Notes from Learning Cognitive-Behavior Therapy – Flashcards
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Who created and developed Rational-Emotive Therapy
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American psychotherapist Albert Ellis (page 2)
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Name the three iterations of REBT
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Rational therapy, rational emotive therapy, rational emotive behavior therapy (REBT) (wiki)
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When did Ellis present Rational-Emotive Therapy?
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1950s (page 2)
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Name two theories that contributed to the creation of CBT
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Rational-Emotive Therapy (Ellis) & Theory of Personal Constructs (Kelly) (page 2)
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What did the Greek Stoic Epictetus write in Enchidridion that relates to CBT?
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"Men are disturbed not by the things which happen, but by the opinions about these things." (page 2)
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Describe cognitive systems using panic disorder as an example
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Cognitive: catastrophic fears of physical calamities or loss of control (page 3)
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What is a targeted cognitive intervention for a client with social anxiety?
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Cognitive-behavior therapists may help the client to recognize and change anxiety ridden thoughts (page 4)
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What is a targeted emotional intervention for a client with social anxiety?
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Relaxation and guided imagery (page 4)
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What is a targeted behavioral intervention for a client with social anxiety?
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Step-by-step breakdown of patterns and social skills training (page 4)
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Discuss one type of medication that might decrease the effectiveness of CBT
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benzodiazepine (page 6)
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What pneumonic describes the Limbic system?
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HATHippo (Khan academy)
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What does HATHippo mean?
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Hypothalamus, Amygdala, Thalamus, & Hippocampus (Khan)
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Which portion of the Limbic system is called the, "Aggression center?"
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Amygdala (Khan)
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What type of emotions does the Amygdala produce?
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Anger/Violence & Fear/Anxiety (Khan)
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What does the Thalamus do?
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Works as a sensory relay station with the exception of smell (Khan)
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What is a Kluver-Bucy syndrome?
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Occurs when there is bilateral distruction of the amygdala, causing hyperorality, hypersexuality, & disinhibited behavior (Khan)
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What does the Hippocampus do?
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Helps with conversion of short to long term memory (Khan)
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Why is the Hippocampus important to emotional life?
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Memories play an important role in emotions (Khan)
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What piece of the limbic system is smaller than a kidney bean?
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Hypothalamus (Khan)
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What does the Hypothalamus do?
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Regulates the Autonomic Nervous System (Khan)
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The brain is an organ...True or False?
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True! (Wiki)
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Using panic disorder as an example describe behavioral symptoms
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Avoidance or escape (page 3)
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According to Beck, what is the highest level of cognitive processing?
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Consciousness (page 7)
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A state of awareness in which decisions can be made on a rational basis
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Consciousness (page 7)
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Name two levels of autonomous information processing
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Automatic thoughts and Schemas (page 7)
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Cognitions that stream rapidly through our minds when we are in the midst of situations or recalling events
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Automatic thoughts (page 7)
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Core beliefs that act as templates or underlying rules for information processing
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Schemas (page 7)
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What does CBT teach clients to do?
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Think about their thinking (page 7)
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Unlike psychodynamic therapy, CBT does not attempt to teach clients to block thought but to ____ and ____ them.
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Modify, Control (page 7)
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What types of thoughts come in rapid fire as we evaluate the significance of events in our lives?
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Automatic thoughts (page 7)
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What types of thoughts are sometimes called preconscious?
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Automatic thoughts (page &)
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What is an important clue that automatic thoughts may be occuring?
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Strong emotions (page 8)
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Clients with these disorders tend to have a high frequency of distorted automatic thoughts?
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Depression, anxiety, & "other psychiatric disorders" (page 8)
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name three automatic thought themes in depression
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Hopelessness, low self-esteem, and failure (page 8)
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name four automatic thought themes in anxiety disorders
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predictions of danger, harm, uncontrollability, or inability to manage threats (page 8
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Cognitive errors occur more often in depressed persons. True or False?
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True (page 10)
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Name the 6 main categories of cognitive errors.
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Selective abstraction, arbitrary inference, overgeneralization, magnification and minimization, personalization, absolutistic (page 11)
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This cognitive error is often referred to as ignoring the evidence or the mental filter
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Selective abstraction (page 11)
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In this cognitive error, the person reaches a conclusion without evidence or in the face of opposing evidence.
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Arbitrary inference (page 11)
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When one makes a conclusion about one or more isolated incidents and then is extended illogically to cover broad areas of functioning.
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Overgeneralization (page 11)
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In this cognitive error, the significance of an event, attribute, or sensation is exaggerated or minimized.
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Magnification and minimization (page 11)
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In this cognitive error, the client takes excessive responsibility or blame for negative events
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Personalization (page 11)
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This cognitive error is often called dichotomous or all or nothing thinking
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Absolutistic (page 11)
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This person experiencing cognitive errors should aim, not to identify each and every cognitive error but simply recognize that cognitive errors are happening. True or False?
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True (page 10)
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These underlie the more superficial layer of automatic thoughts.
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Schema (page 10)
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What type of experiences shape schema?
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Parental teaching and modeling, formal and informal education activities, peer experiences, traumas and successes (page 10)
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What are the 3 main groups of schema.
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Simple, intermediary, and core (page 10-12)
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"A good education pays off." Is an example of what type of schema?
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Simple (page 12)
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"I must be perfect to be accepted." Is an example of what type of schema?
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Intermediary belief and assumption
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"I am stupid." Represents what type of schema?
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Core belief about the self (page 12)
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In CBT, we explain throughly the 3 layers of schema to clients. True or False?
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False (page 12)
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There are only unhealthy schemas. True or False
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False (page 12)
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In this hypothesis, maladaptive schemas lie dormant until a stressful life event occurs.
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Stress-diathesis hypothesis (page 12)
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What is the most important predictor of suicide in depressed patients?
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Hopelessness (page 14)
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Depressed individuals negatively attribute meaning to life events in these three domains.
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Internal versus external, global versus specific, fixed versus changeable
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In this theory, our brains are described as similar to computers.
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Information Processing Model (Khan Academy)
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What is iconic memory?
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Memory for what you see (Khan Academy)
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What is echoic memory?
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Memory for what you hear (Khan Academy)
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What is another term for working memory?
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Short term memory (Khan Academy)
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How many working pieces of information can your working memory store?
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7 plus or minus 2, with variations due to age and complexity of information (Khan Academy)
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In the Information Processing Model, where are pictures stored?
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Visuo-spatial sketchpad (Khan Academy)
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In the Information Processing Model, where are verbal information such as words or numbers
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Phonological Loop (Khan Academy)
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In the Information Processing Model, where is working memory coordinated that requires information from both the visuo-spatial sketchpad and the phonological loop?
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Central Executive (Khan Academy)
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What is the connector to long term memory from the central visuo-spatial sketchpad, phonological loop, and central executive?
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Episodic Buffer (Khan Academy)
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Name the two main categories of long-term memory.
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Explicit (Declarative) and Implicit (Non-declarative) (Khan Academy)
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What type of memory would naming the state capitals include?
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Semantic memory (explicit or declarative) (Khan Academy)
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When you remember your last birthday party, what type of Explicit or declarative long-term memory is that?
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Episodic (Khan Academy)
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Knowing how to ride a bicycle involves what type of long-term memory?
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Implicit or more specifically procedural memory (Khan Academy)
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What are the two types of implicit long-term memory?
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Procedural & Priming (Khan Academy)
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What are the two main categories of explicit memory?
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Semantic and Episodic (Khan Academy)
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What type of long-term memory is influences by recent experiences?
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Priming memory (Khan Academy)
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Long term memory capacity is unlimited. True or False?
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True. The brain cannot always process the memory but can continue to store without limit (Khan Academy)
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How do depressed persons respond differently to feedback?
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Underestimate positive feedback and decrease effort when given negative feedback (page 15)
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What is positive self-serving bias?
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Nondepressed individuals may hear more positive feedback than is actually given or may downplay negative feedback (page 15)
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What is a primary goal of CBT?
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To help patients develop an accurate and rational style of information processing (page 15)
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Name two information processing biases that clients with anxiety may have.
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Heightened level of attention to potential threats and view the triggers to their fears as unrealistically dangerous (page 16)
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Name some common characteristics of clients with anxiety disorders.
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Diminished estimate of their ability to manage or cope with fear-laden situations; a sense of uncontrollability, high frequency of negative self-statements, misinterpretations of bodily stimuli, and overestimates of the risk for future calamities (page 16)
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Clients with depression show less activity in this part of the brain.
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Frontal Lobe (Khan Academy)
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Clients with depression more activity in this part of the brain.
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Limbic (Khan Academy)
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Clients with depression may have more of this hormone in their blood streams.
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Cortisol (Khan Academy)
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Where are the Raphe Nuclei?
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Brainstem (Khan Academy)
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What is the role of the Raphe Nuclei?
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Secret serotonin (Khan Academy)
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Where is the Locus Coerulus?
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Brainstem (Khan Academy)
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What is the role of the Locus Coerulus Nuclei?
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Secret norepinephrine (Khan Academy)
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What does the VTA do?
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Supplies dopamine (Khan Academy)
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What is a new theory concerning the cause of depression?
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Possible issues with neuroplasticity (Khan Academy)
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What are the two classifications systems for mental disorders?
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ICD-10 and DSM-V (Khan Academy)
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What governing body oversees the ICD-10?
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WHO (Khan Academy)
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According to the NIH, how many Americans suffer from mental illness? Serious mental illness?
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25%, 6% (Khan Academy)
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Name nine key methods of CBT.
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Problem-oriented focus, Individualized case-conceptualization, collaborative-empirical relationship, socratic questioning, use of structuring, psychoeducation, and rehearsal, eliciting and modifying automatic thoughts, uncovering and changing schemas, behavioral methods to reverse patterns of helplessness, self-defeating behavior and avoidance, building CBT skills to prevent relapse (Page 17)
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How long would a typical CBT course last for uncomplicated anxiety or depression?
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5-20 sessions (page 17)
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What types of disorders may cause treatment to go beyond 20 sessions?
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Bi-polar, psychosis, personality disorders (page 17)
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How long does a typical CBT session last?
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45-50 minutes (page 17)
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CBT therapists do not consider the clients history, including childhood. True or False
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False. Childhood development, trauma, etc are important to understanding the patient and creating a treatment plan (page 17)
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How did Beck define the therapeutic relationship in CBT?
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Collaborative empiricism (page 19)
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What is guided discovery?
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The CBT therapist uses Socratic questioning through inductive questions to reveal dysfunctional thought patterns or behavior (page 20)
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Name five CBT methods utilized to identify and change maladaptive thought patterns and schemas, other than Socratic questioning and thought records.
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identify cognitive errors, examing the evidenc (pro-con analysis, reattribution (modifying attributional style), listing rational alternative, and cognitiver rehearsal (page 21)
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What are most of the behavioral methods in CBT designed to do?
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Break patterns of avoidance and helplessness, gradually face feared situations, build coping skills, and reduce painful emotions or autonomic arousal (page 21)
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What is the key to showing accurate empathy?
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Genuineness (page 29)
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What is IQ?
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Mental quality that allows you to learn from experiences, solve problems, and use your knowledge to adapt to new situations (Khan Academy)
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What is the difference between analytical and emotional intelligence?
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Analytical relates to education and emotional is how you relate to others (Khan Academy)
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What are the seven dimensions to consider in evaluating patients for CBT?
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Chronicity and complexity, optimism about the chances of success in therapy, acceptance of responsibility for change, compatibility with cognitive-behavioral rationale, ability to access automatic thoughts and identify accompanying emotions, capacity to engage in a therapeutic alliance, ability to maintain and work within a problem-oriented focus (page 47)
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The American Academy of Cognitive Therapy recommends that CBT therapists take a ____ and ___ view of cognitive and behavioral factors that may be influencing behavior expression.
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cross-sectional, longitudinal (page 55)
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How do benzodiazepines work?
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Enhance your brain's response to GABA (Khan academy)
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How do opiates work?
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They work at the endorphine receptor sites (Khan academy)
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What does VTA in the brain stand for?
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VentralTagmental Area (Khan Academy)
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Where is dopamine released?
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VTA (Khan Academy)
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What is the message of structuring?
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Stay focused on the key problems and the answers will follow (page 65).
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Identify the 8 structuring methods of CBT.
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Goal setting, agenda setting, performing symptom checks, bridging sessions, providing feedback, pacing sessions, assigning homework, using therapy tools (page 66)
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When is the first goal setting intervention usually performed in CBT?
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At the end of the first session (page 66)
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How often should goals be reviewed and revised?
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Every fourth session at least (page 68)
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How is agenda setting used in CBT?
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Unlike goal setting, agenda setting structures individual sessions (page 68)
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Name 7 tips for goal setting in CBT.
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Educate the client about goal setting techniques, avoid overgeneralized goals (these type of goals may make the client feel worse, when they cannot be reached quickly), Be specific, guide clients to choose goals that address their most significant concerns or problems, choose short term goals that can be attained in the near future, develop some long-term goals that will require more extensive work in CBT, & try to use terms that make goals measurable and will help you gauge progress (page 69)
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When do CBT therapists usually do a sx check-in?
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At the beginning of the session (page 71)
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Give an example of a symptoms check-in.
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"Can you rate your level of depression from 0-10 with 10 being the worst? (page 71)
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What is one useful strategy to help bridge sessions?
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Have the client review their notes, while your review your notes (page 72)
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CBT therapists do not request feedback during a session. True or False?
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False! CBT therapists believe giving and receiving feedback keeps the session structured, builds the therapeutic relationship, gives encouragement, and corrects errors in information processing (page 72)
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Give and example of a CBT therapist eliciting feedback.
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"How do you think the session is going so far? (page 72)
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Name 6 signs that their may be a problem with the pacing of therapy sessions.
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Therapy time is used inefficiently, only one agenda item is covered when two or three other important items are neglected or given cursory attention, you have difficulty making collaborative decisions on the direction of therapy, the session ends without any sense of movement or action that could lead to progress, you give up prematurely on a topic that held promise, & your skills in managing therapy transitions need further development (page 76).
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What is the function of homework in CBT?
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Building skills for managing problems in real-life situations (page 76)
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In which phase of CBT treatment is there more structure?
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The beginning phase (page 77)
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What is one of the primary goals of CBT?
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To have clients eventually become their own therapist (page 78)
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Name the first eight steps in a session during early treatment?
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Greet client, perform a symptom check, set agenda (may be performed prior to symptom check), review homework from previous session, CBT work on agenda items, socialize to the cognitive model, develop new homework assignment, review key points: give and elicit feedback (page 78)
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Name the seven steps in a middle phase of CBT treatment session.
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Greet the client, perform a symptoms check, set agenda, review homework, CBT work on agenda items, develop new homework assignment, review key points: give and elicit feedback (page 79)
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Name the eight steps performed in a late phase CBT treatment session.
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Greet the client, perform a symptoms check, set agenda, review homework, CBT work on agenda items, relapse prevention and termination prep, develop new homework assignment, and review key points: give and elicit feedback (page 79)
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What are the 3 principal reasons honing your teaching skills can help with CBT?
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1. Clients can learn skills for modifying cognitions, controlling moods, or making productive changes in their behavior. 2. Prevents relapse. 3. Clients become their own therapists (page 80)
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Name 5 psychoeducation methods.
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1. Mini-lessons. 2. Writing out an exercise in session. 3. Using a therapy notebook. 4. Recommended reading. 5. Using computer assisted CBT. (page 80)
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Give an example of a mini-lesson.
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Drawing a circle to help the client make the connections between events, thoughts, feelings, and behaviors (page 81)
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Where can the client organize exercises from therapy sessions, homework assignments, handouts, rating scales, notes on key insights, and other written or printed materials.
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Therapy notebook (page 82)
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When is the concept of the therapy notebook typically introduced?
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First or second session (page 83)
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Describe one of the fundamental concepts of CBT as it relates to automatic thoughts.
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There are distinctive patterns of automatic thoughts in psychiatric disorders and efforts to revise these styles of thinking can significantly reduce symptoms. (page 89)
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What are the two phases of approach to automatic thoughts in CBT?
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Identify and modify (page 89)
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Seven methods for identifying automatic thoughts in CBT.
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1. Recognize mood shifts. 2. Psychoeducation. 3. Guided discovery 4. Thought recording. 5. Imagery exercises. 6. Role play exercises. 7. Use of checklists (page 90)
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9 methods for modifying automatic thoughts.
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1. Socratic questioning 2. Use of thought change records 3. Generating rational alternatives 4. Identifying cognitive errors 5. Examining the evidence 6. Decatastrophizing 7. Reattribution 8. Cognitive rehearsal 9. Use of coping cards (page 90)
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What is the most frequently used CBT technique to identiy automatic thoughts during a session?
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Guided discovery (page 91)
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Name 7 strategies for guided discovery.
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1. Pursue lines of questioning that stimulate emotion. 2. Be specific. 3. Focus on recent events instead of the distant past. 4.Stick with one line of questioning and one topic. 5. Dig deeper. (page 93) 6. Use your empathy skills (page 94) 7. Rely on the case formulation for direction (page 94)
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What is one of the most helpful and frequently used CBT techniques?
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Thought recording (page 95)
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When would advanced techniques such as labeling cognitive errors and generating rational alternatives be introduced into therapy?
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After the client has learned to identify automatic thoughts (page 95 )
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What technique can be used to assist a client, who is having difficulty identifying automatic thoughts?
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Imagery (page 96)
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Role playing is utilized less frequently in CBT because of these potential issues.
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Danger to the therapeutic relationship, client does not have good reality testing and cannot return to the therapist/client relationship, or the client will focus less on the specific interchange and more on past hurts of the relationship (page 98)
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What is the most extensively researched automatic thoughts checklist?
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Automatic Thoughts Questionaire (page 99)
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What is the most important technique used to challenge automatic thoughts?
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Socratic questioning (page 100)
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What is the purpose of the Thought Change Record (TCR)?
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Recognize automatic thoughts, utilize other methods such as examining the evidence and generating rational alternatives, and observe positive outcomes as a result of changing thinking (page 100)
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What clues can the therapist gather about the client's willingness to change?
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Rating of automatic thoughts, example if they rate a thought as 100% true, may have increased resistance to change (page 100)
