Cognitive Approach

Main Ideas

Abnormalities are the result of

errors in thinking

Thinking between stimulus and response

Cognitive Approach contd...

• Errors in thinking

• Heavily influenced by the behavioural approach

• Thinking between the stimulus and the response

• Mental disorders are linked directly to distortions in the thinking process

Cognitive Explanations

1.Cognitive BiasNegative automatic thoughts (NAT’s)

2. Negative TriadNegative views of self, world and

future

E.g. of Cognitive Bias

• Minimising successes – e.g. Good exam grade was luck

Minimisation

• Maximising trivial failures – e.g. Failing at Sudoku puzzle

Maximisation

• Focussing on negative aspects of life, ignoring wider picture

Selective Abstraction

• Black and white thinking (ignoring middle ground) e.g. Success OR failure

All or Nothing thinking

Negative Triad

Self

FutureWorld

Beck’s model of depression3 main forms of negative thinking

“I am worthless”

“Everything is against me”

“Nothing will ever change”

How would the cognitive approach investigate abnormality?

Experiments

Assumptions of the cognitive approach

are often tested experimentally

If a cognitive therapy works it suggests that the cause was cognitive

Thase et al (2007) compared cognitive therapies with antidepressants (the IV) and measured the effectiveness of each in treating depression (the DV)

Evidence like this has provided a huge amount of support for the cognitive approach

Effectiveness of therapies

E.g. CBT has been found to be as effective as prozac in treating

depression

This is positive because it shows that changing thinking can work so there must be a cognitive element to the

disorder.

Support for the negative triad

For example, Beck compared people with depression to those without,

depressed individuals are more negative in terms of themselves,

world and the future

Positive as it suggests that the negative triad is an accurate illustration of

depressed thinking

Blames the patient

For example, the approach considers the individuals

disorder to be caused by their faulty thinking

This is problematic as situational factors are overlooked and it might not be beneficial to place blame on a person prone to negative thoughts & depression.

Cause and Effect?

For example, do NAT’s cause depression or does the depression cause the NAT’s?

This is problematic because it’s hard to determine cause & effect and raises the question over the best way to treat the

patient

Key terms / Buzz wordsCause and Effect

Cognitive Bias

Behavioural approach

All or Nothing

Maximisation

Therapies are effective

Self

Experiments Errors in thinking

Selective abstraction

Thase et al(2007)

Cog therapy Vs. drugsFuture

Minimisation

Support for negative triad

Blame patient

NAT’s

Negative triad World

CognitiveTherapies/Treatments

• Rational-Emotive Behavioural Therapy

Quick recap of the cognitive approach – what can you remember?

Errors in thinking stimulus and response

Cognitive Bias –Minimisation, maximisation, all or nothing, selective

abstraction

Negative Triad –Negative thinking of self, world and future

Investigated using experiments (comparing cognitive therapies with other therapies)

If the cognitive approach believes that all abnormalities are the result of errors in thinking

between a stimulus and response – what treatments do you think the approach would use

to treat disorders?(Or, what would the treatments focus on ?)

Modifying thinking!!!

CBT –how it works

Used for depression and some anxiety disorders

Ellis’ REBT is based on the idea that problems are the result of irrational thinkingIncorporates the ABC model to demonstrate that beliefs are the main influence behind emotional well-being

• Aims to challenge irrational/maladaptive thoughts• Replace irrational thoughts with rational ones• Becks - Cognitive Therapy• Ellis’ – Rational-Emotive Behavioural Therapy

ABC model – before REBTA

• Activating Event

B

• Beliefs

C

• Consequences

Ellis believes that activating events in an individual’s life have consequences such as feelings and actions.

However, these consequences are affected by beliefsabout these events

A

• Failing a driving test

B

• I am never going to pass

C

• State of anxiety (even depression)

REBT –how it works

•Ellis believes that irrational and self-defecting thoughts should be challenged•The therapy is focussed on designing a new beliefs system – allowing the individual to interpret situations in a more realistic and positive way

B

I am never going to pass this test

D

It was my first test, lots of people fail, I’ll be ok in the end

ABC model – after REBTA

• Activating Event

B

• Beliefs

C

• Consequences

Ellis believes that activating events in an individual’s life have consequences such as feelings and actions.

However, these consequences are affected by beliefsabout these events

A

• Failing a driving test

B

• It was my first test, lots of people fail – it will be ok

C

• State of anxiety (even depression)

REBT – how it works

The first part of the therapy is confrontational – with the aim of the therapist persuading the client that their beliefs are irrational and

the cause of their emotional turmoil

The clients beliefs are constantly challenged (cognitive element)

The client is given homework to make them face up to their irrational beliefs in everyday life to ultimately change their behaviour (behavioural element)

The eventual goal is full acceptance of the new, rational beliefs

REBT – how it works

E.G – someone with OCD who has to turn a light switch on and off 30

times before leaving a room because they fear something awful will happen to them if they don’t. The person is taught to challenge this belief and

then change their behaviour to match their new belief

Examples of typical irrational thoughts

Irrational thoughts such as these can cause emotional problems such as

depression/anxiety

I must always be excellent as

everything

I must be loved by everyone

I am competent at everything I do

I must always be happy

CBT– is it any good as a treatment?

Yes and no…

+ Engels et al (1993) found that CBT is effective in some cases

- CBT isn’t effective for all disorders

- Ignores the idea that some disorders may be due to biological factors

CBT is effective

This is positive because it suggests that CBT can be useful to more people than many other treatments, especially as it

doesn’t involve the use of drugs

For example, Engels et al (1993) conducted meta-analysis and concluded that CBT is effective for a range of different disorders e.g. OCD

CBT isn’t effective for all disorders

For example, it’s not effective in treating disorders such as schizophrenia – where anti-psychotics would be preferable

This means that CBT isn’t always the best therapy for everyone and the needs of the client need to be

considered

CBT doesn’t acknowledge that biology could play a part in disorders

This is problematic as it ignores the role the biology could play in certain disorders and means that CBT will

not work for all clients

For example, according to the biological approach depression is caused by low levels of serotonin