Lecture 3: Cognitive Therapy Flashcards
Modes
= networks of cognitive, affective, motivational and behavioral schemes that compose personality and interpret ongoing situations
What are 3 mechanisms of cognitive therapy
1) comprehensible framework
2) patient’s emotional engagement in problem situation
3) reality testing in that situation
What 3 things should one do with cognitive distortions
1) deactivate them
2) modify their content and structure
3) construct more adaptive modes to neutralize them
What are 6 cognitive distortions and explain them
- Arbitrary inference = drawing a specific conclusion without supporting evidence or even in the face of contradictory evidence
- Selective abstraction = conceptualization a situation on the basis of a detail taken out of context, ignoring other info
- Overgeneralization = abstracting a general rule from one or a few isolated incidents and applying it too broadly and to unrelated situations
- Magnification/minimization = seeing something as far more significant or less significant than it actually was
- Personalization = attributing external events to oneself without evidence supporting a causal connection
- Dichotomous thinking = categorizing in one of two extremes —> for example as either a complete success or total failure dependent on whether you write a the best exam they’ve ever seen
What are 4 levels of cognitions and explain how these related to the concepts of accessibility and stability
- voluntary thoughts
- automatic thoughts
- maladaptive assumptions
- core beliefs
Accessibility is higher in higher (in this order) cognitions, stability is higher in lower (in this order) cognitions
What are the 3 aspects of Socratic dialogue
1) clarify/define problems
2) assist in identification of thoughts/images/assumptions
3) assess consequences of maintaining maladaptive thoughts/behaviors
What are 2 cognitive strategies and explain them
- Collaborative empiricism = joint investigative attitude; curiosity, openness, transparency —> thoughts change from facts to testable hypotheses
- Guided discovery = discover things together with the patient
What are the 6 steps of a behavioral experiment
- Identify target belief/thought/process
- Brainstorm ideas for experiment; be as specific as possible
- Write predictions about outcome and devise method to record
- Anticipate problems and brainstorm solutions
- Conduct experiment
- Review experiment and draw conclusions
What are 4 cognitive techniques within treatment
- decatastrophizing/what-if technique = helps prepare for feared consequences, decreases avoidance especially if combined with coping plan
- reattribute = test automatic thoughts/assumptions by considering alternative causes
- redefining = for patients who believe problems are beyond their personal control, make problem more concrete/specific and state it in terms of patients behavior
- decentering = treating patients who wrongfully believe they’re the center of everyone’s attention
What are 5 behavioral techniques within treatment
- exposure therapy = provide data on thoughts/images/physiological symptoms/self-reported level of tension
- behavioral rehearsal/role-playing = practice skills/techniques that ate later applied in real life
- diversion techniques = reduce strong emotions + decrease negative thinking; physical activity, social contact, work, play and visual imagery
- activity scheduling = provide structure + encourage involvement
- graded-task assignment = patient initiates activity at a comfortable level while therapist gradually increases level of difficulty
What are 5 guidelines for working with difficult client that have a history of unsuccessful therapy
1) avoid stereotyping the client as being the problem rather than having the problem
2) remain optimistic
3) identify/deal with your own dysfunctional cognitions
4) remain focused on task instead of blaming the client
5) maintain a problem-solving attitude
Schemas
= people’s perceptions of themselves and others, their goals, expectations, memory, etc
What are 5 techniques of CBT
- Challenging thoughts
- Behavioral experiments
- Pie chart = make a pie chart about a certain situation and identify everything that was responsible for that happening (for example)
- Multidimensional evaluation = have the person put on a dimension something negative they think about themselves and compare this to the complete opposite, then identify things that make up that thing they think about themselves and also write down the opposite of this, then have them rate themselves on all the scales and see how that influences the initial thing they thought about themselves
- Logical assessment
What are 3 aspects of the therapeutic relationship in CBT
- directive; sometimes, when necessary
- guidance; leading from behind —> not telling the client what to do but sort of leading them in the right direction
- continuous (mutual) feedback; give client feedback and ask for it back
CT consist of learning experiences designed to teach patients to… (5)
- Monitor negative automatic thoughts
- recognize connections between behavior/cognitions/affect
- provide evidence for and against distorted automatic thoughts
- substitute more reality-oriented interpretations for these biased conditions
- learn to identify/change beliefs that predispose them to distort their experiences
