CBT

• psychological disorders stem from irrational thinking ,to be cured thinking patterns must change
• Beck


  cognitive triad

  Yourself

  The world around you

  Your future

  People who are depressed will have a negative triad,CBT changed this to positive
• Dysfunctional thought diary


  clients have homework to keep record of any events leading up to unpleasant emotions

  They then record the automatic negative thoughts associated with these events

  rate them on a scale 0-100% on how much they believe in them

  Then write a rational response to the automatic thoughts and rate their belief in the response

  Re-rate their beliefs to automatic thoughts
• Cognitive restructuring


  once the therapist knows more about the client,they work together to change negative thinking patterns.

  Client is taught to challenge dysfunctional automatic thoughts by asking themselves questions such as 'Wheres the evidence that X was talking about me?' or 'What is the worst than can happen if X was?'

  By challenging such thoughts and replacing them with more constructive ones,clients are able to try out new ways of behaving
• Pleasant activity scheduling 


  client plans one pleasant activity for each day(an accomplishment or break from normal routine)

  Engaging in pleasant activities encourages more positive thinking,client is encouraged to keep track of what they did and how they felt while doing the activity

  If it didnt go to plan client must find out why and what can be done to change it
• Evaluation Effectiveness


  Research support

  highly effective compared with drug therapy in terms of treating depression.

  Jarrett et al- CBT is as effective as some antidepressant drugs,108 patients over a 10 week trial

  Hollon et al- no difference in CBT with different antidepressants in 107 patients over a 10 week trial

  Not effective for all antidepressants
• Evaluation Effectiveness


  Therapist competence

  therapist must be able to structure sessions,plan and review homework,apply relaxation skills and ability to have good therapeutic relations.

  Kuyken and Tsivrikos - claim that 15% of the variance in outcomes is attributable to therapist competence
• Evaluation Effectiveness


  Individual differences

  CBT can be more suited to some than others

  It can be less suitable for people who have high levels of irrational beliefs that are resistant to change

  Simons et al - high levels of stress reflect realistic stressors that therapy cant resolve(divorce)
• Evaluation Effectiveness 


  Empowerment

  allowd free will,clients develop their own coping strategies

  A popular alternative to drug therapy as its not deterministic.

  Widely used by clinical psychologists working with the NHS
• Evaluation Ethical issues


  Patient blame

  assumes the client is responsible for their disorder.

  Positive- empowers them to change the way they think

  Negative- situational factors overlooked that link to their disorder(family problems)

  blaming the individual for they way they think/behave is not helpful as it can make them change other factors in their lives to make them feel better
• Evaluation Ethical issues


  What is rational?

  who judges on irrational thoughts?

  A client may change their thoughts just because their therapist decides its irrational

  Alloy and Abrahamson - depressive realists see things as they are but normal people see the rosy picture

  Depressed people are sadder but wiser,they are more accurate in estimating disasters

  CBT damages self-esteem