week 10 troubleshooting and criticisms/future/evaluation

Question 1

Three common reasons why therapy fails (Burns 637-646)

Answer 1

lack of empathy or lack of successful technique
burns p. 638

Question 2

How to “tune in” to the lack of empathy (Burns 637-646)

Answer 2

ask patient for positive/negative feedback; fill out empathy scale
burns p. 639-640

Question 3

Common reasons for technical failure (Burns 637-646)

Answer 3

1. not negotiating meaningful goals for therapy/workable agenda
2. even knowing problem, patient/therapist may not have come up with best strategy for resolving it
3. patients have mixed motives about getting better
   burns p.645-646

Question 4

Two components of agenda setting (Burns 657-677)

Answer 4

1. agree on specific problem patient wants to focus on
2. agree on methods/techniques that will be used to solve problem
   p.658 burns

Question 5

How to deal with backsliding (ellis & blau 157-165)

Answer 5

1. accept that we are human and backsliding is normal
2. look at self-defeating behavior = bad and unfortunate but refuse to put self down
3. go back to ABCs of REBT and see what you did to fall back on old behaviors
4. dispute iB by asking self
5. keep looking for and actively/rigorously disputing iB until you are really convinced and until feelings go away
   p.161-163

Question 6

what are some healthy negative feelings? (ellis & blau 157-165)

Answer 6

sorrow, regret, frustration, concern, annoyance
p.159

Question 7

what are some unhealthy negative feelings? (ellis & blau 157-165)

Answer 7

depression, anxiety, self-hatred, self-pity, enraged
p.159

Question 8

what are the 3 major kinds of irrational beliefs that lead to disturbing self? (ellis & blau 157-165)

Answer 8

1. “i must do well and have to..”
2. “other people must…”
3. “the conditions under which i live must…” p.163

Question 9

Feminist criticisms of cognitive-behavioral therapy (Kantrowitz & Ballou 77-86)

Answer 9

overreliance on empirical concepts, focus on thinking > other processes, lack of consideration of individual processes p.84

Question 10

Limitations of empiricism (Kantrowitz & Ballou 77-86)

Answer 10

questions of the norm are decided by dominant culture at time; p.72

Question 11

Feminist suggestions for improvement (Kantrowitz & Ballou 77-86)

Question 12

General empirical findings for effectiveness of REBT (Prochaska 256-269)

Answer 12

early work is accurate b/c he was his own judge; REBT groups outperform control and no tx groups; REBT prove effective for older children+adolescents; more impact on disruptive and conduct disorders + lengthiner tx is better

Question 13

General empirical findings (1-2 sentence summary) for use of cognitive therapy for depression

Answer 13

ct patient did 98% better than untreated, control groups; findings confirm that depressed clients benefit more from therapy than just medication; question of investigator alliance and early work being accurate; magnitude of effectiveness of CT = declined; ct more effective in adolescents than no tx/placebo/antidepressant; 54% of depressed patients relapse p.257-258; cbt is superior to no tx

Question 14

General empirical findings (1-2 sentence summary) for use of cognitive therapy for anxiety (general)

Answer 14

ct and cbt more effective than waitlist/placebo control/tx as usual groups; cbt for adult anxiety is routine clinical practice; cbt > medications in long run; cbt+medication = short term
p.258-259

Question 15

General empirical findings (1-2 sentence summary) for use of cognitive therapy for panic disorder

Answer 15

cbt most cost-effective for both GAD and panic disorder; most effective tx=combination of cognitive restructuring, exposure and breathing retraining
p.259

Question 16

General empirical findings (1-2 sentence summary) for use of cognitive therapy for OCD

Answer 16

cognitive restructuring alone proved as effective as exposure alone; greater effect sizes+greater rates of clinical improvement
p259

Question 17

General empirical findings (1-2 sentence summary) for use of cognitive therapy for PTSD

Answer 17

leads to large improvement from pretreatment; cbt equally effective as expsoure and emdr among children, adolescents, adults;
p.259-260

Question 18

General empirical findings (1-2 sentence summary) for use of cognitive therapy for eating disorders

Answer 18

cbt=should be first line of tx; long-term effects are “modest”; good but not great; cbt more effective than no tx/medication alone/other ED tx’s but needs higher success rates
p.260

Question 19

General empirical findings (1-2 sentence summary) for use of cognitive therapy for chronic pain

Answer 19

cbt=generally effective;
p.260-261

Question 20

General empirical findings (1-2 sentence summary) for use of cognitive therapy for psychotic disorders

Answer 20

medium effect sizes; cbt slightly more effective than other psych interventions in reducing positive symptoms; social skills training more effective for reducing negative symptoms; cbt doesn’t cure schizo but there is speed recovery in acute schizo
p.261-262

Question 21

General empirical findings (1-2 sentence summary) for use of cognitive therapy for self-harm

Answer 21

cbt reduces suicidal and self-harm behaviors; medium effect sizes
p.262

Question 22

General empirical findings (1-2 sentence summary) for use of cognitive therapy for domestic violence (Prochaska 256-269)

Answer 22

no differences in effect sizes between CBT and other psychotherapies
p.262-263

Question 23

General empirical findings for effectiveness of homework assignments (Prochaska 256-269)

Answer 23

greater outcome than psychotherapy w/ just in-session; medium effect size; HW adds more benefit
p.262

Question 24

Criticisms of Cognitive Therapy: Behavioral

Answer 24

to some extent it works (beck’s research) but not how it works or how people become disturbed p.264

Question 25

Criticisms of Cognitive Therapy: Psychoanalytic

Answer 25

patients are invalidated and confused b/c their explanations are considered dysfunctional and irrational p.264

Question 26

Criticisms of Cognitive Therapy: Humanistic

Answer 26

too many people not feeling full scope of emotions relevant to humans; need to feel more, not less p.264

Question 27

Criticisms of Cognitive Therapy: Cultural, Integrative perspectives (Prochaska 256-269)

Answer 27

cultural: norms based on white, cis, men beliefs
integrative: clinicians shouldn’t overgeneralize that clients disturb themselves, leading to psychopathology p.265

Question 28

Current direction of cognitive-behavioral therapy generally as well as Ellis vs. Beck systems (Prochaska 256-269)

Answer 28

cbt is moving upwards; cbt is manualized, brief, evaluated, can be combined w/ medication, problem-focused and effective
ellis usage is declining, beck usage is rising p.267
beck less controversial and more collaborative than ellis; CT = more precise, evaluated than REBT (more general and philosophical)

Question 29

Two reasons for cognitive therapy’s current popularity (Prochaska 256-269)

Answer 29

commitment to psychotherapy integration and dedication to empirical evaluation
p.268