The Individual Ch.4

J.B. Watson

Widely seen as the creator of behavioural psychology.
He was a psychology professor at the University of Chicago at a time when psychology as an academic discipline was in its infancy.

Wilhelm Wundt

Established psychology as a field of study separate from philosophy and physiology in 1879.

introspection

The method of research into psychological topics – such as memory, learning, problem-solving, and perception. It involves research subjects reporting on their own internal thought processes as they engaged in remembering, learning, or any other psychological activity.

the weakness of introspection

It was not open to objective scrutiny. Only the actual subject could ‘see’ what was happening, and this would inevitably result in bias and subjective distortion.

objective scruitiny

A careful and unbiased examination of something, free from personal bias or subjective interpretation.

Watson suggested that psychology …

should define itself as the scientific study of actual, overt behaviour rather than invisible thoughts an images, because these behaviours could be controlled and measured in laboratory settings.

Skinner (1953) argued that the response that is emitted by someone is …

the one that has been most frequently reinforced in the past.

It is important to recognise that punishment is …

not a necessary component of a behaviour modification regime.

collaborative empiricism

When a CBT therapist explains behavioural ideas to the client and works with them to apply these ideas to bring about change in their own life.

contextualism

To understand or explain any type of human action, it is necessary to take account of the context or environment within which it takes place. Furthermore, the purpose of analysing human action is not to arrive at abstract stories, but rather to find ways to make the world a better place (pragmatism).

functional analysis

A method used to understand the purpose or function of a behaviour by examining its antecedents (what happens before), the behaviour itself, and its consequences (what happens after) (e.g. smoking).

attention to causal sequences

Posits that a key principle in behavioural psychology is that it should always be possible to identify and observe causal sequences, within the actual environment or context in which a person lives, that reinforce and maintain their patterns of problem behaviour.

Two therapeutic techniques that have remained crucial parts of the CBT therapist’s repertoire:

• systematic desentisation

• exposure

systematic desentisation

Pioneered by Wolpe (1958) and relies on Pavlov’s classical conditioning model of learning. The solution to a conditioned emotional response is to re-expose the person to the ‘conditioned’ stimuli in the absence of the original fear-inducing elements. The client learns how to relax. Through systematic desensitisation, the therapist can help the client overcome their avoidance.

Pavlov about systematic desentisation and exposure

‘’When a person had acquired a fear/anxiety response to something that is essentially harmless, such as travelling in a car, or being outside in the street, the fear will dissipate if the person is re-exposed to a fear-eliciting situation/context that they have been avoiding.’’

social learning theory

Bandura (1971, 1977) demonstrated that learning could occur through observation and imitation, as well as through processes of operant and classical conditioning, and made an important contribution to the development of a more cognitively oriented form of therapy.

Beck (1976)

Described self-critical cognitions as ‘automatic thoughts’, and began to see them as one of the keys to successful therapy.

The emotional behavioural difficulties that people experience in their lives are not caused by events but by the way they interpret and make sense of these events.

cognitive distortion

A perceived threat disrupts a person’s ability to think clearly and process information accurately.
For example, a person may interpret events in ways that are highly selective, egocentric, and rigid.

over-generalisation

A type of cognitive distortion that involves drawing general or all-encompassing conclusions from very limited evidence.
For example, if a person fails their driving test at the first attempt they may over-generalise by concluding that it is not worth bothering to take it again because it is obvious that they will never pass.

dichotomous thinking

Type of cognitive distortion that refers to the tendency to see situations in terms of polar opposites.
For example, to see oneself as ‘the best’ at some activity, and then to feel a complete failure if presented with any evidence of less than total competence. Or to see other people as either completely good or completely bad.

personalisation

Type of cognitive distortion which occurs when a person has a tendency to imagine that events are always attributable to their actions (usually to their shortcomings), even when no logical connection need be made.

Albert Ellis

Was the founder of rationale behaviour therapy, one of the cornerstones of contemporary CBT practice.

For Ellis, ‘I must have love or approval from all the significant people in my life’, is an irrational belief because it is exaggerated and overstated.
A rational belief system might include statements such as ‘I enjoy being loved by others’ or ‘I feel most secure when the majority of the people in my life care about me’.

rationale behaviour therapy

A short-term, cognitive-behavioural approach that helps individuals identify and change irrational beliefs and thought patterns to improve emotional well-being and behaviour.

metacognition

Refers to the ability of people to reflect on their own cognitive processes, to be aware of how they are going about thinking about something, or trying to solve a problem.

Dobson and Dozois (2001) highlight three theoretical principles that inform all CBT:

1.      Cognitive activity affects behaviour.

2.      Cognitive activity may be monitored and altered.

3.      Desired behaviour change may be affected through cognitive change.

scientist-practitioner model

Therapists should be trained in methods of systematic research, and routinely collect quantitative data on the outcomes of their work with clients.

case formulation

Comprises a kind of mini-theory of the individual client and their problems.

Dudley and Kuyken (2006) suggest that a cognitive-behavioural case formulation should be constructed around the five P’s:

1.      Presenting issues;

2.      Precipitating factors;

3.      Perpetuating factors;

4.      Predisposing factors;

5.      Protecting factors (person’s resilience, strengths, and safety activities).

precipitating factor

Could be a stressful event causing anxiety or a past trauma resurfacing.

predisposing factors

Historical or enduring vulnerabilities that increase a person's susceptibility to developing a mental health problem or other issue.
e.g., family history of mental illness, early life trauma or adverse experiences, personality, etc.

soctratic dialogue

A method that has two aims: (1) to lead the client in the direction of making connections between their thoughts and the behavioural consequences of these thoughts; and (2) opening a creative, reflective space within which new possibilities (i.e. different ways of thinking about things) might be realised.

behavioural experiments

CBT can also encompass enacting sequences of behaviour.
e.g. a client who experiences agoraphobic panic attacks may be encouraged to be in the therapy room with the door locked.

assertiveness training

A form of behavioural therapy designed to help individuals communicate their needs, thoughts, and feelings more effectively and confidently, while also respecting the rights of others.
e.g. learning the ‘rules’ of everyday social interaction.

exposure techniques

When CBT encourages clients to face the fear directly. The aim is the eventual replacement of anxiety or fear responses by a learned relaxation response.

imaginary rescripting

Can be used if a client is bothered by intrusive memories of traumatic past events. The client is invited to keep the distressing image in mind and tell the story of what happened and  then ‘rescript’ the event by imagining what would need to have happened to have made the original event less distressing.

mindfulness meditation

A way of being in which the person learns to accept the flow of thoughts and feeling without reacting to them.
The development of competence in mindfulness facilitates curiosity about inner states, and makes it possible to avoid being locked into ‘automatic thoughts’ and emotions.

Subjective Units of Distress Scale (SUDS)

Clients are asked to rate their level of anxiety or panic on a scale of 0-100.

On balance, it seems reasonable to conclude that CBT is often an effective form of therapy that is well received by clients. But is it more effective than other forms of therapy?

For very specific behaviour problems such as panic and OCD – possibly so. For more complex conditions such as depression, relationship difficulties, and anxiety – probably not.

transdiagnostic approach

Treats multiple disorders simultaneously by focusing on shared underlying processes and vulnerabilities, rather than focusing on symptom-specific treatments for each individual diagnosis.

Dialectal Behaviour Therapy (DBT)

Is a type of therapy, adapted from Cognitive Behavioural Therapy (CBT), that helps people manage intense emotions and improve their relationships. It focuses on teaching practical skills to cope with stress, regulate emotions, and navigate interpersonal challenges.