Studieboek - Basic theory, developments and current status of CBT

30 important questions on Studieboek - Basic theory, developments and current status of CBT

What were the new aspects of behavioral therapy as a reaction against the Freudian psychodynamic paradigm? (2)

1. Avoided speculations about unconscious processes, hidden motivations, and unobservable structures of the mind
2. Used learning theory to modify unwanted behavior and emotional reactions

What was behavior therapy initially aimed at?

Treating anxiety disorders through systematic desensitisation

What is the idea of the cognitive principle?

People's emotional reactions and behavior are strongly influenced by cognitions. It explains why different people may react differently to the same event. Different cognitions give rise to different emotions
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What does the continuum principle posit? (2)

1. Psychological problems can happen to anyone
2. CBT theory applies to both the therapist and the client

What does the here-and-now principle entail?

Focus on (maintaining) processes in the present rather than the processes that led to the development. However, CBT does not dismiss the past

What are the systems that are assumed to interact in a way that cause problems to occur? (4)

1. Cognition
2. Affect (or emotion)
3. Behavior
4. Physiology

These interact in complex feedback processes and in interaction with the environment

What does the empirical principle stress?

The importance of evaluating theories and treatments as rigorously as possible.

What does the interpersonal principle emphasize in CBT?

That therapy takes place in the context of a dynamic relationship (the working alliance), which is not administered, but fostered

What are automatic thoughts (ATs)

This is a stream of thoughts that almost everyone can notice if they try to pay attention to them. These can be positive, negative or neutral.

What are negative automatic thoughts? (NATs)

These are negatively tinged appraisals or interpretations: meanings we take from what happens around us or within us. These are fundamental to CBT.

How are the levels of cognition thought to be connected within CBT? (3)

1. Core beliefs
2. Underlying assumptions
3. Automatic thoughts

What are the common characteristics of (N)ATs? (8)

1. They exert a direct influence over mood from moment to moment
2. They happen automatically
3. They are specific thoughts about specific events or situations (cán become stereotyped)
4. They can easily become conscious
5. They can be so brief, frequent, and habitual that they are not heard
6. They are often plausible and taken as obviously true (crucial to help stop clients accept their ATs this way)   
7. They can also take the form of images
8. They are often tackled early on in therapy due to their immediate effect on emotional states and their accessibility

What are the characteristics of core beliefs? (4)

1. Mostly not immediately accessible to consciousness
2. Manifest as general and absolute statements, and do not typically vary across situations
3. Usually learned early in life, but can develop or change later in life
4. Generally not tackles in short-term therapy, but may be important in therapy for chronic problems like personality disorders

What are underlying assumptions (UAs) or dysfunctional assumptions (DAs)? (5)

1. They bridge the gap between core beliefs and ATs
2. They develop as a response to the core beliefs, and are often referred to as dysfunctional
3. They can be thought of as rules for living (more specific than core beliefs, but more general than ATs)
4. They often take the form of conditional (if ... then statements)
5. If an UA is violated, NATs and strong emotions are likely to be triggered

What are the characteristics of UAs? (5)

1. Not as obvious as ATs, and may not be easily verbalized
2. Usually conditional statements
3. Some may be culturally reinforced
4. They become dysfunctional when they are too rigid and over-generalised - not flexible enough to cope with inevitable complications and setbacks of life
5. Usually tackles later on in therapy, after the client already has some ability to work on ATs

What are characteristic cognitions in depression? (2)

1. General biases in the way they think
2. Cognitive triad: negatively biased views about oneself, the world in general, and of the future

What are characteristic cognitions in anxiety disorders?

There is a bias towards the overestimation of threats and/or the underestimation of ability to cope with them

What are characteristic cognitions in anger disorders? (2)

1. Thoughts are usually about others' behavior being unfair, breaking some implicit or explicit rule, or having hostile intent
2. Conclusions are drawn rapidly and extremely

How are core beliefs developed?

Through experience (mostly in childhood). These are not necessarily pathological

What can be the effect of encountering an event that violates a core belief or assumption?

If these cannot be handled by our more helpful beliefs, this can lead to unhelpful assumptions becoming more active, which would evoke negative thoughts resulting in unpleasant emotional states.

What can the final result of the process that can be set into motion by a violation of a core belief or assumption?

That subsequent interactions between negative thoughts, emotions, behavior, and physiological changes may result in persisting dysfunctional patterns

What notions of Layard caused the explosive growth of the IAPT program? (2)

1. Mental health problems are a major source of unhappiness and loss of economic activity
2. CBT could make a difference to many of the most common mental health problems

Which two types of CBT were involved in the initial wave caused by the IAPT program due to a shortage of CBT therapists? (2)

1. High-intensity therapy: traditional form
2. Low-intensity therapy: guided self-help, brief interventions, and exercises

What is the use of the CBT competencies framework?

This is linked to the IAPT program with the goal of identifying what skills a therapist needs to provide good-quality CBT for anxiety and depression

What are the domains in the CBT competencies framework? (5)

1. Generic competencies in psychological therapy
2. Basic CBT competencies (basic structure)
3. Specific CBT techniques (core strategies: thought records identifying thoughts and beliefs)
4. Problem-specific competencies
5. Meta-competencies (make judgments about when to use a specific strategy)

For which disorders is CBT recommended by the NICE-guidelines?

1. Depression (subthreshold, moderate to severe, and at rist of relapse)
2. GAD
3. Panic disorder
4. PTSD
5. OCD
6. BDD
7. EDs
8. Psychosis
9. Schizophrenia
10. Chronic fatigue syndrome
11. Alcohol abuse
12. Antenatal and post-natal mental health problems

What evidence is there for specific processes in depression? (3)

1. Increase in negative thinking about the cognitive triad
2. Reduction in positive thinking about the self
3. Specific increase in thoughts and beliefs about loss and failure

What does (some) experimental evidence show on the causal role of negative thoughts?

That negative self-referent thinking can induce subjective behavioral, motivational, and physiological features reminiscent of mild to moderate depression

What experimental evidence is there for cognitive processing biases? (3)

1. A bias towards processing negative information relevant to themselves
2. Enhanced recall of negative events, and increased negative beliefs
3. These changes in processing occur at an automatic, pre-conscious level

What are some important side notes regarding the evidence of CBT theory? (3)

1. The efficacy does not prove the truth of the theory on which it is based
2. There is till room for exploring and developing the approach further in some areas
3. CBT is undoubtedly an effective treatment for many problems

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