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cbt > Week 5 > Flashcards

Week 5 Flashcards

1
Q

List the various types of avoidance behaviours (5)

A

-Social withdrawal
-Non-social avoidance (not taking on challenging tasks)
-Cognitive avoidance (not thinking)
-Avoidance by distraction
-Emotional avoidance (use of substance to numb feelings)

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2
Q

Activity Scheduling is especially effective for which diagnosis?

A

Depression

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3
Q

How do you conceptualize inactivity?

A
  1. Situation (Thinking about initiating an activity)
  2. Common Automatic Thought: “Im too tired”
  3. Common Behaviour (Remain Inactive)
    and;
  4. Common Emotional Reactions (Sadness, Anxiety, Hopelessness)
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4
Q

T/F

The ATs of depressed clients only occur before initiating an activity.

A

False. Clients can have negative thoughts during or after an activity

“I am not enjoying this”

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5
Q

What is an activity chart?

A

Clients write down the activities they do each hour and, if they’re willing, rating their sense of mastery and pleasure

Useful for:
-Activity Scheduling
-Eliciting potential activities

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6
Q

How to use predictions to help clients who are skeptical about activity charts:

A
  1. Ask them to predict levels of mastery and pleasure and connection, or overall mood will be on a chart.
  2. Then record their actual ratings
  3. If they find their predictions are inaccurate, they usually become more motivated to continue scheduling activities.
  4. If their predictions turn out to be accurate, you’ll ask questions to conceptualize the problem, and then likely do problem solving and respond to unhelpful thinking.
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7
Q

What to ask yourself when reviewing the typical day of the client? (3)

A

Which activities is client doing too much?

Which activities is he doing too little or avoiding?

Which new activities is client most likely to engage in?

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8
Q

What is ACT?

A

Acceptance and Commitment Therapy describes useful metaphors for accepting negative emotion and turning one’s attention to valued action.

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9
Q

For whom would Relaxation most benefit?

A

Those experiencing bodily tension

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10
Q

3 methods for relaxation

A

Progressive muscle relaxation = alternately tense and then relax muscle groups in a systematic way

Imagery = having clients create a vision in their minds of feeling relaxed, calm & safe in a particular environment,
such as lying on the beach

Deep breathing

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11
Q

What is the “Oh well” technique?

A

“I don’t like this situation or problem. But there’s nothing I can do to change it, not if I want to reach my goal. So, I might as well stop struggling, accept it, and change my attention to something else”

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12
Q

What you can do when client is having difficulty with problem-solving, via direct-instruction:

A

*Offer own solutions, though least ideal

*Guided self-discovery:
- Ask client how they solved similar problems in the past

*Some problems facilitated by change in environment
- E.g., excess junk food consumption being solved by more frequent supermarket trips

*Some problem solving may involve significant life changes.
- After careful evaluation of a situation, you might encourage battered spouses to seek refuge or take legal action.

*Help clients identify dysfunctional cognitions which interfere with problem solving

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13
Q

When to use Graded Task Assignments?

A

Clients tend to become overwhelmed when they focus
on how far they are from a goal, instead of focusing on
their current step.

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14
Q

What is a Graded Task Assignment?

A

The process of helping the client break their goal down into more manageable parts

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15
Q

When is exposure most applicable?

A

When the client engages in avoidance

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16
Q

What are safety behaviours?

A

A behaviour used while encountering stimulus, which produces a sense of safety without disconfirming the CS = US link

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17
Q

What is a major consequence of avoidance? According to CBT

A

Clients don’t get opportunity to test their automatic thoughts & receive disconformity evidence

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18
Q

Step to introducing exposure to client: (6)

A
  1. Provide strong rational (Research has shown that the way to get over fear is to expose in gradual steps)
  2. Create hierarchy of avoided situations & rate anxiety from 0-10
  3. Link exposure to client’s values (need to drive to car to visit family)
  4. Ask client to engage in activity every day
  5. Ask to monitor automatic thoughts after exposure to alert for unhelpful cognitions
  6. Draw helpful conclusion
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19
Q

What is ‘in vivo’ exposure?

A

Directly facing a feared object, situation or activity in real life

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20
Q

What is Interoceptive exposure?

A

The practice of strategically inducing the somatic symptoms associated with a threat appraisal and encouraging the patient to maintain contact with the feared sensations

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21
Q

In what areas can Role-Play enhance CBT? (3)

A

-Uncover automatic thoughts
-Develop adaptive response & modify intermediate & core
beliefs.
-Useful in learning & practicing social skills

22
Q

How are self-comparisons relevant to CBT?

A

-Clients TEND to compare themselves to an ideal point in the past (prior to the disorder)

-Therapist can propose a more helpful comparison (prior to beginning treatment)

23
Q

What are the 3 theoretical explanations of exposure therapy?

A

-Habituation
-Extinction
-Inhibitory Learning Theory

24
Q

Reasons for inducing positive images (5)

A
  1. Focusing on positive memories
    = recall memories, relevant to a current or upcoming situation, in which they solved problems, coped well
    with difficult situations or experienced success
  2. Rehearsing adaptative coping techniques
    = help clients practice using coping strategies in imagination à boots their confidence & their mood &
    motivates them to use these adaptive behaviors
  3. Distancing
    = reduce distress & help clients to view problem in greater perspective
    * E.g. visualize day in future when mood & functioning have improved
  4. Substituting positive images
    = regularly practiced for the client to experience relief from distressing spontaneous images
    * Image that distressing image is a picture on TV & change channel to different one e.g. lying on a
    beach
  5. Focusing on positive aspects of a situation
    = induced image is designed to allow clients to view a situation more positively
25
Q

Steps before starting exposure (3)

A
  1. Identify the goal
  2. What is the expectancy of CS equally US?
  3. Register the credibility of the expectancy
26
Q

Steps after exposure? (2)

A

-Investigate if the “what if (CS) then (US)” expectancy did come out?”

-How do you know that? Let the patient come up with information which disconfirms the CS = US relationship

27
Q

How do you “Reality Test” an image?

A

Teach clients to treat images as verbal automatic thoughts, using standard Socratic questioning

28
Q

What is inhibited learning?

A

Exposure should be seen more as a behavioural experiment.

Through exposure, the patient learns that the cue (CS) is not followed by the feared catastrophe (US).

The crucial factor is not reducing the fear but reducing the credibility of the CS being followed by the US.

29
Q

In exposure therapy, what does “Response Prevention” mean?

A

Response prevention refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.”

30
Q

How can a conditioned fear be renewed? (4)

A
  1. The CR is not sufficiently repeated in the time following extinction
  2. The surrounding context is changed between extinction and retest.
  3. If unsignaled (or unpaired) US presentations occur in between extinction and retest
  4. if CS-US pairings are repeated following extinctions
31
Q

Would anxious individuals have difficulty with extinction learning?

A

They show deficits in the mechanisms that are believes to be central to extinction learning:
-Poor response to exposure therapy
-Excessive fear & anxiety

32
Q

How long should exposure last when seeking violation of expectancy?

A

Exposure continues for the length of time predetermined as an adequate test of a stated expectancy.

33
Q

How does the phrase “Stay with it” relate to exposure?

A

It conveys the need to attend to the CS during exposure, because distraction is a known safety behaviour.

34
Q

T/F
Safety Signals need to be present during exposure

A

False

Safety signals protect from extinction

35
Q

How can learning be consolidated following exposure?

A

By questioning of what was learned regarding the non-occurrence of the feared outcome (US), discrepancies between what was predicted and what occurred, and the degree of “surprise” from the exposure practice

36
Q

Advanced Extinction Strategies (2)

A

-Deepened Extinction/Compound Extinction
-Occasional Reinforced Extinction

37
Q

What is Deepened Extinction?

A

Multiple feared CS are first extinguished separately before being combined, or a previously extinguished CS is paired with another to-be-extinguished CS.

“Combine it”

38
Q

T/F

During deepened extinction, it is essential that each CS cue should be an independent predictor of the same US

A

True

39
Q

What is Occasional Reinforced Extinction?

A

Involves occasional CS-US paring during extinction training

40
Q

What is the rationale for Occasional Reinforced Extinction?

A

Lessens reacquisition of fear

“Facing it”

41
Q

What situations are applicable for Occasional Reinforced Extinction?

A

When aversive outcomes are likely to be repeated.

-Repeated social rejections
-Re-Traumatization in dangerous environments

42
Q

What are Retrieval Cues?

A

-They retrieve the CS-noUS relationship (i.e., act as an occasion setter)

43
Q

T/F

Retrieval Cues are external stimuli which remind one of what they learned in exposure treatment

A

False

Mental reinstatement can act as a type of retrieval cue.

“Where were you and what did you learn last time?”

44
Q

What is context renewal?

A

The return of fear to a phobic stimulus when encountered in a context (internal or external) that differs from the exposure context

45
Q

What is the rationale behind using “multiple contexts” in exposure therapy?

A

It can offset context renewal by incorporating a variety of contexts

-Location
-Time
-Mood
-Energy

“Changing it up”

46
Q

What is the rationale for “Stimulus Variability?”

A
  1. Exposure occurs to generalized stimuli (GS)
  2. Multiple GS can be used in a single exposure trial, but not all.
  3. Therefore, incorporating a varied selection of GS will be most effective.

“Changing it up”

NOTE: Do not prioritize variety before repetition, which is vital for learning.

47
Q

What is counter-conditioning?

A

Repeatedly pairing the CS with a US of the opposing valence to the original US

48
Q

What is novelty-facilitated extinction?

A

A newer area of research which pairing the CS with a neutral outcome during extinction

49
Q

For whom could novelty-facilitated extinction particularly benefit?

A

Those with high intolerance of uncertainty

50
Q

2 types of behavioural experiment designs

A
  1. Formal hypothesis testing
    -“Is it true that?”
  2. Discovery oriented method
    -“What would happen if?”
51
Q

3 subtypes of hypothesis testing behavioural experiments

A
  1. Testing Hypothesis A: Testing the validity of current unhelpful cognition
  2. Hypothesis A vs B: Comparing and contrasting unhelpful cognition with a potentially better one
  3. Testing hypothesis B: Testing a potentially better and new cognition
52
Q

What is the Lewin-Kolb Experiential Learning Circle?

A

Learning & retention are enhanced when leaners follow a sequence of steps, each of which build on its
predecessor & forms a foundation
for the steps to follow

Patient might enter the circle at any
point:

  1. experiencing distressing &
    disturbing event
    (experience)
  2. expression of a powerful
    underlying belief (reflection)
  3. experience of distress
    followed by observation

cbt (3 decks)

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