Week 4 - CBT

Question 1

Define CBT:

Answer 1

A type of psychotherapy to modify negative thoughts about oneself,
others, and the world (Austin & Boyd, 2015)

Question 2

What is CBT based on?

• What does it describe?
• Example?

Answer 2

Based on the Cognitive Model which describes how:
- A person’s thoughts and perceptions of a situation influence
their emotions and behaviour

For example:
- “A friend passes you in the hallway without saying “Hi”
- A negative thought process could be: “I did something to make them mad”.
- This can make you feel sad (emotion) and avoid your friend next time
(behaviour)

Question 3

What is the objective of CBT?

- What does it improve (2)?

Answer 3

CBT seeks to help clients identify negative thoughts and beliefs, to objectively look at the
evidence that supports and refutes that thought or belief, and produce a more realistic evidence-based alternative perspective
- This leads to improvements in emotions and behaviour (Beck & Dozois, 2011).

Question 4

What are the three levels of cognition? Explain each and provide and example.

Answer 4

1) Core Belief (or Schemas)
- Central assumptions about ourselves, others, and the world (Austin & Boyd, 2015).
- Shapes how we perceive events.
- Can be influenced by adverse events or other experiences in early life (Beck & Dozois, 2011)
- E.g. I’m incompetent

2) Intermediate Thoughts (or Assumptions)
- Often “if-then” or “should” statements (Tompkins, 2019)
- E.g. If I make a mistake, it will show how incompetent I am

3) Automatic Thoughts
- Immediate interpretation of an event (Chand et al., 2020)
- E.g. A supervisor provides a good, but not quite excellent performance review. A
person may think: I can’t do anything right. I’ll lose my job

Question 5

What does CBT techniques target?

- What does it identify and encourage?

Answer 5

Cognitive therapy techniques target different levels of cognition, often starting with automatic

thoughts.
- Techniques identify negative thought patterns and encourage more realistic and balanced thinking.

Question 6

When did CBT begin? By who?

Answer 6

Dr. Aaron Beck, developed CBT in the 1950’s/60’s, while he was providing care to individuals experiencing depression (Beck, 2011)
- CBT is continually evolving and now utilized in the treatment of numerous mental disorders in
many countries around the world (Beck, J., 2020, p.6)

Question 7

What are the underlying principles of CBT?

Answer 7

Based on an evolving Cognitive-Behavioural (CB) formulation of the patient
- Strong therapeutic relationships are required

Goal-Oriented
- Clients have a clear idea of their struggles and set realistic goals with their therapist

Time-Limited
- CBT is short-term, usually 8-24 weekly sessions (Beck & Dozois, 2011)
- CBT focuses on transferring knowledge from the therapist to the client so they can help
themselves and further therapy becomes unnecessary

Structured and Directive
- Sessions follow a similar structure throughout - provide clarity, reassurance and sense of

Question 8

What are cognitive techniques (2)?

Answer 8

1) Socratic dialogue and self-discovery: using open-ended questions to help guide the client to achieve greater insight into their own thoughts and emotions, their impacts, and explore alternative perceptions

2) Cognitive restructuring: Challenging negative thought patterns of oneself, others, or their world
a) Identify automatic thoughts
b) Evaluate automatic thoughts
- Evaluate the evidence for the unhelpful thought being true
- Evaluate the evidence for the unhelpful thought not being true
c) Consider alternative evidence-based views to modify automatic thoughts

Question 9

What are behavioural techniques?

Answer 9

1) Behavioural Experiment: experiments that test the accuracy of maladaptive beliefs or test new more adaptive beliefs
- Create a scenario
- Patient makes a prediction about what might happen
- Potential obstacles are identified with actions to manage them
- Report the actual result of the experiment
- Patient rates how much the results of the experiment support their original
maladaptive belief or new more adaptive belief

2) Hypothesis testing: A type of behavioural experiment that looks at the objective
evidence that supports or refutes a patient’s beliefs

3) Graded Task Assignment: Breaking down tasks into smaller segments to make it easier
to manage

4) Activity scheduling/Behavioural Activation: Recording daily activities with their
accompanying moods in a diary

5) Symptom reduction:
a) Exposure therapy: place patient in contact with avoided thoughts, emotions,
behaviours, or situations to desensitize their fear response
b) Relaxation training: controlled breathing, progressive muscle relaxation to be used when faced with fear