module 1

Question 1

What are the three principles of CBT based counselling

Answer 1

The CBT approach to counselling evolved out of behavioural psychology and has three key features: a problem-solving, change-focused approach to working with clients; a respect for scientific values; and close attention to the cognitive processes through which people monitor and control their behaviour.

Question 2

What was the earliest phase of CBT counselling?

Answer 2

The earliest stage in the emergence of CBT was represented by the application of principles of behavioural psychology into behaviour therapy .

Question 3

What was the second stage of the emergence of CBT counselling?

Answer 3

The second stage was characterized by the addition of cognitive perspectives and techniques, and the use of the term cognitive– behavioural therapy.

Question 4

What is the third and current phase of the development of CBT?

Answer 4

. The second stage was characterized by the addition of cognitive perspectives and techniques, and the use of the term cognitive– behavioural therapy.

Question 5

Who founded behavioural psychology?

Answer 5

J B Watson with the book Psychology through the standpoint of a behaviourist (1919)

Question 6

Where did the term clinical psychology come from?

Answer 6

However, the notion that clinical work should be informed by empirical research is not a new concept. In fact, it dates back to 1896 when Lightner Witmer, an American psychologist, established the first psychology clinic and was credited with introducing the term “clinical psychology”.

Question 7

What is the ‘weakest’ form of evidence that could inform practice? What is the strongest?

Answer 7

According to the NHMRC and APS, the weakest evidence that could inform practice comes from expert opinion or case reports. By contrast, the strongest evidence is obtained from systematic reviews of randomised controlled trials (RCTs). Hence the expression “Level” is used to designate empirical evidence for interventions, as per the following table

Question 8

What is Level I evidence?

Answer 8

Evidence obtained from a systematic review of all relevant randomised controlled trials (e.g., meta-analyses).

Question 9

What is Level IV evidence?

Answer 9

Evidence obtained from case series, either post-test or pretest/post-test.

Question 10

According to EST paper, how efficacious are psychological interventions vs medication?

Answer 10

RCT efficacy research has documented that psychological interventions are better than no treatment or nonspecific intervention and are at least as efficacious as medication for many psychological disorders, and more so in the long run.

Question 11

What is EBT

Answer 11

Evidence based treatment. This is distinguished from EBP (evidence based practice). EBT is an approach to evidence which seeks to identify interventions or programs that meet certain evidentiary criteria.

Question 12

How was EBP defined after the firestorm from the criteria on EBTs by Division 12 was launched.

Answer 12

President Ronald Levant defined EBP as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences”

**The task force did not identify one research methodology to be superior

Question 13

What do effectiveness studies evaluate?

Answer 13

Effectiveness studies evaluate treatment outcomes in naturalistic settings, offering improved generalisability. Eg clients with coomorbidities can participate

Question 14

What is a famous effectiveness study?

Answer 14

the Consumer Reports (1995) survey of readers experience with psychotherapy

Question 15

What type of research is integral to addressing the why and what of an effective treatment

Answer 15

Process research

Question 16

What is the key contribution of common factors research?

Answer 16

Common factors research has made substantial contributions to the psychotherapy literature regarding the key processes that promote change. As specific example is the therapeutic alliance, one of the most consistent predictors of psychotherapy outcome regardless of theoretical approach or orientation used by the clinician

Question 17

What is an advantage of process research?

Answer 17

It is responsive to contextual factors, allowing for evaluation of the complex and nuanced exchanges that comprise psychotherapy

Question 18

What is an advantage or single-subject design?

Answer 18

Single-subject design can be implemented in settings where an RCT is not feasible or with populations of interest that are smaller in number. They are also useful for exploratory analysis to determine if large-scale group comparisions are warranted

Question 19

What is the difference between EBP and EBT?

Answer 19

What qualifies as evidence is the main difference between EBP and EBT. With EBT, the emphasis is on RCT. In contrast, EBP views evidence from more broad-based perspectives. EBT falls on the side of internal validity at the expense of external validity. The EBT approach of Division 12 has focused on a treatment model that is administered with less emphasis on who is providing or receiving the treatment. Researches in social sciences are increasingly realising that who provides intervention is a critical variable to consider.

Question 20

What is the main controversy regarding clinical decision making?

Answer 20

Should clinical decision making be kept to a minimum (EBT approach) or should research be necessarily contextualised by the therapist’s expertise and experience (EBP approach).

Question 21

What does idiographic mean

Answer 21

Idiographic relates to the study or discovery of particular scientific facts and processes, as distinct from general laws.

In contrast, Nomothetic research is about attempting to establish general laws and generalisations.

The idiographic approach, unlike the nomothetic approach, focuses on the individual. It suggests that everyone is unique and therefore everyone should be studied in an individual way. Due to this, no general laws are possible. The methods of investigation, by this approach tend to collect quantitive data, investigating the individual. Case studies are the most common method, but other research methods include: unstructured interviews, self-reports, autobiographies and personal documents.

Question 22

What is the biggest difference between EBP and EBT?

Answer 22

EBT focuses on the treatment, intervention or program itself and not on who is delivering it or receiving it

Question 23

What are the three empirical arguments that cast doubt on the specific effects assumption

Answer 23

1. The dodo bird verdict - basically therapy approaches do not show specific effects or relative efficacy . - basically every phychotherapy has the same success rate. This is the most widely replicated finding in psychology
2. Component studies dismantle approaches to tease out unique ingredients. They have found little evidence to support any specific effects of therapy.

Question 24

What was the largest and most statistically powerful clinical trial in the history of drug and alcohol treatment?

Answer 24

Project MATCH - examined the differential efficacy between Motivational Enhancement Therapy, 12-step facilitation and CBT. It found no support for differential outcomes among the three therapies

Question 25

What is behavioural assessment?

Answer 25

Behavioural assessment involves the direct investigation of problematic behaviours by examining the antecedents (situational events, actions, or circumstances that occur before the behaviour) and the consequences of the behaviour.

Question 26

What is negative reinforcement?

Answer 26

Negative reinforcement: an aversive stimulus or event is removed, which increases the likelihood of a particular behaviour recurring in the future.

Question 27

Whats the preferred method of behavioural assessment?

Answer 27

The preferred method of assessment is direct behavioural observation, for example, using structured charts and time periods to record a child’s behaviours in the kindergarten settings, as per the ABC model pictured above.

Question 28

How are behavioural principles integrated into mental health today?

Answer 28

Mental health: systematic desensitisation and exposure therapy for anxiety disorders and PTSD; response prevention for OCD; behavioural activation for depression; functional analysis, goal setting, and motivational interviewing for addiction; self monitoring and behavioural contracting for eating disorders; many components of Dialectical Behaviour Therapy (e.g. distress tolerance, chain analysis); many components of Acceptance and Commitment Therapy (e.g., contextual function of thoughts/ behaviours, committed actions; stimulus control for insomnia; and positive exchanges, communication, and problem solving for couples therapy.

Question 29

How can behaviour assessments be conducted?

Answer 29

Behavioural interviewing,
Behavioural observation (observing another’s behaviour or self-monitoring),
Behavioural questionnaires and inventories (self-report and informant report), and
Psychophysiological assessment.

Question 30

What 6 factors need to be considered when conducting an assessment involving direct intervention

Answer 30

topography, amount, intensity, stimulus control, latency, and quality.

Question 31

What is the topography of a behaviour response?

Answer 31

the specific movements involved in making the response

Question 32

What does the slope of a line in a cumulative graph represent?

Answer 32

The rate of response. Note: the line can never decrease. A steep line indicates lots of response and a flat line indicates no response

Question 33

What is the relative duration of behaviour?

Answer 33

the length of time it occurs within some period

Question 34

What is continuous recording?

Answer 34

Where every instance of a behaviour is recorded. Usulally used for something like number of cigarettes smoked, number of times a child pinches another or other such behaviours that have a very similar time duration

Question 35

What is a major assumption we make about behaviour

Answer 35

One major assumption is that behaviours follow the principles of classical conditioning and operant conditioning, including positive reinforcement, negative reinforcement, punishment, and extinction.

Question 36

How does the process of behavioural assessment begin? what is the ABC approach?

Answer 36

The process of behavioural assessment begins by selecting and defining the target behaviours and then making connections between the antecedents (i.e what was happening before the specified behaviour) and consequences (i.e. what happens after the specific behaviour occurs), known as the ABC approach - Antecedents, behaviour, consequence

Question 37

What is differential reinforcement

Answer 37

One behaviour is reinforced and another behaviour is put to extinction

Question 38

Whats the difference between DRI and DRA

Answer 38

DRI - differential reinforcement of incompatible behaviour reinforces a behaviour that is incompatible with the problem behaviour and puts the target behaviour to extinction

DRA - differential reinforcement of alternate behaviour reinforces an appropriate alternative to the problem behaviour and extinguishing the problem behaviour through extinction

Question 39

What is somnolence?

Answer 39

Somnolence (alternatively “sleepiness” or “drowsiness”) is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes.

Question 40

Who did the Little Albert experiment?

Answer 40

Watson

Question 41

Who induced neurotic behaviours in cats but rewarding them with eating then punishing them in the same spot they were rewarded for eating?

Answer 41

Masserman

Question 42

What did Skinner discover when animals were rewarded and punished with no link between the behaviour?

Answer 42

The animals developed ritualistic or obsessive behaviours.

Question 43

What is Seligman known for?

Answer 43

Studies on the concept of ‘learned helplessness’. He viewed this as a key to the roots of depression

Question 44

Who is knowns for the operant conditioning model? Who is known for the classical conditioning model>?

Answer 44

Skinner is knowns for operant conditioning and Pavlov for classical conditioning.

Question 45

What is the starting point of behaviour modification?

Answer 45

The Skinnerian idea that in any situation, a person will have a set of reactions to a stimuli and the one the exhibit will be the one that is reinforced. This is operant conditioning

Question 46

How does Skinner view punishment?

Answer 46

Punishment will only temporarily suppress a behaviour and ultimately a new behaviour needs to be conditioned to replace the undesirable behaviour

Question 47

In a counselling context, what is the concept of behavioural self control?

Answer 47

The counsellor explains ideas of behavioural modification to the client and works with them to implement them. This is a process not really of ‘know thyself’ but rather ‘know thy controlling variables’

Question 48

What is CBT

Answer 48

Cognitive Behaviour Therapy (CBT) is a system of psychotherapy that has grown from a model of understanding mental health problems developed by Dr Aaron T. Beck.

The central premise of the cognitive model is that conscious thoughts, beliefs, and assumptions are central to the development of common disorders, such as anxiety and depression. In other words, dysfunctional thinking (which influences the patient’s mood and behaviour) is common to psychological disturbances.

The cognitive model, shown below, explains individuals’ emotional, physiological, and behavioural responses as mediated by their perceptions of events. When individuals are distressed, their perceptions are often distorted and dysfunctional. In cognitive behaviour therapy, clients learn to identify and evaluate “automatic thoughts” (spontaneously occurring verbal or imaginal cognitions) in a more realistic and adaptive way. This can lead to an improvement in their emotional state and in their behaviour, and can also result in a reduction of physiological arousal (e.g., in anxiety).

Question 49

Whats up with socratic questioning in CBT?

Answer 49

Socratic questioning involves using a process of guided discovery with questioning, in which the therapist takes a ‘curious’ stance and encourages the client to reflect on and evaluate their thinking. This is very different from therapies that focus on “disputation” or “challenging” the client’s view (e.g., Rational-Emotive Behaviour Therapy).

Question 50

Whats up with empiricism and CBT?

Answer 50

This approach to therapy also adopts the scientific method to facilitate the change process. Every intervention is treated as an experiment, in which the client generates hypotheses to be evaluated with “new data” from interventions. This is the central way CBT helps the client to “become their own therapist.”