Week 8 Flashcards
What other therapies branch off CBT?
- Rational Emotive Behaviour Therapy (Ellis)
- Dialectical BehaviourTherapy (Linehan)
- Cognitive Therapy (Beck)
- Acceptance & Commitment Therapy (Hayes)
- Schema Therapy (Young)
- Mindfulness-Based Stress Reduction (Kabat-Zinn)
- Mindfulness-Based Cognitive Therapy (Segal et al)
1950s: Albert Ellis
Based on philosophy, personal experience & clinical practice
“human beings are not particularly effected by external people and things, but by the view they take of these things”
1950-60s: Aaron T Beck
Based on the study of depressed patients
cognitive distortions (overgeneralisation, excessive esponsibility, self-references, etc) are a primary factor in affective disturbance
Cognitive Behaivoural Therapy (CBT)
School of therapies based on the premise that it is not what happens that causes how we feel,
Thus a collection of cognitive, behavioural and emotional
strategies are utilised to facilitate therapeutic change. but what we think about what happen
The CBT Model
Thoughts affect Behavior, behaviour affects emotions and emotions affect thoughts.
All in a neat triangle
The ABC’s of CBT
A Activating event or Situation
B Thoughts & Beliefs
C Consequence or Feelings & Behaviour
A Situation -> B Unhelpful thoughts or beliefs -> C Consequence, Extreme feelings, difficult to manage, Unhelpful behaviour blocks goal
What to rememeber about unhelpful thoughts?
Don’t discount every clients thoughts as unhelpful, some thoughts may be helpful.
Sometimes that negativity is realistic, if we mask the negativity we hinder the change that could be done.
All or nothing thinking/black and white thinking
If I’m not perfect I have failed. Either I do that right or not at all.
Mental filter
Only pay attention to certain types of evidence, seeing nothing but our failures or successes.
Mind reading
We imagine we know what other people are thinking. Essentially projection in psychodynamic therapy.
Over-generalising
Seeing a pattern based upon a single event, one bad thing happened so it’s always going to happen again.
Magnification, catastrophic thinking
Throwing things out of proportion
Should statements, mus statements
Make us feel bad about ourselves. Meta-worry. I should be happier
CBT Model more complex
Situation has occured and all these things relate to one anohter: Thoughts, moods/feelings, behaviour, physical reactions that are potentially adding to their distress.
In each of these we can intervene.
Johny -> 1st year, likes a girl. her friends bitching about him, name-calling, avoids parties, avoids girls.
Situation: he has gone up to a girl, she’s rejected him, he’s being teased
Thoughts: he will never get a girlfriend
Mood: terrible
Behavior: affecting his studies, avoiding situations
Physical: sweating, nervous, short of breathe.
Range of interventions
Situation:
- Problem solving
Cognitive (thoughts):
- Cognitive restructuring/challenge
- coping statements
Behavioural:
- activity scheduling/Goal setting
- exposure
- general health behaviours (sleep, exercise, nutrition)
- Communication skills/assertiveness training
Physical reactions
- arousing cortisol
- breathing/relaxation
Feelings:
- medication
- understanding, articulation, tolerating emotions.
The Therapeutic Relationship
CBT advocates a collaborative, straightforward and action oriented relationship.
High degrees of genuineness, warmth, positive regard, empathy and authenticity.
The relationship promotes collaborative empiricism.
CBT contends that the techniques involved help to build and strengthen the therapeutic relationship
Psychoeducation
After testing, diagnosing, you might educate the client on their disorder, give info sheets, also explain the CBT model.
Things that are good at the start of CBT
- Psychoeducation (includes telling them about avoidance or negative thinking)
- activity scheduling (johnny, can you try and go to 80% of all your classes this week)
- homework might be a mood journal, make a record of their thoughts at those times. This will also distance them from their thoughts.
- For anxiety, create a fear hierarchy for graded exposure therapy.
- gently challenge some of those thoughts.
other things CBT treats
Psychosis, skizophrenia, eating disorders, somatoform disorders (unexplained pain in the body), anxiety, depression
When should you not use cbt?
- cognitive disabilities
- antisocial personality disorders
- ## after a traumatic event when it is not requested by victims (must be voluntary)
