Midterm Flashcards
What consists of psychoeducation for CBT with depression?
- Conduct assessment
- Take way the blame about having depression
- Instill hope about symptom relieve
- Identify potential triggers for symptoms
- Identify support system
- Explain the CBT treatment model and its rationale
What is the tripartite model?
Thoughts, behavior and emotions impact each other.
Within the tripartite model, what is the hardest to change?
Emotions.
Within the tripartite model, what happens when we change thoughts and behaviors?
Mood improves.
How is a CBT session structured?
- Check mood, symptoms, and medication adherence
- Review the presenting problem and homework
- Set the agenda for the session
- Discuss items on the agenda
- Assign homework
- From time-to-time: review goals, summarize progress, give feedback, and review direction.
What is behavioral activation?
- It uses behavior to improve emotions and mood.
- It is designed to increase mastery through pleasurable activities.
- It is done through reward planning and activity scheduling.
What are the three levels of cognition?
- Core beliefs.
- Intermediate beliefs.
- Automatic Thoughts.
What are core beliefs
They our most fundamental ways of perception about self, others, and the world. They are based on prior experiences, and are unconscious in nature. “I am unloveable”.
What are intermediate beliefs?
They are overarching rules and expectations about the self, abilities, and the world. They are structured in “if…then” sentences.
Automatic thoughts
Automatic, non-cognitive thoughts about specific situations. They are most easily brought into conscious awareness.
What are the cognitive distortions we covered?
- All-or-nothing thinking: black or white, no gray area
- Overgeneralization: making overarching conclusions (always/never)
- Mental filter: focus on one detail, miss big picture
- Discounting the positive: good things don’t count
- Mind reading: assume know what others think
- Catastrophizing/Fortune telling: exaggerate how bad things are/will be
DSM-V criteria for Major Depression
The person must have at least 5 of the following symptoms listed below. Each symptom must have been present for at least 2 weeks, for nearly every day. Symptoms 1,2, or both must be present for most of the day.
- Sadness
- Loss of interest
- Appetite problems (either eating too much or too little)
- Sleep problems (either sleeping too much or too little)
- Tiredness/lack of energy
- Poor concentration (difficulty in thinking or decision making)
- Movement (either too slow or too fast as seen by others)
- Worthlessness and/or guilt
- Suicidality (person thinks that life isn’t worth living, has a plan for killing herself or has tried to kill herself)
How do we elicit/identify automatic thoughts?
Ask questions like “What [is/was/will be] going through your mind?” or “What [are you/were you/will you be] thinking?” when clients:
- describe a problematic situation, emotion, behavior, or physiological reaction they had (often in the past week) or expect to have (often in the coming week).
- experience a negative shift in affect or exhibit an unhelpful behavior in the therapy session itself.
How should we evaluate automatic thoughts?
Ask questions to:
- examine the validity of the automatic thought,
- explore the possibility of other interpretations or viewpoints,
- decatastrophize the problem situation,
- recognize the impact of believing the automatic thought,
- gain distance from the thought,
- take steps to solve the problem.
What does the problem solving tool RIBEYE stand for?
R is for relax as it is much harder to think clearly about a problem and ways to solve it when you are stressed and upset (youths often attempt to problem solve in stressed state).
I is for identifying the problem clearly - what is the issue and how would things be different if the issue wasn’t there anymore.
B is for brainstorming alternative solutions and write down all ideas even if they don’t think they’d work at the time (encourage them to explore beyond initial options considered. Try to find at least three solutions where possible).
E is for evaluating each possible solution (pros and cons, how likely it is to work)
Y is for saying yes to one solution.
E is for evaluating the outcome and reward success (encourage them to self acknowledge they attempted it and/or succeeded).
