Development of CBT Flashcards
How many people have a diagnosable mental health condition? What age is this from?
1 in 6, school age upwards
How much had the diagnosis of anxiety and depression increased over the past 30 years in 2019?
40%
How much of an increase in anxiety and depression did COVID-19 cause?
25%
What are two effective approaches to treating psychological distress?
Pharmacological and Psychological
How much has pharmacological treatment increased in the past 30 years in Wales? How common is it in some towns in Wales?
10 fold
1 in 3
What is the advantage of psychological treatment in terms of symptom relief? How does it compare to pharmacological treatment?
In terms of symptom relief, effectiveness is about the same
If the definition of effectiveness is broader, psychological therapy fairs better
What are other advantages of psychological therapy
Gives you ‘skills for life’ e.g manage emotions
Increases sense of personal empowerment
Preventive effect - lower relapse rate
No dependency
No rebound effect
What can psychological therapy help people to do?
- Support own recovery
- Understand their problems
- Enhance positive well being
- Build resilience
When did behavioural therapy start?
1960s
When did CBT arise?
1970s
What does CBT view mental health conditions as?
Maladaptive behaviours
How does CBT use conditioning?
Replaces the maladaptive learned responses with adaptive learned responses
What is reciprocal inhibition?
Taking advantage therapeutically the idea that certain emotions are incompatible with other certain emotions (e.g relaxation and anxiety)
What is an example of a therapy that can induce reciprocal inhibition?
Systematic desensitization
What is systematic desensitization?
Deep muscular relaxation is paired with gradual hierarchy of phobic stimuli
What other ways to reduce anxiety can be used in systematic desensitisation?
Green environments, calming music, eating comfort food, sexual arousal, cognitive engagement, laughter
What does behaviour therapy say depression is a result of? How does therapy use this? What does it focus on?
Too little environmental reinforcement or too much environmental punishment
Aims to increase reinforcement and reduce the punishment
External conditions
Who were the two founders of CBT?
Aaron Beck and Albert Ellis
What did Epictetus quote that is linked to the cognitive rationale of CBT?
People are not disturbed by the events themselves but by how they view the events
What does a person’s response to an event depend on? How does this cause mental health issues?
Their appraisal of the event
These appraisals can often be flawed and we pay a heavy emotional price for this
What does cognitive therapy help people to do?
Identify cognitive errors and distortions
Correct biases and unwanted hypotheses
Keep things in perspective
Become more balanced in their judgements
What kind of approach could CBT be considered to be?
Problem-solving approach
What can cognitive therapy help people become to be?
More rational
More reasonable
More realistic
More evidence-based
What are cognitive distortions?
Irrational thoughts and beliefs
Illogical reasoning
Negative judgement biases
What did Aaron Beck say we develop during childhood and beyond?
Core beliefs about ourselves, other people, the world and the future
What are the 3 steps to Beck’s hierarchical model?
Core-Beliefs (schema) -> immediate beliefs (assumptions -> Negative thoughts (inc. NATS)
What are Beck’s 8 types of cognitive distortions?
All-or-nothing thinking
Catastrophising
Magnification/Minimisation
Discounting the positive
Labelling
Mind-reading
Fortune-telling
Emotional reasoning
Give an example of emotional reasoning.
When i feel scared, it tells me the situation is really dangerous
What are the 2 aims of CBT?
- To help the client understand the relationship between their thoughts, feelings and behaviour
- To help the client develop cognitive and behavioural skills to identify to correct cognitive biases, error and distortions
What is important when delivering CBT with regard to you and your client?
Openness and transparency
What are the 3 elements of delivering CBT?
- Psychoeducation
- Exploration (data collection and collab empiricism)
- Strategic change (intervention)
What is collaborative empiricism?
The therapist and client work together to;
- EXPLORE the cognitive basis of the client’s emotional issues
- SET therapeutic goals
- IDENTIFY effective therapeutic strategies
In what ways can you collect data in the exploration stage of CBT?
Clinical interviews, Diaries and thought records
What would be looked at in a clinical interview?
NATs to Core beliefs
Links between thoughts, feelings and behaviours
Pattern discovery - when, where , who
What is it called when someone thinks everyone will be looking at them and judging them?
The Spotlight Illusion
What do you do in the intervention stage for each element discovered in the exploration stage?
NATs -> Identify schema
Cog distortions -> Expose and correct biases
False beliefs -> Challenge them (evidence?)
Conduct behavioural experiments -> evaluate outcomes
What does 2nd wave CBT focus on?
The content of the thoughts
What does 3rd Wave CBT focus on? What is the other name for it?
Exploring a person’s beliefs about their thoughts - Meta cognitions
What are the variations of CBT?
Dialectical Behavioural therapy - DBT
Compassion focused therapy - CFT
Metacognitive therapy - MCT
Mindfulness-Based Stress Reduction
Acceptance and Commitment Therapy - ACT
What type of therapy is Acceptance and Commitment Therapy? What does it aim to do?
Directive and experiential therapy
Help people respond to stress to distressing experiences in a ‘mindful’ way
Aim to reduce suffering to help live a rich and fulfilling life
Who was ACT mainly devised by?
Steven Hayes
What does ACT do?
Teaches mindfulness skills to reduce the impact of distressing thoughts and feelings
encourages people to respond in a mindful way rather than reacting impulsively
Aims to reduce pointless struggling against things that cannot be changed (Acceptance)
How does ACT increase cognitive flexbility?
Helps develop skills to will enable them to;
- Be present
- Open up to experience
- Act in line with their values
What are the key messages for ACT?
- You are separate from your mind
- It is better for us to accept what cannot be changed and carry on
- We often react to situations without thought, better to respond wisely/mindfully
- It is good to be aware of your values and act in accordance to them
- We can limit the negative effects of our mind’s activities by being more aware
What is the commitment part of ACT?
Commit to living in line with our values to make life more rewarding
What is the Serenity Request
May I have the strength to change the things I can change, the courage to accept the things I cannot change, and the wisdom to know the difference
What is the 1st wave of CBT
Behavioural therapy using conditioning
What is the big issue with CBT?
Resource limitations making it hard to deliver 1 to 1 counselling/therapy
What is the solution to the issue highlighted with CBT?
Develop additional delivery strategies
What percentage of people are treated mainly by primary care?
90%
What can people with similar symptoms and issues benefit from?
Provisional standard, low intensity interventions
What are the different ways you can deliver therapy?
Zoom, email, face to face individual, computer, group, apps, bibliotherapy, group-based psychoeducation
What are deliberate actions?
When what we do is a result of conscious decisions
What are some examples of things automatically controlled by our minds?
Breathing, walking, driving
What are some examples of things we deliberately control?
writing an essay, planning a holiday, doing a puzzle
What is being mindful?
Thinking things through and deciding what you are going to do
What are examples of ‘unhelpful’ things the mind can do?
Jump to conclusions, constantly make comparisons, hard to control, react automatically to situations by triggering emotional feelings
What is very important to recognise regarding your emotional reactions to events?
Feelings are not actions - many just HAPPEN
What is very important to recognise regarding your critical mind?
You are not bound to believe everything that your mind tells you
What is the one thing we cannot change?
What we are feeling and unwanted thoughts
What does suppressing unwanted thoughts do?
Increase their strength and frequency
What should you do if you get unwanted thoughts
Notice them, accept them and let them be
What is the key distinction with pain and suffering?
It is often possible to reduce suffering even when level of pain cannot be reduced
Why does fighting pain not help?
You are bringing it to the centre of attention and tenses muscles which can increase the pain
What happens every time we use the avoidance strategy?
Increases our belief that avoidance is ‘necessary’ and ‘best thing to do’ - less likely to confront issue
What does ACT say about phobias?
Expose yourself to the thing you fear, Confront the object/situation you dread and accept when you do you will feel fear and anxiety
What is experiential avoidance?
Avoiding distressing emotions
What is fusion according to ACT?
Confusing thoughts with reality e.g I am a loser compared to I have thoughts that I am loser
