Reading 7 – Cognitive Therapy – Flashcards

CT was developed by this man in the early 1960s, he focused on the treatment of depression, but now its expanded to many disorders he noticed several things with his depressed patients: - automatic thoughts during free associations - self-critical thoughts, negative attributions - in ambiguous situations, patients adopted negative assumptions - identifying distortions: abstractions, overgeneralizations, dichotomous thinking

Beckian CT is founded in the idea that if some part of therapy is not working, it will be abandoned empirically based psychotherapy therapist and client should look at therapy this way Beckian view of psychotherapy to be based only on science, but others in CT point out different ways to understand humans

not a single approach but made up of a lot of other ones like REBT, PST, SIT, RP, etc each approach varies the amount of emphasis it puts on cognitive vs behavioral principles/interventions

- the way people construe/interpret events and situations mediates how they subsequently feel and behave - construing process is ongoing and thats what create personal meaning in life - people develop a unique set of beliefs and assumptions that affect how they will interpret events, to what they will focus their attention, and their behaviors (information-processing model) - this process leads to maladaptive behaviors - cognitive specificity hypothesis

the basis of cognitive theory of psychopathology when we become emotional distressed our normal information-processing abilities tend to become faulty because we introduce a consistently negative bias into our thinking, thereby maintaining our problems aka distorted thinking underlies all psychological disturbances common information-processing distortions include: all-or-nothing thinking, mind-reading, labelling, jumping to conclusions, emotional reasoning helping clients identify and change these cognitive distortions helps return normal information processing, that is more flexible, evidence-based, and relative

common information-processing distortion situations are viewed in either/or terms (no in between) also called dichotomous thinking ex. "either success or failure"

common information-processing distortion believing you can discern the thoughts of others without any accompanying evidence ex. "she think's I'm an idiot"

common information-processing distortion instead of labelling only the behavior, you attach the label to yourself A more severe type of overgeneralization; attributing a person's actions to their character instead of some accidental attribute. Rather than assuming the behavior to be accidental or extrinsic, the person assigns a label to someone or something that implies the character of that person or thing

common information-processing distortion assuming that your feelings are facts ex. "I feel inadequate so I must be inadequate"

common information-processing distortion Reaching preliminary conclusions (usually negative) from little (if any) evidence two types: mind reading and fortune telling

common information-processing distortion making hasty generalizations from insufficient experiences and evidence. Making a very broad conclusion based on a single incident or a single piece of evidence. If something bad happens only once, it is expected to happen over and over again

common information-processing distortion catastrophizing is an irrational thought a lot of us have in believing that something is far worse than it actually is, or that if you do one wrong thing everything will be ruined

common information-processing distortion a detail is taken out of context and believed whilst everything else in the context is ignored aka only focusing on only the negative aspects of an event

cognitive model advanced three levels of thinking: (1) negative automatic thoughts NATs (2) underlying rules (intermediate beliefs) (3) core beliefs during treatment, first the NATs are addressed for symptom relief, then therapist deals with underlying rules and core beliefs

the first of the three levels of thinking thoughts that come rapidly, automatically, and involuntarily, to mind in response by a stressful or upsetting external or internal event - can point to them concretely three general questions can be used to modify them: 1. what is the evidence for/against this thought 2. what are alternative ways to think about the situation 3. what are the implications of thinking this way

the second of the three levels of thinking unarticulated assumptions that guide our everyday behavior, set our standards and values, establish rules for living often identified by "if... then..." construction if these standards are met, individuals remain stable, however these rules serve to maintain/reinforce negative core beliefs rather than change them maladaptive assumptions focus on three major issues: acceptance, competence, and control interventions here are based on discussing the usefulness of following rigidly certain rules and assumptions that do not reflect the complexities of life

the third of the three levels of thinking fundamental beliefs about ourselves, others, and the word that help make sense of our life experiences we have both positive and negative are usually formed through early learning experiences and become instrumental in shaping our outlook in emotional disturbance, absolute/negative beliefs are activated and therefore process information in a biased way that maintains these beliefs can also be recently acquired during trauma once the negative disturbance has passed, negative core beliefs become deactivated and more positive outlook is re-established three broad categories: helplessness, unlovability, and worthlessness once the core belief has been identified, alternative views of the self can be formulated that are balanced, realistic, flexible, and compassionate

thoughts, moods, behaviors, physical reactions, and environment all interact, a disturbance with one can cause issues with the others

each emotional disorder has its own typical cognitive content/theme linked to Beck's concept of the personal domain how a person responds emotionally to events depends on whether he perceives events as adding to, subtracting from, endangering, or impinging upon his domain disorder-specific treatment protocols, each disorder has cognitive behavioral commonalities

anything an individual finds important in his/her life, when issues arise in that domain, can lead to psychological problems

an endogenous, stable characteristic that remains latent until activated by a precipitating event dormant negative beliefs are activated with the precipitating event matches the content of these beliefs

the CT message is that no one is immune from experiencing psychological difficulties, and that a disorder is just a more extreme normal experience - a continuum

CT considers current cognitive functioning crucial to the maintenance and persistence of psychological disturbance what is happening now is judge more important than what happened in the past: - what started a problem is not necessarily what keeps it going - gaining understanding of the present is easier to dredge up the past - present factors can be changed where as the past cannot

behavior plays a crucial role in maintaining emotional disorders as individuals act in ways that support or strengthen their dysfunctional beliefs

distinctive features of cognitive therapy practice that allow clients to develop a cognitive understanding of their problems and the change methods required to tackle them includes: socialization, collaborative empiricism, openness, agenda setting, problem focused and goal-oriented, guided discovery

part of the practice of cognitive therapy explaining to the client what the cognitive model is and how it will be used to tackle their problems their expected role in therapy is outlined to them along with the therapist's role also called socialization

part of the practice of cognitive therapy relationship factors such as therapist warmth, empathy, unconditional positive regard are viewed as necessary but not sufficient - collaborative empiricism

part of the practice of cognitive therapy describes the working style of therapy, the therapist and client join forces to tackle the client's problems by collaborating, clients are actively engaged in problem-solving process empiricism focuses on reality-testing client's thoughts and beliefs, and the evidence collected is evaluated to determine if it confirms or contradicts client's hypotheses

part of the practice of cognitive therapy based on collaboration, so therapy is open and explicit about what is going on not a private therapist model, as that would not be collaborative

part of the practice of cognitive therapy client and therapist agree which topics are to be put on the agenda, keeps therapy on track, makes the client active in the therapy, and makes efficient use of time

part of the practice of cognitive therapy clients are encouraged to list their problems in the first session early problem-solving focus is used so the client does not go on and on about their problems goals are stated in clear and specific terms so progress can be measured rather than assumed

part of the practice of cognitive therapy a process where the therapist acts as a guide to help clients uncover, examine, and reality test their maladaptive thoughts and beliefs facilitated by Socratic method cognitive therapists do not lead clients to the "truth" but instead help them to discovery new perspectives that challenge their maladaptive thoughts and beliefs helping clients think things through for themselves assists and accelerates their progress toward becoming their own therapist

tactic used during guided discovery these types of questions should be phrased in such a way that they stimulate thought and increase awareness, rather than requiring a correct answer

part of the practice of cognitive therapy making sense of a client's problems within the cognitive model of emotional disorders the conceptualization focuses on how the client's problems developed, current examples of when these problems are activated, and how these problems are being maintained the maintaining factors are the main focus of the case conceptualization of the treatment plan that flows from it

part of the practice of cognitive therapy CT focuses on finding specific solutions to current problems delving in to the past is not usually done, only done when: - client asks - work directed at current problems doesn't create change - therapist thinks it's important to understand where maladaptive ideas came from

part of the practice of cognitive therapy during the session, the therapist makes sure that the client is understanding or correct any misunderstandings at the end of the session, the client can give positive or negative feedback

part of the practice of cognitive therapy for uncomplicated anxiety/depression - 4/14 sessions typical CT - 10/15 sessions chronic problem - 9 months

part of the practice of cognitive therapy tasks that are carried out between the sessions based on what was done in the session logical way or reality-testing

part of the practice of cognitive therapy goal of CT is for the client to become their own therapist by using the cognitive model for present and future issues as the client's problem solving abilities increase, the therapist can become less active independence and self-reliance are explicit goals in CT

part of the practice of cognitive therapy instilling hope that change is possible is important, as well as likelihood of relapse setbacks are normal and are learning experiences

- identifying automatic thoughts - psychoeducation about cognitive model - evaluating automatic thoughts: classifying into one of the cognitive distortions, using evaluation questions, evidence alternative explanation, decatastrophizing, impact questions, behavioral experiments - after evaluating automatic thoughts, therapists encourage patient to draw new balanced conclusions, adaptive responses should be factual and be able to acknowledge both positive and negatives - identifying core beliefs (downward arrow technique) - using various techniques to examine the extent to which they are correct or useful, ex. behavioral experiments