Lecture 3 CBT and 1/2 stage of GD Flashcards
Cognitive Behaviour Therapy
- Grounded on what
- What 3 key parts
- What sort of relationship
- Have been what and can be what
- Approach is largely what
Grounded on a scientific view of human behavior that implies a systematic and structured approach to counseling
Cognitions, emotions and behaviors
- interact and have a cause-effect relationship.
- have been learned and can be modified by new learning.
Approach is largely educational in that learning is viewed as being at the core of the therapy.
CBT
- Which factors interplay with which ones
- what in our lives do not have power to what
- Emphasizes teach the members what?
- Members are empowered through what
- What are an integral part of therapy
- Approach is relatively what
Cognitive and emotional factors interplay with behavioral ones
Events in our lives do not have to power to determine us – it is our interpretations of these events that is crucial
Emphasizes teaching the members skills of self-management, with the expectation they will be responsible for transferring what they learn in the group to their everyday lives.
Members are empowered through this process of being responsible for their changes.
Homework assignments are an integral part of the therapy.
Approach is relatively brief often involving fewer therapy sessions and less overall time than other approaches
Goals of CBT
- Generally to what
- To focus on what
- Clients have an active what
- Stated in what terms
- Members what are influenced by what
- General goal is to create new what
- Emphasis on the members taking an active what
Generally, to eliminate maladaptive behaviours and learn more effective behaviours.
To focus on factors influencing behaviour and find what can be done about problematic behaviour.
Clients have an active role in setting treatment goals and evaluating how well these goals are being met.
Stated in concrete and objective terms
Members problems are influenced by present conditions
General goal is to create new conditions for learning on the assumptions that learning can change problem behaviors.
Emphasis on the members taking an active role in deciding what they want to work on.
Types of Learning Processes in CBT
-2 Types of conditioning and modeling, describe them
Operant Conditioning
- Positive and negative re-inforcers
- Getting treats or being sprayed for doing something
- Skinner
- Repetitive
Respondent Conditioning
- Pavlovian conditioning or pairing of behaviours
- When you eat you want to smoke
- If sound goes off, food comes out
Modeling
-Imitation
Therapeutic relationship
-What are the 6 steps and describe them
CFIIEC
Clarify -Clarify the problem Formulate -Formulate goals Identify -Identify a plan Implement -Implement the change plan Evaluate -Evaluate Success of plan Conduct -Conduct follow up sessions
CBT Leader Characteristics
- ADC
- Function as what
- What of members desire to what
Active, directive, and confrontational (pointing out incongruencies)
Function as consultants and problem solvers
Supportive of member’s desire to change the problem behavior
CBT Techniques
-Leaders use what techniques to change what factor that are influencing the members what
Techniques are tailored to what
Members are expected to be what
Rather than what
It works until what
Leaders use behavioral focused techniques to change their relevant current factors that are influencing the member’s behaviors.
Techniques are tailored to fit the unique needs/situation of the member
Members are expected to be active in engaging in specific actions to deal with their problems.
Rather than simply talking/exploring their current condition, they do something to bring about change.
It works until the members are no longer active in their treatment
CBT
Behavioural Contracting
- Contracts provide what
- Can be what
- Contracts serve as what
- It provides a method for what?
- Contracts used often for what
Written -Written contract has the advantage of what -Written is easier for what Verbal -Has the advantage of what -Research has indicated what
Contracts provide the client with a set of rules that govern the change process.
Can be unilateral or bilateral
Contracts serve as guides to clients as to the specific actions they need to take in order to improve their problematic situations.
It provides a method for measuring progress
Contracts used often for maladaptive or criminal behaviour
Written
- A written contract has the advantage of emphasizing the commitment to the contract by both the nurse and the client, and it minimizes the risk of misunderstanding.
- Written is easier for you to come back and see the goals not being met
Verbal
- “has the advantage of avoiding the sterility of a written contract”
- Research has indicated that the verbal is generally as effective as the written contract with regard to the goals being successful.
CBT Techniques To change cognitions :
3 Tech niques
TDR
Thought stopping and covert assertion,
Diversion techniques, and
Reframing: (looking at things a different way)
- Positive thinking
- Deawfulizing
- Decatastrophizing
- Separate positive intents from negative behaviours
- Redefining
- Decentering
Contributions of CBT
- Focuses on what
- Variety of specific what
- Used in areas of what
Focuses on specifics
Variety of specific behavioral focused techniques used by the therapist – emphasis on doing rather than talking to gain insight
Used in areas of health psychology to help people maintain a health lifestyle and manage illness
CBT uses
Cognitive behaviour approaches have been used to help people 4
Also used in 3
Cognitive behavior approaches have been used to help people:
- Quit smoking,
- Quit drinking,
- Stop overeating,
- Manage stress
Also used in:
- Social skills training
- Assertiveness training
- Stress management
CBT Limitations and Criticisms
- Focus on what
- does not what
- treats what
- Involves some what
Focus on changing behaviors and ignores the important relational factors
Does not provide insight
Treats symptoms rather than causes
Involves some control and manipulation by the leaders
Cognitive Behavioural Foundations Videos
Stress is a response to something
Stressor is the thing that sets us off\
We can stress us off even with non real thing
Is it chronic or acute
Stress can be from wear and tear
There is adaptive or maladaptive ways of coping
The girl is struggling with loss of spouse
You cant change all sources of stress but you can handle it differently
Stress assessment
-How many times do you get stressed a month
-What are the stressors
-How long has the stress been bothering you
-How has the stress been affecting you
-How are you trying to cope with the stress
-How can others help you
Therapeutic relationship is important
Investing in yourself is already starting the coping and healing experience
Breathing exercises can help you calm down
Therapeutic Communication
- Undertaken to carry what
- P
- How many goals
- Aimed at what
- Self-disclosure by what
- Undertaken to carry out the nursing care
- Purposeful
- Has one or more goals
- Aimed at meeting the needs of one of the participants
- Self-disclosure by the interviewer is limited
Basic Characteristics of Initial Stage
- Participants test what
- Members learn the what
- Risk taking is what
- They figure out what
- What are two important things to be established for members
- Members are concerned with what
- A central issue is what
- Members may look for what
- Members are deciding whom they
- Members are learning the basic attitudes of?
Participants test the atmosphere and get acquainted.
Members learn the norms and what is expected, learn how the group functions, and learn how to participate in the group.
Risk taking is relatively low and exploration is tentative.
They figure out if they want to stay or not
Group cohesion and trust are gradually established if members are willing to express what they are aware of in the here-and-now.
Members are concerned with whether they are included or excluded, and they are beginning to define their place in the group.
A central issue is safety and being assured of a supportive atmosphere.
Members may look for direction and wonder what the group is about.
Members are deciding whom they can trust, how much they will disclose, how safe the group is, whom they are drawn to and with whom they feel distant, and how much to get involved
Members are learning the basic attitudes of respect, empathy, acceptance, caring, and responding – all attitudes that facilitate trust building.
Member Functions Of initial Stage
- Taking what
- Learning to
- Being willing to?
- Being involved in what
- Establishing what
- Learning how groups what and how to best what
Taking active steps to create a trusting climate.
Learning to express one’s feelings and thoughts.
Being willing to express fears, hopes, concerns, reservations, and expectations concerning the group.
Being involved in the creation of group norms.
Establishing individual goals that will govern group participation.
Learning how groups work and how to best participate in the process.
Initial Stage Leader Functions -Three functions TDAMS -The leader should be what
Provides what
Helps with what
Deals with what
Teaches what
Teaching
-Teaching participants the basics of group process.
Developing
-Developing ground rules and setting norms.
Assisting
-Assisting members in expressing their fears and expectations and working toward the development of trust.
Modeling
-Modeling the facilitative dimensions of therapeutic behaviour.
Showing
-Showing members that they have a responsibility for the direction and outcome of the group.
The leader should also be modelling
Providing
-Providing a degree of structuring that will neither increase member dependence nor promote excessive floundering.
Helping
-Helping members to establish concrete personal goals.
Dealing
-Dealing openly with members’ concerns and questions
Teaching
-Teaching members basic interpersonal skills such as active listening and responding.
Transition Stage
-During this stage members deal with their? ADCA
The leaders help members to what?
Long transition leads to
During this stage members deal with their:
- Anxiety
- Defensiveness
- Conflict, and
- Ambivalence about participating in the group
The leader helps members to learn how to begin to work on the concerns that brought them to the group.
Long transition leads to lots of conflict
Characteristics of Transition Stage
ACCR
Anxiety
Conflict and struggle for control
Challenging the group leader
Resistance
Transition Stage
Member Functions and Possible Problems
The central role of members at this stage is to recognize and deal with the many forms of defensiveness.
Transition Stage
The Challenging Group Member
Problematic Behaviours: -Monopolizing what -Making What -B -Being overly I -Being overly S Giving what
What to do with a difficult group member or leader
- The best way to deal therapeutically with difficult member behaviours is to what
- The approach is a what?
Minimizing Disruptiveness
- Allow what
- Attempt to what
- Show what
Guidelines for handling confrontation
- Focus on?
- What individual is responsible for what
- A second what may be needed
- Clearly inform what member that if what happens, what will happen
- Explain what
- Follow what
What - messages (they don’t provide what and they do not what)
Problematic behaviours:
- Monopolizing the group’s time
- Making interpretations for others
- Bullying
- Being overly intellectual and detached
- Being overly silent and not contributing
- Giving advice or reassurance when it is not appropriate
- The best way to deal therapeutically with difficult member behaviours is to simply describe what we are observing and let members know how we are affected by what we see and hear.
- This approach is an invitation for members to determine if what they are doing is working for them.
- Allow to express discontent
- Attempt to resolve concerns; provide honest answers to questions
- Show empathy; convey understanding; validate concerns
- Focus on behavior, not the person
- Disruptive individual is responsible for change
- A second confrontation may be necessary
- Clearly inform disruptive member that if behavior continues consequences will result
- Explain consequences
- Follow through
I-messages (they don’t provide solutions and they do not criticize)
- The sender says to the receiver, “When you ________________________ (sender identifies the irritating behaviour), I feel ______________ (sender describes his or her feelings).”
- An “I-message” is an invitation by the sender to the receiver for a dialogue.
Transition Stage
Reducing the Likelihood of Disruptive Behaviour 5 steps -Seek what -Set what -Seek what -Establish what -Confront what
Seek
-Seek member input when formulating goals and making decisions
Set
-Set clear expectations and establish goals that are both operational and measurable
Seek
-Seek to create a cooperative atmosphere
Establish
-If necessary, establish “house rules”
Confront
-Assertively confront group with concerns when necessary
Transition Stage
Member Functions
- Recognizing and expressing what
- Respecting ones own what
- Taking an increased what for what
- Learning how to what
- Be willing to work with what
- Recognize unresolved what from the what
Member functions
- Recognizing and expressing a range of feelings
- Respecting one’s own resistance but working with it
- Taking an increased responsibility for what they are doing in the group
- Learning how to confront others in a constructive manner
- Be willing to work with conflicts rather than avoiding them
- Recognize unresolved feelings from the past as they are being acted out in relation to the group leader or other members
Transition Stage
Leader functions
- The central challenge is what
- The basic task is to what
- Noticing signs of what
The central challenge is the need to intervene in the group in a sensitive manner and at the right time.
The basic task is to provide both encouragement and the challenge necessary for the members to face and resolve the conflicts that exist in the group.
Noticing signs of resistance and communicating that some resistance is natural and healthy
