CBT

• Dysfunctional thought diary:

  Client records events leading up to unpleasant emotions experienced. Records, 'automatic thoughts' associated with event & rate belief. Write rational response to automatic thought & rate belief. Re-rate belief in automatic thought.
• Cognitive restructuring:

  Challenges automatic thoughts- ask yourself 2 questions. 'Where is evidence for X & what's worst that could happen if X was true?
• What is the cognitive triad? (Beck)

  Depressed people have negative cognitive triad. Unrealistic thoughts about self, world and future. Informs techniques used in CBT to help clients change pessimistic views.
• Pleasant activity scheduling:

  Plan for each day 1 pleasant activity to engage in. Induces more positive emotions (behavioural activation technique). Clients keep record of experience & feelings. Focusing on new things will detract from negative thinking patterns. Client keeps record of experience & notes how they felt. If something goes wrong, client explores why & what might be done to change it. By taking action that moves toward positive solution & goal, the client moves further away from negative thinking & maladaptive behaviour.
• Ethics of CBT?

  Gives consent & ownership (e.g, diary). Tasks uncomfortable, assumes client is responsible for disorder, may damage self-esteem (psychological harm, as who judges an irrational thought?).
• CBT effectiveness:

  Empowers people (positive change in their lives), just as effective as drugs. Not dealing with past experiences limits effectiveness, may feel unable to complete homework tasks (distractions, stigma from home ,time & commitment), challenging for those who don't open up about thoughts.
• Overview of CBT:

  Combines cognitive & behaviourist techniques. Identify negative thoughts contributing to problems. Client encouraged to engage in reality testing during session (roleplay) or as homework.
• Alloy & Abrahamson (1979)


  Depressive realists see things way they are & normal people distort things in positive way. Display sadder but wiser effect. More accurate in their estimates of the likelihood of disaster than those non-depressed.
• Simons et al (1995)


  CBT less suitable for those with high levels of irrational beliefs that are rigid & resistant to change. Less suitable in situations where high levels of stress in individual reflect stressors in person's life that therapy can't resolve.
• Kuyken & Tsivrikos (2009)

  As much as 15% of the variance in outcomes of CBT effectiveness may be attributable to therapist competence.
• Jarrett et al (1999)


  CBT was as effective as some antidepressant drugs when treating 108 patients with severe depression over 10-week trial. Hollon et al (1992) found no difference in CBT when compared with slightly different kind of antidepressant drug in sample of 107 patients over 10-week trial. CBT not superior to all antidepressants.
• Griffiths (1994) :


  Suggests verbalisations he asked gamblers to make while gambling could be played back to them-may help highlight irrational nature. Tried this on small scale & the regular gamblers were surprised by what they heard, suggesting they may find it useful in overcoming their problems.