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Summary Cognitive Behavior Interventions - Clinical Psychology Master

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  • Cognitive Behavior Interventions (6464CLCBIY)
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  • Universiteit Leiden (UL)

Week 1: EXPOSURE AND BEHAVIORAL ACTIVATION Chapter 1 (Wright et al): Basic Principles of CBT Chapter 1 (O’Donohue & Fisher): Core Principles of CBT Chapter 4 (O’Donohue & Fisher): Exposure Therapy Chapter 2 (O’Donohue & Fisher): Understanding the contingencies of reinforcement Chapter 9...

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  • January 18, 2024
  • 46
  • 2023/2024
  • Summary

Subjects

  • cbi
  • leiden university
  • behavior activation
  • exposure
  • cognitive interventions
  • self regulation
  • self co
  • cognitive behavior interventions
  • clinical psychology master
  • combined cognitive behavioural strategies

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  • Universiteit Leiden (UL)
  • Psychologie
  • Cognitive Behavior Interventions (6464CLCBIY)
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‭COGNITIVE BEHAVIOR INTERVIEWS 2023-24‬

‭Week 1: EXPOSURE AND BEHAVIORAL ACTIVATION‬
‭●‬ ‭Chapter 1 (Wright et al): Basic Principles of CBT‬
‭●‬ ‭Chapter 1 (O’Donohue & Fisher): Core Principles of CBT‬
‭●‬ ‭Chapter 4 (O’Donohue & Fisher): Exposure Therapy‬
‭●‬ ‭Chapter 2 (O’Donohue & Fisher): Understanding the contingencies of reinforcement‬
‭●‬ ‭Chapter 9 (O’Donohue & Fisher): Behavioral Activation‬

‭Week 2: COMBINED COGNITIVE-BEHAVIOURAL STRATEGIES‬
‭●‬ ‭The Cognitive Behavioral Model of Medically unexplained symptoms: A theoretical and empirical review (Deary, V.,‬
‭Chalder, T., & Sharpe, M. (2007))‬

‭Week 3: COGNITIVE INTERVENTIONS‬
‭●‬ ‭Chapter 6 (O’Donohue & Fisher): Cognitive Restructuring‬
‭●‬ ‭Chapter 13 (O’Donohue & Fisher): Principles of Positive Psychology‬
‭●‬ ‭Chapter 14 (O’Donohue & Fisher): Acceptance and cognitive-behavior therapy‬

‭Week 4: SELF-REGULATION AND SELF-CONTROL‬
‭●‬ ‭Chapter 8 (O’Donohue & Fisher): Self-Regulation‬
‭●‬ ‭Chapter 26 (G. Martin & J. Pear): Helping an individual to develop self-control‬

,‭ hapter 1: Basic Principles of CBT (Wright et al)‬
C
‭CBT IS BASED ON TWO CENTRAL BELIEFS‬
‭●‬ ‭Our‬‭cognitions‬‭have a controlling influence on our emotions and behavior‬
‭○‬ ‭Aaron T. Beck (1960):‬‭First person to develop theories/methods for using cognitive & behavioral interventions‬
‭■‬ ‭Based on his ideas on the psychoanalytic concepts + several post-Freudian analysts (focused on distorted‬
‭self-images)‬
‭○‬ ‭Beck’s negative cognitive triad:‬‭Cognitive conceptualization of depression‬
‭■‬ ‭Symptoms related to a negative thinking style:‬‭self, world, and the future‬
‭■‬ ‭Later, it applied to other disorders‬
‭●‬ ‭How we‬‭act or behave‬‭can strongly affect our thought patterns and emotions‬
‭○‬ ‭Behavioral components:‬‭Pavlov, Skinner‬‭, and other experimental behaviorists‬
‭○‬ ‭Focus: Shaping measurable behavior with reinforcers and extinguishing fearful responses with exposure protocols‬
‭○‬ ‭Meichenbaum & Lewinsohn‬‭: incorporated cognitive theories/ strategies into their treatment programs‬
‭○‬ ‭Barlow & Clark‬‭: combined cognitive techniques (to modify fearful cognitions) + behavioral methods (breathing‬
‭training, exposure therapy) = efficient‬

‭COGNITIVE BEHAVIORAL MODEL‬
‭●‬ ‭Cognitive processing => central role in this model‬
‭●‬ ‭Interacting parts =>‬ ‭Cognitions, Emotions, Behaviors‬
‭●‬ ‭Strongly recommended: gather full information regarding cognitive-behavioral, biological, social, and interpersonal‬

‭LEVELS OF COGNITIVE PROCESSING - BECK ET AL‬
‭●‬ ‭CONSCIOUSNESS‬
‭○‬ ‭Highest level of cognition‬
‭○‬ ‭State of awareness in which decisions can be made on a rational basis (e.g.: problem-solving)‬
‭○‬ ‭Allows us:‬
‭■‬ ‭Monitor and assess interactions with the environment‬
‭■‬ ‭Link memories with present experiences‬
‭■‬ ‭Control and plan future actions‬
‭●‬ ‭AUTOMATIC THOUGHTS (PRECONSCIOUS)‬
‭○‬ ‭Cognitions that stream rapidly => might be occurring in the presence of strong emotions‬
‭○‬ ‭Depression or anxiety disorders => increase distorted automatic thinking‬
‭○‬ ‭Beck‬‭stated that people with emotional disorders =>‬‭Cognitive errors‬
‭■‬ ‭E.g.: All or nothing thinking / Personalization‬
‭●‬ ‭SCHEMAS‬
‭○‬ ‭Core beliefs that act as basic templates or underlying rules for information processing‬
‭○‬ ‭Function in allowing humans to‬‭screen, filter, and assign meaning to information‬‭from the environment‬
‭○‬ ‭Shaped in early childhood‬‭: parental teaching and modeling, trauma or education‬
‭○‬ ‭Need schemas to manage large amounts of information and make decisions‬
‭○‬ ‭Main groups:‬
‭■‬ ‭Simple schemas‬‭: rules about the physical nature of the environment, management of activities (little to no‬
‭effect on psychopathology)‬
‭■‬ ‭Intermediary beliefs and assumptions‬‭: if-then statements that influence self-esteem and emotional‬
‭regulation‬
‭■‬ ‭Core beliefs about the self‬‭: global and absolute rules for interpreting environmental information related to‬
‭self-esteem‬
‭○‬ ‭Stress-diathesis hypothesis:‬
‭■‬ ‭In psychiatric conditions maladaptive schemas may remain dominant until a stressful life event occurs that‬
‭activates the core beliefs => the‬‭maladaptive schema‬‭is then strengthened to the point that it stimulates and‬
‭drives the most superficial stream of‬‭negative automatic thoughts‬

,‭CBT vs PSYCHODYNAMIC ORIENTED THERAPY‬
‭●‬ ‭Does not believe that specific structures/defenses block thoughts from awareness‬
‭●‬ ‭Emphasizes techniques designed to help patients‬‭detect and modify their inner thoughts‬
‭●‬ ‭Teaches patients to‬‭think about their thinking‬

‭THERAPY METHODS‬
‭●‬ ‭Therapist develops an‬‭individualized conceptualization‬‭that ties CB theories with the patient’s unique psychological makeup‬
‭and their presenting problem‬
‭●‬ ‭Problem-oriented focus‬
‭●‬ ‭Collaborative empirical therapeutic relationship‬
‭●‬ ‭Socratic questioning‬
‭●‬ ‭Use of structuring, psychoeducation, and rehearsal to enhance learning‬
‭●‬ ‭Eliciting and modifying automatic thoughts etc‬

‭THERAPY‬
‭●‬ ‭Short-term format (5-20 sessions, 45 minutes)‬
‭●‬ ‭Case conceptualization‬‭: bring together information from the diagnostic assessment, observations on the unique background of‬
‭the patient, and CBT in the detailed treatment plan‬
‭●‬ ‭Therapeutic relationship‬‭: understanding, kindness and empathy, collaborative, action-oriented intervention‬
‭●‬ ‭Socratic questioning:‬‭stimulate curiosity and inquisitiveness‬
‭●‬ ‭Cognitive restructuring:‬‭help patients recognize and change maladaptive automatic thoughts and schemas‬
‭●‬ ‭Behavioral methods‬
‭○‬ ‭Break patterns of avoidance or helplessness‬
‭○‬ ‭Gradually face feared situations‬
‭○‬ ‭Build coping skills‬
‭○‬ ‭Reduce painful emotions or autonomic arousal‬



‭Chapter 1: Core Principles of CBT (O’Donohue & Fisher)‬

‭COGNITIVE BEHAVIORAL THERAPY:‬‭Viewed as the only paradigm in psychotherapy‬

‭ADVANTAGES‬ ‭DISADVANTAGES‬

‭‬
● ‭ any disorders can be treated‬
M F‭ idelity problem: having the therapy be executed with other‬
‭●‬ ‭Often quicker‬ ‭therapists, in other settings with other clients‬
‭●‬ ‭Cheaper‬
‭●‬ ‭Scaled, constructs are easier to define, measure and‬ ‭Solution: Core principles‬
‭teach other therapists‬ ‭●‬ ‭Functional analysis and contingency management‬
‭●‬ ‭Skills training‬
‭●‬ ‭Exposure‬
‭●‬ ‭Relaxation‬
‭●‬ ‭Cognitive restructuring‬
‭●‬ ‭Problem-solving‬
‭●‬ ‭Self-regulation‬
‭●‬ ‭Behavioral activation‬
‭●‬ ‭Social skills‬
‭●‬ ‭Emotional regulation‬
‭●‬ ‭Communication‬
‭●‬ ‭Positive psychology‬
‭●‬ ‭Acceptance‬

, ‭Lecture 1: Exposure and Behavioral Activation‬
‭ hapter 4 (Fisher): Exposure Therapy‬
C
‭Chapter 9 (Fisher): Behavioral Activation‬


‭WAVES OF BEHAVIOR THERAPY‬
‭●‬ ‭FIRST WAVE: BEHAVIORISM‬
‭○‬ ‭School of Behaviorism (1930-40s):‬‭Reaction to psychoanalysis‬‭(dominant paradigm in psychology for a long time)‬
‭■‬ ‭Key concept =>‬‭unconscious‬
‭●‬ ‭The concept that is not observable and not knowable‬
‭●‬ ‭People become frustrated =>‬‭Focus on the observable, measurable behaviors‬
‭●‬ ‭Can only help people by focusing on observable behavior‬
‭○‬ ‭People learn through interaction with the environment‬
‭○‬ ‭Focus on observable behaviors, ignore internal states‬‭(response to psycho-analysis)‬
‭○‬ ‭Based on‬‭conditioning paradigms‬‭(classical and operant)‬
‭■‬ ‭Pavlo‬‭: Classical conditioning‬
‭■‬ ‭Skinner‬‭: Operant conditioning‬
‭■‬ ‭Therapies that stem from them: only focus on modifying behavior by directly targeting the environment‬
‭(rewards or punishments)‬
‭○‬ ‭Led to‬‭dissatisfaction‬
‭■‬ ‭Important to‬‭include cognitive processes‬‭=> how people process information‬
‭●‬ ‭SECOND WAVE: COGNITIVE BEHAVIORAL THERAPY‬
‭○‬ ‭Cognitive revolution‬‭: more researchers theorized that they needed to‬‭bring back mental and cognitive processes‬‭to‬
‭understand how people learn and behave‬
‭○‬ ‭“Mental unobservable processes play a role in learning” =>‬‭Integrate the role of cognitive processes‬
‭○‬ ‭Also acknowledging the role of behavioral processes‬
‭○‬ ‭Influential figures‬
‭■‬ ‭Aaron‬‭T. Beck‬
‭■‬ ‭Albert‬‭Ellis‬
‭○‬ ‭It was‬‭not a rejection from the first wave‬
‭■‬ ‭Still acknowledged that these behavioral processes (classical and operant) are very fundamental to‬
‭understanding people‬
‭■‬ ‭They build upon the first wave => Combination of those‬



‭COGNITIVE BEHAVIORAL THERAPY‬
‭●‬ ‭Family of‬‭psychological interventions‬‭that are based on‬‭cognitive and/or behavioral principles‬
‭●‬ ‭Goal‬‭:‬‭identify and increase adaptive schemas‬‭while‬‭modifying and reducing‬‭the influence of‬‭maladaptive schemas‬
‭●‬ ‭Psychological problems are based on:‬
‭○‬ ‭Faulty or unhelpful ways of thinking‬
‭○‬ ‭Learned patterns of unhelpful behaviors‬
‭●‬ ‭Aims to‬‭reduce emotional problems‬‭by‬‭focusing on thinking and behavior‬
‭○‬ ‭By engaging in new behavior => one might also start thinking differently‬

‭EXPOSURE THERAPY‬
‭●‬ ‭Purposefully generates anxiety by‬‭exposing‬‭(instead of avoiding) an individual‬‭repeatedly to fear‬‭(CR)‬‭provoking stimuli‬‭(CS)‬
‭○‬ ‭In the absence of presented aversive outcomes (UCS) (safe environment)‬
‭○‬ ‭Leads to‬‭extinction to fea‬‭r (CR), and people‬‭no longer feel the need for avoidance‬
‭○‬ ‭Reduce pathological fear and related emotions‬
‭●‬ ‭Types‬‭: In vivo (real life); In vitro (imaginal); Interoceptive exposure‬
‭○‬ ‭Gradual exposure =>‬‭Systematic desensitization‬‭(brief‬‭arousing)‬
‭○‬ ‭Flooding techniques: more highly feared stimuli‬

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