Example of Administering CBT | Assignments Psychology

Assignment day -4

Name

Pathak Sham Ratnakar

Course

MA (Psychology)

College

Vision Institute of Advanced Studies, Delhi

University

IGNOU, Delhi

ANSWERS

Day 4: Tenets of CBT: An Evidence Based Approach

Read the following excerpts of therapy sessions in the form of case transcripts provided below.

Identify the concepts/techniques of CBT demonstrated. You could also write a transcript for how

you could have responded differently. (The first case has been annotated as an example)

Therapist: Okay, Seema, you said you wanted to talk about a problem with finding a part-time job?

Patient: Yeah. I need the money… but I don’t know

Therapist: (noticing that Seema looks more dysphoric) What’s going through your mind right now?

Patient: [automatic thought] I won’t be able to handle a job.

Therapist: [labeling her idea as a thought and linking it to her mood] And how does that thought

make you feel?

Patient: [emotion] Sad. Really low.

Therapist: [beginning to evaluate the thought] What’s the evidence that you won’t be able to

work?

Patient: Well, I’m having trouble just getting through my classes.

Therapist: Okay. What else?

Patient: I don’t know . . . I’m still so tired. It’s hard to make myself even go and look for a job, much

less go to work every day.

Therapist: Ok. We’ll get to that in a minute. [suggesting an alternative view] Maybe it’s actually

harder for you at this point to go out and investigate jobs than it would be for you to go to a job that

you already had. In any case, is there any other evidence that you couldn’t handle a job, assuming

that you can get one?

Patient: No, not that I can think of.

Therapist: Any evidence on the other side? That you might be able to handle a job?

Patient: I did work last year. And that was on top of college and other activities. But this year . . . I

just don’t know.

Therapist: Any other evidence that you could handle a job?

Patient: I don’t know… It’s possible I could do something that doesn’t take much time. And that

isn’t too hard.

Therapist: What might that be?

Patient: A sales job, maybe. I did that last year.

Therapist: Any ideas of where you could work?

Patient: Maybe the coaching centre? I saw a notice that they’re looking for new volunteers.

Therapist: Okay. And what would be the worst that could happen if you did get a job at the coaching

centre?

Patient: I guess if I couldn’t do the job…

Therapist: And if that happened, how would you cope?

Patient: I guess I’d just quit.

Therapist: And what would be the best that could happen?

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Assignment day - 4

Name Pathak Sham Ratnakar Course MA (Psychology)

College Vision Institute of Advanced Studies, Delhi University IGNOU, Delhi

ANSWERS

Day 4 : Tenets of CBT: An Evidence Based Approach

Read the following excerpts of therapy sessions in the form of case transcripts provided below. Identify the concepts/techniques of CBT demonstrated. You could also write a transcript for how you could have responded differently. (The first case has been annotated as an example) Therapist: Okay, Seema, you said you wanted to talk about a problem with finding a part-time job? Patient: Yeah. I need the money… but I don’t know Therapist: (noticing that Seema looks more dysphoric) What’s going through your mind right now? Patient: [automatic thought] I won’t be able to handle a job. Therapist: [labeling her idea as a thought and linking it to her mood] And how does that thought make you feel? Patient: [emotion] Sad. Really low. Therapist: [beginning to evaluate the thought] What’s the evidence that you won’t be able to work? Patient: Well, I’m having trouble just getting through my classes. Therapist: Okay. What else? Patient: I don’t know... I’m still so tired. It’s hard to make myself even go and look for a job, much less go to work every day. Therapist: Ok. We’ll get to that in a minute. [suggesting an alternative view] Maybe it’s actually harder for you at this point to go out and investigate jobs than it would be for you to go to a job that you already had. In any case, is there any other evidence that you couldn’t handle a job, assuming that you can get one? Patient: No, not that I can think of. Therapist: Any evidence on the other side? That you might be able to handle a job? Patient: I did work last year. And that was on top of college and other activities. But this year... I just don’t know. Therapist: Any other evidence that you could handle a job? Patient: I don’t know… It’s possible I could do something that doesn’t take much time. And that isn’t too hard. Therapist: What might that be? Patient: A sales job, maybe. I did that last year. Therapist: Any ideas of where you could work? Patient: Maybe the coaching centre? I saw a notice that they’re looking for new volunteers. Therapist: Okay. And what would be the worst that could happen if you did get a job at the coaching centre? Patient: I guess if I couldn’t do the job… Therapist: And if that happened, how would you cope? Patient: I guess I’d just quit. Therapist: And what would be the best that could happen?

Case 1: [This case is an example of Generating Rational Responses Technique] Technique] Patient: I'm a complete failure in every way. [Core Belief] Therapist: You look defeated when you say that. Do you feel defeated? Patient: Yes. I'm no good. [Core Belief] Therapist: You say you are no good. Is it true that you haven't done anything good at all good? [Evaluation of the thought] Patient: Nothing of importance. [Intermediate Belief] Therapist: How about for your children this week -- did you care for them at all? [Thought replacement] Patient: Of course, I helped my wife put them to bed and took them to soccer practice. Therapist: Do you think that was important to them? Patient: I suppose so. [Cognitive Restructuring] Therapist: And did you do anything to make your wife happy this week? Patient: She liked the fact that I came home from work on time. Therapist: Would a "complete failure" be able to respond to his wife's request in such a successful way? [Reflection and Generation of Rational Response] Patient: I guess not. Therapist: So, is it really accurate to say you are a complete failure in every way? [Reality Testing] Patient: I suppose not. Therapist: So how do you feel now? Patient: I guess a little better [Generating Rational Response]

Case 2: [This case is an example of Worst Case Scenario Technique] Patient: I just felt very self-conscious in the group. [Automatic Thought] Therapist: What thoughts did you have when you felt that way? [Evaluating thought] Patient: I wasn’t aware of any thoughts, it was just a feeling. Therapist: What were you most aware of when you were self-conscious? [Probing] Patient: My mind goes blank, I don't know what to say. Therapist: What’s the worst that can happen if you have nothing to say and your mind is blank? [Worst Case Scenario] Patient: People will think there is something wrong with me. Therapist: What’s the worst they could think? Patient: They will think I am boring and stupid. [Core Belief]

Therapist: How about other areas of your life—managing your apartment, managing your finances, taking care of yourself...? [Evaluating alternatives] Patient: I’m doing pretty badly at them, too. Therapist: So this idea that you’re incompetent extends to other things too? Patient: Just about everything. [Core Belief] Therapist: Okay, I can see how strongly you believe in this idea. Can we go back to the situation in which you couldn’t finish the statistics assignment and you had the thoughts: “I can’t do anything right. I’ll never be able to make it here.”

Case 5: [This case is an example of Socratic Questioning Technique] Patient: I can’t explain the feeling, it’s like everything is changed around me. Therapist: When you say things have changed around you, what is it like? [Reflection and Informational Question] Patient: It’s as if everything is unreal, as if I am drifting away. [Negative Automatic Thought] Therapist: As if you’re drifting away? Is it like you are detached from things around you? [Summarizing & Reflection] Patient: Yes. It’s like being in an unreal word, it’s scary. I’ve got it now just talking about it. (places his hand over his head) Therapist: It looks as if you are feeling anxious right now. [Probing Question] Patient: Ohh... I feel panicky. [Secondary Thought] Therapist: What thoughts are going through your mind right now? [Probing Question] Patient: I think I am going mad. [Core Belief]

Case 6: [This case is am example of Re-counting Specific Episodes Technique & Skill Training] Therapist: Should we talk about how upset you were at the park yesterday? [Concrete & Recent Specific Episode] Patient: Yes. Therapist: How were you feeling emotionally: Sad? Anxious? Angry? Patient: Sad. [Negative Automatic Thought] Therapist: What was going through your mind? Patient: I was looking at the people in the park, hanging out, playing Frisbee, things like that. Therapist: What was going through your mind when you saw them? Patient: I’ll never be like them. [Secondary Thought]

Therapist: Okay. You just identified what we call an automatic thought. Everyone has them. They are thoughts that just seem to pop into our heads. We’re not deliberately trying to think about them; that’s why we call them automatic. Most of the time, they’re very quick and we’re much more aware of the emotion—in this case, sadness—than we are of the thoughts. Lots of times the thoughts are distorted in some way. But we react as if they’re true. [Definition of a NAT] Patient: Hmmm. Therapist: What we’ll do is teach you to identify your automatic thoughts, and then evaluate them to see just how accurate they are. For example, in a minute we’ll evaluate the thought, “I’ll never be like them.” What do you think would happen to your emotions if you discovered that your thought wasn’t true—that when your depression lifts you’ll realize that you are like the people in the park? [Training on how to identify a NAT] Patient: I’d feel better. Therapist: Let’s get that down on paper. When you have the thought, “I’ll never be like them” , you feel sad. Do you see how what you’re thinking influences how you feel? [Training on how to Record a NAT] Patient: Uh-huh. Therapist: That’s what we call the cognitive model. What we’ll do in therapy is teach you to identify your automatic thoughts when you notice your mood changing. That’s the first step. We’ll keep practicing it until it’s easy. Then you’ll learn how to evaluate your thoughts and change your thinking if it’s not completely right. Is that clear? [Cognitive Restructuring] Patient: I think so. Therapist: Could you tell me in your own words about the relationship between thoughts and feelings? Patient: Sometimes I have thoughts that are wrong and these thoughts make me feel bad…... But what if the thoughts are right? Therapist: Good point. Then we’ll do some problem solving or find out what’s so bad about it if they are right. My guess, though, is that we’ll find a lot of mistakes in your thinking because you are depressed. Unrealistically negative thinking is always part of depression. In any case, we’ll figure out together whether your thoughts are right or wrong. [Training on Problem Solving Skills]

All case transcripts have been based on therapist’s experiences (with modifications to protect the identity of the patients) as well as adaptations from Beck, J. S. (2011). Cognitive Behaviour Therapy – Basics and Beyond (2nd Ed). The Guilford Press: London

Example of Administering CBT, Assignments of Psychology

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Download Example of Administering CBT and more Assignments Psychology in PDF only on Docsity!

Assignment day - 4

Name Pathak Sham Ratnakar Course MA (Psychology)

College Vision Institute of Advanced Studies, Delhi University IGNOU, Delhi

ANSWERS

Day 4 : Tenets of CBT: An Evidence Based Approach