Cognitive Behavioural Therapy.doc

7/27/2019 Cognitive Behavioural Therapy.doc

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Cognitive Behavioural Therapy (pg 62-63, 67)

WHAT CAUSES MENTAL ILLNESS?

One of the key assumptions of the cognitive approach is that

behaviour can be explained by

_____________________________________. This means that the best

way to understand behaviour is to investigate how an individual

thinks about a situation. The cognitive approach argues that

mental illness such as ________________, ___________________ or

___________________ are caused by maladaptive or negative

thoughts and beliefs. It has been found that people who think negatively about the world

are more likely to suffer from depression.

Attribution (pg63)Yost and Weary (1996) compared depressed and non depressed

students with an attribution task. They found that

_____________________________________________________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Similarly, Wall and Hayes (2000) found that

___________________________________

________________________________________________________________________

________________________________________________________________________

Becks Cognitive Triad (pg 65-66)Fill in the boxes below using the information on pg 66. Give an example of these types ofthoughts.

This type of thinking can lead individuals to pay more attention to thenegative aspects of situations, and ignore the positive. The glass isalways half empty. It can be difficult for individuals to be able to breakout of this pattern of negative thinking.


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Becks Negative self-schemas (pg66)Our self schema is all the information, thoughts and feelings that we haveabout ourselves. If someone has a negative self schema, what sort ofbeliefs might they hold about themselves?

Cognitive errors (pg 2 of magazine article)These are examples ofautomatic negativethoughts that seem reasonable to theindividual, but do not reflect reality. They bias our interpretation of the world, thosearound us, and ourselves.

Name Description Example

Catasrophising

Mind reading

Overgeneralising

Labelling

TaskUsing the information above (attribution, the cognitive triad, self schemas and cognitiveerrors) write a description of someone who suffers with anxiety, stress or depression.

AIMSThe aim of CBT is to challenge the negative thoughtsand replace them with constructive positive thinkingthat will lead to healthy behaviour. People are oftenunaware that they are subject to cognitive errors, or

that there are problems with their thinking. Thetherapist will try to make these maladaptive thoughtsconscious, and then by challenging them, the client willsee that there is no basis for these thoughts. In theory,this should cause the problem to disappear.


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There are various types of CBT. We will be looking at two: Beckand Meichenbaum

MAIN FEATURES BECKS CBTRead the magazine article, and answer the following questions.

What problems has CBT been used to treat?

What is Socratic questioning, how is it used, and what is its purpose?

What aspects of CBT use cognitive principles (investigating how people think)?

What aspects of CBT use behaviourist principles

What role do early life experiences have in CBT?

Dysfunctional thought diary: As homework, clients are asked tokeep a diary of thoughts and feelings associated with anynegative events. They have to pay particular attention to anyautomatic negative thoughts. For each negative thought theyhave to rate how much they believe this (from 0%-100%). They thengive a rational response to this thought, and rate their belief in that.Finally, they rerate their belief in the automatic thought.E.g. Automatic negative thought: My boss hates me because I am a bad person(belief: 60%)

Rational response: My boss does not hate me. He is rude to everyone, and has

had a very stressful day. Therefore, its nothing really to do with me. (belief: 80%)Rerated belief: My boss hates me because I am a bad person (belief: 20%)


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Challenging dysfunctional thoughts:The client is taught how tochallenge dysfunctional automatic thoughts outside of therapy by askingthemselves questions such as Where is the evidence for X? and What isthe worst that can happen ifXwas true. By answering these questions, thenegative thought can be replaced by more positive constructive ones.

E.g. Automatic negative thought: I am going to fail psychology, andmy life will be over!Question 1: Where is the evidence that I am going to fail? I have

done quite well in the last few tests the teacher has set. I should beok if I revise.Question 2: What would be the worst thing that could happen if I fail? I wouldhave to retake the exam, which isnt so bad. I would still be able to get a goodgrade.

MAIN FEATURES MEICHENBAUMS SITMeichenbaum (1985) took CBT and adapted it to deal with stress.While he argued that you cannot avoid the causes of stress (school,

job, family etc), you can adapt to cope with stress by changing the

way you think about it. It is cognitive as it involves changing how aperson think and behavioural as the result is to alter behaviour.

Meichenbaum suggested that we can inoculate ourselves againststress in the same way that you can be protected from illnesses.

Therefore, he called it Stress Inoculation Training. There are 3stages.

1. Conceptualisation: learning to view perceived threats as problems to be solved,and to break down large stresses into smaller chunks that can then be dealt with.

2. Skills acquisition and rehearsal: Preparing how you will act including positivethinking, relaxation, social skills and using social support. The client uses coping

self-statements such as Stay calm, I can deal with this, Ill make a plan of whatto do, and This wont be as bad as I think it will.

3. Application: Applying what they have planned to different situations whichincrease in stressfulness.

How could you use these 3 phases to help you inoculate yourself against exam stress?

Conceptualisation

SkillsAcquisition

Application


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TASK In pairs Using the description you wrote on the second page of a person with anissue, role play in pairs. One person is the client; the other person is the therapist. Thetherapist needs to use CBT principles to help first identify and then challenge thenegative thoughts held by the client. Once you have done so, write down a sample of

dialogue that demonstrates how CBT worked.FINDINGS FROM RESEARCH (pg 67)

What did Cahill et al (2003) find?

What did Sandahl et al (1998) find?

David and Avelino (2003) found that CBT has the highest overall success rate of alltherapies. However, Kuyken and Tsivikos (2009) suggested that as much as 15% ofthe effectiveness of CBT may be attributable to the competence of the therapist. Thismeans that it may be the case that when CBT is effective it is due in part to the ability ofthe therapist more than the therapy itself.

EVALUATION OF CBT

Strengths Weaknesses

Has been shown to be effective for awide variety of mental illnesses

It is the predominant method of therapyprovided by the NHS

It uses both cognitive and behavioural

In some cases, other types of therapy(such as psychodynamic therapy) aremore effective

It pays little attention to early childhoodexperiences, and focuses instead on the


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principles It is relatively quick and cheap compared

to other therapies Has many real world applications

here and now It can be dependent upon the skills of

the therapist who delivers the therapy Clients who do not complete a full course

of CBT will often benefit little

Going further...Are negative automatic thoughts affecting your life? Try this quiz online:www.testandcalc.com/Self_Defeating_Beliefs/indexf2.asp

Research into CBT being used for a social phobiahttp://bps-research-digest.blogspot.com/2005/02/social-phobia.html

One person who was treated with SIT is Liverpool footballer Ryan Babel. What sort of stress would footballersbe under, and how would SIT help them on the pitch?

Pick a character from a film or TV show who exhibits maladaptive behaviour. If they were your client, howwould you use CBT to help them overcome their issues?
http://bps-research-digest.blogspot.com/2005/02/social-phobia.htmlhttp://bps-research-digest.blogspot.com/2005/02/social-phobia.html

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Cognitive Behavioural Therapy.doc