Cognitive Therapy Flashcards by Sarah Kleban

who emphasized role of beliefs in behavior change/what you think influence feelings and behavior

Kelly (1955)

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who did the cognitive theories of emotion

Lazarus (1984)

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who gave cognitive therapy importance in 1962?

Ellis with REBT

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bandura emphasized expectancies and efficacies, the difference being…

ex - what you think will happen/influence experiences people will have

ef - specific experience in ability to achieve something

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aaron beck was trained in …

psychoanalysis

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what does Beck’s theory of emotional disorders and cognitive model of depression say

biasing world is what is causing distress, like depression

systematic biasing perceptions = ability to identify and work through ways of perceiving

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Beck said, “For people with depression, nothing succeeds liked _______ but for people without depression, nothing succeeds like _______”

success; failure

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personality = ________ + __________-

temperament; cognitive schemas

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2 dimensions of personality

clusters of attributes

styles of responding

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psychological distress results from… (3 things)

perceived threat
- threat to self image, esteem, etc./something in conflict to goals

maladaptive interpretations
- misinterpreting information

reduced cognitive and reasoning abilities

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what causes distress in cognitive therapy

systematic bias in information processing

sys. = tendency to do same types of misinterpretations consistently with beliefs

info. = how I take information from world and interpret it

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cognitive vs. REBT

cogn = focused on biased way we receive information around us

REBT = irrational demands we make on self/others/world

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cognitive distortions

change what we think/your thoughts are no longer accurate

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cognitive distortions: catastrophizing

the tendency to blow circumstances out of proportion by making problems larger than life

ex. fail test = fail college, think problem is bigger than it is

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cognitive distortions: personalization

the tendency to take the blame for absolutely everything that goes wrong in your life

ex. someone is in a bad mood, you think you did something to upset them

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cognitive distortions: overgeneralization

the tendency to make broad generalizations based upon a single event and minimal evidence

ex. phobias! bit by dog once = fear of dogs

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cognitive distortions: emotional reasoning

the tendency to interpret your experience based upon how you’re feeling in the moment

hard to find

ex. yelled @ but in reality person didn’t raise voice but felt like yelling

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critique of CT

invalidating towards emotions

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cognitive distortions: shoulding and musting

the tendency to make unrealistic and unreasonable demands on yourself or others

REBT, “should” or “must” be this way

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cognitive distortions: magnification and minimization

the tendency to magnify the positive attributes of another, while minimizing your own

downplaying own achievement while supporting others, major issue with social media

ex. you got a 90 on a test and are upset but praise friend who got a 91

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cognitive triad of depression

Maladaptive beliefs about:

self
- decrease self worth, ex. I’m not good enough

future
- bias information in ways that feel hopelessness/ helplessness

world
- negative, everything is awful/horrible

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what aspect of CT is this depicting:

everything is bad + I’m bad + it’s never getting better

cognitive triad of depression

goal of CT is to change the way of ________

thinking

3 major systematic biases with anxiety

exaggerated perception of danger
- over perceiving threat

difficulty recognizing cues of safety
- in environment with danger, can’t recognize environmental cues to realize there is safety

minimizing ability to cope
- biasing information to process

Obsessive compulsive disorder

**uncertainty of safety (obsession)** - intrusive thoughts are normal but reaction/obsession causes distress **sense of responsibility to take action (compulsion)** - compulsion = process to prevent obsession - ex. as long as I am counting posts, I won't swerve

cognitive schema comparison video

fish always in water doesn't know what it is = cognitive schemas (how we always see the world, don't realize that's how we see things)

hierarchy of thought for CT

1. core beliefs 2. underlying assumptions 3. automatic thoughts 4. voluntary thoughts

hierarchy of thought for CT: core beliefs

foundation of maladaptive schemas big and general beliefs we hold developed in childhood lead to anxiety and depression

hierarchy of thought for CT: underlying assumptions

give rise to automatic thoughts; shape perceptions, provided interpretation and meaning conclusion drawn with absence of evidence

hierarchy of thought for CT: automatic thoughts

spontaneous and triggered by circumstances **stimulus --> automatic thought --> emotion and behavior** actual words said to self about assumption differs from situation to situation

hierarchy of thought for CT: voluntary thoughts

most accessible and stable thoughts thoughts we decided to have, easiest to identify because done on purpose

goal of therapy for CT is to correct ...

faulty information/systematic bias in processing

is the goal of therapy in CT just substitution of positive beliefs for negative ones?

NO; need balance!

treat thoughts as _____ _________ in CT

testable hypotheses

therapeutic relationship in CT

collaborative (key component) therapist as a guide and catalyst for change warmth, empathy, genuineness, curiosity emphasizes patient responsibility (10,080 minutes in a week, only 45 of those are in person therapy)

3 theories of psychotherapy in CT/what we do about distress

collaborative empiricism socratic dialogue guided discovery

collaborative empiricism

work together and use evidence to draw conclusion that may or may not support hypothesis thought to be little scientists treat patient and therapist as co-investigators developing testable hypothesis

socratic dialogue

asking questions that designed to help someone form conclusion by bringing them along with you/lead to answer instead of just giving it to them

guided discovery

teach people how to set up/conduct experiment to test hypotheses

how do therapists work through the hierarchy of thought?

top to bottom

structure of treatment in CT

initial phase - assessment and contract (like BT) - skills education middle and later sessions - identify themes in automative thoughts - challenge core beliefs (design behavioral experiments to test thoughts) ending treatment - relapse prevention (how to identify when a skill is needed and when you may need a booster session)

goal of CT is for the therapist to talk (more/less) throughout progression of treatment

less! transfer responsibility to patient

session structure for CT

1. set agenda (with patient input) 2. review previous material 3. review homework 4. cover new material 5. summarize and assign new homework 6. elicit feedback (ex. "How do you think today went?")

psychoeducation terms

thoughts (influence behavior and feelings) behaviors (influence feelings and thoughts) feelings (influence behaviors and thoughts)

define alexithymia and what is a CT tool used to combat it

inability to communicate how one is feeling; self monitoring

techniques for challenging distortions

**decatastrophizing** - imagining what if's/worst case scenario/how you will cope **reattribution** - considering alternative causes for something - assigns responsibility on entire body of evidence **redefining** - restate problem with concrete things within your control **decentering** - challenging idea that people are so concerned with you (they aren't)

incorporation of behavioral techniques in CT

homework hypothesis testing (e.g., via behavioral experiments) exposure therapy behavioral rehearsal or role playing activity scheduling (commit to engaging in activities, feel better after!)

CT allows patient to experience _______ and _____ ________ simultaneously

emotion; reality testing

core beliefs must be made ______ to be modified

accessible

modification of dysfunctional _______ leads to effective change

assumptions

large effects are shown among what in CT

depression (Child and adult) GAD, panic disorder

medium effects are shown among what in CT

marital distress anger chronic pain childhood somatic disorders (unexplained physical symptoms/physical expression of distress)

when patient's own beliefs don't match culture, therapist should...

develop flexibility and reconcile beliefs with environmental constraints