psychotherapy - specific cbt techniques

why can it be hard to identify automatic thoughts?

often embedded within a broader statement or phrased as a question

how can you identify automatic thoughts?

ask “what was going through my mind just then?” when there is a change in emotion or mind/body or when feel the urge to engage dysfunctionally

what are the different types of automatic thoughts?

thought is distorted, thought is accurate but conclusion is distorted, and thought is accurate but not helpful

how can you evaluate automatic thoughts?

review evidence for and against the thought, advantages and disadvantages of having the thought, and identifying worst case, best case, and most realistic case

what are the ways you can evaluate automatic thoughts through advice?

distancing self from thought (what would you tell a friend to do), or problem solving (what can you do)

what are the sections of a CBT thought record?

situation, emotion or feeling, negative automatic thought, evidence that supports the thought, evidence against the thought, alternative thought, emotion or feeling

what are some cognitive distortions?

all-or-nothing thinking, mental filter, jumping to conclusions, emotional reasoning, labeling, over-generalizing, disqualifying the positive, magnification, should/must, personalization

how can you combat all-or-nothing thinking?

identify the relevant extremes and explore the stages or steps between the extremes

how can you combat mental filter?

pay attention to all instances of an event and note both good and bad

behavioral experiments

planned experiential activities undertaken to test validity of patient’s beliefs and construct more adaptive beliefs

how are behavioral experiments different from observation?

hypothesis testing rather than discovery and active versus passive

what should you keep in mind when planning behavioral experiments?

spontaneity can be good, want to push client but avoid setbacks, design experiment so something is learned either way, prepare for challenges ahead of time

how should you implement behavioral experiments?

client needs to fully engage rather than go through the motions, monitor thoughts/feelings throughout, be flexible and respond to the unexpected

what should you consider after the experiment?

save time to debrief on what happened, how did the outcome fit with predictions, what was learned, what might be done differently next time based on results

what CBT techniques are used for making decisions?

advantages and disadvantages analysis, weigh pros and cons of both options and rate importance of each from 1-10

what CBT technique is used for refocusing?

evaluating automatic thoughts is not always desirable or feasible, so client can instead label automatic thought as such and deliberately refocus attention on task at hand

graded task assignments

break goal down into smaller pieces, focus on one step at a time, success encourages further action

pie technique

useful for setting goals or determining relative responsibility

self-comparisons

are you comparing yourself to you at your best or your worst and is that appropriate?

credit lists

give yourself credit when its due

example of all-or-nothing thinking

if I’m not perfect, I have failed

example of mental filter

when you receive a C, ignore assignments where you got an A and tell yourself you’re a bad student

example of jumping to conclusions

my first answer was incorrect, so I’m bound to fail this test

example of emotional reasoning

I feel like a bad friend therefore I am a bad friend

example of labeling

I’m a loser

example of over-generalizing

nothing good ever happens

example of disqualifying the positive

you win an award and think it’s just a fluke

example of magnification

I failed my first university assignment, so I am not cut out for university

example of should/must

I should be a straight A student

example of personalization

my partner is unhappy and it’s my fault