WEEK 10 - 1 Cognitive Behaviour Therapy

CBT

  • based on cognitive model → explores how thoughts and thinking process affect how we feel and behave

  • talking and doing therapy

  • teaches coping skills; goal orientated

Cognitive model

  • how you think determines how you feel and behave

  • different thoughts → different feeling and behaviours

  • ABC model

    • Activation event

    • Beliefs (thoughts)

    • Consequences (emotional, physical, behavioural)

  • suggests that the thoughts are the main cause

  • CBT: changing those thoughts

‘Hot-cross bun’ modes

  • our environment have an effect on us and our psychological being

    • body sensations, thoughts, feelings, behaviour, etc.

where do thoughts come from?

  • learned from our life experiences, interactions, etc

  • influenced by genetics and personality

  • unique to each one of us

Cognitive behaviour model

  • mental health problems can be understood in terms of unhelpful or unrealistic beliefs (or schema) → about ourselves, the world and the future (leading to depression, anxiety, etc.)

  • these influence how we see the world

Cognitive vulnerability model

  • life experiences + genetic factors, etc. → core beliefs, attitudes, assumptions → triggering event → thoughts, feelings, behaviour, body sensations

  • influences how we make sense of our current life experiences, how we feel, and what we do.

Beck’s negative cognitive triad

  • self → future → world

  • biased beliefs that may be associated with mental distress (depression, anxiety, etc.)

EVIDENCE

  • Clark & Beck, 2010, p. 418

    • “hundreds of correlational and prospective studies have supported major tenets of the cores sectioned cognitive model, with moderate support also accruing for cognitive vulnerability”

Cognitive Behaviour Therapy (CBT)

  • first describes as an approach to depression be Aaron T. Beck (1967)

  • helps the client to think and act in a more realistic and adaptive way

CBT in practice

  • time limited and structured

  • listens and focuses on here and now problems

  • help patient learn and understand their own patterns

  • works towards specific goals

  • offers a cognitive account of emotional distress

  • variety of situations: distressful, happy, neutral to better understand triggers

    • exploring underlying patterns of underlying beliefs, attitudes and assumptions → where these may have come from?

  • collect ans weight up evidence for unhelpful thoughts → generate ideas and test them out with behavioural experiments

    • T. S. Eliot (1917)

Does CBT work?

  • Evidence

    • DeRubeis et al. (2005)

    • comparing CBT with antidepressants medication in adults

    • after 8 weeks: placebo → no more symptoms of depression

    • after 8 weeks: CBT → really good response

    • no difference in outcome between CBT anti depressant medication at 8 or 16 weeks

    • HOWEVER

    • Hollow et al. (2005)

    • followed up data

    • CBT patients were less likely to relapse into depression than those discounting medication and no more likely to relapse than those continuing to take antidepressant medication

Evidence of effect of CBT for many disorders

  • depression, panic disorder, eating disorders, schizophrenia and others.