Clinical. Psych Chapter 15- Cognitive Psychotherapy and Mindfulness- Based Therapies – Flashcards

Cognitive therapy has risen in popularity in recent decades. More clinical psychologists endorse it than any other single-school approach to therapy. reaction to both behavioral and psychodynamic therapy. Contines to evolve with 3rd wave therapies.

Increase logical thinking, or fix faulty thinking. the way we think about or interpret events determines the way we respond emotionally.

can also be called thought, belief, or interpretation. we describe our feelings coming from events, cognitions actually intervene. Events don't make us happy or sad but the way we think about those events does. According to beck 1995, things happen, we interpret those things, those interpretations influence our thinking.

If cognitions determine feelings, revising illogical cognitions can lead to more appropriate emotional reactions. If cognitions are more extreme than warranted, unwanted feelings can unnecessarily occur. Three steps to revising Cognitions: 1. Identify illogical cognitions (automatic thoughts) - Automatic thoughts- take place in an instant and without deliberation. Can become habits so it is had to recognize. Responsibility in therapy is to assist the client in identifying these. 2. Challenge them 3. Replace them with more logical cognitions.

Cognitive therapists often function as teachers with clients. - educate about the cog. model - use handouts, mini-lec. and readings - written assignments/homework significantly - aspire for clients to use the lessons learned to teach themselves rather than remaining dependent on the teacher.

Cognitive therapists often assign homework between sessions. written- clients are asked to keep a record of events, cognitions, feelings, and attempts to revise the cog. to change the feelings they experience. behavioral- clients are asked to perform certain behaviors before the next meeting, typically for the purpose of examine the validity of an illogical thought.

Cognitive therapy is typically... Relatively brief- 15 or less sessions structured and planned - session not as free flowing as other therapies focused on particular goals determined by clients and therapist at the outset

Albert Ellis Rational Emotive Behavior Therapy (REBT) - it is cognitive not behavioral despite the name connection between rationality and emotion ABCDE model A- activating event B- belief C- emotional consequence D- dispute E- effective new belief - these five columns provide a format for written records of client experiences - also provide a model of understanding and change for client Check slide for model example

Aaron Beck (daughter Judith beck is also leading figure) Cognitive Therapy Cognitive triad - thoughts about self, external world, future all contribute to our mental health dysfunctional thought record instead of ABCDE format for recording client experiences. - a brief description of event -automatic thoughts about the event ( with extent to which the client believes these) - emotions (intensity) - adaptive response (identifying the distortion in the automatic thought and challenging it) also the outcome (emotions after the adaptive response has been identified and extent to which the client still believes the automatic thoughts) discredit illogical automatic thoughts so came up with a list down as COMMON THOUGHT DISTORTIONS. Taught to clients All-or-nothing thinking (no gray area) Catastrophizing (unrealistically expecting the worst) Magnitication/minimizaiton (mountain out of molehill) Personalization (assume too much responsibility) overgeneralization ( neg. thoughts applied too broadly) mental filtering (ignoring pos. events and focusing only on neg.) Mind reading (presuming to know that others think) Beliefs as hypotheses -our beliefs are hypothesis, even though we may live as if they are proven facts. -therapy can involve putting these beliefs to the test to see if they hold true. - a way to expose a belief as illogical is to "put it to the test" in real life, just like in the lab.

Mindfulness- and acceptance-based therapies - known as 3rd wave - involves full attention to present moment without judging or wishing things were otherwise -engage with own mental process rather than experiential avoidance -derives from Buddhist tradition -rather than engaging in EXPERIENTIAL AVOIDANCE, as 3rd wave therapists call it, an individual can engage in ACCEPTANCE: allowing these internal experiences to run their course without fighting against them.

Specific 3rd wave therapies: - acceptance and commitment therapy (evidence based as per APA) for chronic pain, depression, mixed anxiety, OCD, psychosis -Dialectical behavior Therapy (evidence-based as per APA) for borderline personality disorder

Steven Hayes Learn to ACCEPT internal psychological experience COMMIT to ones own personal values move from FEAR to ACT FEAR Fusion- with inner experiences such as thoughts feelings and sensations that limits flexibility in responding. Evaluation- of self, inner experiences Avoidance- of unpleasant inner experiences via such means as distracting or numbering oneself Reason-giving- or leaning too heavily on rationalization that sound legitimate but actually perpetuate unhealthy approaches to life. ACT Accepting- ones own inner experiences for what they are, and nothing more. Choosing- directions in life based on ones core values, which will enhance life meaning and purpose. Taking action- in matters large and small that are consonant with ones own values.

Marsha Linehan Treatment of borderline personality disorder BPD. BPD conceptualized as problem of emotional regulation -Core practices of DBT problem solving- encourage clients to strategize for the best possible outcome, considering what will happen if they act on emotional impulses vs. deliberate actions. -Validation- directly persuasively communicate to BPD clients that their feelings are important and they have a sensible reaction to their situation - Dialectics- refers to exchanges between client and therapist intended to resolve simultaneous, contradictory feelings held by the client and arrive at the truth of their emotions. 4 specific modules of skill training 1. emotion regulation- involves identifying, describing, and accepting rather than avoiding neg. emotions. 2. distress tolerance- development of self-soothing techniques. impulse control to help minimize BPD behaviors such suicide attempts ect. 3. Interpersonal effectiveness- helps clients determine social skills in order to preserve relationships that might be damaged by extreme emotional outbursts. 4. Mindfulness skills- present life, internal experiences such as feelings thoughts and sensations without avoidance.

The way patients think about injury, illness, or condition can be powerful, especially when irrational. Increasing logical thinking can improve mental and physical health. Has been successfully applied to a variety of medical probs.

recent variation of cog therapy borderling personality disorder Addressing maladaptive schemas formed during childhood, often resulting from poor parenting. Unlike other cog. therapies, pays attention to the "roots" of the cog. - this therapy has a notable and growing amount of evidence in the treatment of borderline and other personality disorders.

Efficacy of cog. therapy is strongly supported by a body of empirical evidence that is large and continues to grow. - empirical support for treatment of many disorders, including depression, anxiety disorders, bulimia, PTSD, and others. - Cognitive therapists often conduct therapy in a manner that facilitates empirical study.