Cognitive Therapy

Question 1

Principles of CT

Answer 1

1. focus on current adaptation and present problems
2. time limited, focused, goal-oriented
3. structured therapy

Question 2

intrasession/intersession structure

Answer 2

intrasession – preparation phase, work phase, completion phase

intersession structure – behavioral focus & restoration of adaptive functioning to a focus on automatic thoughts

Question 3

role of activity and homework

Answer 3

Can be quite variable – may be used to gather info or how the client functions in their environment, assess the validity of negative thoughts
To create real world change, to translate what is learned into concrete action

Question 4

nature of therapeutic interaction

Answer 4

collaborative empiricism

Work together as a team to identify problems, ways to effect change in client’s life
Development of objective evidence – attempt to separate perception from objective evidence
Beliefs viewed as hypothesis to be tested
Time-limited
Sessions are structured
Identify, evaluate, and respond to dysfunctional beliefs

Question 5

structure of initial session

Answer 5

1. setting an agenda
2. conducting a mood check
3. review presenting problem from intake and an update
4. identify problems and set goals
5. educate client about cognitive model
6. client expectations
7. educating client about their disorder
8. homework
9. summary
10. feedback

Question 6

cognitive model

Answer 6

situation-thought-emotion
what was going through your mind?
People’s emotions, behaviors, and physiology are influenced by their perception of events. The situation doesn’t determine how they feel but how they construe a situation does.

Question 7

identifying automatic thoughts

Answer 7

becoming aware of them
What was going through your mind just then?
What’s the meaning of that thought?
Can elicit within the session or in discussion of a problematic situation
Can be important to continue questioning to elicit additional automatic thoughts
May explore automatic thoughts related to the reaction to the reaction (someone experiencing anxiety, thinking about the anxiety makes them even more anxious)

Question 8

evaluating automatic thoughts

Answer 8

taking a deeper look at them
Do not directly challenge the thought
Use of questions
Preferable to statements and lectures
Client is actively working
Allows therapist to observe where client gets stuck

Question 9

responding to automatic thoughts

Answer 9

working on them
Dysfunctional thought record
Elicit automatic thoughts, work on identifying distortions, and responding to them
Ask about another person (taking a different point of view – what if someone else was going through this? What would you tell them?)
Behavioral experiments to test beliefs interventions
Act “as if” (play a role that is the opposite of your problem – act as if you are not afraid of driving)

Question 10

types of maladaptive thoughts

Answer 10

Self-criticism
Coping – “I can’t handle this and won’t be able to do this.”
Rumination – “I should have studied differently for that exam.”

Question 11

downward arrow technique

Answer 11

use to identify core beliefs/schemas

Core beliefs > intermediate beliefs (rules, attitudes, assumptions) > situation > automatic thoughts > reaction (emotional, behavioral, physiological)

Question 12

Types of questions to evaluate automatic thoughts

Answer 12

1. Evidence
2. Alternative explanations
3. Decatastrophizing
4. Impact of the automatic thought
5. Distancing
6. Problem solving

Question 13

Why was eval of the AT ineffective?

Answer 13

1. There may be a more central AT left unevaluated
2. Eval was implausible, superficial, or inadequate
3. Patient hasn’t sufficiently expressed evidence to support the AT
4. AT is also a core belief
5. Patient understands the AT is distorted, but doesn’t believe it on an emotional level