PSYC 3347 Chapter 13
Cognitive therapy is...
a cognitive restructuring therapy that emphasizes empirically testing the validity of maladaptive beliefs
Thought stopping is...
a simple, straightforward procedure used to treat persistent and intrusive disturbing thoughts by interrupting them and substituting pleasant thoughts instead
Think-aloud approaches to assessing cognitions have clients verbalize their thoughts (typically into a voice recorder) while engaging in...
a simulated task or role-playing situation
Decatastrophizing is...
a specific form or reattribution that is useful when clients anticipate dire consequences
What is rational emotive behavior therapy? (REBT)
a well-known treatment that primarily employs cognitive restructuring to change the irrational thoughts that cause psychological problems
Psychological problems are maintained by irrational beliefs that come from faulty reasoning or logical errors, such as...
absolute thinking, overgeneralizing and catastrophizing
An activity schedule provides a structure that encourages clients to engage in ________ throughout the day, which is also a key component of behavioral activation
active behaviors
Who designed rational emotive behavior therapy? (REBT)
Ellis
What is cognitive processing therapy?
an adaptation of cognitive therapy for clients who have experienced trauma and are suffering from stress disorders
What type of hallucinations predominate in schizophrenia?
auditory hallucinations, which typically involve hearing nonexistent voices that are extremely disturbing
Beck refers to maladaptive (irrational) cognitions as...
automatic thoughts
What is self-talk?
behavior therapists often operationally define cognitions as self-talk, what people say to themselves when they are thinking
What is the mastery and pleasure rating technique?
it provides clients with feedback about a sense of accomplishment and pleasure they actually experience
What is attention narrowing?
it restricts the client's focus and thereby reduces the stimulus overload often experienced in schizophrenia
Much of our thinking involves the explicit use of ____
language
What are psychological problems, specifically?
negative emotions and maladaptive behaviors
________ of the client's problem is central in cognitive therapy and allows the treatment to be modified based on the client's progress
ongoing assessment
_______ involve the thoughts that people are following, plotting against and wanting to harm the client
paranoid delusions
Using a rating scale encourages clients to recognize ____ accomplishments and ___ pleasure
partial, small
Epectatus' statements says that...
people are not disturbed by things, but by the views they take of them
Potentially, rational emotive education could prevent _______ but longitudinal studies have not been carried out to evaluate this possibility
psychological disorders
Cognitive processing therapy was initially used to treat adult victims of...
rape
Thought stopping gives clients _____ that they can generalize to other problems
self-control skills
Cognitive therapists help clients recognize dysfunctional beliefs through...
socratic dialogue (also called guided discovery)
Musturbatory statements are irrational because...
there are only a few behaviors that people must do
What are graded task assignments?
they involve clients engaging in a series of small sequential steps that lead to a therapeutic goal, which essentially is shaping
What is an important potential limitation of think-aloud approaches?
they may miss highly relevant but low-frequency thoughts that are likely to occur only in vivo
(T/F) According to Beck's theory, psychological disorders occur when people perceive the world as threatening
true
(T/F) Active disputing of irrational beliefs is the key element that distinguishes REBT from other cognitive restructuring therapies
true
(T/F) Becoming aware of how one's emotions (both positive and negative) are influenced by one's thoughts is central for rational emotive education and REBT
true
(T/F) Besides changing clients cognitions directly, cognitive therapy changes clients overt behaviors
true
(T/F) Clients frequently use what voices say as "evidence" to support the source of the voices
true
(T/F) Delusions are described as frightening, threatening and bizarre
true
(T/F) Imagery rescripting may be particularly helpful for clients who experience recurrent distressing thoughts related to prior traumatic experiences
true
(T/F) People with little training can practice cognitive processing therapy
true
(T/F) The focus in cognitive-behavioral therapy is on inner, verbal language
true
(T/F) The majority of cognitive processing therapy consists of challenging clients maladaptive thoughts and beliefs concerning the trauma using Socratic questioning and replacing them with more adaptive cognitions
true
(T/F) The words must, have to, should and ought to are all examples of musturbation
true
(T/F) Therapists sometimes introduce thought stopping to clients with a dramatic demonstration of its effect
true. for example, when a client starts talking about a disturbing thought, the therapists interrupts saying "stop!" to startle the client
Cognitive therapy has the client...
view beliefs as tentative hypotheses then the client tests the validity of these hypotheses of gathering evidence that refutes or supports them
Can cognitive therapy be effective in reducing delusions and hallucinations?
yes, along with the conjunction of antipsychotic medication
Delusions are blatantly _____ people steadfastly hold in the face of contradictory evidence
false beliefs
What is absolute thinking?
it is viewing an event in an all-or-none, black-or-white fashion
Rational emotive education is...
- an adaptation of REBT for children and adolescents - although it can be used to treat problems, it is typically used to prevent them
What are the coping strategies that are used in addition to the basic cognitive therapy procedures for delusions and hallucinations?
- awareness training - attention switching - attention narrowing - self-instruction - activity scheduling
What is an activity schedule?
- is a written plan of a client's daily activities and is especially useful for clients who are anxious or depressed
What are the common problem areas for trauma victims?
- safety - trust - control - esteem - intimacy
Self-reports are...
- the only way to gain direct information about another's thoughts - give the therapist a general idea about the type of thoughts the client is having
What are the goals of cognitive therapy?
- to correct client's faulty information processing - to modify client's dysfunctional beliefs that maintain maladaptive behaviors/emotions - to provide clients with the skills and experiences that create adaptive thinking
What are the three particular overt behavioral interventions commonly used in cognitive therapy?
1.) activity schedules 2.) mastery and pleasure ratings 3.) graded task assignments
What are the 6 common cognitive distortions (or logical errors) that are frequently in the thoughts of people experiencing psychological distress?
1.) arbitrary interference 2.) overgeneralization 3.) selective abstraction 4.) personalization 5.) polarized (dichotomous) thinking 6.) magnification or minimization
What are the 4 steps in rational emotive education?
1.) identifying emotions and differentiating them from thoughts 2.) learning how thoughts (rather than situations) influence these emotions 3.) recognizing rational and irrational thoughts 4.) dealing with common difficult situations with these concepts and skills
What are the 2 phases involved with thought-stopping?
1.) interrupting the disturbing thought 2.) focusing on a competing adaptive thought instead
What are the 4 basic methods used to assess client's cognitions?
1.) interview 2.) self-recording 3.) direct self-report inventory 4.) think-aloud procedures
What two themes did Ellis identify as irrational ideas that lead to psychological problems?
1.) personal worthlessness (a specific form of overgeneralization associated with failure) 2.) sense of duty (using the words must, have to, should and ought to in speech and thoughts)
What are the 5 distinct advantages that think-aloud approaches have over direct self-report inventories?
1.) think-aloud approaches have an open-ended response format 2.) it eliminates problems associated with retrospective reporting 3.) it can be customized for each client 4.) audio recorded responses are more emotionally landed compared to written ones 5.) anybody, no matter the age, is capable of responding to think-aloud approaches
What are the 5 different dimensions of the 4 basic methods that are used to asses clients' cognitions?
1.) timing 2.) degree of structure 3.) mode of response 4.) nature of the stimulus 5.) source of evaluation
What are the 3 steps in REBT?
1.) to identify the thoughts based on irrational beliefs 2.) to challenge the irrational beliefs 3.) to replace irrational thoughts with rational thoughts
As much as ___ of the therapy session involves the client challenging their thoughts (the second step)
90%
_____ is an anxiety-related disorder for which cognitive therapy is employed with such diverse traumatic precipitants as war and sexual assault
Posttraumatic stress disorder (PTSD)
Who developed cognitive processing therapy?
Resick
Cognitive therapy for auditory hallucinations involves _____ the interpretations and content of hallucinatory voices
challenging
Reattribution of responsibility is helpful when...
clients believe they have more control over potentially negative outcomes than they actually do
Which are the two specific techniques used in cognitive therapy to change clients dysfunctional thinking?
cognitive interventions and over behavioral interventions
One of the main differences between cognitive therapy and REBT is that...
cognitive therapists ask clients a series of easily answerable questions that lead clients to recognize dysfunctional beliefs and automatic thoughts for themselves rather than directly pointing out such beliefs to clients, as it is done in REBT
Although Beck's cognitive therapy is widely used for anxiety and other disorders, it is often part of a ___________
cognitive-behavioral treatment package
What does Beck call the process of designing homework "experiments" to test the clients hypotheses?
collaborative empiricism
To help identify specific delusional beliefs, the client maintains a ____ of his or her delusions that includes a measure of the clients ______ that the delusion is true, rated on a 0 to 100 scale
daily log, strength of conviction
_____ and _____ are the hallmark of schizophrenia and can be treated with cognitive therapy
delusions and hallucinations
REBT primarily relies on...
direct instruction, persuasion and logical disputation to challenge distorted beliefs
Cognitive interventions, which are based on cognitive restructuring, change clients cognitions ___
directly
Both cognitive therapy and REBT rest on the fundamental assumption that psychological disorders are maintained by _____ cognitions, and they share the goal of _____ these cognitions
distorted, modifying
Cognitive therapy is more ___ based, whereas REBT tends to be more ____ based
empirically, philosophically
Cognitive processing therapy includes _____ and _____ components, is typically structured into ___ sessions and can be administered individually to in groups
exposure and cognitive components, 12
Combined with _____, cognitive therapy is an effective treatment for social phobia and can be as effective as medication
exposure therapies
(T/F) Pleasure refers to a sense of accomplishment (though not perfection as the word connotes) and mastery refers to feelings of enjoyment or satisfaction while performing a task
false, it is the other way around mastery refers to a sense of accomplishment (though not perfection as the word connotes) and pleasure refers to feelings of enjoyment while performing a task
(T/F) Establishing a good therapeutic relationship is not considered a prerequisite for effective treatment
false. in fact, a positive relationship between the therapist-client (or therapist-patient) is a key element in cognitive therapy
(T/F) Thought stopping is almost never part of a treatment package
false. in fact, it is usually a part of a treatment package
(T/F) Irrational beliefs are only made through a biological factor
false. irrational beliefs are influenced by a complex interaction of biological, developmental, and environmental factors
(T/F) Ellis' theory holds that our behaviors towards events are what make us angry, frustrated, annoyed, upset and depressed
false. it is our beliefs (not the event itself) that make us angry
(T/F) Rational emotive behavior therapy is used primarily with children
false. it is primarily used with adults
(T/F) Anxiety disorders are the most frequent problem that cognitive therapy is used to treat
false. it is the second most frequent
(T/F) Treatment of delusions proceeds in a backwards fashion
false. it proceeds in a stepwise fashion
(T/F) Once clients in cognitive therapy learn to challenge the validity of the dysfunctional beliefs, the sessions have been completed
false. the clients are then taught to replace them with adaptive beliefs
(T/F) Thought stopping is only meant to help the client reduce disturbing (irrational) thoughts momentarily
false. the ultimate goal of thought stopping is to help clients replace (and eventually, eliminate) their irrational thoughts for a lifetime
What is the first step during cognitive restructuring therapy?
for the client to become aware of their self-talk especially before, during and after their problem behaviors occur
_______ is a crucial aspect of cognitive restructuring
generating alternative interpretations
How are hallucinations described as in cognitive therapy?
hallucinations are sensory perceptions that have no external stimulus and that people experience as real
Cognitive therapy requires client's active participation, including completing ________ that are considered an integral part of the treatment
homework assignments
________ is used to treat recurrent nightmares by having clients rescript them into a more positive light and then, while awake, reverse the rescripted dream
imagery rehearsal therapy
According to Ellis' rational emotive theory, psychological problems are maintained by the ____ people make of the events in their lives
interpretations
What is attention switching?
it changes the client's focus from a delusion or hallucination and to an alternative stimulus (such as a pleasant scene)
What is imagery rescripting?
it has the client modify the disturbing thought, image, or belief so that it is more tolerable (and maybe even pleasant)
What is awareness training?
it helps the client attend to the onset of a delusion or hallucination and allow the client to engage in active coping strategies
What is activity scheduling?
it increases the clients activity level, which is important because clients are most likely to experience delusions and hallucinations during periods of inactivity
What is catastrophizing?
it involves seeing minor situations as disastrous
What is self-instruction?
it involves specific adaptive self-statements (such as "I don't need to be afraid")
What are automatic thoughts?
it is a term that emphasizes how clients experience their distorted thinking
What is overgeneralization?
it is drawing the conclusion that all instances of a situation will turn out a particular way because one or two did
Does cognitive therapy for schizophrenic delusions involve the same basic procedures used to treat depression and anxiety?
yes. first, cognitive distortions are identified second, evidence for their validity is sought third, adaptive cognitions are substituted for the distorted cognitions (irrational thoughts)