Lectures introduction to cognitive behavioral therapy
Lecture 1
Clinical work is about story telling and writing, listen to the client and restore the
writing in such manner that it is understandable for others. In this course you will
get the role of client and therapeutic perspective.
Tutorials are core, lectures are extra:
Tutorials
Homework before tutorial
End assignment (after last tutorial)
Objectives of the course
Understand and apply case conceptualisation
Practice CBT techniques
Learn to design treatment plan (case Bjorn/Nina)
Select appropriate CBT techniques
Reflex on your own therapeutic skills
Report on the process
Cognitive behavioural therapy: a form of brief structured psychotherapy
based on the premises that thoughts, feelings and behaviour affect each other in
reciprocal ways.
History of therapy: Freud is one of the main founders of our field, he created the
concept of therapy. In 1950, the concept of treatment and waitlist are the same,
which was the start for many research to prove that therapy does work. In 2020,
we know it works.
—> how something is learned helps to determine how we can unlearn something
—> learning history.
History learning:
Operant conditioning: behaviour that the client has learned that, in a
particular context, it will have a particular consequence. (Reinforcement
and punishment) (positive is stimulus toevoegen, negative is stimulus
weghalen)
Classic conditioning: two stimuli that go together, the initial stimulus
meaningful. By accompanying it, the second stimulus acquires meaning.
This leads to a response which is called to mind with each contact with the
initial stimulus. Bijvoorbeeld: naar de dokter gaan, de zin ‘het zal geen pijn
doen’ horen, waarna het toch pijn doet (ongeconditioneerde stimulus).
Later kom je bij de tandarts die ‘het zal geen pijn doen’ zegt
(de geconditioneerde stimulus), oorspronkelijk doet die zin niks
You should unlearn maladaptive behaviour and thinking.
Cognitive therapy: correction of underlying dysfunctional interpretations.
Behavioral therapy: learning new adaptive behaviour through operant/classical
conditioning.
Systematic desensitisation: combination of relaxation and imagination.
Children learn to relax and, in a relaxt stage, to imagine anxiety producing
situations. Anxiety is learned through (classical) conditioning. It is therefore
unlearned trough counter-conditioning (reciprocal inhibition). Anxiety producing
, stimuli are presented simultaneously with stimuli that are not associated with
anxiety.
Socratic dialogue: asking questions to show clients how they think. For children
and youth the techniques have to be adapted.
Case conceptualisation: starting point for treatment, helps determine how
behaviour has been learned and thus provides information on how to unlearn this
behaviour (H3-4). It is a set of hypotheses about causes antecedents and
maintaining factors of a client’s emotional, interpersonal and behavioural
patterns.
1. Identity target behaviours & causal/maintaining factors
2. Arrive at a diagnosis
3. Form initial case conceptualisation
4. Proceed with treatment, planning and selection
5. Develop outcome monitoring and evaluation strategies
Cognitions and emotional states can also be targeted but this course only focuses
on changing behaviour. You select target variable which you research in:
Frequency, intensity, duration
Overt behaviour, affective states, cognitive processes
Context in which in occurs.
—> rank these in severity to decide the order for treatment.
Historical events set the stage for causal factors, thus they are not the same.
Contextual information helps to determine when and where behaviour occurs.
Case conceptualisation
5G model (trigger, gedachte, gevoel, gedrag, gevolg): dutch approach including
timing and order of treatment. The model gives insight in an interpersonal chain
of events. It covers (milli) seconds when used in treatment. You can expand it
with the next chain of events (consequent is the trigger). You can expand it with
the parental response (understand the dynamics).
Antecedent = behaviour
Response = consequence (thoughts, feeling, behaviour)
1. Trigger/situation
2. Thought
3. Feeling
4. Behavior
5. Consequence (to see how intense the behaviour impacts her life)(short
term/long term. Positive/negative). Short term positive explains why
behaviour exists.
But in children behaviour sometimes comes before thinking.
For youth it is hard to know what they are thinking, thus you first ask for
feelings.
Assignment: compare transactional case formulation with conceptualisation
(updated glossary on bb)
Identify target factors for Bjorn or Nina
Lecture 1
Clinical work is about story telling and writing, listen to the client and restore the
writing in such manner that it is understandable for others. In this course you will
get the role of client and therapeutic perspective.
Tutorials are core, lectures are extra:
Tutorials
Homework before tutorial
End assignment (after last tutorial)
Objectives of the course
Understand and apply case conceptualisation
Practice CBT techniques
Learn to design treatment plan (case Bjorn/Nina)
Select appropriate CBT techniques
Reflex on your own therapeutic skills
Report on the process
Cognitive behavioural therapy: a form of brief structured psychotherapy
based on the premises that thoughts, feelings and behaviour affect each other in
reciprocal ways.
History of therapy: Freud is one of the main founders of our field, he created the
concept of therapy. In 1950, the concept of treatment and waitlist are the same,
which was the start for many research to prove that therapy does work. In 2020,
we know it works.
—> how something is learned helps to determine how we can unlearn something
—> learning history.
History learning:
Operant conditioning: behaviour that the client has learned that, in a
particular context, it will have a particular consequence. (Reinforcement
and punishment) (positive is stimulus toevoegen, negative is stimulus
weghalen)
Classic conditioning: two stimuli that go together, the initial stimulus
meaningful. By accompanying it, the second stimulus acquires meaning.
This leads to a response which is called to mind with each contact with the
initial stimulus. Bijvoorbeeld: naar de dokter gaan, de zin ‘het zal geen pijn
doen’ horen, waarna het toch pijn doet (ongeconditioneerde stimulus).
Later kom je bij de tandarts die ‘het zal geen pijn doen’ zegt
(de geconditioneerde stimulus), oorspronkelijk doet die zin niks
You should unlearn maladaptive behaviour and thinking.
Cognitive therapy: correction of underlying dysfunctional interpretations.
Behavioral therapy: learning new adaptive behaviour through operant/classical
conditioning.
Systematic desensitisation: combination of relaxation and imagination.
Children learn to relax and, in a relaxt stage, to imagine anxiety producing
situations. Anxiety is learned through (classical) conditioning. It is therefore
unlearned trough counter-conditioning (reciprocal inhibition). Anxiety producing
, stimuli are presented simultaneously with stimuli that are not associated with
anxiety.
Socratic dialogue: asking questions to show clients how they think. For children
and youth the techniques have to be adapted.
Case conceptualisation: starting point for treatment, helps determine how
behaviour has been learned and thus provides information on how to unlearn this
behaviour (H3-4). It is a set of hypotheses about causes antecedents and
maintaining factors of a client’s emotional, interpersonal and behavioural
patterns.
1. Identity target behaviours & causal/maintaining factors
2. Arrive at a diagnosis
3. Form initial case conceptualisation
4. Proceed with treatment, planning and selection
5. Develop outcome monitoring and evaluation strategies
Cognitions and emotional states can also be targeted but this course only focuses
on changing behaviour. You select target variable which you research in:
Frequency, intensity, duration
Overt behaviour, affective states, cognitive processes
Context in which in occurs.
—> rank these in severity to decide the order for treatment.
Historical events set the stage for causal factors, thus they are not the same.
Contextual information helps to determine when and where behaviour occurs.
Case conceptualisation
5G model (trigger, gedachte, gevoel, gedrag, gevolg): dutch approach including
timing and order of treatment. The model gives insight in an interpersonal chain
of events. It covers (milli) seconds when used in treatment. You can expand it
with the next chain of events (consequent is the trigger). You can expand it with
the parental response (understand the dynamics).
Antecedent = behaviour
Response = consequence (thoughts, feeling, behaviour)
1. Trigger/situation
2. Thought
3. Feeling
4. Behavior
5. Consequence (to see how intense the behaviour impacts her life)(short
term/long term. Positive/negative). Short term positive explains why
behaviour exists.
But in children behaviour sometimes comes before thinking.
For youth it is hard to know what they are thinking, thus you first ask for
feelings.
Assignment: compare transactional case formulation with conceptualisation
(updated glossary on bb)
Identify target factors for Bjorn or Nina
