1. Key Assumptions of The Cognitive Perspective  Individuals who suffer from mental disorders have distorted and irrational thinking – which may cause maladaptive behaviour.  It is the way you think about the problem rather than the problem itself which causes the mental disorder.  Individuals can overcome mental disorders by learning to use more disorders by learning to use more appropriate cognitions. appropriate cognitions.

2. Beck’s Model of Depression (1979) ‘The Cognitive Triad’  Negative Triad (3 negative Schemata) –Negative view of the self –Negative view of the world –Negative view of the future Negative view of the self (I am incompetent and undeserving Negative view of the world it is a hostile place Depression Negative view of the future problems will not disappear, there will always be emotional pain Negative Automatic Thoughts

3. Cognitive Bias ExplanationMinimisation The bias towards minimising success in life. Maximisation The bias towards maximising the importance of even trivial failures. Selective Abstraction A bias towards focusing on only the negative aspects of life and ignoring the wider picture All or nothing Thinking A tendency to see life in terms of black and white and ignoring the middle ground; you are a success or a failure, rather than not good at some things but OK at others.

4. A: Activating Event Mary and her boyfriend split up. B: Beliefs (about A) Rational Thoughts Mary tells herself that although it is a sad situation they were not compatible and she may learn from the experience Irrational Thoughts Mary tells herself that the break up is her fault and that she is not loveable, and so will always fail at relationships C: Consequences (of B) Desirable Emotions Mary feels sad, but is hopeful that she will have successful relationships in the future Undesirable Emotions Mary feels guilty that she spoilt the relationship and that she is unlovable Desirable Behaviour Mary looks forward to forming new healthy relationships and tries to learn from her experience Undesirable Behaviour Mary resolves not to form new relationships as she will only fail and get hurt again.

5. Cognitive Therapy  Cognitive Behaviour Therapy (CBT)  Aim – to challenge irrational and dysfunctional thought processes

6. What is CBT?  It is a way of talking about: –how you think about yourself, the world and other people –how what you do affects your thoughts and feelings.  CBT can help people to change how they think ('Cognitive') and what they do ('Behaviour'). These changes can help them to feel better.  It focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of distress or symptoms in the past, it looks for ways to improve the state of mind now.

7. When does CBT help?  CBT has been shown to help with many different types of problems. –Anxiety, depression, panic, phobias, stress, bulimia, OCD, Post-Traumatic Stress Disorder, bipolar disorder and psychosis.

8. How does it work?  CBT can help to break the vicious circle of maladaptive thinking, feelings and behaviour.  When the parts of the sequence are clearly outlined and understood, they can be changed.  CBT aims to get the person to a point where they can ‘DIY', and work out their own ways of tackling their problems.

9. What does CBT involve? The Sessions Meet with a therapist for between 5 and 20, weekly, or fortnightly sessions. Each session will last between 30 and 60 minutes.

10. How effective is CBT?  CBT is effective in reducing symptoms of depression and in preventing relapse (Kuyken et al, 2007)  It is the most effective psychological treatment for moderate and severe depression.  It is as effective as antidepressants for many types of depression (Fava et al, 1994).

11. CBT and Drug Treatment  Keller et al (2000)  Recovery rates (from depression) –55% drugs alone –52% CBT alone –85% when used together.

12. Strengths Client is actively involved in their recovery Client is actively involved in their recovery CBT is not physically invasive CBT is not physically invasive Client learns to help themselves, and can use the skills in new situations. Client learns to help themselves, and can use the skills in new situations. CBT works (e.g. Kuyken, Fava) CBT works (e.g. Kuyken, Fava) Particularly when combined with drug treatment (Keller) Particularly when combined with drug treatment (Keller) Weaknesses  Clients can become dependant on their therapist, or non- cooperative  CBT is not effective for people with rigid attitudes or resistance to change,  or for people who have high stress levels in response to genuinely difficult life circumstances (depressive realism)  CBT is not a quick fix. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for the client.

13. REBT "Men are disturbed not by events, but by the views which they take of them." Epictetus around 2,000 years ago  Rational Emotive Behavior Therapy (REBT) is a form of psychotherapy created by Albert Ellis in the 1950's. Albert EllisAlbert Ellis  REBT is based on the premise that whenever we become upset, it is not the events taking place in our lives that upset us; it is the beliefs that we hold that cause us to become depressed, anxious, enraged, etc.  The ABC Model

14. The Three Basic ‘Musts’ (Self-defeating Philosophies) –I must do well and win the approval of others for my performances or else I am no good. anxiety, depression, shame, and guilt –Other people must treat me considerately, fairly and kindly, and in exactly the way I want them to treat me. If they don't, they are no good and they deserve to be condemned and punished. rage, passive-aggression and acts of violence rage, passive-aggression and acts of violence –I must get what I want, when I want it; and I must not get what I don't want. It's terrible if I don't get what I want, and I can't stand it. self-pity and procrastination

15. Disputing is the D of the ABC model. The goal of REBT is to help people change their irrational beliefs into rational beliefs. Changing beliefs is the real work of therapy. Insight  Albert Ellis and REBT contend that although we all think irrationally from time to time, we can work at eliminating the tendency. The only way to get better is to work hard at changing our beliefs. It takes practice, practice, practice. Acceptance  Emotionally healthy human beings develop an acceptance of reality, even when reality is highly unfortunate and unpleasant. REBT therapists strive to help their clients develop three types of acceptance: –(1) unconditional self-acceptance; –(2) unconditional other-acceptance; –(3) unconditional life-acceptance.

16. CHANGE VIEW: 10 key facts about CBT Change: your thoughts and actions View: events from another angle Homework: practice makes perfect I can do it: self-help approach Action : don't just talk, do! Experience: test out your beliefs Need: pinpoint the problem Write it down: to remember progress Goals: move towards them Evidence: shows CBT can work

17. "We are what we think. All that we are arises with our thought. With our thoughts, we make our world." The Buddha