Describe the cognotive model in psychological interventions
We interact with the world through interpretations of our environment. It isn’t situation itself but our interpretation of it that causes our emotional response. These thoughts/meanings can change and therefore, so can our emotional reaction
What are the 3 levels of thought?
- Automatic Thoughts: fleeting, involuntary thoughts. E.g. “what a dick”
- Underlying Assumptions: can be healthy or unhealthy. E.g. “talking loudly in library is a dickish thing to do”
- Core Beliefs: often unconditional, rigid beliefs that give rise to our rules/assumptions. E.g. any selfish behaviour makes you a dick
Give examples of common cognitive biases/maladaptive thinking - 7 listed
Arbitrary inference Catastrophising Selective abstraction Magnification and minimisation Personalisation Absolutistic, dichotomous thinking “Fait accompli” thinking (‘what the hell effect’) "I didn't mean to eat that piece of pie. There goes my diet, may as well finish it!”
Drawing conclusions on the basis of insufficient or irrelevant evidence is what type of maladaptive thinking?
Arbitrary Inference
Define selective abstraction
Focusing on a detail taken out of context and ignoring other important features of situation
Describe magnification and minimisation in maladaptive thinking
Errors and distortions in way an event is perceived. Magnify weaknesses and minimise strengths
What is “Fait accompli” thinking?
‘What the hell effect’ - “I didn’t mean to eat that piece of pie. There goes my diet, may as well finish it!”
Aims of cognitive interventions
Identify maladaptive (self defeating) thoughts or beliefs (cognitions), challenge them and change them to become more adaptive (cognitive restructuring). Change the way we relate to our thought. Develop effective coping strategies
What is self monitoring?
Aims to increase awareness of thoughts and subsequent emotions by recording them (this also allows external monitoring by a health professional)
What is a desicion balance sheet?
Thinking about costs/benefits of changing/not changing a behaviour and drawing up a table
What is the goal of motivational interviewing?
Encourage individuals to explore own conflicting beliefs and attitudes towards a particular behaviour. Effective in decreasing smoking, alcohol/drugs misuse, addictions, improving adherence to lifestyle changes. Induces cognitive dissonance
Common cognitive therapies
Rational Emotive Therapy Acceptance and Commitment therapy (ACT) Integrative therapy (IT) Cognitive Analytic Therapy (CAT) Interpersonal psychotherapy (IPT) Systemic/Family therapy
Aim and principle of behavioural interventions
Aim: substitute maladaptive behaviours for adaptive ones and relieve symptoms
Principle: interventions assume that maladaptive behaviour is a learned response and can be substituted for a better one
Operant conditioning is a behavioural intervention. What are the 3 types?
Positive reinforcement
Negative reinforcement
Punishment
Describe modelling in behavioural intervention
Learning behaviour by observing and imitating others. Models are observed performing stressful tasks without adverse effects. Most effective when model is perceived to be of ‘higher status’ or a peer
Describe progressive muscle relaxation
Most widely used relaxation technique in clinics. Focusing on 16 specific muscle groups in sequence combined with abdominal breathing. Daily practice should take about 20 mins
Pros of relaxation techniques
Easy to learn Can be used virtually anywhere Once learned relaxation is rapid Easily combined with other techniques No special equipment required Choice of techniques
Cons of relaxation techniques
Daily practice required
Not suitable for all clinical populations (caution: psychosis, schizophrenia)
Can take time to learn (PMR/meditation)
Does not address underlying cognitive processes
Describe exposure interventions
Method of eliminating fears by substituting a response that is incompatible with anxiety such as relaxation.
Based on principles of classical & operant conditioning
Gradual controlled increased exposure (imagined or real) to the feared subject whilst maintaining a relaxed state until fear is extinguished
Describe flooding
Inescapable continuous exposure to feared subject (real, virtual or imagined) until anxiety subsides (extinction). Useful in treating phobias, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder etc.
Aims of Combined Cognitive and Behavioural Interventions (CBT) - 3 listed
- Identify and modify maladaptive beliefs and strategies
- Teach positive coping strategies
- Empower patient to become their own therapist
Pros of CBT - 5 listed
- Can be used in a wide range of disorders e.g. Depression, Generalised Anxiety Disorder, Bipolar disorder, Panic Disorder, Agoraphobia, Social Phobia, OCD etc…
- Can be used for children and adults
- Self help versions available
- Good evidence base for use for mild/moderate cases but also in severe cases alongside drugs
- Brief, time limited - 5 to 20 sessions
What is psychotherapy?
Treatment modality (talking therapy)
By a trained person
To relieve distress/ disability in another person
Based on a particular theory/ model
Aims of psychotherapy
Relieve symptoms
Explore and change maladaptive emotional, cognitive and behavioral patterns
Encourage and facilitate self-exploration and knowledge
Enable learning of tools and skills to help oneself
Increase resilience
