feelings.
- The meanings we make affect how we feel and behave.
- We are constantly assigning meaning to our experiences, but often this happens implicitly, automatically, without much conscious engagement wit the meaning-making process.
6
Q
Define ANTs
A
They are cognitive reflexes linked to core beliefs we hold about ourselves.
They are not facts
7
Q
What are autonomic nervous thoughts linked to?
A
- Autonomic nervous thoughts are often linked to specific trigger situations e.g. criticism, conflict, not being in control, perceived failures.
8
Q
What is the nature of core beliefs?
A
- Often we are not cognitively conscious of core beliefs but with the help of a cognitive therapist we can work backwards from our autonomic thoughts to identify these core beliefs.
9
Q
What are the different common cognitive distortions that characterise ANTs?
A
- All or nothing thinking. This is when a person sees things in black and white categories. If they fall even a little bit short of perfect they see themselves as a total failure. E.g. “I fail at everything I try”
- Overgeneralization. This is when a person makes broad conclusions that a single negative event represents pattern defeat, using words such as “always” and “never”. E.g. “I am never comfortable around others”
- Mental filter. This is when a person picks out a single negative detail and dwells on it. E.g. picking out the one negative comment in an otherwise positive email from your boss and obsessing about it for the rest of the day.
4.Disqualifying the positive. This is when a person rejects positive experiences by insisting they “don’t count” for some reason or another. E.g. If you perform well, you tell yourself it still wasn’t good enough, that you just got lucky this time, or anyone could have done the same.
10
Q
Common cognitive distortions that characterise ANTs (part 2)
A
- Jumping to conclusions. This is when a person make negative interpretations even though there are no facts to support your conclusions. There are two subsets to this: i) Mind-reading: automatically assuming people are reacting negatively to you. “I know she hates me because she didn’t reply to my posts”
ii) The fortune teller error: this happens when people anticipate and take it as fact that things will turn out badly. E.g. “I spent a week drafting this report but I know my boss will think it is garbage” - Magnification or minimization. Magnification occurs when people exaggerate the importance of their mistakes or exaggerate someone else’s achievements, so that by comparison they always look worse. Minimization occurs when people inappropriately discount their own desirable qualities and discount another person’s imperfections so that once again by comparison they always look bad.
- Emotional reasoning. This occurs when people assume their negative emotions necessarily reflect the way things really are. e.g. “I feel guilty, therefore I must be a bad person”
- Should statements. This is when people are attached to a certain outcome or expectation about how things should be. E.g. “I should be doing something better with my time right now.”
- Labelling. This is when people attach a negative label to themselves. E.g. “I’m a loser”
- Personalization. This is when people hold themselves accountable for things that are beyond their control. E.g. when someone blames themself for not spending enough time at the office when a large project fails (despite the fact that there were 20 other people involved).
11
Q
List 5 examples of ANTs
A
- “I’ll never make it”
- “I’m useless”
- “I always mess things up”
- “Nobody likes me”
- “I’m so stupid”
12
Q
List five examples of negative core beliefs
A
- “I have to be perfect otherwise I’m worthless”
- “I must not be too needy/demanding”
- “I’m not good enough as a person”
- “I have to be responsible for looking after everyone”
- “I can’t trust anybody”
13
Q
How are ANTs adaptive in some circumstances
A
ANTs can be adaptive in some circumstances because these biases were potentially adaptive during one’s childhood, but they are less helpful for them in their adulthood.
14
Q
Compare CBT and Psychodynamic therapy.
A
- CBT recognises an unconscious realm that is completely unknown to the client, but it does not focus on this.
- CBT focuses on core beliefs about self and others that often underlie our automatic thoughts. These are often not immediately in our conscious awareness but we can become aware of them when asked (they are not repressed, but just below the surface of conscious awareness)
- CBT recognises the importance of early history in setting up core beliefs but the focus is on how our thoughts and behaviours that derive from these core belief are maintaining our current difficulties- and how to shift this. (e.g. by changing our ways of thinking about these situations/relationships or changing our habitual ways of responding)
15
Q
How does second wave CBT work?
A
- Meta-cognition: developing an awareness and understanding of our habitual ways of thinking; tracking and identifying our ANTs and cognitive distortions.
- Meta-cognition can help us to take a step back, review the basis for the conclusions that we habitually, automatically draw, and explore alternative meanings/conclusions that may be more helpful.
