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Summary Cognitive Behaviour Interventions - Clinical Psychology Master

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More in-depth summary 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...

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  • 7 février 2024
  • 20
  • 2023/2024
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‭WEEK 1. EXPOSURE AND BEHAVIORAL ACTIVATION‬


‭CBT: TWO CENTRAL BELIEFS‬ ‭Our‬‭cognitions‬‭have a controlling influence on our‬‭emotions and behavior‬

‭How we‬‭act or behave‬‭can strongly affect our‬‭emotions‬‭and thought patterns‬

‭THERAPY METHODS‬ ‭Individualized conceptualization, Problem-oriented focus, Collaborative therapeutic relationship, Socratic question, Cognitive restructuring‬

‭AARON T. BECK‬ ‭‬
o F‭ irst person to develop theories/methods for using‬‭cognitive & behavioral interventions‬
‭o‬ ‭Ideas from: psychoanalytic concepts + post-Freudian analysts‬
‭o‬ ‭Negative cognitive triad: cognitive conceptualization of depression (negative thinking style: self, world, and future)‬

‭FIRST WAVE:‬ ‭‬
o ‭ eaction to psychoanalysis‬‭: focus on‬‭observable‬‭and‬‭measurable‬‭behaviors (ignore internal states)‬
R
‭WAVES OF BEHAVIOR‬ ‭BEHAVIORISM‬ ‭o‬ ‭Based on‬‭conditioning paradigms‬‭: classical (Pavlo)‬‭and operant (Skinner) conditioning‬
‭THERAPY‬ ‭o‬ ‭Led to dissatisfaction => important to include cognitive processes‬

‭‬
o ‭ ognitive‬‭revolution‬‭: bring back cognitive processes‬‭to understand how people learn & behave‬
C
‭SECOND WAVE:‬ ‭o‬ ‭Acknowledging the role of behavioral processes‬
‭CBT‬ ‭o‬ ‭Influential figures:‬‭Aaron T. Beck + Albert Ellis‬
‭o‬ ‭Not a rejection from the first wave => combination of both‬

‭COGNITIVE BEHAVIOR‬ ‭‬
o F‭ amily of psychological interventions that are based on‬‭cognitive and behavioral principles‬
‭THERAPY‬ ‭o‬ ‭Identify and increase adaptive schemas‬‭+‬‭modify and‬‭reduce the influence of maladaptive schemas‬
‭o‬ ‭Reduce emotional problems by focusing on thinking and behaviors‬
‭o‬ ‭Psychological problems are based on => unhelpful ways of thinking + learned patterns of unhelpful behaviors‬

‭EXPOSURE THERAPY‬ ‭‬
o (‭ purposefully)‬‭Exposure‬‭patient‬‭repeatedly to fear-provoking‬‭stimuli =>‬‭extinction of fear, no more avoidance‬
‭o‬ ‭Goal: promote emotional processing through the‬‭activation‬‭of the fear structure‬‭and the integration of information‬‭that is inconsistent with the‬
‭pathological elements of the fear structure‬
‭o‬ ‭Types‬‭: in vivo, in vitro (imaginal), interoceptive‬‭exposure, systematic desensitization (gradual), flooding techniques‬

, ‭Passive way of learning - Pavlov =>‬‭ONSET‬‭of pathological‬‭fear‬

‭Neutral stimuli‬‭paired with a‬‭CS‬‭repeatedly trigger‬‭a‬‭UCR‬ ‭=>‬‭NS becomes a CS‬ ‭=>‬‭triggering a CR similar‬‭to the original UCR‬

‭‬
o ‭ S = problematic situation/thought that elicits emotional response‬
C
‭ LASSICAL‬
C ‭o‬ ‭UCS/ UCR = theme/event that enables to explain why the CS leads to the UCR (didn’t learn it)‬
‭CONDITIONING‬
‭o‬ ‭CR = negative emotion (learned it)‬

‭Fear conditioning‬ ‭‬
o ‭ eneralization‬‭: stimuli that are similar to the CS‬‭also elicit fear =>‬‭pathological‬‭=> stopped through‬‭extinction‬
G
‭o‬ ‭Fear extinction‬‭: CS repeatedly presented‬‭without the‬‭UCS‬‭or with‬‭pleasant stimuli‬

‭Examples‬ ‭ CS (bully) => UCR (fear)
U UCS (dog bite) => UCR (frightened)‬
‭CS (people) => UCS (bully) => UCR (fear) CS (sight of dog) => UCS (dog bite) => UCR (frightened)‬
‭CS (people) => CR (fear) CS (sight of dog) => UR (frightened)‬

‭Active way of learning - Skinner =>‬‭MAINTENANCE‬‭of‬‭pathological fear‬

L‭ earning through the consequences of our behaviors => changes in voluntary behavior‬
‭Reinforced behavior => repeated vs punishment behavior => weakened‬
‭OPERANT‬
‭CONDITIONING‬
‭Positive‬‭reinforcement‬ ‭Behavior‬‭strengthened‬‭=>‬‭adding‬‭something‬‭desirable‬

‭Negative‬‭reinforcement‬ ‭Behavior‬‭strengthened‬‭=‬‭removing‬‭something‬‭undesirable‬

‭Positive‬‭punishment‬ ‭Behavior‬‭weakened‬‭=‬‭adding‬‭something‬‭undesirable‬

‭Negative‬‭punishment‬ ‭Behavior‬‭weakened‬‭=‬‭removing‬‭something‬‭desirable‬

L‭ earning‬
‭MOWRER’S TWO‬ ‭o‬ ‭Acquired‬‭from‬‭Classical conditioning‬
‭FACTOR MODEL‬ ‭o‬ ‭Maintained‬‭by‬‭Operant conditioning‬

, ‭Program for escape or avoiding danger (model to understand anxiety)‬

‭ types of‬
3 ‭ .‬ F‭ eared stimuli‬
1
‭information‬ ‭2.‬ ‭Fear responses‬
‭FEAR STRUCTURE‬ ‭3.‬ ‭Meaning of the stimulus and response‬
‭(Lang)‬
‭o‬ ‭ ecomes pathological‬‭: associations among stimulus,‬‭response, and meaning representations‬‭don’t reflect‬‭reality‬
B
‭-‬ ‭The‬‭meaning‬‭you add to a certain stimulus => which‬‭determines how you will react‬
‭‬
o ‭Shows that fear is both cognitive and behavioral‬
‭o‬ ‭Anxiety disorder: harmless stimuli + responses are viewed as erroneously dangerous‬

‭Effective exposure therapy =>‬‭Correct fear structure‬‭(expanded from Lang's fear structure)‬
E‭ MOTIONAL‬
‭PROCESSING‬ ‭Modifying old associations =>‬‭new associations are‬‭created‬‭=> forming competing structures (not include‬‭pathological associations)‬
‭THEORY‬
T‭ HEORIES OF‬ ‭(Kozak & Foa)‬ ‭Demands‬ ‭‬
o F‭ ear structure needs to be activated‬
‭EXTINCTION OF‬ ‭o‬ ‭New information must be introduced in the fear structure‬‭(not compatible with old)‬
‭FEAR‬
‭Correction of fear structure is indicated by‬‭habituation‬‭=>‬‭not predictive of therapy outcomes‬‭(follow up:‬‭not less anxiety or avoidance)‬

‭Effective exposure therapy =>‬‭Form new, competing‬‭non-FS (FS stays intact)‬‭=> focused on strengthening‬‭CS‬

‭INHIBITORY‬ ‭ uided ET (explains why some people after ET might experience fallbacks =>‬‭fear comes back bc the old‬‭fear structure is still intact‬‭)‬
G
‭LEARNING THEORY‬ ‭Fear structure + Non-threat structure‬‭compete for‬‭retrieval‬

‭Demands‬ ‭‬
o ‭ ew information must be introduced to form a new representation‬
N
‭o‬ ‭Enhancing the accessibility + retrievability of non-threat association‬

S‭ trategies to‬ ‭‬
o E‭ xpectancy violation‬‭: design exposure to violate specific‬‭expectations‬
‭enhance IL‬ ‭o‬ ‭Remove safety behaviors‬‭: decrease the use of them‬
‭o‬ ‭Variability‬‭: vary stimuli and contexts‬
‭o‬ ‭Deepened‬‭extinction‬‭: present 2 cures during the same‬‭exposure after conducting extinction with 1 of them‬
‭o‬ ‭Attentional‬‭focus‬‭: maintain attention on the CS target‬‭during exposure‬
‭o‬ ‭Mental reinstatement/ retrieval cues‬‭: use cue present‬‭during extinction to reinstate previous exposure‬

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