NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
Individual Therapy- Cognitive-behavioral, Acceptance & Commitment, Solution-Focused and Motivational Interviewing
Chapter 8 Cognitive Behavior Therapy
CBT principles
• CBT is based on the idea that thoughts, feelings, and behaviors are interconnected.
• Maladaptive thinking patterns contribute to psychological distress.
• Change in thinking patterns can lead to changes in emotions and behavior.
• Therapy is structured, time-limited, and goal-oriented.
• Involves collaborative empiricism – patient and therapist work together.
CBT’s relationship to nursing theory
• Aligns with Orem’s Self-Care Deficit Theory: emphasizes empowering patients to care for themselves.
• Compatible with Peplau’s Interpersonal Relations Theory: uses the therapeutic nurse-client relationship as a tool for
behavioral change.
Diagnosis treated with CBT
• Depression
• Anxiety disorders (e.g., GAD, OCD, PTSD, Panic Disorder)
• Eating disorders
• Substance use disorders
• Sleep disorders
• Chronic pain and somatic symptom disorders
Define Cognitive distortions. Table 8.2 Wheeler pg 365
Distorted thinking patterns contributing to emotional distress. Common types include:
• All-or-nothing thinking (black-and-white)
• Overgeneralization
o Example: “I didn’t get the job I applied for—I’ll never get a good job.”
o Often uses absolute terms like always, never, everything, or nothing.
o Leads to reinforcement of negative beliefs and discouragement.
o Common in depression and anxiety disorders.
• Mental filtering (only seeing negatives)
• Disqualifying the positive
• Jumping to conclusions (mind reading, fortune-telling)
• Catastrophizing
• Emotional reasoning
• Should statements
• Examples:
o “I should always be able to handle things without help.”
o “They should know how I feel.”
o Often reflects unrealistic standards or internalized pressure.
o Common in anxiety, depression, perfectionism, and low self-esteem.
• Labeling and mislabeling
• Labeling is an extreme form of overgeneralization.
• Examples:
NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
, NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
o Labeling self:
o “I made a mistake — I’m such a loser.”
o “I failed the test — I’m a failure.”
o Labeling others:
o “He didn’t call me back — he’s a jerk.”
• Mislabeling:
o “That was the worst thing ever.”
o “I’m worthless because I cried at work.”
• Personalization
o Blaming yourself for events outside your control or assuming excessive responsibility for negative outcomes.
o Examples:
o “My client didn’t improve — I must be a terrible PMHNP.”
o “My child is struggling at school — I’m a bad parent.”
What are techniques for stabilization?
• Socratic Dialogue: Asking open-ended, guided questions to help clients examine and challenge their beliefs.
• De-catastrophizing: Helping clients reframe worst-case scenarios and assess their realistic probability.
• Behavioral activation: Encouraging engagement in enjoyable or goal-oriented activities.
• Thought records: Documenting thoughts, feelings, and alternative thoughts.
• Cognitive restructuring: Challenging and modifying negative core beliefs.
• Relaxation techniques and grounding: For anxiety and trauma symptoms.
Motivational Interviewing – OARS, RULE, who is the founder?
OARS (Therapeutic Skills):
• Open-ended questions
• Affirmations
• Reflections
• Summaries
RULE (Principles of MI):
• Resist the righting reflex
• Understand your client’s motivations
• Listen with empathy
• Empower your client
Founder of the OARS/RULE William R. Miller (developed in 1983)
What is ACT therapy?
• A type of behavioral therapy that encourages acceptance of thoughts and feelings rather than fighting or feeling guilty for them.
• Focuses on psychological flexibility—the ability to stay in contact with the present moment and values.
Core Processes
• Cognitive defusion – detaching from unhelpful thoughts.
• Acceptance – embracing thoughts/feelings without judgment.
• Contact with the present moment – mindfulness.
NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
Individual Therapy- Cognitive-behavioral, Acceptance & Commitment, Solution-Focused and Motivational Interviewing
Chapter 8 Cognitive Behavior Therapy
CBT principles
• CBT is based on the idea that thoughts, feelings, and behaviors are interconnected.
• Maladaptive thinking patterns contribute to psychological distress.
• Change in thinking patterns can lead to changes in emotions and behavior.
• Therapy is structured, time-limited, and goal-oriented.
• Involves collaborative empiricism – patient and therapist work together.
CBT’s relationship to nursing theory
• Aligns with Orem’s Self-Care Deficit Theory: emphasizes empowering patients to care for themselves.
• Compatible with Peplau’s Interpersonal Relations Theory: uses the therapeutic nurse-client relationship as a tool for
behavioral change.
Diagnosis treated with CBT
• Depression
• Anxiety disorders (e.g., GAD, OCD, PTSD, Panic Disorder)
• Eating disorders
• Substance use disorders
• Sleep disorders
• Chronic pain and somatic symptom disorders
Define Cognitive distortions. Table 8.2 Wheeler pg 365
Distorted thinking patterns contributing to emotional distress. Common types include:
• All-or-nothing thinking (black-and-white)
• Overgeneralization
o Example: “I didn’t get the job I applied for—I’ll never get a good job.”
o Often uses absolute terms like always, never, everything, or nothing.
o Leads to reinforcement of negative beliefs and discouragement.
o Common in depression and anxiety disorders.
• Mental filtering (only seeing negatives)
• Disqualifying the positive
• Jumping to conclusions (mind reading, fortune-telling)
• Catastrophizing
• Emotional reasoning
• Should statements
• Examples:
o “I should always be able to handle things without help.”
o “They should know how I feel.”
o Often reflects unrealistic standards or internalized pressure.
o Common in anxiety, depression, perfectionism, and low self-esteem.
• Labeling and mislabeling
• Labeling is an extreme form of overgeneralization.
• Examples:
NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
, NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
o Labeling self:
o “I made a mistake — I’m such a loser.”
o “I failed the test — I’m a failure.”
o Labeling others:
o “He didn’t call me back — he’s a jerk.”
• Mislabeling:
o “That was the worst thing ever.”
o “I’m worthless because I cried at work.”
• Personalization
o Blaming yourself for events outside your control or assuming excessive responsibility for negative outcomes.
o Examples:
o “My client didn’t improve — I must be a terrible PMHNP.”
o “My child is struggling at school — I’m a bad parent.”
What are techniques for stabilization?
• Socratic Dialogue: Asking open-ended, guided questions to help clients examine and challenge their beliefs.
• De-catastrophizing: Helping clients reframe worst-case scenarios and assess their realistic probability.
• Behavioral activation: Encouraging engagement in enjoyable or goal-oriented activities.
• Thought records: Documenting thoughts, feelings, and alternative thoughts.
• Cognitive restructuring: Challenging and modifying negative core beliefs.
• Relaxation techniques and grounding: For anxiety and trauma symptoms.
Motivational Interviewing – OARS, RULE, who is the founder?
OARS (Therapeutic Skills):
• Open-ended questions
• Affirmations
• Reflections
• Summaries
RULE (Principles of MI):
• Resist the righting reflex
• Understand your client’s motivations
• Listen with empathy
• Empower your client
Founder of the OARS/RULE William R. Miller (developed in 1983)
What is ACT therapy?
• A type of behavioral therapy that encourages acceptance of thoughts and feelings rather than fighting or feeling guilty for them.
• Focuses on psychological flexibility—the ability to stay in contact with the present moment and values.
Core Processes
• Cognitive defusion – detaching from unhelpful thoughts.
• Acceptance – embracing thoughts/feelings without judgment.
• Contact with the present moment – mindfulness.
NR 605 Final Exam Review: Cognitive Behavioral Therapy & Family Therapy Insights
