Lecture 9 - CBT Specific Intervention Techniques Flashcards
How do you identify automatic thoughts? When should you ask the basic question?
➢Come in verbal form, visual form, or both
➢Often embedded within a broader statement or phrased as a question –have to work to identify thought and re-phrase as simple statement
➢Basic question: “What was going through my mind just then?”
➢Ask when:
▫Notice a change in emotion▫
Notice a change in mind/body
▫Feel the urge to engage in a dysfunctional way
What are the 3 types of automatic thoughts?
➢Thought is distorted: occurring despite objective evidence to the contrary
▫“I am going to fail this exam” despite being an A student
➢Thought is accurate, but conclusion is distorted
▫“I didn’t meet the deadline; thus, I am a horrible student”
➢Thought is accurate, but not helpful
▫“It is going to take me hours to finish this assignment. I will be up all night!”
What are the steps to evaluating automatic thoughts?
➢Reviewing evidence for and against the thought
▫What evidence supports the thought? What evidence does not support the thought? What is a more balanced way of looking at things?
➢Worst case, best case, most realistic case
▫What is the worst that could happen? If that happened, how would I cope?
➢Advantages and disadvantages of having the thought?
▫Thought may be true, but not helpful
▫What are the effects of believing versus not believing your thought? How do you behave in response to the thought?
➢Distancing self from thought
▫What would you tell a friend or family member in this situation?
➢Problem-solving
▫What can you DO in this situation? What could you do differently next time?
➢Assess outcome of automatic thought evaluation process
▫Change to emotion/feeling
How does a CBT thought record work?
Situation: Describe what was happening who, what when, where
Emotion or feeling: Emotions can be described with one word e.g..angry, sad scared
-Rate 0-100%
Negative automatic thought: Identify one thought to work on: What thoughts were going through your mind? What memories or images were in my mind?
Evidence that supports the thought: What facts support the truthfulness of this thought or image?
Evidence that does not support the though: What experiences indicate that this thought is not completely true all of the time? If my best friend has this thought, what would I tell them? Are there any small experiences which contradict this thought?
Alternative thought: Write a new thought which takes into account the evidence for and against the original thought
Emotion or feeling: How do youfeel about the situation now? Rate 0 -100%
Examples of evaluating automatic thoughts (in a faster way than the thought record)
➢Automatic thought: “All of my studying was useless”
▫Evidence that supports the thought?▫Evidence that does not support the thought?
▫Alternative thought?
➢Automatic thought: “She never called, which means she is going to break up with me!”
▫Evidence that supports the thought?▫Evidence that does not support the thought?
▫Alternative thought?
Name and explain some cognitive distortions. How can we treat them?
➢All-or-nothing thinking (black and white thinking)
▫Identify the relevant extremes
▫Explore the stages or steps between the extremes
➢Mental filter (only paying attention to certain types of evidence)
▫Pay attention to all instances of an event and note both good and bad
Other cognitive distortions: jumping to conclusions (mind reading and fortune telling), emotional reasoning (assuming that because we feel a certain way it must be true), labelling (assigning labels to ourselves or others…ex: I’m a loser), over-generalizing, disqualifying the positive, magnification (catastrophizing) and minimization, using “should” and “must”, personalization (this is my fault)
What are behavioural experiments?
➢Planned experiential activities undertaken to test validity of patient’s beliefs and construct more adaptive beliefs
▫Hypothesis testing versus discovery
-hypothesis testing = test specific hypothesis vs. discovery = do a situation and learn from it (no specific hypothesis in mind)
▫Active versus observational
-active = speak to someone vs. observational = watching other people interact with one another
➢Planning behavioural experiments
▫Spontaneous can be good!
▫Want client to push themselves but avoid setbacks
▫Design experiment so that you learn something either way
▫Prepare for challenges ahead of time
➢Implementing behavioural experiments
▫Client needs to full engage rather than “go through motions”
▫Monitor thoughts/feelings throughout
▫Be flexible and respond to the unexpected
➢After the experiment
▫Save time to debrief
▫What actually happened? How did outcome fit with predictions?
▫What did you learn? What might you do differently next time based on results?
Name and explain 5 other CBT techniques.
➢Making decisions
▫Advantages and disadvantages analysis
▫Weigh the advantages and disadvantages of BOTH options, and rate importance of each from 1-10
➢Refocusing
▫Evaluating automatic thoughts is not always desirable or feasible
▫Label automatic thought as such
▫Deliberately refocus attention on task at hand
➢Graded task assignments
▫Break goal down into smaller pieces
▫Focus on one step at a time
▫Success encourages further action
➢Pie technique
▫Useful for setting goals or determining relative responsibility
➢Self-comparisons and credit lists
▫Are you comparing yourself to you at your best or your worst?
▫Give yourself credit when its due
