CBT Lecture Notes

Flashcards about Cognitive Behavioural Therapy

Cognitive Model: Core Beliefs

Core beliefs lead to dysfunctional assumptions, which lead to negative automatic thoughts

Areas to assess in detail

Thoughts, Mood states and specific emotions, Body states and sensations, Behaviour (safety behaviours), Environmental factors

Adaptive coping mechanisms

Character strength resilience, Valued roles, relationships, supporting community structures and adaptive and healthy beliefs about self

Modes of assessment

Self-monitoring, self-report questions, direct observation, observations offered by others, self-ratings, frequency count, belief rating, duration checks, diaries

Depression Assessments

BDI, PHQ-9

Social phobia Assessment

Social phobia inventory (SPIN)

OCD assessment

Obsessive compulsive inventory (OCI)

PTSD assessment

Impact of events scale (IES)

Health Anxiety assessment

Health anxiety inventory (HAI)

GAD assessment

GADD-7, Penn state worry questionnaire

Salkowski’s model of OCD

Intrusive thoughts become problematic due to personal significance. (moral responsibility)

Clarks and well model of panic – social anxiety disorder

Exposure to social situations, reducing self-focused attention

Dugas and Robichaud’s model of GAD

Intolerance of uncertainty, positive beliefs about worry and poor problem solving maintain GAD, challenging beliefs about worry

Clarks cognitive model of panic disorder

Misinterpretation of bodily sensations as catastrophic which leads to anxiety.

Elhers and Clark model of PTSD

PTSD persists when trauma is processed in a way that leads to a sense of current threat. Avoidance and safety behaviours maintain this. Using trauma focused CBT, cognitive restructuring and imaginal and in vivo exposure

Fairburn’s transdiagnostic model of Eating Disorders

Overevaluation of weight and shape drives it, normalise eating, address dysfunctional beliefs about body image and control

WAS model of depression

Monitoring, the negative cognitions contribute to the decreased behaviour Activity to contribute to monitor activity and mood. Test the idea of I don’t get pleasure from anything – maybe try activities

Beck cognitive model

Aaron beck proposed that distorted or dysfunctional thinking (which influences mood and behaviour) is common in all psychological disturbance

Model structure of CBT

Event, Thoughts, Feelings, Behaviours, Physiological reactions

Schemas (cognitive structures)

Schemas are deeply held core beliefs or mental frameworks that influence how people interpret events

Automatic thoughts

Quick, involuntary, and situation specific Reflect underlying schemas Often distorted or unhelpful (cognitive distortion)

Step-by-Step Guide

Case Formulation (CBT Style)

Structure it around

Presenting problem, Precipitating factors, Predisposing factors (history, upbringing, trauma), Perpetuating factors (maladaptive coping, negative thinking), Protective factors (their resiliance and strenght)

The hot cross bun consists of

Cognition (thoughts), affect (emotional states), physiology (bodily states), behavior (what one does or says)

Structure of Hot Cross Bun

Event, Thoughts, Feelings, Behaviours, Physiological reactions

Cognitive errors

Jumping to conclusions, blowing it out of proportion, Overgeneralization, Magnification/minimization (overemphazing situations), Personalisation (she didn’t say hello she must hate me), Dichotomous thinking (black and white thinking) – evaluate things on a scale from 0-100, Catastrophizing (predicting the future negatively), Mind reading (he’s thinking I’m a failure)

Cognitive restructuring

re- evaluating a situation to find a more balanced or helpful perspective on it by identifying and challenging negative automatic thoughts (NATS)

Socratic questioning

Use guided discovery to evaluate the evidence for and against a belief

Thought record

Help clients track situations, automatic thoughts, emotions and alternative responses (track situation, feelings and thoughts)

Address Core Beliefs

Identifying and modifying core beliefs/schemas Address deep seated negative beliefs (trace automatic thoughts back to core beliefs), downward arrow technique.

The survey method Ask people questions to find out if client’s thoughts and attitudes are realistic

The semantic method

Cost benefit analysis

Create a pros and cons list about your list

Behavioural activation

Increase engagement in positive and meaningful activities to combat avoidance and depression (scheduling enjoyable activities)

Exposure therapy

Reduce avoidance and fear through gradual exposure (for example in social anxiety)

Behavioural experiments

Test the validity of beliefs through real life experiments ( if you speak up you’ll be ridiculed, share your opinion and see what happens).

Graded task assignment

Break overwhelming tasks into manageable steps

Social skills training

Teaching social skills follows a characteristic cognitive-behavioural process mood influences social behaviours and social behaviour influences mood rejection and mood are transactional

Techniques for social skills training

Direct instruction, Graduated practice and rehearsal , Real world experiment and positive reinforcement

Relaxation training

Reduce physical symptoms of anxiety (deep breathing, progressive muscle relaxation and mindfulness)

Problem solving skills

Teach structured approaches to manage real life challenges (identify problem – brainstorm solutions - weigh pros and cons – try solution – review outcomes)

Mindfulness- based CBT

Increase present -moment awareness and reduce rumination

Anchors

Identify cues that mood is begging to escalate, identify what needs to be done to prevent outburst