Lecture 1: Introduction, FA & TA
Part 1: Introduction
● Full cycle of CBT treatment during the course
● Verdeling
○ W1,W2,W3: assessment & case formulation
○ W3-W5: treatment planning & measurement
○ W4-W5: treatment implementation & monitoring
○ W7: evaluation & accountability
● Videos every week
● Role: exam stress/dividing work, worrying
● Week 6 (18-24 october) teaching free week → work on work assignment
Deadlines:
OCTOBER 1ST: Mid as one document (Part 1: A, B and C & three questions)
OCTOBER 28th: Part 1 and 2 + cover letter
OCTOBER 29th: feedback on fellow students course assignment using peer feedback form
NOVEMBER 2nd: final
Exam: open questions (different cases), online, november 1st.
The Why and What of CBT
CBT is systematic, action-oriented psychological treatment to improve mental health →
challenging and changing unhelpful cognitions (thoughts, beliefs, attitude), behaviours and
emotions.
● Evidence-based treatment for many disorders (depression, anxiety, PTSD, OCD)
Basic principle of CBT: cognitions, behaviors and emotions are interconnected: what you
do/feel/think influences what you do/feel/think → change one, change all.
Part 2: Case formulation approach
Every patient (even with the same disorder) is different.
,The focus is on understanding why (do detective work) → why continue drinking despite
negative consequences, why so much fighting while the couple also loves each other.
Develop hypotheses → based on individual analysis, information gathering, link to theoretical
model.
The why is important: when why because of traumatic → emdr, trauma therapy.
The why can change in the individual analysis → different treatment plan
Part 3: Functional Analysis
Conditioning models help understanding behaviour: most behaviours are adaptive as well as
maladaptive and are associations they have learned in the past.
+S+ → something positive is added
+S- → something negative is added
-S+ → something positive is removed
-S- → something negative is removed
~S- → something negative stays the same
~S+ → something positive stays the same
FA focus is on the function of the problem/behaviour and the consequences of it
● Links to OC → strength of behaviour modified by reinforcement/punishment
● Focus on when → always, only certain situations, what defines the context
○ Antecedents are the activating events (also called discriminating
stimulus/Sd)
● 3 elements: activating event (A), behaviour (B), consequences (C).
Antecedents and consequences can be external events (comment from boss) or internal events
(depressed feelings).
Part 4: Topographical analysis
How to get input for a functional analysis
● Ask client → using topographical analysis
● Registration assignment for client
● Use clinical knowledge and scientific knowledge of common antecedents and
consequences of certain behaviour
TA → aim first group session
● Very detailed procedure where you talk about one event and go through it step by step.
● Preferably a recent event (“Did something happen last week that made you upset?”)
, ○ Client may start to talk about general events, but you want to focus on the
specific event
● What you do: get info about A/Sd, B and C
○ B: verbal (overt: complaining, covert: worrying), psychophysiological (heart rate,
sweating), motor
■ Too much of certain behaviour can be a problem, but too little also (lack
of assertiveness, lack of social contact)
○ C: short term, midterm or long term effects
Ask about:
● Event → details, sensory input (feel, smell, see etc)
● Thoughts/cognition → ask also about images (because some people find it hard to talk
about thoughts)
● Emotions → 4 central emotions: anxiety, anger, sadness and happiness
○ Also check physiological symptoms
● Behaviour → what did the client do?
● Consequences → not only behaviour, but also feelings/thoughts
And the the consequences can cause an event again.
Part 1: Introduction
● Full cycle of CBT treatment during the course
● Verdeling
○ W1,W2,W3: assessment & case formulation
○ W3-W5: treatment planning & measurement
○ W4-W5: treatment implementation & monitoring
○ W7: evaluation & accountability
● Videos every week
● Role: exam stress/dividing work, worrying
● Week 6 (18-24 october) teaching free week → work on work assignment
Deadlines:
OCTOBER 1ST: Mid as one document (Part 1: A, B and C & three questions)
OCTOBER 28th: Part 1 and 2 + cover letter
OCTOBER 29th: feedback on fellow students course assignment using peer feedback form
NOVEMBER 2nd: final
Exam: open questions (different cases), online, november 1st.
The Why and What of CBT
CBT is systematic, action-oriented psychological treatment to improve mental health →
challenging and changing unhelpful cognitions (thoughts, beliefs, attitude), behaviours and
emotions.
● Evidence-based treatment for many disorders (depression, anxiety, PTSD, OCD)
Basic principle of CBT: cognitions, behaviors and emotions are interconnected: what you
do/feel/think influences what you do/feel/think → change one, change all.
Part 2: Case formulation approach
Every patient (even with the same disorder) is different.
,The focus is on understanding why (do detective work) → why continue drinking despite
negative consequences, why so much fighting while the couple also loves each other.
Develop hypotheses → based on individual analysis, information gathering, link to theoretical
model.
The why is important: when why because of traumatic → emdr, trauma therapy.
The why can change in the individual analysis → different treatment plan
Part 3: Functional Analysis
Conditioning models help understanding behaviour: most behaviours are adaptive as well as
maladaptive and are associations they have learned in the past.
+S+ → something positive is added
+S- → something negative is added
-S+ → something positive is removed
-S- → something negative is removed
~S- → something negative stays the same
~S+ → something positive stays the same
FA focus is on the function of the problem/behaviour and the consequences of it
● Links to OC → strength of behaviour modified by reinforcement/punishment
● Focus on when → always, only certain situations, what defines the context
○ Antecedents are the activating events (also called discriminating
stimulus/Sd)
● 3 elements: activating event (A), behaviour (B), consequences (C).
Antecedents and consequences can be external events (comment from boss) or internal events
(depressed feelings).
Part 4: Topographical analysis
How to get input for a functional analysis
● Ask client → using topographical analysis
● Registration assignment for client
● Use clinical knowledge and scientific knowledge of common antecedents and
consequences of certain behaviour
TA → aim first group session
● Very detailed procedure where you talk about one event and go through it step by step.
● Preferably a recent event (“Did something happen last week that made you upset?”)
, ○ Client may start to talk about general events, but you want to focus on the
specific event
● What you do: get info about A/Sd, B and C
○ B: verbal (overt: complaining, covert: worrying), psychophysiological (heart rate,
sweating), motor
■ Too much of certain behaviour can be a problem, but too little also (lack
of assertiveness, lack of social contact)
○ C: short term, midterm or long term effects
Ask about:
● Event → details, sensory input (feel, smell, see etc)
● Thoughts/cognition → ask also about images (because some people find it hard to talk
about thoughts)
● Emotions → 4 central emotions: anxiety, anger, sadness and happiness
○ Also check physiological symptoms
● Behaviour → what did the client do?
● Consequences → not only behaviour, but also feelings/thoughts
And the the consequences can cause an event again.
