CBT Final

What is the working alliance between therapist and client called in CBT?

Collaborative empiricism

In CBT, the relationship between therapist and client is considered to be the PRIMARY mechanism of change.

False

In terms of the concept of Transference in CBT, the therapist…

Views it as a habitual way of thinking that is recapitulated in the treatment setting.

In general, do CBT therapists take an active or passive approach with clients?

Active

Transference can be a healthy and productive phenomenon in therapy that does not necessarily need to be confronted or curtailed.

True

When there is the potential for the negative impact of transference in therapy, setting strict boundaries is NOT a good strategy.

False

Beck’s “negative cognitive triad” of depression consists of negative thinking styles in which domains?

Self, world, future

__ is/are given a central role in the CBT model because humans appraise the significance of events in the environment around them.

Cognitions, Thoughts, Thinking

CBT and medication can:

Combine to improve efficacy of treatments.

The highest level of cognition is:

Consciousness

Schemas are cognitions that stream rapidly through our minds when we are in the midst of situations.

False

An important clue that automatic thoughts might be occurring is:

The presence of strong emotions.

Name a central theme of automatic thoughts typically seen in depression.

Cognitive distortions, hopelessness, negative views of self or world, low self-esteem, being a failure

In implementing CBT methods for reducing cognitive errors, therapists typically teach patients that the most important aim is to simply recognize that one is making cognitive errors.

True

What are the three main groups of schemas?

Simple, Intermediary, Core

Hopelessness has been found to be the most important predictor of suicide.

True

In terms of implementing CBT a therapist should first:

Develop an individualized conceptualization

You cannot carry through the behavioral activation protocol without also doing thought challenging.

False

According to research studies, which interventions have support for treating depression in long-term and short-term?

Behavioral Activation, Cogitive Restructuring of Automatic Thoughts, Cognitive Restructuring of Schemas

According to Ferster, why might a depressed individual self-isolate and avoid others?

To avoid negative feelings

Accor

What does Lewinsohn mean by “response-contingent” positive reinforcement?

Reinforcement is dependent on the individual’s actions.

Rehm conceptualized self-control as a feedback loop containing all concepts except:

Self-visualization

Within the context of Beck’s CBT, activities selected for scheduling should be rated on a 0-10 scale according to which two criteria?

Pleasure and mastery

Behavioral activation was better than medication as an intervention for maintaining treatment engagement over time.

True

Depressed individuals are inherently self-motivated to get better.

False

From a behavioral activation perspective, why do people remain depressed?

A skills deficit; Favoring short-term coping over long-term; Their goals do not feel achievable

Reinforcers that do not occur naturally within the environment and require the patient to carry out themselves (like rewarding themselves with candy) are called what?

Arbitrary

In behavioral activation, we cannot learn from failures and only focus on meaningful success stories.

False

Which quality is the most important for determining homework assignments?

Collaboration

Contraindications for CBT include advanced dementia, delirium, and drug intoxication.

True

The following are all dimensions to consider when evaluating a client for CBT except:

A dependent personality style

“Contributions of childhood experiences and other formative influences” is NOT one of the seven domains in a CBT case conceptualization.

False

Give an example of a short-term coping strategy that, according to Behavioral Activation, may keep people stuck over time.

Avoidance

The following are types of homework assignments in Behavioral Activation except:

Genogram

Validation does not play a significant role in Behavioral Activation.

False

The A B C’s of Behavioral Activation stand for “__”, “Behaviors,” and “Consequences.”

Antecedents

In an activity chart, a client can record their behavior by

Hour by hour monitoring; Monitoring blocks of time during the day; Time sampling procedures

Taking note of what happens before a behavior but not after a behavior is important to focus on when using an activity chart.

False

A risk assessment is not a necessary part of Behavioral Activation when treating depressed clients.

False

Behavioral activation can be effective at any point in the CBT treatment process; what are the benefits of introducing it early in the treatment process?

Helps them move in a positive direction quickly; Builds confidence that they can tackle bigger problems with the therapist later on; Instills a sense of hope and engagement

You should focus on developing a collaborative relationship after trying behavioral activation.

False

Activity Scheduling is used:

With moderate depression; With severe depression; With clients who have difficulty organizing their days; With clients who have difficulty engaging in productive activities

A decisional balance worksheet helps a client examine the pros and cons of changing and not changing, with the goal of helping the client see the benefit of making changes. 

True

Where is a behavior plan first rehearsed?

In session

Problem solving can be hard for patients who have performance or skill deficits; name two obstacles to effective problem solving listed in the book:

Avoidance (e.g., procrastination) and practical problems (e.g., lack of time and/or resources).

In working with clients who have deficits with problem-solving skills, some helpful steps could be generating potential solutions and choosing the most reasonable one.

True

The two overlapping phases in CBT include terms of addressing automatic thoughts are:

Identify and Modify

Recognizing mood shifts, psychoeducation, guided discovery, and thought recording are all methods for identifying automatic thoughts?

True

In addressing automatic thoughts, CBT attempts to replace irrational negative thoughts with positive thoughts even if the positive thoughts are irrational.

False

The following are all dimensions of distorted attributions except:

A. Internal vs External; B. Concrete vs Abstract; C. Invariant vs Variable; D. General vs Specific

3×5 index cards or smaller to write down instructions that patients can use to help them cope with issues or situations are called what?

Coping cards

Negative core beliefs that remain dormant and under the surface until activated by a stressful event describes what model/theory?

Stress diathesis model

Using various questioning techniques, performing psychoeducation, spotting patterns of automatic thoughts, and conducting a life history review are all methods of:

Identifying Schemas

All of the following are methods for changing schemas except

Paradoxical interventions

Developing coping strategies for overcoming obstacles, coaching the patient on ways to make the homework a productive experience, and practicing Tai Chi are all tips for challenging schemas.

False

Name at least one important type of information to gather when using a Life History Review to help identify schemas:

Information on family history, childhood experiences and trauma

In Behavioral Activation, the following are strategies for targeting depressive rumination except

Empty Chair Technique

Given the emphasis in BA on contextual factors that maintain depression, problem solving should take a front-and-center role throughout the course of therapy.

True

Which of the following is a step of traditional problem solving in BA:

Define the problem; Brainstorm; List pros and cons; Clarify best course of action; Evaluate the outcome

In BA – Primary Problems are considered problems beyond the client’s control. Secondary problems are what?

The problems that result from the clients’ response to their primary problems.

When assigning activation practice, it is important to spend time identifying things that might derail or limit success on the assignment.

True

What are the two most commonly used behavioral procedures in CBT?

Reciprocal inhibition and exposure

Which of the following is NOT a method used in CBT related to decatastrophizing:

Normalizing their fear by engaging in a conversation about how you fear the same thing.

Family members, friends, and others helping the patient can be considered a safety behavior.

True

When identifying targets for interventions it is typically best to start by targeting:

A symptom or goal that is easily accomplished

Select ALL relaxation/calming exercises described in Wright et al.

Muscle Relaxation; Imagery; Breathing; Distraction

A strategy sometimes used in developing a hierarchy for graded exposure is to ask the patient to generate ideas for activities that would result in over-the-top anxiety ratings.

True

At the end of a therapeutic relationship you should focus on all the positive changes and challenges the patient has overcome. Keep things positive. There is no need to review future challenges and this will likely prolong therapy.

False

Response Generalization

Instances when responses themselves change in nature over time and in varying contexts.

Stimulus Generalization

Occurs when the same response occurs in the presence of different contextual factors.

Why is assessing the generalization of skills an important part of the later parts of treatment?

It enables the client to respond effectively when presented with new situations that may have once triggered depression.

What are 2 different "ingredients" you would encourage a patient to consider putting in their personalized end of therapy handbook?

Triggers, skills learned, therapy notes, future warning signs, completed worksheets

When creating a relapse plan, a therapist can utilize their original conceptualization, treatment plan, and symptom fluctuation graphs to help the patient prepare for future high-risk situations. 

True

Name a benefit of spacing sessions further apart towards the end of treatment.

A. Can allow for a broader array of situations to arise with which the client will need to cope

B. More time to practice strategies that have been helpful and then return to troubleshoot w/ the therapist any difficulties experienced

C. Provides a refresher in planning strategies for continuing to engage and activate rather than avoiding and withdrawing  from difficult situations

The end of the Martell chapter offers one more acronym for BA: ACTIVATES.

Select all answers below that are NOT correct for this acronym

Assess

Coping skills in every session

Time – sessions should be kept to 45 minutes

Include monitoring

Validate their parking

Assign activities

Troubleshoot

Encourage

Name one evidenced-based treatment shown to help prevent suicidal behavior and self-directed violence in adults.

CT-SP, brief CBT, and DBT are examples

Patients who are overwhelmed and feeling hopeless do not respond well to realistic treatment goals.

False

All of the following are considered risk factors for suicidal behavior except:

A. Feelings of hopelessness and despair B. Substance Use Disorder C. Perceived burdensomeness D. Political Affiliation E. Gender F. Chronic physical pain (D and E)

All of the following are safety planning steps except:

A. Identify warning signs B. Develop coping strategies C. Identify Social contacts and social settings D. Contact Family members and friends  E. Contact professionals or agencies F. Plan a long drive G. Make the environment safe H. Identify and build up reasons to live.    

A Hope Kit is a collection of items that help remind a patient of their reasons for living.

True

Name one way a therapist should take care of themselves when working with suicidal patients.

Self-care; see a therapist; create boundaries; consult with peers or supervisors. Be understanding and empathetic but realize suicide is not an acceptable solution to life’s problems. Be aware of personal reactions and automatic thoughts.

__ is a potential target of treatment resistant depression.

A. Hopelessness B. Suicidal Risk Reduction C. Anhedonia D. Nonadherence to pharmacotherapy E. Evil spirits F. All of the above G. A,B, C, and  D.

Name one goal of CBT when treating Bipolar Disorder.

Educate the patient and family about bipolar disorder. Teach self-monitoring. Routinize circadian rhythms. Develop relapse prevention strategies. Enhance adherence to pharmacotherapy regimes. Relieve symptoms with cognitive and behavioral methods. Develop a plan for long-term management of bipolar disorder.

What is on of the principle adaptation of CBT for the treatment of Personality Disorders called?

DBT

CBT is used to treat substance use disorders but not eating disorders.

False