Starter The biological approach was all about biological causes of behaviour therefore the biological therapy of chemotherapy has the aim of altering the balance of The psychodynamic approach was all about emotions and the unconscious therefore the psychodynamic therapy of ID: 1042163
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1. 4.2 Therapy: CBTApproach 4: The Cognitive Approach
2. StarterThe biological approach was all about biological causes of behaviour, therefore the biological therapy of chemotherapy has the aim of altering the balance of ____________The psychodynamic approach was all about emotions and the unconscious, therefore the psychodynamic therapy of dream analysis has the aim of altering _____________________________ neurotransmittersemotions and things in the unconscious
3. STARTERThe behaviourist approach was all about behaviour, therefore the behaviourist therapy of systematic desensitisation has the aim of altering _____________________The cognitive approach is all about _________, therefore cognitive therapies have the aim of altering ____________________thinkingmaladaptive thoughtsmaladaptive behaviour
4. How the cognitive approach explains mental illnessOne 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. internal mental processesanxietystressdepression
5. How the cognitive approach explains mental illnessCan lead people to pay more attention to the negative aspects of situations, ignoring the positive.Beck’s Negative Cognitive TriadOn the diagram, write down three things that someone with the negative triad may think1:2: 3:
6. How the cognitive approach explains mental illnessA person with depression will have many automatic negative thoughts. Thoughts that that seem reasonable to the individual, but do not reflect reality. They bias our interpretation of the world, those around us, and ourselves. Automatic negative thoughts are an example of cognitive errors.
7. How the cognitive approach explains mental illnessThese are examples of automatic negative thoughts that seem reasonable to the individual, but do not reflect reality. They bias our interpretation of the world, those around us, and ourselves. CatasrophisingMind readingOver generalisingLabelling
8. How the cognitive approach explains mental illnessOur self schema is all the information, thoughts and feelings that we have about ourselves. If someone has a negative self schema, what sort of beliefs might they hold about themselves?I am useless at everythingNobody likes me
9. How the cognitive approach explains mental illnessUsing the information above (the cognitive triad, self schemas and cognitive errors) write a description of someone who suffers with anxiety, stress or depression. Give them one or two specific problems. E.g. They feel that they are going to fail their driving test because they fail everything.They were dumped by their girlfriend because they believe they are a bad person
10. AIM of Cognitive Behavioural TherapyThe aim of CBT is to challenge negative maladaptive thoughts and replace them with healthy thinking. Often people are unaware that there is anything wrong with their thinking. Change the thinking, change the behaviour
11. Links to the assumptions:CBT is concerned with internal mental processesIt aims to alter how we process informationCognitive restructuring can alter behaviourAssumes that mental illness can be explained partly through schemasAIM of Cognitive Behavioural Therapy
12. Main components of CBTRead the magazine article and answer the questions on the sheetWhat problems have 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?
13. Main components of CBTDysfunctional thought diary:Write down automatic negative thoughtsRate them, write a logical alternative, and then rerateAutomatic 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, it’s nothing really to do with me. (belief: 80%)Rerated belief: My boss hates me because I am a bad person (belief: 20%)
14. Main components of CBTCognitive RestructuringAsk self two questions“Where is the evidence for X?” “What is the worst that can happen if X was true.” Automatic negative thought: I am going to fail psychology, and my life will be over!What would be the response to the two questions?
15. Main components of CBTRead the section on page 72. What is pleasant activity scheduling? Give an exampleWhat is the rationale behind pleasant activity scheduling?
16. Main components of CBTUsing the description you wrote on the second page of a person with an issue, role play in pairs. One person is the client; the other person is the therapist. The therapist needs to use CBT principles to help first identify and then challenge the negative thoughts held by the client.Once you have done so, write down a sample of dialogue that demonstrates how CBT worked.
17. EVALUATION: EFFECTIVENESSCahill et al (2003) By the end of the therapy which lasted 12-20 sessions, 71 percent of patients who had completed their therapy experienced significant reduction in their symptoms. However, only 13% of the patients who did not complete the therapy showed improvement.
18. EVALUATION: EFFECTIVENESSDavid and Avelino (2003) found that CBT has the highest overall success rate of all therapies. However, Kuyken and Tsivikos (2009) up to 15% of the effectiveness of CBT may be attributable to the competence of the therapist.
19. EVALUATION: EFFECTIVENESSSummarise how effective CBT is when compared to drug treatments (pg 73)What advantages might CBT have over treatments such as drugs, psychosurgery and ECT?Side effects?Permanence?
20. EVALUATION: EFFECTIVENESSNeeds to take into account individual differencesNot appropriate for all: high levels of irrational beliefsSimons et al (1995)CBT has limited use where mental illness is caused by a real life stressor
21. EVALUATION: EFFECTIVENESSReal life stressors: losing a job, divorce, illness. Stress or depression is a reasonable response to a stressful life event. This is a weakness of CBTCBT might just treats the symptoms of a mental illness rather than the cause. Someone may receive CBT for stress, but as soon as therapy is over, the cause of the stress (illness, divorce etc) is still present, and so the mental illness may return.
22. EVALUATION: EFFECTIVENESSCBT is sometimes used with schizophrenics, but is of limited use, and nearly always needs to be paired with medication. Why do you think this is?Why could it be argued that CBT allows patients to feel “empowered” and allow people to have “free will”? (pg 73)
23. EVALUATION: EFFECTIVENESSCause and effectDepressed people do experience many negative thoughtsBUT do the negative thoughts lead to the depression, or does the depression lead to the negative thoughts?Lewisohn (1981)No relationship between negative thought and irrational beliefs and future depression
24. EVALUATION: EFFECTIVENESSIf it is the case that negative thinking is caused by depression, and is not the cause of depression, then this undermines the whole therapy of CBT. By changing the negative thinking, you will not actually be treating the root cause of depression, only treating the symptoms.
25. EVALUATION: Ethical issuesImagine that you are depressed. You feel helpless and don’t know what to do, so you decide to undergo CBT. Your therapist says that the reason that you feel the way you do is because of your thinking, and that you can change how you think. What are the positives and negative of being told this? What about if your depression was the result of an uncontrollable stressor?
26. EVALUATION: Ethical issuesCBT might put the blame for the mental illness on the patients themselves. Patient may feel worse than they already do, and reduce their self-esteem. Patients with depression are more likely to have low self-esteem anyway, and are also more likely to already hold a number of self-critical, self-blaming thoughts. CBT might actually make the patient’s issues worse!
27. EVALUATION: Ethical issuesAnother issue with CBT is that it is up to the therapist’s judgement to decide what is and is not a rational thought. For example, look at these “irrational” thoughts below.“I’m going to fail my exams.”“My boss hates me.”“I will never be able to get a job.”“My husband is going to leave me.”“I’m not as good as other people.”“The future is going to be terrible.”“Nobody likes me.”“I will never find love.”“My life is over.”“My parents don’t want me.”With a partner discuss these “irrational” thoughts. Can you think of situations or contexts when these thoughts would not be considered irrational?
28. EVALUATION: Ethical issuesWhat did Abrahmson (1979) suggest about people with depression?
29. Exam Practice Exam corner pg 73Therapies activity on pg 85