PSY343 - 5. Behaviour Therapy, Cognitive Therapy, Third Wave Therapies

Question 1

History of Behavioural Therapies

Answer 1

Closely linked patterns of thoughts + values first
developed in Enlightenment that emphasize reason and
science

Question 2

History of Behavioural Therapies

Answer 2

• Emerged as a therapeu1c approach in the 1950s as an

alterna1ve to psychoanalysis

Question 3

History of Behavioural Therapies

Answer 3

• Derived from behaviour change principles of operant

condi1oning and classical condi1oning

Question 4

History of Behavioural Therapies

Answer 4

• Focuses on observable, explicit behaviours and their

interac1ons with the immediate environment

Question 5

History of Behavioural Therapies

Answer 5

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Question 6

Assumptions of Behavioural Therapy

Answer 6

1. Most abnormal behaviour is acquired and maintained according to the same principles as normal
   behaviour

Question 7

Assumptions of Behavioural Therapy

Answer 7

• 2. Most abnormal behaviour can be modified through the applica1on of social learning principles
• 3. Assessment is con1nuous and focuses on the current determinants of behaviour

Question 8

Assumptions of Behavioural Therapy

Answer 8

• 4. People are best described by what they think, feel, and do in specific life situa1ons
• 5. Treatment is derived from theory and experimental findings of scien1fic psychology

Question 9

Assumptions of Behavioural Therapy

Answer 9

• 6. Treatment methods are precisely specified, replicable, and objec1vely evaluated

Question 10

Assumptions of Behavioural Therapy

Answer 10

• 7. Treatment outcome is evaluated in terms of the ini1al induc1on of behaviour change, its
generaliza1on to the real life se_ng, and its maintenance over 1me

Question 11

Assumptions of Behavioural Therapy

Answer 11

• 8. Treatment strategies are individually tailored to different problems in different individuals.

Question 12

Three Branches of Behaviour Therapy

Answer 12

Countercondi1oning – operates from

principles of classical condi1oning

Question 13

Three Branches of Behaviour Therapy

Answer 13

• Con1ngency Management – operates from

principles of operant condi1oning

Question 14

Three Branches of Behaviour Therapy

Answer 14

• Cogni1ve-Behaviour Modifica1on – integrates

cogni1ve explana1ons and techniques

Question 15

Three Branches of Behaviour Therapy

Answer 15

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Question 16

Theory of Personality

Answer 16

• No comprehensive theory of personality

Question 17

Theory of Personality

Answer 17

• Environmental conditions control behaviour

more than internal personality traits

Question 18

Theory of Personality

Answer 18

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Question 19

Theory of Psychopathology

Answer 19

Slightly different depending on the branch of behaviour therapy
• Countercondi1oning: condi1oned anxiety leads to behavioural disorders

Question 20

Theory of Psychopathology

Answer 20

• Con1ngency Management: human behaviour (adap1ve or

maladap1ve) is largely controlled by its consequences

Question 21

Theory of Psychopathology

Answer 21

• Cogni1ve-Behavioural Modifica1on: psychopathology largely

due to deficits, excesses, or inappropriate cogni1on

Question 22

Theory of Psychopathology

Answer 22

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Question 23

Goal of Therapy

Answer 23

To change the client’s specific maladap1ve
target behaviour to adap1ve behaviour
through interven1ons based on empirical
learning

Question 24

Goal of Therapy

Answer 24

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Question 25

Goal of Therapy

Answer 25

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Question 26

Therapy Process

Answer 26

Countercondi1oning – anxiety is learned through
condi1oning; can be unlearned through
countercondi1oning

Question 27

Therapy Process

Answer 27

• Con1ngency management – behaviour modifica1on
aUempts to control con1ngencies to shape and maintain
adap1ve behaviour and ex1nguish maladap1ve behaviour

Question 28

Therapy Process

Answer 28

• Cogni1ve-behaviour modifica1on – train clients to modify physiological ac1vity through cogni1on; challenge inappropriate or ineffec1ve cogni1ons; enhance problem solving deficits

Question 29

Therapy Process

Answer 29

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Question 30

History of Cognitive Therapy

Answer 30

In the 1960s and 1970s, others began to reconsider the role of cogni1on in
psychiatric disorders:

Question 31

History of Cognitive Therapy

Answer 31

• Albert Ellis developed Ra1onal Emo1ve Behaviour Therapy (REBT), which
postulates that emo1onal distress primarily originates from one’s evalua1ons
of an event, not from the event itself

Question 32

History of Cognitive Therapy

Answer 32

• Aaron T. Beck developed Cogni1ve Therapy, which theorizes that an
individual’s affect and behaviour are determined largely from the way he or
she “structures the world” based on a_tudes and assump1ons derived from
previous experience

Question 33

History of Cognitive Therapy

Answer 33

• Subsequently, behavioural modifica1on and cogni1ve therapy techniques were
merged to form Cogni1ve Behavioural Therapy

Question 34

History of Cognitive Therapy

Answer 34

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Question 35

History of Cognitive Therapy

Answer 35

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Question 36

History of Cognitive Therapy

Answer 36

Humans respond primarily to cogni1ve
representa1ons of their environments rather
than to their actual environments

Question 37

History of Cognitive Therapy

Answer 37

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Question 38

History of Cognitive Therapy

Answer 38

• Helps clients become more conscious of
maladap1ve cogni1ons and to replace them
with more adap1ve cogni1ons

Question 39

History of Cognitive Therapy

Answer 39

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Question 40

History of Cognitive Therapy

Answer 40

The premise of Cogni1ve Behavioural Therapy (CBT) is that how people think
affects how they feel emo1onally and how they behave

Question 41

History of Cognitive Therapy

Answer 41

• Thoughts, emo1ons, behaviours interact and influence one another as part of a
reciprocal system; interven1on at any one point of the system affects chance
throughout the system

Question 42

History of Cognitive Therapy

Answer 42

• Just as ways of thinking, feeling, and behaving can be learnt, so can they be
unlearnt or modified

Question 43

History of Cognitive Therapy

Answer 43

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Question 44

Key Concepts

Answer 44

Automa1c Thoughts – repe11ve, habitual self-statements (posi1ve or nega1ve),
that we say to ourselves oken outside of our awareness

Question 45

Key Concepts

Answer 45

• Occur spontaneously in response to situa1on, they do not arise from
reasoning

Question 46

Key Concepts

Answer 46

• Underlying Assump1ons - Oken shaped as If-Then statements, rules for living
(e.g., “If I am nice, then people will like me “)
• Core Beliefs – the most deeply-seated, stable beliefs about ourselves, they
underlie and produce automa1c thoughts

Question 47

Key Concepts

Answer 47

• Influence informa1on processing and organize understanding about ourselves,
others, and the future

Question 48

Key Concepts

Answer 48

• Remain dormant un1l ac1vated by stress or nega1ve life events
• They are difficult to access and difficult to change

Question 49

Key Concepts

Answer 49

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Question 50

Theory of Psychopathology

Answer 50

Psychopathology originates in the clients
preconscious construc1ons of reality, which
represent the person’s underlying cogni1ve
organiza1on

Question 51

Theory of Psychopathology

Answer 51

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Question 52

Theory of Psychopathology

Answer 52

• Content specificity hypothesis – underlying
cogni1ons vary with the behavioural disorder
of the client (e.g., cogni1ve triad in
depression)

Question 53

Theory of Psychopathology

Answer 53

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Question 54

Goals of Therapy

Answer 54

To challenge thoughts about a par1cular situa1on by iden1fying the
cogni1ve distor1ons
• To help people iden1fy less threatening alterna1ves (in thinking,
behaviour)

Question 55

Goals of Therapy

Answer 55

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Question 56

Goals of Therapy

Answer 56

• To test out these alterna1ves in the real world

* To challenge the assump1ons that lead to the automa1c thoughts

Question 57

Goals of Therapy

Answer 57

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Question 58

Therapy Process

Answer 58

Ini1al Stage

• Symptom relief

Question 59

Therapy Process

Answer 59

• Middle and Later Stage

* Focus shiks from client’s symptoms to client’s paUerns of thinking

Question 60

Therapy Process

Answer 60

• Termina1on
• Therapy ends when client’s goals have been reached and the client feels about
to prac1ce his or her new skills independently

Question 61

Therapy Process

Answer 61

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Question 62

Therapy Process

Answer 62

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Question 63

The Therapeutic Relationship

Answer 63

Collabora1ve Empiricism – The therapist and client are co-inves1gators, examining
the evidence to support or reject the client`s cogni1ons. Interpreta1ons or
assump1ons are treated as testable hypotheses

Question 64

The Therapeutic Relationship

Answer 64

• Guided Discovery – The therapist serves as a guide who elucidates problem
behaviour and errors in logic by designing new behavioural experimetns that lead
to the acquisi1on of new skills and perspec1ves

Question 65

The Therapeutic Relationship

Answer 65

• Socra1c Dialogue – The therapist engages in informa1onal ques1oning,
listening summarizing, and asking analy1cal/synthesizing ques1ons to promote new learning, clarify problems, and examine the meaning of
events for the individual

Question 66

The Therapeutic Relationship

Answer 66

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Question 67

The Therapeutic Relationship

Answer 67

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Question 68

Therapy Techniques

Answer 68

Cogni1ve restructuring – modifying the thinking process
• Thought Records - Iden1fying significant events and associated feelings,
automa1c thoughts, and behaviours

Question 69

Therapy Techniques

Answer 69

• Distancing – crea1ng space between person and their thoughts
• Relaxa1on, mindfulness, and distrac1on techniques

Question 70

Therapy Techniques

Answer 70

• Exposure - Gradually facing ac1vi1es which may have been avoided in the past
• Experimenta1on - Trying out new ways of behaving and reac1ng outside of
therapy

Question 71

Therapy Techniques

Answer 71

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Question 72

Therapy Techniques

Answer 72

• Between-session homework – Helps client maintain gains, generalize skills outside
of therapy; produce greater outcomes than in-session only work (Kazan1s et al.,
2000)

Question 73

Video of Cognitive Therapy

Answer 73

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Question 74

History of ‘Third Wave’ Behavioural Therapies

Answer 74

Third wave behavioural therapies (e.g., ACT,
DBT, mindfulness-based approaches)
incorporate acceptance and mindfulness

Question 75

History of ‘Third Wave’ Behavioural Therapies

Answer 75

• Integra1on of Western and Eastern

philosophies

Question 76

History of ‘Third Wave’ Behavioural Therapies

Answer 76

• Focus on no1cing and accep1ng experience

rather than trying to control it

Question 77

History of ‘Third Wave’ Behavioural Therapies

Answer 77

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Question 78

History of Dialectical Behaviour Therapy

Answer 78

Developed within the context of chronically suicidal pa1ents with Borderline Personality Disorder (BPD)

Question 79

History of Dialectical Behaviour Therapy

Answer 79

• Clients experienced change focused strategies as
invalida1ng, which led to increased emo1on
dysregula1on

Question 80

History of Dialectical Behaviour Therapy

Answer 80

• Emo1on dysregula1on - difficul1es increasing,

decreasing or maintaining emo1on as required or in a specific context

Question 81

History of Dialectical Behaviour Therapy

Answer 81

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Question 82

Dialectical Behaviour Therapy

Answer 82

Acceptance	
Dialec1cal	Behaviour	Therapy	
Valida1on, Mindfulness
Problem	Solving,	
Behavioural	Analysis
Change

Question 83

Dialectical Behaviour Therapy

Answer 83

Synthesis

Question 84

Dialectical Behaviour Therapy

Answer 84

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Question 85

Theoretical Foundation of DBT

Answer 85

Learning Theory
• All behaviour is learned and behavioural change occurs
via the principles of learning.

Question 86

Theoretical Foundation of DBT

Answer 86

• Zen Philosophy
• Suffering stems from being aUachment to things being a
par1cular way and decreasing suffering involves
accep1ng reality.

Question 87

Theoretical Foundation of DBT

Answer 87

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Question 88

Theoretical Foundation of DBT

Answer 88

Dialec%cal Philosophy
• There is no absolute truth; extreme posi1ons can both
contain a kernel of truth. Change involves the synthesis
of elements from each pole.

Question 89

Theory of Personality

Answer 89

Biosocial Theory in DBT:
• Emo1on dysregula1on is the result of an
interac1on between a biological sensi1vity to
emo1on AND an environment that is
invalida1ng

Question 90

Theory of Personality

Answer 90

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Question 91

Theory of Personality

Answer 91

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Question 92

Theory of Psychopathology

Answer 92

Emo1on dysregula1on is the underlying issue

driving problema1c behaviours

Question 93

Theory of Psychopathology

Answer 93

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Question 94

Theory of Psychopathology

Answer 94

• Func1on of impulsive or self-destruc1ve
behaviours: An aUempt to solve the problem
of emo1on dysregula1on

Question 95

Theory of Psychopathology

Answer 95

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Question 96

Goals of DBT

Answer 96

Eliminate life-threatening behaviors
• Self-harm, suicidal behaviours/thoughts
• Address anything that gets in the way of therapy (both client and therapist behaviours)

Question 97

Goals of DBT

Answer 97

• Absences, lateness, not being prepared, conflict, etc.

* Address issues that impact quality of life

Question 98

Goals of DBT

Answer 98

• Rela1onships, work/employment, housing, substance use,

mood and/or anxiety problems, etc.

Question 99

Goals of DBT

Answer 99

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Question 100

How are these goals achieved?

Answer 100

Individual Therapy
• Weekly sessions
• Personalized applica1on of skills
• Diary cards and homework

Question 101

How are these goals achieved?

Answer 101

• Skills Group
• Teaches effec1ve ways to cope with distress
• Mindfulness, Emo1on Regula1on, Interpersonal Effec1veness, and Distress Tolerance

Question 102

How are these goals achieved?

Answer 102

• Homework to generalize skills

* Phone and in-person coaching

Question 103

How are these goals achieved?

Answer 103

• Access support to use the skills in moments of crisis and “in real life”
• Consulta1on Team
• Provides support and mo1va1on to therapists

Question 104

How are these goals achieved?

Answer 104

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Question 105

DBT Modules

Answer 105

Content of Group Sessions by Module:

•Mindfulness: Awareness and acceptance of the present moment

Question 106

DBT Modules

Answer 106

• Distress Tolerance: Having urges without ac1ng on them
• Emo%on Regula%on: Understanding emo1ons; increasing posi1ve and
decreasing nega1ve emo1ons

Question 107

DBT Modules

Answer 107

• Interpersonal Effec%veness: Asking for what you want in a way that makes
the other person want to give it to you
• Walking the Middle Path: Learning “both-and” thinking, how to validate self
and others, and principles of behaviourism

Question 108

DBT Modules

Answer 108

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Question 109

DBT Modules

Answer 109

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Question 110

Therapeutic Relationship

Answer 110

Warm, genuine, direct, transparent
• Valida1on:
• Seeing the world from another’s perspec1ve

Question 111

Therapeutic Relationship

Answer 111

• Communica1ng to another that his/her feelings,
thoughts, behaviours make sense or are
understandable in some way

Question 112

Therapeutic Relationship

Answer 112

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Question 113

Therapy Techniques

Answer 113

Behavioural analysis

Question 114

Therapy Techniques

Answer 114

• Exposure

Question 115

Therapy Techniques

Answer 115

• Mindfulness

Question 116

Therapy Techniques

Answer 116

• Behavioural experiments

Question 117

Therapy Techniques

Answer 117

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Question 118

Psychotherapy Research

Answer 118

Lambert and Oogles (2004) found that behaviour and cogni1ve therapies result in greater improvements than other theore1cal orienta1ons, especially psychodynamic therapy

Question 119

Psychotherapy Research

Answer 119

• When allegiance effects are controlled for, behavioural and
cogni1ve therapies show equivalent effects to other
treatments

Question 120

Psychotherapy Research

Answer 120

• Third Wave Therapies

Question 121

Psychotherapy Research

Answer 121

• DBT effec1ve for trea1ng Borderline Personality Disorder

* Equivalent to other BPD-specific treatments (eg. mentaliza1on-based tx)

Question 122

Psychotherapy Research

Answer 122

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