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Cognitive-Behavioral Interventions
Study material exam:
• Chapter 1 of the Wright, Basco, & Thase (2006/2017) book;
• Chapter 1, 2, 4, 6, 8, 9, 13 & 14 of the O’Donohue & Fisher (2012) book;
• The weblectures posted on Brightspace + the pdfs of the lectures posted on Brightspace;
• Additional literature posted with the lectures on Brightspace.
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Chapter 1 - CBT general (O’Donohue & Fisher) ............................................................................................... 3
Chapter 2 – Clinical Functional Analysis/ Understanding the contingencies of reinforcement (O’Donohue &
Fisher) ............................................................................................................................................................ 3
Working group notes on CBT (FA and MA) ...................................................................................................... 5
Lecture 1: Exposure and cognitive restructuring (chapter 4+6) ....................................................................... 7
Exposure therapy (Chapter 4) .............................................................................................................................. 7
Cognitive Restructuring (Chapter 6 + Chapter 1 wright et al.,) ........................................................................... 9
Lecture 2: Cognitive behavioral interventions in medically unexplained symptoms and syndromes ............. 12
Lecture 2 ............................................................................................................................................................ 12
The CBT model of MUPS (Article Deary et al., 2007) ......................................................................................... 15
Lecture 3: Experiential and behavioral interventions in depression (chapter 9, 13, 14) ................................. 16
Lecture VS Chapter 9 (Behavioral activation - BA) ............................................................................................ 16
Lecture VS chapter 13 (principle of positive psychology) .................................................................................. 18
Lecture ............................................................................................................................................................... 20
Acceptance and Commitment Therapy VS Chapter 14 (acceptance and cognitive-behavior therapy) ............. 20
Lecture 4: Self-Regulation and Self-Control (Ch 8 + article self-control) ......................................................... 21
Lecture VS chapter 8 (self-regulation) ............................................................................................................... 21
Lecture VS Article (self-control) ......................................................................................................................... 23
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Chapter 1 - CBT general (O’Donohue & Fisher)
Paradigm: In the philosophy of science, paradigm refers to the system of models and theories that,
within a given scientific discipline, forms the framework from which reality is analyzed and described.
The approach has to have a demonstrated problem-solving ability. CBT has shown to be effective for a
wide variety of psychological problems while other therapeutic theories simply have not. à CBT may
be said to be the only or at least the foremost paradigm in psychotherapy.
Pro’s CBT is not a ‘‘one problem therapy’’ like other interventions (e.g., EMDR for PTSD). It is quicker
CBT (few sessions), cheaper, there is a clear treatment manual (many therapists can do it).
The problem attempted to be solved with a treatment manual is fidelity (faithful to the
treatment), which is related to generalizability. How can the therapy be faithfully executed
with other therapists, in other settings, with other clients? With over 600 mental disorders?
à A set of core principles underlies effective CBT. Understanding these principles can provide a better
understanding of the treatment in a broader range of individual disorders. Example: when a patient
has certain individual needs: an understanding of the core principles underlying the manual can help
the clinician to accomplish these modifications in a faithful and effective manner.
13 1. Functional analysis and contingency management 2. Skills training 3. Exposure 4.
core Relaxation 5. Cognitive restructuring 6. Problem solving 7. Self-regulation 8. Behavioral
princip activation 9. Social skills 10. Emotional regulation 11. Communication 12. Positive
les psychology 13. Acceptance
Chapter 2 – Clinical Functional Analysis/ Understanding the contingencies of
reinforcement (O’Donohue & Fisher)
Functiona Powerful method of empirically identifying the variables that maintain a problem
l analysis behavior.
(FA) Defined as The identification of important, controllable, causal functional relationships
applicable to a specified set of target behaviors for an individual client.
à FA fosters precise matching of a client’s problem with effective intervention.
à FA is an alternative to the ‘‘diagnose and treat paradigm,’’ in which clinicians respond
to treatment failure by applying a new diagnosis and another generic treatment package.
History Functionalism = explaining the purpose of psychological events and behavior.
o Studying observable behavior instead of invisible internal events + Looking at the
environment surrounding the organism to help understand behavior
Radical Behaviorism = prediction and control of behavior (operant conditioning)
o Behavior does not mean only overt, observable behavior, but can entail broad
psychological events, including private (emotions and thoughts) and publicly observable
psychological events.
Functional analytic treatments are used for complex problems as mood disorders, substance
abuse, eating disorders, and psychotic disorders, many years ago it was only used for
developmentally disabled people.
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Disting FA is dynamic and iterative:
uishing If the prescribed intervention does not result in the expected outcome, then the therapist
Featur and client can loop back to reconceptualize the functional relationships identified.
es of Focus on function of behavior over Enhanced treatment utility:
FA Topography: o Treatment utility = the degree to which
(from o Topography = the form or descriptive assessment is shown to contribute to
other features of a behavior, independent beneficial treatment outcome
forms of the consequences that follow a o A well-done FA leads logically to
of behavior. (e.g., weight loss describes interventions that manipulate the
assess topography but fails to explain why environmental variables identified in the
ment) the behavior is occurring). assessment. A functional approach allows
o FA wants to explain why the behavior you to target the primary problem and
is occurring and focuses on the select the specific empirically supported
function or purpose of the behavior, intervention without having to waste time
instead of topography. and resources by using a complete
treatment package
Idiographic approach: The unit of analysis:
FA recognize the complexity of human o Core foundation of FA is that behavior
behavior and examine it on an individual cannot be understood in isolation
basis. o The unit of analysis = the whole person
interacting in and with his particular
environment
Basic The three term contingency (= coherence): Antecedents, Behavior and Consequences:
Behavi You’re
oural traveling
princip and low on
les fuel, a road
sign
designating a gas station would be an antecedent to the behavior of exiting the highway
because it may increase the probability of exiting behavior. Important to emphasize in FA:
the occurrence of a behavior depends on both antecedents and consequences! making them
both integral components of assessment.
Antecedents = Environmental stimuli or events (verbal or non-verbal) that are consistently
present in the context in which the behavior occurs. An example of antecedent-behavior
occurrence is a telephone ring (antecedent) followed by an individual answering the
telephone (behavior).
Behavior = Is defined as anything an individual does, including private events such as thinking
or feeling.
Consequences= Changes in the environment that occur after the behavior, that alter the
probability of future occurrences of the behavior. The consequent changes to the
environment include a stimulus or event being added to the environment or an existing
stimulus or event being removed from the environment.
Reinforcement, Punishment and extinction:
Reinforcement = is defined as in-crease in the frequency of behavior as a function of the
behavior’s consequences. Reinforcement occurs in one of two ways:
1)Positive reinforcement e.g., asking for a glass of water (behavior), a glass of water
(stimulus introduced into environment) + crying (behavior) gets attention (if the individual in
several situations now asks for water / cries, the behavior is positively reinforced). à
2)Negative reinforcement e.g., child starts crying at the dentist for a painful procedure
dentist does not perform procedure (if crying behavior now increases in similar situations
then it is negatively reinforced) à
Punishment = is defined as a decrease in the frequency of behavior as a function of the
behavior’s consequences. Punishment occurs in one of two ways:
