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PTS FINAL EXAM > L3: Cognitive Therapy > Flashcards

L3: Cognitive Therapy Flashcards

1
Q

On what theory is cognitive therapy based?

A

a theory of personality positing that ppl respond to life events through cognitive, affective, motivational, and behavioral responses. The cognitive system focuses on responses to events based on how they were perceived and interpreted. These responses can be maladaptive, thus cognitive therapy tries to adjust this information processing and enact change in all systems as a result.

Maladaptive conclusions are treated as hypotheses that can be tested

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2
Q

What are the basic concepts of cognitive therapy? Strategies & Techniques

A

strategies:
- collaborative empiricism
- guided discovery
style
- socratic dialogue: ask questions to help client see their world differently
techniques:
- logical examination
- challenging thoughts
- behavioural experiment
- pie chart, reattribution technique usually for guilt & responsibility
- socratic questioning
- multidimensional evaluation
- often combined w other (behavioural) tehcniques

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3
Q

Define collaborative empiricism

A

exploring and modifying dysfunctional / nonadaptive interpretations together w client through behavioral experiments & logical examination

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4
Q

What is the aim of guided discovery?

A

to discover the etiology of the current misperceptions and beliefs the client has, usually linked to past events.

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5
Q

Define socratic dialogue

A

integrates collaborative empiricism & guided discovery
1. Ask information questions
2. Listen
3. Summarize
4. Ask synthesizing / analytical questions applying the discovered information to the original belief of the client (e.g. How does this new information fit with your belief that you can’t do anything right?)

⇒ goal = improve reality testing & reduce cognitive distortions & biased judgments individual experiences and change them into more neutral judgments

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6
Q

Define schema

A

structures of survival which determine people’s perceptions of themselves, their goals, expectations, memories, fantasies, and previous learning. - influence info processing

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7
Q

What are the 3 major approaches to treating dysfunctional modes?

A
  1. deactivate them
  2. modify content & structure
  3. constructing more adaptive modes so maladaptive one is neutralized
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8
Q

Define mode

A

networks of schemas that make up personality
- some are primal: meaning they are universal & tied to survival (ex: anxiety mode)
- others are minor & under conscious control

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9
Q

How do core beliefs, schemas, and modes contribute to mental illness?

A
  • in mental disorders: dysfunctional schemas and core beliefs make their info processing more biased
  • some primal modes like the anxious mode can be overridden by conscious intentions & deliberate thinking = the aim of cognitive therapy
    -> CT focuses on correcting errors & biases in info processing through modification of modes & core beliefs
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10
Q

What are the steps of a behavioural experiment?

A
  1. precisely identify the belief/thought/process the experiment will target
  2. collaborate w your patient to brainstorm ideas for an experiment; be as specific as you can
  3. write predictions about the outcome & devise a method to record the outcmoe
  4. anticipate problems & brainstorm solutions
  5. conduct the experiment
  6. review the experiment & draw conclusions
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11
Q

Is a behavioural experiment, cognitie or behaioural?

A

most behavioural experiments involve (new) behaviours & exposure to feared situations
but:
- explicity intended to challenge & modify dysfuncitonal thoughts
- reduciton of fear during experiment is not required
- particularly suitable to solidify (new) thoughts that have high credibility but are not yet “felt” to be true
so its actually more a cognitive technique!

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12
Q

Whats a common misconception on cognitive therapy?

A

that its wishful thinking or denying real problems

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13
Q

How does cognitive therapy compare to psychoanalysis (similarities & differences)?

A
  • both examine conscious common themes present in persons emotional reactions, narratives, and imagery used
    differences
  • but psychoanalysis also focuses on unconscious meanings, libidinal needs, repressed childhood memories, and infantile sexuality
  • CT is highly structued & usually short term, psychoanalysis is long term & unstructured
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14
Q

How does cognitive therapy compare to Rational Emotive Behaviour Therapy (REBT) (similarities & differences)?

A

similarities:
- both focus on changing maladaptive assumptions as based on an active & directive form of therapy
differences
- CT assumes that each disorder has cognitive specificity (its own unique cognitive profile that requires a different technique to treat based on the disorder) & assumes that cognitive deficitis are present in psychopathology which can impede ppls ability to foresee later occuring negative consequences, hinder concentration, directed thinking, or recal

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15
Q

How does cognitive therapy compare to behaviour therapy (similarities & differernces)?

A

similarities:
- time limited
- goal oriented
- very collaborative
- monitoring of goals is important
- relation w science is similar
- both very effective
differences
- behaviour therapy ignores internal events of individual & focuses more on behaviour analysis (but this is not entirely true)

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16
Q

What are the causes of psychological distress according to cognitvie therapy? L3

A

personality develops as interaction between one’s innate disposition & the environment, and personality attributes refelct interpersonal strategies that were dev in response to environment
- psych distress results from ++ factors, main one being one’s learning history (social learning theory)
- psych distress is exaggeration of normal emotional reactions shown persistently in different ways. when one’s vital interests are threatened, one experiences psych distress -> one’s perceptions & interpretations being highly selective, egocentric, and rigid
- everyone has unique vulnerabilities that predispose them to distress, for some these are your cognitive schemas (cognitive vulnerability)

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17
Q

What does the social learning theory say?

A

different events will impact any single individual differently, idiographic account necessary

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18
Q

What is the theory of causality?

A

Distress is caused by various innate, biological, developmental, and environmental factors which interact with each other.

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19
Q

What are the 2 major personality dimensions related to depression (& possibly to other disorders)?

A
  • social dependence (sociotropy) -> depressed after relationships are disrupted
  • autonomy -> depressed after a desired goal is not attained

most ppl display aspects of both of these behaviours

20
Q

What are the forms of cognitive distortions?

A
  • arbitrary inference
  • selective abstraction
  • overgeneralization
  • magnification/minimization
  • personalization
  • dichotomous thinking:
  • cognitive specificity: patients w similar problems will have similar cognitive distortions
21
Q

Define arbitrary inference

A

drawing a specific conclusion without supporting evidence

22
Q

Define selective abstraction

A

considering a situation based solely on a single detail taken out of context and while ignoring other information

23
Q

Define overgeneralization

A

abstracting a general rule from one or few isolated incidents

24
Q

Define magnification & minimization

A

making something seem much more important or less important than it actually is

25
Q

Define personalization

A

attributing external events to the self

26
Q

Define dicothomous thinking

A

categorizing experiences in one of 2 extremes

27
Q

What is the cognitive profile of depression?

A
  • cognitive triad: negative view of self, the world, and the future
  • self is inadequate, deserted, and worthless
  • Often present with increased dependency which reflects belief about the self being incompetent.
28
Q

What is the cognitive profile of (hypo)mania?

A
  • inflated view of self & future
  • block out negative experiences or reinterpet them as positive- overly positive thinking drives continous goal directed activity
29
Q

What is the cognitive profile of anxiety disorder?

A

sense of physical or psych danger
- excessive funcitoning / malfunctioning of adaptive survival mechanisms (fight of flight)
- often struggle w recognizing signs of safety & correcting misperceptions w logic & evidence

30
Q

What is the cognitive profile of panic disorder?

A

catastrophic interpretation of bodily or mental experiences - inability to view symptoms or sensations realisitically

31
Q

What is the cognitive profile of phobia like agarophobia?

A

sense of danger in specific, avoidable situations - anticipation of physical/psych harm

32
Q

What is the cognitive profile of paranoid state?

A

attribution of bias to others - others treat them unjustly, abusively etc

33
Q

What is the cogntivie profile of hysteria?

A

concept of motor or sensory abnormality

34
Q

What is the cognitive profile of obsession?

A

repeated warning or doubts about safety - attribute unceretaintly to situations normally thought of as safe & show continual doubts about them

35
Q

What is the cognitive profile of compulsion?

A

rituals to ward off perceived threat - feel responsibility about having done an action to counter the obsession

36
Q

What is the cognitive profile of suicidal behaviour?

A

hopelessness & cognitive deficit in problem solving

37
Q

What is the cognitive profile of anorexia?

A

fear of being fat cus body image associated w one’s worth & social acceptability

38
Q

What is the cognitive profile of schizophrenia?

A

complex interaction of factors
- impaired integrative function
- various cognitive deficits increase vulnerability to stressors, thus leading to dysfunctional beleifs
- excessive psychophysio response + release of corticosteriods + resulting activation of dopaminergic system -> delusions & hallucinations
- cognitive disorganization results from neurocognitive deficits
- negative self schemas often contribute to auditory hallucinatons
- delusions often rooted in cognitvie biases

39
Q

What is the cognitive profile of hypochondriasis?

A

attribution of serious medical disorder

40
Q

How does cognitive therapy work?

A
  • goal: correct faulty information processing + help modify assumptions maintaining maladaptive emotions and behaviors
  • initial focus on symptoms relief then start modifying core beliefs
  • core beliefs used as testable hypotheses in behavioural experiments
  • meaning, funciton, usefulness, & consequences of beliefs examined by asking qs & client decides what to keep/reject
  • CT acknowledges reality of clients problems, but says that clients have biased views of themselves & the situation
  • cognitive changes help promote new behaviours by letting client take risks
  • emotions in turn can help cognitive change cus learning is improved if emotions are triggered
41
Q

What is the role of the cognitive therapist? What is the therapeutic relationship like?

A
  • collaborative!
  • directive if necessary (ex: severe symptoms or in crisis)
  • guidance (leading from behind)
  • can act as a catalyst helping to identify corrective experiences that can induce cogntivie change
  • continous feedback
  • core traits of therapist: warmth, accurate empathy, genuiness, sensitive to clietns comfort, flexibible
42
Q

What is the process of psychotherapy?

A

intial session: build relationship, elicit essnetial info (diagnosis, history, symptoms etc get funcitonal & cognitive analyses) , provide symptom relief (make problem list), clear up misconceptions
middle & later sessions: shift from symptoms to thinking patterns & underlying assumptioms. modify them though behavioural experiments, logical analysis etc. client starts taking more responsibbility & lead
end: 15-25 weeks

43
Q

What are the 3 fundamental components of cognitive therapy?

A
  • comprehensive framework
  • clients emotinal engagement in the problem situation
  • reality testing in the problem situation
44
Q

What does “evidence based practice” mean?

A

evidence usually evaluated based on treatment efficacy or its causal relation to the outcome AND its utility or generalizability

45
Q

Who can be helped w cognitive therapy?

A
  • best suited for cases where cognitive distortions are apparent & problems can be clearly delineated
  • often used when medication is not an option
  • best results w clients w adequate reality testing, good concentration, & sufficient memory functions
  • not recommended as stand alone treatment for bipolar, schizophrenia, psychotic depression
46
Q

What are some of the cognitive techniques used?

A
  • automatic thoughts elicitied by talking about them
  • decatastrophizing: considering the what if, what could help in the situation if it actually occured
  • reattribtuion: alternative causes of events are considered which help test automatic thoughts; particularly useful when problems are overpersonalized
  • Redefining: potentially making a problem more concrete and specific and stated in terms of the client’s own behaviors so that catastrophizing can be avoided
  • Decentering: after examining the conviction behind being the center of attention, testing the hypothesis using behavioral experiments (primarily used in anxious clients)
  • intrusive imagery can be remodified by reexamining aspects & changing their interpretation
47
Q

What are some of the behavioural techniques used?

A
  • skills training: to expand response repertoire
  • progressive muscle relaxation: to erlax
  • activity rescheduling: ativation
  • behavioural rehearsal: to prepare individuals for avoided situations, often videotape to serve as objective source of info
  • exposure therapy: to expose to feared stimuli
  • Hypothesis testing: involves making specific and concrete hypotheses and examining them both with cognitive and behavioral techniques.
  • Diversion techniques are also often used to reduce strong emotions and negative thinking and often include social contact, work, play.
  • Graded-task assignment involves client initiating an activity at nonthreatening level and therapist gradually increasing the difficulty of the task

PTS FINAL EXAM (6 decks)

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