Lecture 7: CBT Flashcards
Epidemiology of Mental Health
- 1/6 have a diagnosable mental health condition
World Health Organisation
- 2019: no. of people diagnosed with anxiety and depression has increased by 40% over the last 30 years
-2022: COVID 19 triggered a 25% increase in anxiety and depression
Behaviour Therapy
1960-2023
* viewed MH conditions as learned maladaptive behaviours
* conditioning (reward being drugs and sexual high, punishment being social rejection)
* behaviour therapy uses conditioning to replace maladaptive learned responses with adaptive learned responses
Systematic Desensitisation
Deep muscular relaxation is paired with a gradual hierarchy of phobic stimuli
Behaviourism and depression
depression results from too little environmental reinforcement or too much environmental punishment. Treatment therefore aims to increase reinforcement and reduce punishment
2nd wave - cognitive therapy (Beck & Ellis)
A persons emotional response to a situation depends on their appraisal of that situation. Our appraisals are often flawed and we may pay a heavy emotional price
Cognitive therapy helps people identify cognitive errors and distortions that lead to unnecessary distress or maladaptive behaviour (problem-solving approach - helping people become more rational, realistic, reasonable etc.)
Becks Cognitive Hierarchy Model
Core Beliefs (Schema)
Intermediate beliefs (assumptions)
Automatic thoughts (inc. NATs)
- Negative Automatic Thoughts “I am hopeless”
The aim of CBT
- To help clients understand the relationships between their thoughts, feelings and behaviour
- To help clients develop cognitive and behavioural skills to identify and to correct their cognitive biases, errors and distortions
Three elements of delivering CBT:
- Psychoeducation
- Exploration (collaborative empiricism)
- Strategic change (intervention)
What is Collaborative Empiricism
Therapist and client work together to explore the cognitive basis of the clients emotional issues, to set therapeutic goals and to identify effective therapeutic strategies
- Data collection through clinical interviews, diaries and thought records, behavioural experiments
Going from exploration -> intervention
- looking for NATs to identify schema
- looking for cognitive distortions to expose and correct biases
- looking for false beliefs by challenging beliefs and getting Ps to provide evidence
- conduct behavioural experiments and evaluate that outcome
3rd wave CBT
- rather than focusing on the content of the thought, 3rd wave approaches place more emphasis on exploring a persons belief about their thoughts (“metacognition”)
- 3rd wave approaches focus on changing the persons relationship to their thoughts, feelings and behaviour
What is ACT
Acceptance and Commitment therapy (Steven Hayes)
- ACT is a directive and experiential therapy
- doesn’t aim to repair, change or ‘fix’ problems but helps people to respond to distressing experiences in a different (“mindful”) way - which frees them to live a rich and meaningful life
What does ACT do for the recipient?
- teaches mindfulness skills to reduce impact of distressing thoughts
- encourages people to respond mindfully rather than impulsively
- aims to reduce pointless struggling about things that can’t be changed (acceptance), and to help people live rich and meaningful lives
ACT and Psychological flexibility
ACT develops skills to
- be present in the here and now
- to open up to experience
- to act in line with their values
Key messages from ACT
- You are separate from your mind - the mind is often cautious, critical and controlling - its actions often lead us to become distressed and hold us back
- We naturally try to ‘fix’ or avoid things but such efforts make things worse and decrease our distress. Its better for us to ACCEPT what cannot be changed and to carry on THE SERENITY REQUEST
- We often react to situations without giving them any conscious consideration BUT it is often better for us to RESPOND thoughtfully, mindfully and wisely
- Its good to be aware of your values and act in accordance with these