Test 2 - CBT Flashcards
6 Facts About Aaron Beck:
- Dr. Aaron Beck was a psychiatrist (MD) at a time when psychiatrist were conducting a majority of the psychotherapy.
- Differed with Freud concerning Freud’s belief that depression was anger turned inward.
- In working with depressed and anxious clients, Beck noticed that their thinking was distorted. He called this concept cognitive distortions.
- He believed clients could take an active role in modifying their thinking about themselves and their situations.
- He built a body of research that established validity for the cognitive behavioral model of therapy (CBT).
- He created The Beck Institute; a research and training institute for therapists in Pennsylvania, which still exists. https://beckinstitute.org/
1st fact about Aaron Beck
Dr. Aaron Beck was a psychiatrist (MD) at a time when psychiatrist were conducting a majority of the psychotherapy.
2nd fact about Aaron Beck
- Differed with Freud concerning Freud’s belief that depression was anger turned inward.
3rd fact about Aaron Beck
In working with depressed and anxious clients,
2 Points
- Beck noticed that their thinking was distorted.
- He called this concept cognitive distortions.
What Did Beck Believe?
. He believed clients could take an active role in modifying their
- He believed clients could take an active role in modifying their
- thinking about themselves
- and their situations.
What did Beck do to create CBT ?
He built a body of research that established validity for the cognitive behavioral model of therapy (CBT).
What else did Beck create?
- He created The Beck Institute;
- a research and training institute for therapists
- in Pennsylvania,
- which still exists. https://beckinstitute.org/
1st Key Concepts in Beck’s Cognitive Behavioral Model
- Insight-Oriented therapy; aimed at changing negative thoughts and maladaptive behaviors.
2nd Key Concepts in Beck’s Cognitive Behavioral Model
- Clients need to first become aware of how they think.
3rd Key Concepts in Beck’s Cognitive Behavioral Model
2 Points
- Individual’s internal dialogue is accessible to introspection.
- How we think is open to our understanding.
4th Key Concepts in Beck’s Cognitive Behavioral Model
3 Points
- To understand why a client is upset, the therapist must focus on the thought content of their reaction to the emotionally upsetting situation.
- What or how you’re thinking while a situation is going on is key to understanding why you feel and behave the way you do.
- Once you understand it, then it’s possible to replace those “automatic thoughts” (this is the basis for keeping a journal).
5th Key Concepts in Beck’s Cognitive Behavioral Model
- Emphasis in this therapy is on the here and now, not the past.
6th Key Concepts in Beck’s Cognitive Behavioral Model
- Time-limited type of therapy.
7th Key Concepts in Beck’s Cognitive Behavioral Model
- Offers the most transparency about the therapeutic process.
7 Key Concepts in Beck’s Cognitive Behavioral Model
- Insight-Oriented therapy; aimed at changing negative thoughts and maladaptive behaviors.
- Clients need to first become aware of how they think.
- Individual’s internal dialogue is accessible to introspection. How we think is open to our understanding.
- To understand why a client is upset, the therapist must focus on the cognitive (thought) content of their reaction to the emotionally upsetting situation. What or how you’re thinking while a situation is going on is key to understanding why you feel and behave the way you do. Once you understand it, then it’s possible to replace those “automatic thoughts” (this is the basis for keeping a journal).
- Emphasis in this therapy is on the here and now, not the past.
- Time-limited type of therapy.
- Offers the most transparency about the therapeutic process.
To understand why a client is upset, the therapist must focus on the
Cognitive (thought) content of their reaction to the emotionally upsetting situation.
How we think is open to our understanding meaning:
Individual’s internal dialogue is accessible to introspection.
Explain Insight-Oriented therapy;
Aimed at changing negative thoughts and maladaptive behaviors.
To understand why a client is upset, the therapist must focus on the ________ of their reaction to the emotionally upsetting situation. _____or ____ you’re thinking while a situation is going on is key to understanding why you _____ and _____the way you do. Once you understand it, then it’s possible to replace those _______ (this is the basis for keeping a journal).
- cognitive (thought) content
- What; how
- feel; behave
- automatic thoughts
Way of thinking that distorts reality and leads to faulty assumptions and misconceptions.
Cognitive Distortions:
Personalized notions that are triggered by a particular stimulus, that then leads to emotional responses.
Define Automatic Thoughts:
Types of Cognitive Distortions:
4 Points
- Arbitrary Inference
- Overgeneralization:
- Personalization
- Polarized Thinking
Drawing conclusions without supporting evidence. This includes catastrophizing (thinking the worst possible case scenario will be the outcome).
Arbitrary Inference:
If I have to move, it will be a major catastrophe!
This is an example of?
What will you change the automatic thought to:
- Arbitrary Inference
- If I have to move, it will be very inconvenient, but I’ll get through it.
Holding an extreme belief on the basis of one incident and applying that belief to other dissimilar incidents.
Overgeneralization:
You make a mistake while speaking at a meeting, and you think you’re not good at talking to people in general. “I screwed up, I can’t even talk”.
What is this an example of ?
What will you change the automatic thought to?
- Overgeneralization
- The talk went very well, just one or two mistakes”.
The tendency of clients to relate external negative events to themselves. The most childlike of all the distortions because it’s a very ego-centric way of thinking.
Personalization:
Example: The client doesn’t show up for second session; it’s your fault as a therapist. Yet, it could be a dozen reasons that have nothing to do with you.
Example: The professor ignores you in the hall; she doesn’t like you
What is this an example of ?
What will you change the automatic thought to?
- Personalization
- Change automatic thought to: “Wow, she must be really distracted”.
- “She didn’t notice or recognize me”.
All or nothing thinking, thinks in black and white terms.
Polarized Thinking:
Example: If you’re not perfect, you’re a failure. If you didn’t get the job, you failed again.
What is this an example of ?
What will you change the automatic thought to?
- Polarized thinking
- Change automatic thought to: “I didn’t get the job, but I learned so much from that interview that I can use for the next one”.
1st Goal of Cognitive Behavioral Therapy:
2 points
- Begin to introduce the idea of schema restructuring.
- Understand how you think, your patterns, then begin to restructure, or change the typical way you think about the world.
2nd Goal of Cognitive Behavioral Therapy:
2 Points
evaluation
- Client learns to separate the evaluation of their behavior from the evaluation of themselves.
- I screwed up, rather than, I’m a screw-up.
3rd Goal of Cognitive Behavioral Therapy:
differentiate between
learn what’s
2 Points
- Differentiate between realistic and unrealistic goals.
- Learn what’s changeable and what isn’t.
4th Goal of Cognitive Behavioral Therapy:
learn that you can only change
- Learn that you can only change the way you think and talk about yourself and situations and react to them, rather than trying to change others or the situation.
5 Goals of Cognitive Behavioral Therapy:
- Begin to introduce the idea of schema restructuring.
- Understand how you think, your patterns, then begin to restructure, or change the typical way you think about the world.
- Client learns to separate the evaluation of their behavior from the evaluation of themselves. I screwed up, rather than, I’m a screw-up.
- Differentiate between realistic and unrealistic goals. Learn what’s changeable and what isn’t.
- Learn that you can only change the way you think and talk about yourself and situations and react to them, rather than trying to change others or the situation.
A pattern or organizational framework by which someone relates to the events they experience. Your typical way of thinking about the world.
Define Schema:
10 points about Therapist’s Role in CBT
- The therapist assumes more of a didactic (teaching) and collaborative role with the clients in the therapy and is warm and supportive.
- Will periodically revisit the progress made in therapy and reset goals.
- After a few weeks of therapy, not unusual for therapist to revisit the few concrete issues the client brought up and ask the client if they think they’ve made any progress towards the goals, if not, try some other techniques.
- Teaches clients to recognize their irrational thinking. Change the “I should, I must” syndrome to recognize their choices.
- Teaches clients to engage in activities that minimize their irrational, distorted way of thinking.
- Teaches clients techniques to eventually be their own therapist.
- Teaches the client that our thoughts lead to our feelings, which leads to our behavior.
- Early on in treatment (during the first few sessions) the therapist identifies, along with the client, a few specific measurable goals for the client to achieve in therapy or presenting problems they would like to solve.
- Teaches clients that the words they use inside their heads and the things they say aloud to themselves and others greatly influences their emotions and behavior.
- Gives homework to the client; books to read, keeping a journal, testing a hypothesis, activity scheduling.
1st Therapist’s Role in CBT
The therapist assumes more of a didactic and collborative
3 points broken down
- The therapist assumes more of a didactic (teaching)
- and collaborative role with the clients in the therapy
- and is warm and supportive.
2nd Therapist’s Role in CBT
2.Will periodically revisit the progress made in therapy and reset goals.
3rd Therapist’s Role in CBT
not unsual
After a few weeks of therapy, not unusual for therapist to revisit the few concrete issues the client brought up and ask the client if they think they’ve made any progress towards the goals, if not, try some other techniques.
4th Therapist’s Role in CBT
2 Points
Teaches clients to recognize their
- Teaches clients to recognize their irrational thinking.
- Change the “I should, I must” syndrome to recognize their choices.
5th Therapist’s Role in CBT
Teaches clients to engage in activities that minimize
Teaches clients to engage in activities that minimize their irrational, distorted way of thinking.
6th Therapist’s Role in CBT
Teaches clients techniques to
- Teaches clients techniques to eventually be their own therapist.
7th Therapist’s Role in CBT
Teaches clients that our thoughts lead to
- Teaches the client that our thoughts lead to our feelings, which leads to our behavior.
8th Therapist’s Role in CBT
Early on in treatment the therapist identifies along with the client
3 Points
- Early on in treatment (during the first few sessions) the therapist identifies, along with the client,
- a few specific measurable goals for the client to achieve in therapy
- or presenting problems they would like to solve.
9th Therapist’s Role in CBT
Teaches clients that the words they use inside their heads
Teaches clients that the words they use inside their heads and the things they say aloud to themselves and others greatly influences their emotions and behavior.
10th Therapist’s Role in CBT
Gives homework to the client;
5 Points (1st point given)
- Gives homework to the client
- books to read
- keeping a journal,
- testing a hypothesis
- activity scheduling.
3 Points about Client’s Role in CBT Therapy:
- Identifies a few concrete issues they’d like to work on.
Examples: Not getting along with the boss, spouse, partner, friends, difficulty being alone, unable to speak up for themselves, - Client completes homework; journal writing, reading books on cognitive behavioral therapy, activity scheduling.
- Clients test their hypotheses outside of the therapy sessions. If a client brings up an anxiety provoking situation that’s giving them angst, the therapist will assign a behavioral experiment to test the client’s hypothesis. It challenges the client’s worse-case scenario hypothesis.
1st Client’s Role in CBT Therapy:
Examples: Difficulty being alone, unable to speak up for themselves
- Identifies a few concrete issues they’d like to work on.
2nd Client’s Role in CBT Therapy:
- Client completes homework; journal writing, reading books on cognitive behavioral therapy, activity scheduling.
3rd Client’s Role in CBT Therapy:
Testing their
2 Points
- Clients test their hypotheses outside of the therapy sessions.
- It challenges the client’s worse-case scenario hypothesis.
Explain Testing the hypothesis:
3 Points
- The therapist and client create an experiment
- the client will perform in real life (outside of the office)
- to support or reject the hypothesis.
Examples of testing the hypothesis:
3 Points
- Client fears giving a party, therapist encourages them to give one, then they discuss the results.
- Fears going to a museum themselves, encouraged to go and see if it was as bad as they hypothesized.
- Fears speaking up for themselves, encouraged to do it in a safe haven first.
6 Therapeutic Techniques in CBT:
- Behavioral Experiments
- Social Skills/Assertiveness Training
- Exposure Therapy
- Activity Scheduling
- Socratic Dialogue
- Journaling
Explain Behavioral Experiments:
Experiments the client would do outside of the therapeutic setting (testing the hypothesis/worse case scenario) /
You think you can’t go to the movies alone, so you try it out and then journal your thoughts and feelings and discuss it the next time you’re in session.
This an example of ?
Behavioral Experiments
Explain Social Skills/Assertiveness Training:
Client identifies the most challenging types of social situations.
6 points
- Client identifies the most challenging types of social situations.
- The therapist might break down the situation into smaller components,
- role play with the client in the office,
- provide constructive feedback,
- positive reinforcement,
- and encourage the client to practice outside of therapy.
Examples of Social Skills/Assertiveness Training:
4 Points
- Client has an upcoming job interview or first date, might role play in the office.
- Client has difficulty initiating conversations with people they barely know.
- Client has difficulty expressing negative emotions in a socially acceptable way.
- Client has difficulty saying no.
Explain Exposure Therapy (this is different than Flooding, which is extreme and should be avoided at all times):
3 Points
- Teaching the client relaxation techniques,
- then gradually exposing them to their fears or prior trauma.
- Often used with PTSD, phobias.
1st Point in Activity Scheduling
It’s a therapeutic technique based on the premise
It’s a therapeutic technique based on the premise that regularly engaging in pleasant activities may help alleviate depression and elevate mood.
2nd Point in Activity Scheduling
Activity scheduling can be used on its own or
Activity scheduling can be used on its own or in conjunction with cognitive behavioral therapy.
3rd Point in Activity Scheduling
It may help clients engage in behaviors they would ordinarily
It may help clients engage in behaviors they would ordinarily avoid due to depression, anxiety, or other reasons.
4th Point in Activity Scheduling
Usually, it’s choosing a behavior that has a history
2 Points
- Usually, it’s choosing a behavior that has a history with the client of rewarding them with positive feelings,
- or it could be trying something new.
Explain Activity Scheduling in 4 Points:
4 Points
- It’s a therapeutic technique based on the premise that regularly engaging in pleasant activities may help alleviate depression and elevate mood.
- Activity scheduling can be used on its own or in conjunction with cognitive behavioral therapy.
- It may help clients engage in behaviors they would ordinarily avoid due to depression, anxiety, or other reasons.
- Usually, it’s choosing a behavior that has a history with the client of rewarding them with positive feelings, or it could be trying something new.
4 Points of Activity Scheduling:
- Client mentions when they go for a walk around in nature, they usually feel less stressed or depressed afterwards. However, they haven’t been scheduling time to do it.
- Client mentions when they take time to dress up, they feel better about themselves during the day.
- Therapist helps client figure out way to put this into their schedule at least a few times a week.
- Client notices they feel better when out with friends for dinner, movies, or the theater.
Explain Socratic Dialogue:
6 Points broken down
A technique that involves a series of
- A technique that involves a series of
- questions and answers,
- or statements and rebuttals
- that helps the client see that the “evidence” doesn’t support their negative thoughts
- (originally developed by the Greeks; Plato’s Socrates).
- It’s a critical thinking skill that’s done in a supportive way with the therapist.
A technique that involves a series of questions and answers, or statements and rebuttals that helps the client see that the “evidence” doesn’t support their negative thoughts .
Socratic Dialogue:
Example of Socratic Dialogue:
4 Points
- Client: Eating out alone is for losers.
- Therapist: I eat out alone quite often.
- Client: That’s different if you do it.
- Therapist: So, if I eat out alone, it’s fine, but if you do, you’re a loser? Help me to understand that.
1st Strengths of CBT:
4 Points
- Highly intellectualized individuals are rarely threatened by this approach
- since it concentrates on the here and now
- and doesn’t need to delve into the past
- or why they think and feel the way they do.
2nd Strengths of CBT:
2 points broken down
Emphasizes
- Emphasizes thoughts and behavior,
- rather than just emotions.
3rd Strengths of CBT:
2 Points broken down
- Clients are empowered
- by learning to use specific skills they’re taught in therapy.
3 Strengths of CBT:
- Highly intellectualized individuals (people out of touch with their feelings) are rarely threatened by this approach since it concentrates on the here and now and doesn’t need to delve into the past or why they think and feel the way they do.
- Emphasizes thoughts and behavior, rather than just emotions.
- Clients are empowered by learning to use specific skills they’re taught in therapy.
1st Possible Shortcomings of CBT:
Possible conflict
Interdependence vs independence
Possible conflict between achieving personal goals and the values of the client’s culture.
2nd Possible Shortcomings of CBT:
Some clients may be offended
- Some clients may be offended when reading about CBT’s use of words
- such as irrational thoughts or maladaptive behavior
3rd Possible Shortcomings of CBT:
Some clients may feel the need
Some clients may feel the need to delve into their past more than CBT usually does
4th Possible Shortcomings of CBT:
Some clients feel it downplays
4 Points
- Some clients feel it downplays
- the role of unconscious factors,
- early trauma,
- and feelings.
Possible Shortcomings of CBT:
4 Points
- Possible conflict between achieving personal goals and the values of the client’s culture.Example: Client may be from a culture that emphasizes interdependence rather than independence.
- Some clients may be offended when reading about CBT’s use of words such as irrational thoughts or maladaptive behavior
- Some clients may feel the need to delve into their past more than CBT usually does
- Some clients feel it downplays the role of unconscious factors, early trauma, and feelings.
