COGNITIVE BEHAVIOUR THERAPY (CBT)

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COGNITIVE BEHAVIOUR THERAPY (CBT)
DR GIAN LIPPI
CONSULTANT PSYCHIATRIST
UNIVERSITY OF PRETORIA WESKOPPIES HOSPITAL
FORENSIC UNIT
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BASICS
PSYCHOTHERAPY TREATMENT OF CHOICE FOR A NUMBER OF
CATEGORIES OF PSYCHIATRIC DISORDERS
- MOOD DISORDERS
- ANXIETY DISORDERS
- SOMATOFORM DISORDERS
- ADJUSTMENT DISORDERS
- PERSONALITY DISORDERS
- SLEEP DISORDERS
- IMPULSE-CONTROL DISORDERS NOT ELSEWHERE
CLASSIFIED
- ETC
2 COMPONENTS
- COGNITIVE COMPONENT
- BEHAVIOURAL COMPONENT
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COGNITIVE RESTRUCTURING
PATIENTS WITH MOOD DISORDERS PRESENT WITH
COGNITIVE DISTORTIONS (ERRORS IN LOGICAL THOUGHT)
- SELECTIVE ABSTRACTION (SELECTIVELY ATTEND TO
CERTAIN DETAIL, IGNORE THE REST)
- DICHOTOMOUS REASONING (BLACK OR WHITE, NO
GRAY AREAS)
- OVERGENERALIZATION
- ARBITRARY INFERENCE (JUMP TO CONCLUSIONS WITH
VERY LITTLE EVIDENCE)
- PERSONALIZATION (EVERYTHING THAT GOES WRONG
IS MY FAULT)
- CATASTROPHISING (MAKING A MOUNTAIN OUT OF A
MOLEHILL)
DEPRESSION RESULTS IN THOUGHTS BEING NEGATIVE
NEGATIVE AUTOMATIC THOUGHTS DEVELOP
- INSTANT, REFLEX NEGATIVE THOUGHTS
CHARACTERIZED BY COGNITIVE DISTORTIONS
COGNITIVE COMPONENT OF CBT IS COGNITIVE
RESTRUCTURING
- PATIENT IS INSTRUCTED TO IDENTIFY COGNITIVE
DISTORTIONS NEGATIVE
AUTOMATIC THOUGHTS
- COGNITIVE DISTORTIONS ARE BROKEN DOWN BY
PROVIDING ALTERNATIVE
VIEWS THOUGHTS ABOUT EVENTS
- MOST COMMON NEGATIVE AUTOMATIC THOUGHTS ARE
REPLACED BY
POSITIVE THOUGHTS ABOUT THE SUBJECT
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BEHAVIOURAL MODIFICATION
DAILY BEHAVIOUR IS INFLUENCED BY MOOD
- DEPRESSED PATIENTS WHO DONT WANT TO EAT OR
GET OUT OF BED
BEHAVIOURAL COMPONENT OF CBT IS BEHAVIOUR
MODIFICATION
- PATIENT TO CHANGE BEHAVIOUR EVEN IF THE MOOD
MAKES IT DIFFICULT
(GET OUT OF BED AT A CERTAIN TIME, MAKE SURE
SOMETHING IS REGULARLY EATEN)
- SCHEDULE ACTIVITIES (LIKE EXERCISE)
- SCHEDULE PLEASURABLE ACTIVITIES
- ASSERTIVENESS TRAINING
- PROBLEM SOLVING TRAINING
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THE END