Cognitive Therapy Flashcards
Cognitive Therapy: Theoretical Foundations
1) Our interpretations of events produce our responses (not the events themselves)
2) Interpretations can be accurate or inaccurate (adaptive or maladaptive)
3) Inaccurate and maladaptive interpretations result from prior experience, and are often habitual and patterned.
4) Inaccurate and maladaptive thoughts often occur automatically and lead to negative emotions and problem behaviors.
Cognitive Therapy: Theoretical Foundations - Cognitive Mediation
Normal and abnormal behavior triggered by cog interpretation of events (not events themselves)
–> every event followed by an appraisal / cognitive response that then shapes our emotional and behavior responses to that event.
Therefore the same event can produce very diff rxns depending on what thoughts intervene.
Cognitive Therapy: Theoretical Foundations - Realism
Cognitive T. based on realist model of reality.
–> external events happen (whether they are perceived or not) and cognitions that mediate between events/emotions can be evaluated as accurate or inaccurate, useful or not useful..
(diff from constructivism of humanism because externe reality at best isn’t objectively knowable in that model)
Cognitive Therapy: Theoretical Foundations - Schemas
Schemas= Organized knowledge structures that influence how we perceive, interpret, and recall information.
–>Can create problems when schemas lead to inaccurate stereotypes about categories of people or things.
- Influence (like filters) how we see ourselves in relation to our world.
- –> ex) a depressed person who feels unworthy will likely interpret new information in light of that schema.
Cognitive Therapy: Theoretical Foundations - The Role of Automatic Thoughts
Empahsizes the habitual nature of some thoughts (including many maladaptive ones..)
–> negative schema driven thoughts may occur so quickly were not aware of them… so they are more like learned habits; unconscious but near the surface and accessible with questioning.
–COGNITIVE SPECIFICITY HYPOTHESIS: clusters of cognitive errors are associated with specific disorders.
EX) Depressed: negative attributional style; more likely to attribute negative events to factors that are internal, stable, and global.
—> this helps create depression and contribute to maintenance.
Cognitive Therapy: Assessment
Similar to behavior therapy, but more focus on the details of cognitive distortions.
– also will measure severity of distortions (like behavioralist) at the beginning, in the middle, and at the end of treatment using rating scales, self reports, standards etc.
– Also attend to clients ability to engage in tasks necessary for cognitive therapy ( like being able to be challenged, objection rational self reflection)
Cognitive Therapy: Role of the Therapist
“Scientist” who tries to help clients ID and alter maladaptive thoughts..
- success depends partially on productive and collaborative therapeutic relationship (built partially on education about maladaptive schemas, distortions, etc)
- –edu is important here because helps clients understand therapists view of problems and how to address/fix them.
Question/challenge client regarding their beliefs (esp. experiences associated with cognitive distortions)
–> COLLABORATIVE EMPIRICISM
Cognitive Therapy: Goals
1) EDU client about role of maladaptive thoughts in behavior and experience
2) Help clients learn to recognize when they engage in them
3) Give clients skills for challenging maladaptive thoughts and replace them with more adaptive/accurate ones.
Cognitive Therapy: Clinical Applications
2 Major Forms of Cognitive Therapy:
1) Becks’ Cognitive Therapy
2) Ellis’s Rational-Emotive Behavior Therapy
Beck’s Cognitive Therapy
Beck - first developed approach to depression
- -> approach based on idea that emotions determined by the way people think about experiences.
- -> depressive symptoms are the result of logical errors and distortions people make about events.EXAMPLE: depressed tend to..
1) draw conclusions based on irrelevant info: not invited to a party so I’m worthless
2) exaggerate importance of the trivial (this counter is ruined because it has 1 scratch)
3) minimize the significance of positive events (good test score was luck not hard work)
So depressed show pattern of negative conclusions about:
a) themselves b) their world and c) their future
- ->known as the COGNITIVE TRIAD
Rational Emotive Behavior Therapy
Albert Ellis - REBT
= psychological problems are not the result of external stress but ARE the result of irrational ideas/beliefs held.
- attack irrational beliefs and instruct clients to more rational/logical think patterns that won’t upset them.
- Therapist is active, challenging, and can be abrasive.
- ->strong direct communication emphasized to make clients relinquish irrational thoughts
-Therapist challenges the client cognitively through questioning and behaviorally through desensitization, assertion training, and hw assignments (so behavioral techniques supplement)
Cognitive Therapy: Psychoeducation
Early in therapy should educate about role of cognitions in disorders..
–>to encourage them to become self-sufficient in ID and replacing cognitive errors.
- Discuss but may also assign homework.
- Socialization important to cognitive therapy esp. because if they don’t edu patients on rationale, they can come off as accusatory or non supportive..
Cognitive Therapy: Socratic Questioning and Guided Discovery
Pursue questioning until the client’s fundamental beliefs/assumptions are exposed – and open to analysis.
Beck called it - GUIDED DISCOVERY – said helped clients see cognitions as ideas rather than certainties ***
Ex Q’s :
-what is the evidence? Is there an alternative way of viewing the situation? What is the worst that could happen? How could you cope? What will realistically happen?
- sometimes will ask to quantify feelings on scale (1-100) to make client more explicit about belief.. often will show that some clients automatically produce and accept exaggerated evaluations of themselves.. (so point isn’t to find the true standing its to show how they see themselves)
Cognitive Therapy: Challenging and Replacing Maladaptive Thoughts
Self defeating beliefs/attributions in clients can be hard to challenge/overcome (preserve core beliefs)
– partly b/c of ‘confirmation bias’ ((we tend to pay more attention to evidence that supports our beliefs than to evidence that refutes it))
- to overcome: repeatedly challenge maladaptive beliefs and push to consider alternatives.
- –> Ex) Reattribution training for depressed with negative attributional style (consider internal vs. external dimension of attributions)
Cognitive Therapy: Decatastrophizing
Help evaluate catastrophic predictions.
- help client see graduations in discomfort.. and that most feared scenarios could actually be tolerable. (and capacity to tolerate discomfort might be larger than they realize)
- -> especially with anxious / socially phobic
