Cognitive Behavioural Therapy

* What is "Selective Abstraction"?

"Blowing it out of proportion". Judging the whole on the basis of a small negative. Focusing on a detail taken out of context, ignoring other more salient features, and conceptualizing whole experience based on this element.

* What are the 5 areas of assessment?

-A life situation, relationship or practical problem -Altered thinking -Altered emotional feeling -Altered physical feelings/ symptoms -Altered behaviour How you think affects the way you feel and therefore what you do.

What is Responsibility Pie/ Cost-Benefit Analysis?

-Chose a belief you want to change -List the advantages of believing this -List the disadvantages of believing this -Have a revised attitude

Why is homework for patients critical to treatment? and what are they designed to help patients with?

-Develop coping skills. -Apply skills learned to multiple situations. -Significantly improved outcomes when completed -Develop objectivity about situations. -Identify underlying assumptions. -Develop and test alternative conceptualization and assumptions.

What is the therapist's role?

-Identify irrational beliefs. -Challenge Automatic thoughts -Introduce the concept of an internal dialogue. -Have the person think of a recent example when something went wrong. -Ask person what they were thinking when that happened

According to the general assumptions of CBT, humans...

-are capable of reason -can consider -can reflect -'construct' our reality -can get things 'screwed up'

* What are the parts that an overwhelming problem could be broken down into?

1) A Situation - a problem, event or difficult situation. From this can follow: 2) Thoughts 3) Emotions 4) Physical feelings 5) Actions / behaviour

What are the techniques of CBT?

1) Identify distortion 2)Examine the evidence for the negative thought 3)The double standard method (Would you say the same thing to a friend in the same situation?) 4) The experimental technique e.g. test the validity of your claim 5) Rate the situation, no extremes (Rate from 0-100 and think of things as partial success rather than failure)

What happens during a CBT session?

30 - 60 minute session, once a week or once every two weeks. x1 course = 5 - 20 sessions. The patient (Pt) and therapist work together to break down the problems into separate parts - 1) Thoughts 2) Physical feelings 3) Actions. The Pt and therapist analyse these areas to work out if they're unrealistic or unhelpful and to determine the effect they have. The therapist will then be able to advise how to change unhelpful thoughts and behaviours. After working out what the Pt can change, the Pt will be asked to practise these changes in their daily life and then discuss their success next time. The eventual aim is to teach the Pt to apply the skills learnt during treatment to their daily life. This helps Pts manage their problems and stop them having a negative impact on their lives. The cost of private therapy sessions varies, usually £40-100 per session.

* What is "Overgeneralisation"?

A single incident or person serves as a basis for judging all instances in the same way.

* What is the ABC model, connecting thoughts to feelings?

A: Activating events (event) B: Beliefs (thoughts) C: Consequences (actions and emotions)

What are the characteristics of thoughts?

Automatic - no effort required! Not arising from reason. Distorted - don't fit all the facts. Unhelpful - keep you anxious / depressed, making difficult to change. Plausible - face value accepted, unchallenged. Involuntary - Not chosen to have them and difficult to 'switch off'. Global - tendency to generalise to other situations / scenarios.

* What is "Dichotomous Thinking"?

Black or white", "All or nothing thinking", Viewing a situation in only two categories instead of on a continuum

* How does CBT work?

CBT is based on the concept that our thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap us in a vicious cycle. CBT aims to help patients deal with overwhelming problems in a more positive way by breaking them down into smaller parts. Patients are shown how to change these negative patterns to improve the way they feel. Unlike some other talking treatments, CBT deals with the current problems rather than focusing on issues from the past. It looks for practical ways to improve patients state of mind on a daily basis.

* What is CBT?

Cognitive Behavioural Therapy (CBT) is a talking therapy that can help patients manage their problems by changing the way they think (cognitive) and what they do (behaviour). It's most commonly used to treat anxiety and depression

* What is a cognitive disorder?

Cognitive distortions are ways that our mind convinces us of something that isn't really true. Reinforces negative thinking or emotions.

What is a DTR?

Daily thought record 1. Situation - Objective description of what is happening 2. Feelings - Feeling word and Intensity 3. Thoughts - "What is going through my mind?"

* What is "Magnification/Minimisation"?

Here the individual has a tendency to exaggerate the importance of negative information or experiences, while trivialising or reducing the significance of positive information or experiences.

What are the underlying assumptions of CBT?

How an individual interprets life events plays a role in determining how they responds to those events (Beck, 1991). Individual is an 'active' agent in process. Patients are seen as being excessively negative in their beliefs. Results of cognitive processes are accessible to consciousness as thoughts and images. Individual has the potential to change them.

* What is "Personalisation"?

Inappropriately relating external events to oneself without an obvious basis for making such connections. Tendency to feel responsible for things that are out of their control.

* When is CBT used to treat long term conditions?

Irritable bowel syndrome (IBS) Chronic fatigue syndrome (CFS) Chronic pain syndrome. Note: Although CBT can't cure the physical symptoms of these conditions, it can help people cope better with their symptoms.

* What is "Arbitrary Inference"?

Jumping to conclusions" not supported by evidence.

* What is "Mind reading"?

Making assumptions about other people's thoughts, feelings and behaviours without checking the evidence.

What are the advantages of CBT?

May be helpful in cases where medication alone hasn't worked. It can be completed in a relatively short period of time compared to other talking therapies. The highly structured nature of CBT means it can be provided in different formats (groups, self-help books and computer programs). It teaches useful and practical strategies that can be used in everyday life.

* What mental health conditions can CBT be used to treat?

Obsessive compulsive disorder (OCD). Panic disorder. Post-traumatic stress disorder (PTSD). Phobias. Bipolar disorder. Psychosis. Anger. Low self-esteem. Eating disorders - E.g. anorexia and bulimia. Sleep problems - E.g. insomnia. Problems related to alcohol misuse.

* What is "Catastrophising?"

Predict the future negatively without considering other, more likely outcomes.

What are the goals of CBT?

Provide patients with clear and credible rationale for understanding their disorder and mechanisms of therapeutic change. Offer highly structured sessions and a viable course of action for addressing their concerns. Be active and problem-focused. Encourage self-monitoring and the assessment of progress. *CBT aims to get you to a point where you can 'do it yourself', and work out your own ways of tackling these problems.*

What are the disadvantages of CBT?

The Pt must commit to the process and co-operate. Attending regular CBT sessions and carrying out any extra work between sessions can take up lots of time. May not be suitable for people with more complex mental health needs or learning difficulties. It involves confronting emotions and anxieties - Pt may experience initial periods of anxiety or feel emotionally uncomfortable. It focuses on the individual's capacity to change themselves which doesn't address any wider problems in systems or families. CBT only addresses current problems and focuses on specific issues, it doesn't address the possible underlying causes of mental health conditions.

* What is "Disqualification or Discounting"?

When a compliment or favourable outcome is transmuted into something negative.

* What is "Labelling or Global Judgements"?

When a negative or judgmental label is applied to a single situation or person.

* What is "Emotional Reasoning"?

When an individual takes a 'feeling' as evidence and proof of the thought