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Cognitive approach & therapies


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Cognitive approach & therapies

  1. 1. Cognitive Approach
  2. 2. Main Ideas Abnormalities are the result of Thinking betweenstimulus and response errors in thinking
  3. 3. Cognitive Approach contd...• Errors in thinking• Heavily influenced by the behavioural approach• Thinking between the stimulus and the response• Mental disorders are linked directly to distortions in the thinking process
  4. 4. Cognitive Explanations 1.Cognitive BiasNegative automatic thoughts (NAT’s) 2. Negative Triad Negative views of self, world and future
  5. 5. E.g. of Cognitive BiasMinimisation• Minimising successes – e.g. Good exam grade was luckMaximisation• Maximising trivial failures – e.g. Failing at Sudoku puzzleSelective Abstraction• Focussing on negative aspects of life, ignoring wider pictureAll or Nothing thinking• Black and white thinking (ignoring middle ground) e.g. Success OR failure
  6. 6. Negative Triad Beck’s model of depression 3 main forms of negative thinking “I am worthless” Self World Future“Everything is “Nothing will against me” ever change”
  7. 7. How would the cognitive approach investigate abnormality?ExperimentsAssumptions of the cognitive approachare often tested experimentallyIf a cognitive therapy works it suggests that the cause was cognitiveThase et al (2007) compared cognitive therapies withantidepressants (the IV) and measured the effectiveness ofeach in treating depression (the DV)Evidence like this has provided a huge amount of support forthe cognitive approach
  8. 8. Effectiveness of therapies E.g. CBT has been found to be as effective as prozac in treating depressionThis is positive because it shows that changing thinking can work so there must be a cognitive element to the disorder.
  9. 9. Support for the negative triadFor example, Beck compared people with depression to those without, depressed individuals are more negative in terms of themselves, world and the futurePositive as it suggests that the negative triad is an accurate illustration of depressed thinking
  10. 10. Blames the patient For example, the approach considers the individuals disorder to be caused by their faulty thinking This is problematic as situational factors are overlooked and it might notbe beneficial to place blame on a personprone to negative thoughts & depression.
  11. 11. Cause and Effect?For example, do NAT’s cause depressionor does the depression cause the NAT’s?This is problematic because it’s hard todetermine cause & effect and raises thequestion over the best way to treat the patient
  12. 12. Key terms / Buzz words Cause and Experiments Errors in Effect Behavioural thinking All or Nothing approach Minimisation Cognitive Bias Maximisation NAT’s Selective Therapies are abstractionNegative effective Support fortriad World negative Self triad Cog therapy Thase et al Future Vs. drugs (2007) Blame patient
  13. 13. Cognitive Therapies/Treatments• Rational-Emotive Behavioural Therapy
  14. 14. Quick recap of the cognitiveapproach – what can you remember? Errors in thinking stimulus and responseCognitive Bias – Minimisation, maximisation, all or nothing, selective abstractionNegative Triad – Negative thinking of self, world and future Investigated using experiments (comparing cognitive therapies with other therapies)
  15. 15. If the cognitive approach believes that allabnormalities are the result of errors in thinking between a stimulus and response – whattreatments do you think the approach would use to treat disorders? (Or, what would the treatments focus on ?) Modifying thinking!!!
  16. 16. CBT – how it worksUsed for depression and some anxiety disorders• Aims to challenge irrational/maladaptive thoughts• Replace irrational thoughts with rational ones• Becks - Cognitive Therapy• Ellis’ – Rational-Emotive Behavioural TherapyEllis’ REBT is based on the idea that problems are theresult of irrational thinkingIncorporates the ABC model to demonstrate thatbeliefs are the main influence behind emotional well-being
  17. 17. ABC model – before REBTA B C • Activating • Beliefs • Consequences EventEllis believes that activating events in an individual’s life have consequences such as feelings and actions. However, these consequences are affected by beliefs about these eventsA B C • Failing a • I am never • State of driving test going to pass anxiety (even depression)
  18. 18. REBT – how it works•Ellis believes that irrational and self-defectingthoughts should be challenged•The therapy is focussed on designing a newbeliefs system – allowing the individual tointerpret situations in a more realistic andpositive way D B It was my first test, I am never going to pass this lots of people fail, test I’ll be ok in the end
  19. 19. ABC model – after REBTA B C • Activating • Beliefs • Consequences EventEllis believes that activating events in an individual’s life have consequences such as feelings and actions. However, these consequences are affected by beliefs about these eventsA B C • Failing a • It was my • State of driving test first test, anxiety (even lots of people depression) fail – it will
  20. 20. REBT – how it worksThe first part of the therapy is confrontational – with the aim of the therapist persuading the client that their beliefs are irrational and the cause of their emotional turmoilThe clients beliefs are constantly challenged (cognitive element)The client is given homework to make them face up to theirirrational beliefs in everyday life to ultimately change theirbehaviour (behavioural element)The eventual goal is full acceptance of the new, rational beliefs
  21. 21. REBT – how it works E.G – someone with OCD who has to turn a light switch on and off 30 times before leaving a room becausethey fear something awful will happen to them if they don’t. The person is taught to challenge this belief andthen change their behaviour to match their new belief
  22. 22. Examples of typical irrational thoughts I must alwaysI must be loved by be excellent as everyone everything Irrational thoughts such as these can cause emotional I must always be problems such as happy depression/anxiety I am competent at everything I do
  23. 23. CBT– is it any good as a treatment?Yes and no…+ Engels et al (1993) found that CBT is effective in some cases- CBT isn’t effective for all disorders- Ignores the idea that some disorders may be due to biological factors
  24. 24. CBT is effectiveFor example, Engels et al (1993) conducted meta-analysis andconcluded that CBT is effective for a range of differentdisorders e.g. OCDThis is positive because it suggests that CBT can be usefulto more people than many other treatments, especially as it doesn’t involve the use of drugs
  25. 25. CBT isn’t effective for all disordersFor example, it’s not effective in treating disorders such asschizophrenia – where anti-psychotics would be preferable This means that CBT isn’t always the best therapy for everyone and the needs of the client need to be considered
  26. 26. CBT doesn’t acknowledge that biology could play a part in disordersFor example, according to the biological approachdepression is caused by low levels of serotonin This is problematic as it ignores the role the biologycould play in certain disorders and means that CBT will not work for all clients