Cognitive - Therapy Flashcards
CBT is thought to combine both the behaviorist and cognitive approach - why is this?
Cognitive element - The therapist works with the client in order to help them identify the negative thoughts that are contributing to their problems.
Behaviourist element – the therapist encourages the client to engage in reality testing either during the session or as homework. The client will have to work on various things outside of the session in order to aid with their recovery.
Approach is unique as both therapist and client play an active role in the therapy - e.g homework for the client.
What are the three stages of CBT
- Dysfunctional thought diary
- Cognitive restructuring
- Pleasent activity sceduling
Describe ‘Dysfunctional thought diary’
As ‘homework’ clients are asked to keep a record of events that lead up to any unpleasant emotions they experience.
Next they should record the negative emotions themselves and what they are, for instance, perhaps you feel SAD because you think people are talking about you badly behind your back.
The clients then record how much they believe in these thoughts from 1-100%.
A rational response is then written next to this and finally, the client rates their belief again. This helps rationalise the client’s thoughts.
The participants then re-rate their beliefs in the thoughts they recorded earlier.
Describe ‘Cognitive Restructuring’
In this stage the clients works with the therapist collaboratively in order to CHALLENGE their negative thoughts for instance ‘what’s the proof they are talking about me’. ‘What’s the worst that could happen if they were? etc’ in order to ‘cognitively reconstruct’ their thought process and change dysfunctional thoughts into constructive ones to get clients into a new pattern of thinking.
Describe ‘Pleasent Activity Scheduling’
This method involves having the client plan for each day ONE PLEASANT activity they will engage in that they wouldnt usually.
For instance it could be starting to go to the gym! Or breaking the normal mundane routine such as eating lunch outside rather than in the office.
It is thought that by doing this, we will induce more positive emotions and focus on new things that will detract from negative thinking patterns.
During this, the client will record how these changes / activities made them feel.
If it doesn’t go as planned the client is advised by the therapist to explore why and how they can change it.
Without description what are the evaluative points of CBT
Effectiveness:
For: Research support (Jarett)
Against: Individual difference and Therapist skill (Kuyken)
Ethics:
For: Empowerment / free will
Against: Patient Blame and Subjectivity (Abrahamson)
Give a strength of the effectiveness of CBT in relation to research support
One strength of CBT is that the therapy has practical evidence of its efficiency.
This was seen in Jarrett et al. (1999) where he compared the effectiveness of CBT with antidepressants (specifically Phenelzine) in 108 patients with severe depression.
Participants were randomly assigned to one of three groups: the CBT group, the antidepressants group, or the placebo group.
The study lasted 10 weeks and found that CBT was as effective as the antidepressants and more effective than a placebo.
Give one weakness of the effectiveness of CBT in relation to individual difference
One weakness of CBT is Individual differences, these are prevalent in all therapies. CBT is no exception meaning it may be more suitable for some people than others.
For instance CBT has been show to be less effective for people who have high levels of irrational beliefs that are rigid / resistant to change.
As well as people in situations of high levels of stress that they cannot resolve, such as a family member having cancer.
Give a weakness of the effectiveness of CBT in relation to the therapist
Another weakness of CBT is that in order to be effective, it is heavily reliant on the competence of the therapist and their ability to structure sessions, plan and review assignments (homework) and to foster good therapeutic sessions.
Kuyken claim that as much as 15% of the outcomes of CBT effectiveness are attributed to the competence of the therapist, meaning if the therapist lacks experience or skill in the field, the CBT will likely not be effective.
Give a strength of the ethics of CBT to do with empowerment / determinism
A strength of the ethics of CBT is that it empowers individuals / clients to develop their own coping strategies - enforcing the idea of ‘free will’.
Because of this, CBT has become a very popular alternative to drug therapy. Particularly for people who struggle to cope with the determinist approach of those therapies and the feeling they have no control over their thoughts and behaviours.
Give one ethical issue with CBT to do with patient blame
One ethical issue with CBT is the idea of patient blame. The cognitive approach to the therapy assumes the client themselves is responsible for their dysfunctional thoughts.
While this could be seen as a positive as it instils freewill. It could be distressful for the patient themselves especially if their problems are rooted by situational factors like family problems or life events that the participant can’t change, meaning ‘blaming’ the individual for this could be unhelpful and cause further distress.
Give one ethical issue with CBT in relation to subjectivity
Another ethical weakness of CBT is the subjectivity of it.
For example what is deemed as an ‘irrational’ or ‘dysfunctional’ thought is entirely subjective and up to interpretation, what a therapist may view as a dysfunctional thought may not be dysfunctional at all.
Abrahamson (1979) suggests that most ‘normal’ people distort things in a positive way while depressed people display the ‘sadder but wiser’ effect where they don’t twist things in a positive way / through ‘rose tinted glasses’ but may be actually more accurate to reality.
This could mean CBT is unethical as we are distorting their view further from what is actually reality.
