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PSY348 - Clinical 2 > Cognitive Behavioural Therapy > Flashcards

Cognitive Behavioural Therapy Flashcards

1
Q

Who developed CBT?

A

Aaron Beck (1979)

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2
Q

What observations is CBT based on?

A

Common thinking styles and themes in depression sufferers, and common behaviours

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3
Q

Key ideas of CBT summarised

A

What you think and do affects the way you feel

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4
Q

Skinner (1953)

A 
Reinforcement 
Positive reinforcement 
Negative reinforcement 
Punishment 
Frustration
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5
Q

Skinner reinforcement

A

The notion that the way in which we behave can be reinforced by positive or negative reinforcement

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6
Q

Skinner positive reinforcement

A

Rewarding good behaviour

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7
Q

Skinner negative reinforcement

A

Behaviour leads to the removal of a negative stimulus or feelings
E.g. crying when hungry and getting fed reinforces crying behaviour

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8
Q

Skinner punishment

A

Adverse consequences for bad behaviour, attempts to stop behaviour

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9
Q

Skinner frustration

A

If you expect a reward for a behaviour and that reward does not come, you may become unmotivated to perform that behaviour

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10
Q

Ferster (1973)

A

The depressed person’s activities function as avoidance and escape from aversive thoughts, feelings or external situations
Reduced access to pleasure and satisfaction are consequences of avoidance

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11
Q

Lewinsohn (1974-76)

A

Social reinforcement theory
Lack of social reinforcement of adaptive behaviour
Depressive behaviours can also become reinforced (sympathy, help)

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12
Q

Who developed the first behavioural treatment for depression?

A

Lewinsohn

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13
Q

Ellis (1957)

A 
Emotions influenced by appraisals 
Irrational beliefs cause suffering's 
A - antecedent 
B - beliefs 
C - consequences
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14
Q

Beck (1979)

A

Focus on modifying cognitive biases and maladaptive behaviours that maintain emotional disorders

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15
Q

Beck (1979) cognitive triad beliefs (depression)

A

Core beliefs about the self (I am useless)
Core beliefs about others (Others are better than me)
Core beliefs about the future (No matter how hard I try I will never amount to anything)

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16
Q

How does the cognitive triad work in depression?

A

Core beliefs about self, others and future feed into conditional beliefs which are rules that help us navigate interpersonal relationships and interactions (If I get close to others, they will eventually reject me)

This then feeds into automatic thoughts (I will make a fool of myself, people will think I’m the odd one out, nobody will talk to me, I’ll feel awful)

Can be triggered by social situations (being invited to the office party)

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17
Q

Beck (1979) cognitive triad beliefs (generalised anxiety)

A

Core beliefs about self (I am unable to cope and protect myself)
Core beliefs about others (others are threatening, the world is dangerous)
Core beliefs about the future (terrible things can happen at any moment)

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18
Q

How does the cognitive triad work in generalised anxiety?

A

Core beliefs about self, others and future feed into conditional beliefs which are rules that help us navigate interpersonal relationships and interactions (If I leave the house something bad will happen)

This then feeds into automatic thoughts (What if I get lost? What if I get robbed?)

Can be triggered by everyday events (needing to go shopping)

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19
Q

All or nothing thinking

A

If I am not perfect, I have failed

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20
Q

Mental filter

A

Only paying attention to certain types of evidence, noticing failures but not seeing successes

21
Q

Jumping to conclusions

A

Mind reading - imagining what others are thinking

Fortune telling - predicting the future

22
Q

Over generalising

A

Seeing a pattern based upon a single event, or being overly broad in the conclusions we draw

23
Q

Disqualifying the positive

A

Discounting the good things that have happened or that you have done for some reason or another

24
Q

Magnification (catastrophising) and minimisation

A

Blowing things out of proportion

Inappropriately shrinking something to make it seem less important

25
Q

Role of case formulation in CBT

A

Explanatory models for an individual’s differences
Usually includes predisposing, precipitating and maintaining factors
Emphasis is put on current cycle of distress
Guides the selection of relevant treatment strategies

26
Q

Idiographic formulation

A

A specific formulation for an individual given that the individual’s life history

27
Q

Disorder specific formulation for panic disorder

A 
Clark (1986) 
Trigger 
Threat perceived 
Anxiety 
Body symptom or mental symptom 
Catastrophic misinterpretation (I am dying) 
(final three in a cycle)
28
Q

Disorder specific formulation for social phobia (Wells and Clark, 1997)

A

Social situation
Activates assumptions
Perceived social danger -> somatic and cognitive symptoms and safety behaviours
Processing of self as a social object (from and feeds into perceived social danger)

29
Q

Epictetus quote

A

Human beings don’t suffer because of the things that happen to them; human beings suffer because of what they think about the things that happen to them

30
Q

Common strategies in CBT

A 
Goal setting 
Behavioural activation 
Graded exposure 
Cognitive restructuring 
Behavioural experiments 
Problem solving 
Attention training 
Automatic thought record
31
Q

Goal setting

A

Long-term - reconnect with meaningful others

Short-term - get out of bed for a few hours a day

32
Q

Behavioural activation

A

Gradual activity scheduling in a way that the easiest is scheduled first, gradually moving on to the more difficult ones

33
Q

Graded exposure

A

Gradual exposure to the anxiety inducing stimuli

34
Q

Cognitive restructuring

A

Central technique

Recognising the ways in which your thinking may be problematic and changing this

35
Q

Behavioural experiments

A

Experiments set up to check whether core beliefs are true

When your belief doesn’t come true, it changes your belief

36
Q

Problem solving

A

Enables people to work through problems in a systematic way
Weigh up the pros and cons of different decisions
Gain a sense of control over problems

37
Q

Attention training

A

Used when paying attention to specific components of the environment or in the body are the problem
Retrain to pay attention to other things

38
Q

Automatic thought record

A

When you notice your mood getting worse, ask yourself ‘what is going through my mind right now?’

Fill in table with columns of: 
Situation 
Automatic thoughts 
Emotions 
Adaptive response 
Outcome
39
Q

Key principles of CBT treatment in practice

A 
Structured and time-limited 
Goal oriented 
Emphasis on the present 
Change oriented 
Active 
Evidence-based 
Collaborative empiricism 
Educational
40
Q

Structured and time-limited

A

Sessions have an agenda

There is a set number of sessions

41
Q

Goal oriented

A

Focused on the defined problems and targets

42
Q

Emphasis on the present

A

We consider relevant history to make sense of the problem but mainly focus on finding ways to improve wellbeing today

43
Q

Change oriented

A

Promoted changes in how we think and/or behave

44
Q

Active

A

CBT involved talking, but is primarily a doing therapy, patients are encouraged to practice skills in between sessions

45
Q

Evidence-based

A

Guided by case formulation, grounded in research data, use of validated outcome measures to assess progress

46
Q

Collaborative empiricism

A

We work as a team to learn about what maintains problems, take an objective view about our internal and external worlds

47
Q

Educational

A

We use psycho-education and guided discovery to learn about ourselves

48
Q

Traditional high intensity CBT

A 
Individual psychotherapy (typically 16-20 sessions, 1hr/week) 
Group-based
49
Q

Contemporary low intensity CBT

A

Self-help (biblio-therapy)
Individual guided self-help (<8 sessions, 30mins/week, in person and/or via phone)
Computerised CBT (online modules, forums, apps)
Large group psycho-educational CBT (e.g. stress control classes)
Less costly and quite effective for common psychological problems

PSY348 - Clinical 2 (9 decks)

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