Cognitive-Behavioral Therapy Flashcards

Flashcards based on lecture notes about Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioural Therapy (CBT)

A therapy approach characterized by short sessions, collaboration, and empirical methods, focusing on changing cognitions and behaviors to improve emotional outcomes.

Underlying Assumption of CBT

Interpretations of events determine emotional outcomes. Changing cognitions can alter emotional and behavioral responses.

Goals of CBT

Identify and change maladaptive thoughts and behaviors, improve emotional regulation, develop coping skills, increase self-awareness, promote autonomy, and enhance self-efficacy.

Benefits of CBT

Structured, goal-oriented, skills-based, evidence-based, collaborative, flexible, present-focused, and transparent.

Limitations of CBT

Can be restrictive, may not explore developmental roots, may not suit all clients, time-limited, potentially invalidating, and has a high dropout risk.

History and Evolution of CBT

Evolved from behavioral therapy by incorporating cognitive elements to address internal problems like depression, emphasizing personal appraisal and distorted thinking.

Cognitive Therapy

Focuses on the meaning individuals make of experiences, emphasizing that problems arise from distorted or maladaptive thinking patterns.

Reasons for CBT Popularity

Based on the scientific model, easily testable, produces positive outcomes, cost-effective, and empowers patients with a sense of control and self-efficacy.

Assessments in CBT

Involve evaluating the presenting problem across different contexts, identifying disorders met, and understanding maintaining factors, body states, emotions, thoughts, and beliefs.

Aims of Assessment in CBT

Establish therapeutic relationship, determine suitability for CBT, gather relevant information for treatment planning, and provide psychoeducation about CBT.

Outputs of Assessment in CBT

A problem list structured by priority, possible diagnosis, and a detailed description of issues in various contexts.

Modes of Assessment in CBT

Clinical interviews, self-report measures, disorder-specific measures, behavioral assessments, cognitive assessments, functional and risk assessments, and direct observation.

Assessing Suitability for CBT

Requires client self-awareness, access to thoughts/images, clearly defined problems, motivation, therapeutic alliance, and an understanding of CBT rationale.

Clients Unsuitable for CBT

Those with low insight/motivation, cognitive limitations, severe life instability, high emotional dysregulation, extreme rigidity, or differing cultural beliefs may require alternative therapies.

Formulations/Case Conceptualizations

The application of general CBT theory to a specific client, which includes a detailed description of the presenting issue, its development, and maintenance processes.

Aims of Formulation

To understand/conceptualize the patient's case, provide rationale treatments, manage and predict issues that may arise in therapy.

Cross-Sectional Perspective

Assess for current issues based on the ABC model with recent and well-defined examples, including cognitions, sensations, emotions, environmental factors, and maintenance behaviors.

Longitudinal Perspective

Assess for problem development and vulnerabilities, including onset, precipitating events, and influencing factors.

Choosing a CBT Strategy

Requires a clear formulation to address maintaining factors and matching the strategy with the presenting issue, considering patient details like suicidal ideation and cognitive readiness.

Daily Thought Record

Includes situation, feeling, and thought columns to differentiate interpretations from objective events.

Daily Mood Log

Records emotions and their intensity, as well as automatic thoughts, distortions, and rational responses.

Double-Standard Method

Encourages patients to treat themselves with the same compassion they would offer a friend.

Evidence Testing

Involves writing down reasons for and against a statement to challenge cognitive distortions.

Graded Thinking

Evaluates problems on a scale to counteract all-or-nothing thinking.

Re-Attribution

Assigns values and assigns them a value to contributing factors in an event to reduce self-blame and black-and-white thinking.

Cost-Benefit Analysis

A pros and cons list for an attitude or belief to see whether it's proving useful.

Positive Data Logs

Encourages gratitude, serves as a form of evidence testing for distortions related to discounting/minimization

Survey Method

Clients can ask individiuals what they think about a specific behavior to normalize behavior

Semantic Method

Using language to modulate emotions by choosing to rephrase statements to be more neutral

Counterthinking/Cognitive Restructuring

Use of thought records, evidence logs, aiming to challenge and reframe thoughts, identify cognitive errors and create new, more adaptive ones

Relapse Prevention

Aim is to maintain therapeutic gains and provide skills to prevent or handle setbacks after therapeutic sessions are over

Psychoeducation

Normalise and inform on the nature of the condition and how it affects the individual

Behavioural Experiments/Homework

Planned experiential activities, based on experimentation or observation, helping the patients test validity of existing beliefs

Hypothesis-Testing

Testing the validity of a current unhelpful cognition

Discovery

Used for when the patient has no insight into the processes maintaining the problem

Pleasant Event/Activity Scheduling/Behavioural Activation

Useful for depression, higher rates of hopelessness, distress, ideation etc., and increased level of positive reinforcement within the person’s life

Relaxation Training & Mindfulness

Reduces stress and anxiety symptoms

Social Skills Training (SST)

Assess social deficits and lacking skill

Problem Solving Training

Begin with Relaxation Techniques Training to reduce emotional volatility as it clouds judgement

Psychodrama techniques/Roleplay

Used as part of behavioural experiments like teaching a socially anxious person to speak up within a safe setting

Affect Regulation

Teach identification of emotions and the buildup when it is occurring – triggers, physical & sensate cues that escalation is occurring

Cognition

Flexibility in switching between different ways of processing; eg. ability to shift attention, rumination, all-or-nothing thinking, dissociation etc.

Automatic thoughts

Automatic, involuntary thoughts which are easily accessible, are usually negative in the context of disorders

Underlying assumption

Operating principles/rules which are generalised across situations; affect both other conclusions/thoughts and behaviours

Core beliefs

Enduring, global beliefs about the self, others and the world

Cognitions & the Learning Circle

Plan → Experience → Observe → Reflect, starting at any point during these

Overgeneralisation

Drawing a conclusion from a single incident

Mental Filter

he person ‘filters out’ positive experiences and focuses exclusively on the negative

Discounting/Disqualification

Discarding or downplaying evidence of positive experiences and qualities that goes against fixed negative beliefs

Jumping To Conclusions

Thoughts would not be supported by evidence; not thinking through the process but immediately drawing a conclusion based on the first evidence presented

Blowing out of Proportion

Focusing on a detail taken out of context, ignoring more salient features, conceptualising the whole experience based on the detail

Magnification/Minimization

Errors in evaluating based on over/underemphasising certain aspects of situations

Emotional Reasoning

Thinking something is true, despite evidence of the contrary, just because it elicits strong emotions

‘Should’ Statements

Using ‘I should have/be_ ’ – often leads to harsh evaluations of oneself and a focus on shortcomings

Labelling

Placing of a global label on oneself & others without considering other factors or evidence

Personalisation

Thinking everything is about ‘you’→ attributions of events/behaviours of others to oneself without any obvious basis for these connections

Dichotomous Thinking (All-or-Nothing/Black-and-white)

Viewing a situation as being of two opposing categories rather than on a continuum – everything is either good or bad

Catastrophizing/Fortune-telling

Predicting the future excessively negatively – ‘worst case scenario’ without considering the far more likely neutral outcomes

Mind Reading

The belief that one knows what other people are thinking; usually in the negative, and failing to consider other possibilities