Wk 1 - Introduction

Question 1

Describe the 4 clusters of therapies.

Answer 1

1. CBT Cluster
   - BT, CBT, REBT
2. 3rd Wave CBT Approaches
   - ACT, DBT
3. New psychodynamic therapy
   - CAT
4. Postmodern contextual therapies
   - Solution-Focused Therapy (SFT), Family Therapy, Narrative Therapy

Question 2

Describe why CBT is the most popular therapy today.

Answer 2

1) strongest evidence base
2) manualized –> easy for different therapists to practice
3) short term –> cost effective
4) easy to measure outcomes
5) highly successful for mood and anxiety problems which have high prevalence in the community

Question 3

Name the 2 prominent 3rd wave approaches

Answer 3

1) Acceptance and Commitment Therapy (ACT)

2) Dialectical Behavioral Therapy (DBT)

Question 4

Describe the difference between 2nd wave and 3rd wave therapies.

Answer 4

2nd wave is more about challenging and restructuring thoughts. 3rd wave is more about developing different relationships with thoughts, learning to accept those thoughts and live with them. 3rd wave also tend to contain mindfulness components.

Question 5

What is Cognitive Analytic Therapy useful for?

Answer 5

Useful for cases with historical attachment difficulties as an ongoing pattern.

Question 6

What do solution-focused therapy, family therapy, and narrative therapy emphasize?

Answer 6

Emphasize that reality is socially constructed in the discourse of the situation or the person. Problems are located in the system and interactions between people. Need to change the perspective of the family and system, rather than work with the individual.

Question 7

Why are theories helpful?

Answer 7

1) give focus on mechanisms for change (informed theoretical framework)
2) helps you organise client’s information (BUT may blind you to certain information)
3) provides a roadmap of where things stand and where the work should be heading

Question 8

Clinical selection of approach depends on the 3 legged stool. What are the 3 legs?

Answer 8

1) Evidence base
2) Client’s preference
3) Therapist’s professional training

Question 9

What are some features of case formulation?

Answer 9

1) summarise the client’s core problems
2) suggest how difficulties may relate to one another, rooted in psychological theories
3) find out how difficulties are developed and maintained
4) indicate a plan of intervention based on psychological principles
5) open to revision and re-formulation, collaborative process with client

Question 10

Describe the 4Ps formulation.

Answer 10

1) Predisposing (historical factors)
2) Precipitating (trigger)
3) Perpetuating (maintaining)
4) Protective (strength, resilience)

Question 11

Describe the Blobby formulation.

Answer 11

1) “Why Me?” [personal factors]
2) “Why Now?” [precipitating factors]
3) “Why doesn’t the problem go away?” [what’s maintaining/perpetuating the problem]

Question 12

What is an advantage of using the “hot cross bun” CBT formulation?

Answer 12

Visually shows us how the factors are linked and how they influence one another.

Question 13

When should we use an approach-specific formulation?

When should we use a generic formulation?

Answer 13

1) when problem is well-defined and clear cut

2) for complex problems; not clear what theory to use

Question 14

What are some common problems that occur in formulation?

Answer 14

1) over- or under-pathologising of cases (eg. overpathologize the child and make the child the scapegoat)
2) being unaware of problem-specific formulation models
3) cherry picking information from the assessments; must try to use as much of the information gathered as possible!!!