Cognitive Restructuring

Question 1

Beck 1979

Answer 1

Cognitive triad

Question 2

Westbrook et al 2007

Answer 2

Unhelpful thinking style

Question 3

AHA

Answer 3

Accurate
Helpful
Alternative thought

Question 4

Critique

Answer 4

More research for LICBT for BA

Question 5

Horley et al

Answer 5

Different aspects of mind over mood

Question 6

Jonco et al 2014

Answer 6

Cognitive flexibility

Question 7

CR process for anxiety and depression

Answer 7

1. Present rationale
   - formulation
   - maintenance cycle
   Why? helps client to understand that thoughts are subjective and based on their current understanding and thoughts are often the reason why they are feeling low - vicious cycle
2. Identify hot thoughts
   - record them
   - rate thoughts
3. Challenge hot thought
   - gain a more balanced perspective
   - for and again thought
   - how much do you believe the hot thought now?

Question 8

Padesky & Greenberger 1995

Answer 8

Hot thought: thought associated with the most intense emotion

Question 9

Greenberger & Padesky

Williams 2009

Answer 9

Questions to support a client to find evidence that does not support the hot thought

Question 10

Drawbacks of CR

Answer 10

Difficulties identifying NATs

• so frequent and habitual they are difficult to identify
• confusion with core beliefs (Beck, 1976), assumptions for living (Beck, 1976) and NATs

Challenging NATs leads to limited change

• Clinician to focus the client on present thoughts, not future oriented
• core belief has been identified

Environmental factors
Brown & Harris 1978
Hagan & Donnison 1999
- White 2010

Question 11

Kinsella & Garland 2008

Answer 11

support a client to avoid core beliefs by focussing on thoughts related to a specific incident

Question 12

Brown & Harris 1978

Hagan & Donnison 1999

Answer 12

Clients will inevitably experience low mood if their living standards are poor

Question 13

White 2010

Answer 13

evidence of groups working in deprived communities; normalising and providing strategies to cope with depression and stress

Question 14

Anderson et al 2005

Gellatly et al 2007

Answer 14

GSH is helpful for depression mild to mod

Question 15

Boden et al 2012

Answer 15

negatively based, inaccurate and rigid beliefs are significantly impactful on the mood- anxiety disorders

Question 16

Muran & Motta 1993

Answer 16

heightened fear responses and thoughts endorse distorted and irrational beliefs, preventing them from attending to the problem

THINK- Avoidance studies

Question 17

What is CR

Answer 17

A classical treatment supporting a client to-

• recognise
• explore
• challenge
• adapt cognitions

DOES NOT IMPOSE NEW THOUGHTS, just facilitates the client to reframe/perceive differently a situation

Best used to underpin exposure based treatments in LICBT

Question 18

McManus et al 2012

Answer 18

Behav change has been found to be more effective than purely cognitive treatments thus, should be combined with exposure types

Question 19

Cognitive bias

Answer 19

thinking errors- predisposition etc

Question 20

Most common thinking errors in anxiety are…

Answer 20

catastrophising
personalising
selective abstraction

Question 21

Watts & Seems 2006

Answer 21

Selective abstraction

Anxiety patients are more likely to acknowledge events that support their thoughts/feelings and ignore others

Question 22

Working empathically with patients during thought challenging techniques are difficult because…

Answer 22

1. their thoughts/feelings are strongly held
2. feels out of place when considering core CBT principles of collaborative working and socratic questioning - eg challenging