What Does CT for Depression Look Like? Flashcards
3 main propositions
1) access hypothesis: individuals can become aware of the content and process of their thinking
2) mediation hypothesis: thinking about events influences emotional and behavioral responses
3) change hypothesis: cognitions are knowable and mediate responses to situations, individuals can modify responses to events to be more useful/functional
CT theory: realist assumption
- realist assumption: there is an objective reality that exists independently of our awareness of it
- people can come to know the world more accurately
- in general, good mental health = appraising world more accurate
- CT also cares about how useful cognitions are
CT theory: exploration, examination, experimentation
therapists help patients become scientific observers of thinking and view thoughts not as reality but as hypotheses
therapeutic principles
1) collaborative empiricism - patient and therapist as co-investigators
2) guided discovery - therapist helps patient test their own thinking
3) socratic dialogue - guided discovery technique using a series of deliberate and sequenced questions
Case conceptualization
evolving, collaborative process b/w therapist and client that synthesizes theory, evidence, and practice to generate hypotheses about the causes and mechanisms that maintains a person’s psychopathology and problems
- functions to guide therapy
CBT treatment plan for depression
1) assessment
2) psychoeducation
3) set treatment goals
4) behavioral activation/ other behavioral interventions
5) cognitive intervention - automatic thoughts, assumptions, core beliefs and schemas
6) relapse prevention
treatment plan: behavioral activation
monitor daily activities and emotions and assess links, monitor mastery and pleasure and identify deficits, generate and schedule activities
treatment plan: cognitive interventions
psychoeducation, identifying thoughts (3 column thought record), identifying cognitive distortions, challenging thoughts (6 column thought record), identifying underlying maladaptive assumptions and core beliefs and changing them
treatment plan: relapse prevention
goal is to identify potential stressors and prevent a small lapse from leading into a full relapse
cognitive technique: psychoeducation about the role of thoughts in emotions and behaviors
- the same situation can be interpreted in different ways
- different interpretations will lead to different emotional responses and behavioral consequences
- often we can’t know the correct interpretation, but which are more likely to be more accurate and useful
cognitive technique: evidence gathering
lawyer in court - is this admissable
therapist uses socratic questioning to help client generate additional evidence
cognitive technique: cost-benefit analysis
taking a thought and then writing out the costs/benefits of having that thought
other cognitive techniques
third-person perspective, self-compassion, humor, identifying positive aspects of thought, finding grey area in black and white thinking
cognitive technique: working with core beliefs and schemas
towards end of therapy
psychoeducation
identify beliefs and schemas - look for themes in thought record
cognitive technqiue: changing core beliefs/schemas
evidence gathering, cost/benefit of schemas and beliefs, recognizing continua, behavioral experiments, changing past narratives, imagining the new self, acting “as if”
