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Cognitive Approach
Main Ideas
Abnormalities are the result of
errors in thinking
Thinking between stimulus and response
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
Cognitive Explanations
1.Cognitive BiasNegative automatic thoughts (NAT’s)
2. Negative TriadNegative views of self, world and
future
E.g. of Cognitive Bias
• Minimising successes – e.g. Good exam grade was luck
Minimisation
• Maximising trivial failures – e.g. Failing at Sudoku puzzle
Maximisation
• Focussing on negative aspects of life, ignoring wider picture
Selective Abstraction
• Black and white thinking (ignoring middle ground) e.g. Success OR failure
All or Nothing thinking
Negative Triad
Self
FutureWorld
Beck’s model of depression3 main forms of negative thinking
“I am worthless”
“Everything is against me”
“Nothing will ever change”
How would the cognitive approach investigate abnormality?
Experiments
Assumptions of the cognitive approach
are often tested experimentally
If a cognitive therapy works it suggests that the cause was cognitive
Thase et al (2007) compared cognitive therapies with antidepressants (the IV) and measured the effectiveness of each in treating depression (the DV)
Evidence like this has provided a huge amount of support for the cognitive approach
Effectiveness of therapies
E.g. CBT has been found to be as effective as prozac in treating
depression
This is positive because it shows that changing thinking can work so there must be a cognitive element to the
disorder.
Support for the negative triad
For example, Beck compared people with depression to those without,
depressed individuals are more negative in terms of themselves,
world and the future
Positive as it suggests that the negative triad is an accurate illustration of
depressed thinking
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 not be beneficial to place blame on a person prone to negative thoughts & depression.
Cause and Effect?
For example, do NAT’s cause depression or does the depression cause the NAT’s?
This is problematic because it’s hard to determine cause & effect and raises the question over the best way to treat the
patient
Key terms / Buzz wordsCause and Effect
Cognitive Bias
Behavioural approach
All or Nothing
Maximisation
Therapies are effective
Self
Experiments Errors in thinking
Selective abstraction
Thase et al(2007)
Cog therapy Vs. drugsFuture
Minimisation
Support for negative triad
Blame patient
NAT’s
Negative triad World
CognitiveTherapies/Treatments
• Rational-Emotive Behavioural Therapy
Quick recap of the cognitive approach – what can you remember?
Errors in thinking stimulus and response
Cognitive Bias –Minimisation, maximisation, all or nothing, selective
abstraction
Negative Triad –Negative thinking of self, world and future
Investigated using experiments (comparing cognitive therapies with other therapies)
If the cognitive approach believes that all abnormalities are the result of errors in thinking
between a stimulus and response – what treatments do you think the approach would use
to treat disorders?(Or, what would the treatments focus on ?)
Modifying thinking!!!
CBT –how it works
Used for depression and some anxiety disorders
Ellis’ REBT is based on the idea that problems are the result of irrational thinkingIncorporates the ABC model to demonstrate that beliefs are the main influence behind emotional well-being
• Aims to challenge irrational/maladaptive thoughts• Replace irrational thoughts with rational ones• Becks - Cognitive Therapy• Ellis’ – Rational-Emotive Behavioural Therapy
ABC model – before REBTA
• Activating Event
B
• Beliefs
C
• Consequences
Ellis believes that activating events in an individual’s life have consequences such as feelings and actions.
However, these consequences are affected by beliefsabout these events
A
• Failing a driving test
B
• I am never going to pass
C
• State of anxiety (even depression)
REBT –how it works
•Ellis believes that irrational and self-defecting thoughts should be challenged•The therapy is focussed on designing a new beliefs system – allowing the individual to interpret situations in a more realistic and positive way
B
I am never going to pass this test
D
It was my first test, lots of people fail, I’ll be ok in the end
ABC model – after REBTA
• Activating Event
B
• Beliefs
C
• Consequences
Ellis believes that activating events in an individual’s life have consequences such as feelings and actions.
However, these consequences are affected by beliefsabout these events
A
• Failing a driving test
B
• It was my first test, lots of people fail – it will be ok
C
• State of anxiety (even depression)
REBT – how it works
The 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 turmoil
The clients beliefs are constantly challenged (cognitive element)
The client is given homework to make them face up to their irrational beliefs in everyday life to ultimately change their behaviour (behavioural element)
The eventual goal is full acceptance of the new, rational beliefs
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 because they fear something awful will happen to them if they don’t. The person is taught to challenge this belief and
then change their behaviour to match their new belief
Examples of typical irrational thoughts
Irrational thoughts such as these can cause emotional problems such as
depression/anxiety
I must always be excellent as
everything
I must be loved by everyone
I am competent at everything I do
I must always be happy
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
CBT is effective
This is positive because it suggests that CBT can be useful to more people than many other treatments, especially as it
doesn’t involve the use of drugs
For example, Engels et al (1993) conducted meta-analysis and concluded that CBT is effective for a range of different disorders e.g. OCD
CBT isn’t effective for all disorders
For example, it’s not effective in treating disorders such as schizophrenia – 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
CBT doesn’t acknowledge that biology could play a part in disorders
This is problematic as it ignores the role the biology could play in certain disorders and means that CBT will
not work for all clients
For example, according to the biological approach depression is caused by low levels of serotonin