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Cognitive-Behavioral Therapy: Cognitive Restructuring
NATURE OF COGNITIVE-BEHAVIORAL THERAPY
Operationalizing Cognitions: Making Private Thoughts Public
Participation Exercise 13-1: Thinking About Thinking
In Theory 13-1: Talking to Yourself Isnt Necessarily Crazy
Case 13-1: Eliminating Jealousy by Self-Prescribed Thought Stopping
Thought Stopping in Perspective
RATIONAL EMOTIVE BEHAVIOR THERAPY
Participation Exercise 13-2: What Are You Mad About?
Rational Emotive Theory of Psychological Disorders
Participation Exercise 13-3: Kicking the Musturbation Habit
The Process of Rational Emotive Behavior Therapy
Case 13-2: Rational Emotive Behavior Therapy for Depression
Rational Emotive Education
Participation Exercise 13-4: I Think, Therefore I Feel: Making the Connection
Rational Emotive Behavior Therapy in Perspective
Cognitive Therapy Theory of Psychological Disorders
The Process of Cognitive Therapy
Participation Exercise 13-5: Turning Your Thinking Upside Down: Cognitive Restructuring
Overt Behavioral Interventions
Mastery and Pleasure Ratings
Participation Exercise 13-6: Are You Completing Tasks Competently and
Enjoying Doing Them?
Graded Task Assignments
Case 12-3: Using Graded Task Assignments to Accelerate Walking in a Japanese-American Man with Somatic Complaints
Cognitive Therapy for Anxiety-Related Disorders
Cognitive Processing Therapy for Stress Disorders
Cognitive Therapy for Delusions and Hallucinations
Cognitive Therapy for Delusions
Cognitive Therapy for Hallucinations
Cognitive Therapy for Delusions and Hallucinations in Perspective
Schema-Focused Cognitive Therapy
Assessment of Schemas
Schema-Focused Cognitive Therapy Interventions
Schema-Focused Cognitive Therapy in Perspective
Adaptations of Cognitive Therapy to Diverse Populations
Cognitive Therapy in Perspective
ALL THINGS CONSIDERED: COGNITIVE RESTRUCTURING THERAPIES
In Theory 13-2: Constructivism: All in the Eye of the Beholder
PARTICIPATION EXERCISE ANSWERS
13-1. What are cognitions, and what is the causal relationship between cognitions and overt behaviors?
13-2. What is the meaning of the term cognitive-behavioral in cognitive-behavioral therapy?
13-3. What is cognitive restructuring, and when is it used?
13-4. What are the two basic models of cognitive-behavioral therapy, and what are the fundamental differences between them?
13-5. What is the primary operational definition of cognitions used by behavior therapists?
13-6. What are the four methods that behavior therapists use to assess clients cognitions, and along what five dimensions do they differ?
13-7. What is the think-aloud approach, and what are its five advantages over direct self-report inventories?
13-8. What is thought stopping, and what occurs in each of its phases?
13-9. What is Elliss rational emotive theory of psychological disorders?
13-10. What are the three common forms of irrationality that Ellis found in maladaptive thoughts, and what are the two common themes?
13-11. What did Ellis mean by musturbation, and why is it harmful?
13-12. What are the three basic procedures for implementing rational emotive behavior therapy?
13-13. What is the style of the clienttherapist interaction in rational emotive behavior therapy, and what are the advantages and the problems with this style?
13-14. What is rational emotive education, and what is its purpose?
13-15. What are the four elements of the curriculum for rational emotive education?
13-16. What are the findings of the research on the effectiveness of rational emotive behavior therapy?
13-17. What is the fundamental emphasis in cognitive therapy?
13-18. What are the similarities and the differences between rational emotive behavior therapy and cognitive therapy?
13-19. Why does Beck call maladaptive cognitions automatic thoughts?
13-20. What are the six cognitive distortions identified by Beck as being associated with psychological distress?
13-21. What are the three basic goals of cognitive therapy and the process involved in changing clients dysfunctional beliefs?
13-22. What is meant by Socratic dialogue, and how is it used in cognitive therapy?
13-23. What is collaborative empiricism, and how is it implemented?
13-24. What are the cognitive interventions used in cognitive therapy, and why are they considered cognitive?
13-25. What are the three overt behavioral interventions used in cognitive therapy, and what are the purposes and processes of each?
13-26. What is cognitive processing therapy, and how is it implemented?
13-27. What are the issues that arise in using cognitive therapy to treat schizophrenic delusions and hallucinations, and what are the cognitive therapy procedures used to treat them?
13-28. What are the five coping strategies taught to clients suffering from hallucinations and delusions?
13-29. What are schemas, and how do they develop?
13-30. What are the four steps used to assess schemas?
13-31. What three major procedures are used in schema-focused cognitive therapy, and what are their purpose?
13-32. In what ways does schema-focused cognitive therapy differ from traditional cognitive therapy?
13-33. What are the general findings of research on the effectiveness of cognitive therapy?
13-34. What are the two ways by which cognitive therapy may prevent recurrence of depression?
13-35. What is constructivism, and how does it relate to cognitive-restructuring therapies?
Multiple Choice Questions
13-1 (p. 316, b)
One example of cognition is
13-2 (p. 316, a)
Cognitive-behavioral therapy changes cognitions that
a. maintain disorders and problems.
b. do not match social expectations.
c. are inherently negative.
d. promote self-criticism.
13 3 (p. 316, c)
In cognitive behavioral therapy, cognitions are modified directly through
a. negative punishment.
b. social mediation.
c. cognitive intervention.
13-4 (p. 316, b)
Cognitive-behavioral therapy modifies cognitions indirectly through
a. cognitive modeling techniques.
b. overt behavioral interventions.
c. covert extinction and reinforcement.
d. cognitive restructuring.
13-5 (p. 316, d)
Cognitive restructuring therapy teaches clients to
a. suppress maladaptive cognitions.
b. verify self-indulging cognitions.
c. avoid active metacognition.
d. change erroneous cognitions.
13-6 (p. 316, a)
Cognitive restructuring involves recognizing maladaptive cognitions and
a. substituting more adaptive ones.
b. imagining positive/humorous details.
c. incorporating relevant distraction-prompts.
d. avoiding maintaining setting events.
13-7 (p. 316, c)
Cognitive restructuring is used primarily with problems maintained by
a. fear and avoidance behaviors.
b. a deficit in adaptive cognitions.
c. an excess of maladaptive thoughts.
d. inadequate self-reinforcement.
13-8 (p. 316, d)
Cognitive-behavioral coping skills therapy teaches clients
a. the mediating effects of behavioral predispositions.
b. to avoid situations maintaining undesirable behavior.
c. to accept certain uncontrollable stresses.
d. adaptive responses to problematic situations.
13-9 (p. 316, d)
Cognitive-behavioral coping skills therapy is used primarily with problems maintained by
a. an excess of maladaptive thoughts.
b. internalized, social expectations.
c. disabled cognitive processes.
d. a deficit in adaptive cognitions.
13 10 (p. 317, a)
Behavior therapists operationally define cognitions as
a. self talk.
b. memory rehearsal.
c. image memory.
d. covert behavior.
13 11 (p. 317, b)
To access a clients cognitions, a behavior therapist would ask,
a. What do you see in your mind?
b. What are you saying to yourself?
c. What are you thinking?
d. What are you remembering?
13 12 (pp. 317-318, d)
One major problem with asking clients about their cognitions is that
a. self talk is too subjective.
b. people rarely think in words.
c. verbalization is inadequate.
d. few notice their self-talk.
13-13 (p. 318, a)
All techniques for assessing cognitions are
13 14 (p. 319, d)
Procedures in which clients speak their thoughts into a tape recorder while engaging in some behavior are called _____ procedures.
a. automatic thinking
b. self talk
c. cognitive scripting
d. think aloud
13-15 (p. 320, c)
One limitation of think-aloud procedures is
a. impression management.
b. low acceptability.
c. limited application.
d. high reactivity.
13-16 (p. 320, a)
Thought stopping procedures interrupt intrusive thoughts and then
a. substitute them for pleasant ones.
b. engage the client in overt behaviors.
c. discuss specific content and meaning.
d. administer positive punishment.
13 17 (p. 320, d)
The first phase of thought stopping involves
a. developing thought-awareness.
b. selecting alternative thoughts.
c. monitoring intrusive thoughts.
d. interrupting upsetting thoughts.
13 18 (p. 320, b)
The purpose of the word Stop in thought stopping is to
a. make clients aware of what they are thinking.
b. interrupt a disturbing thought temporarily.
c. punish holding the disturbing thought.
d. associate the thought with a startle response.
13 19 (p. 320, a)
The second phase of thought stopping
a. keeps the upsetting thought from returning.
b. is faded out over the course of treatment.
c. involves cognitive positive practice.
d. internalizes the therapists verbal instruction.
13 20 (p. 320, d)
The main difference between thought suppression and thought stopping is that thought suppression
a. uses a different punishment strategy for negative thoughts.
b. has a different paradigm of reinforcement.
c. is used to treat different types of negative thoughts.
d. can result in an increase of distressing thoughts.
13 21 (p. 321, c)
_____ involves modifying a disturbing thought so that it is more tolerable or even pleasant.
a. Thought suppression
b. Cognitive restructuring
c. Imagery rescripting
d. Cognitive role-playing
13-22 (p. 322, a)
Although thought stopping is not a well studied treatment, it is still widely used because of its
a. minimal risk.
b. theoretical fidelity.
c. recent invention.
d. empirical inaccessibility.
13 23 (p. 322, d)
Rational emotive behavior therapy was developed by
13-24 (p. 322, c)
The primary element of rational emotive behavior therapy is
a. emotional coping.
b. thought stopping.
c. cognitive restructuring.
d. imaginal exposure.
13 25 (p. 323, b)
According to the rational emotive theory, psychological problems are created by
a. traumatic life events.
b. maladaptive interpretations.
c. cognitive impulsivity.
d. poor emotional regulation.
13 26 (p. 323, c)
The two themes Ellis has identified in clients irrational thoughts that lead to psychological problems are
a. catastrophizing and personal worthlessness.
b. sense of duty and absolute thinking.
c. sense of duty and personal worthlessness.
d. absolute thinking and catastrophizing.
13-27 (p. 323, a)
Absolute thinking is
a. failing to appreciate shades of gray.
b. missing the big picture for the details.
c. preferring the tangible and observable.
d. privileging thoughts over behavior.
13-28 (p. 323, b)
Overgeneralization is the
a. indiscriminant application of a mental heuristic.
b. assumption of consistency across situations.
c. errant distribution of situation-specific behavior.
d. expression of learning outside of therapy.
13-29 (p. 323, d)
a. transferring emotion to an unrelated situation.
b. failing to appreciate any positive elements.
c. decreasing effort to minimize social risk.
d. blowing small events out of proportion.
13 30 (p. 323, c)
Personal worthlessness is a form of _____ about failure.
b. absolute thinking
d. sense of duty
13 31 (p. 323, b)
I must get all As is an example of
b. sense of duty.
c. social pressure.
13 32 (p. 323, d)
Musturbation refers to
b. absolute thinking.
d. sense of duty.
13 33 (p. 325, a)
After identifying maintaining cognitions, the next step in REBT is to
a. challenge them.
b. dismiss them.
c. replace them.
d. punish them.
13 34 (p. 330, d)
The distinguishing element of rational emotive behavior therapy is its
a. empirical approach.
b. belief substitution.
c. emotional focus.
d. confrontational method.
13 35 (p. 330, c)
Rational emotive education was adapted from rational emotive behavior therapy in order to better serve
a. clinical populations
b. inpatient populations.
c. young populations.
d. cognitively-impaired populations.
13-36 (p. 330, b)
The major procedural change made to REBT in the development of rational emotive education is a
a. shorter treatment time.
b. less confrontational focus.
c. focus on cognitive elements.
d. broader philosophical application.
13 37 (p. 330, d)
Rational emotive education teaches the difference between
a. maintaining and neutral situations.
b. reality and beliefs.
c. inference and assumption.
d. emotions and thoughts.
13 38 (p. 330, a)
With the Expression Guessing Game, clients learn
a. to ask others what they are feeling.
b. reliable behavioral cues for emotion.
c. how to communicate their feelings.
d. appropriate ways to demonstrate emotion.
13-39 (p. 332, c)
REBT may be inappropriate for some cultures which
a. discourage emotional expression.
b. hold collectivist community values.
c. disagree with direct confrontation.
d. eschew environmental evidence.
13-40 (p. 332, b)
Cognitive therapy was developed by
13-41 (p. 332, d)
Cognitive therapy is similar to REBT in that they both seek to
a. engender specific coping mechanisms.
b. reduce metacognitive behaviors.
c. improve overall social skills.
d. modify maladaptive cognitions.
13 42 (p. 332, a)
To challenge irrational beliefs, cognitive therapy uses
a. hypothesis testing.
c. logical disputation.
d. philosophical explanation.
13 43 (p. 333, b)
Cognitive therapy was developed initially to treat
d. posttraumatic stress.
13 44 (p. 333, d)
Beck calls maladaptive cognitions
a. invalid hypotheses.
b. absolute thoughts.
c. negative ideology.
d. automatic thoughts.
13 45 (p. 333, b)
Automatic thoughts are Becks term for
a. intrusive emotions.
b. irrational cognitions.
c. unconscious behaviors.
d. instinctual drives.
13 46 (p. 333, c)
Automatic thoughts are so-called because they are
13-47 (p. 334, c)
Believing that you have a brain tumor because you often feel tired in the morning is one example of
b. polarized thinking.
c. arbitrary inference.
d. selective abstraction.
13-48 (p. 334, d)
Thinking that the national newscasters are speaking directly to you is one example of
c. arbitrary inference.
13-49 (p. 334, a)
Believing that Spain is a rude country because your Spanish exchange student is rude is one example of
b. selective abstraction.
c. dichotomous thinking.
13-50 (p. 334, b)
Deciding that your best friend is evil after learning that she doesnt agree with your politics is one example of
b. polarized thinking.
c. selective abstraction.
13-51 (p. 334, c)
Thinking that you will become president despite dropping out of high school is one example of
a. arbitrary inference.
b. selective abstraction.
13-52 (p. 335, a)
Cognitive therapists help clients recognize dysfunctional beliefs through
a. Socratic dialogue.
b. projection analysis.
c. implicit attitude tests.
13 53 (pp. 335-336, d)
In cognitive therapy, the designing and carrying out homework assignments to test the validity of automatic thoughts is known as
b. graded task assignments.
c. activity scheduling.
d. collaborative empiricism.
13 54 (p. 336, b)
A three-column technique is used in cognitive therapy for
a. activity planning.
b. logic analysis.
c. social-skills training.
d. problem solving.
13 55 (p. 336, d)
Reattribution of responsibility is used for when clients
a. habitually blame others for their mistakes.
b. have poor social lives due to work stress.
c. are motivated by feelings of personal inadequacy.
d. believe they control an uncontrollable situation.
13-56 (p. 337, c)
Decatastrophizing is a specific form of reattribution used when clients
a. experience personal loss.
b. often catastrophize mistakes.
c. anticipate ominous outcomes.
d. imagine past misfortune.
13-57 (pp. 336, 338, b)
In addition to cognitive restructuring, cognitive therapy employs
a. thought stopping.
b. overt-behavioral interventions.
c. active persuasion.
13-58 (p. 338, a)
Overt behavioral interventions are likely to be used when the client is
a. severely depressed.
b. in fact correct.
c. not easily persuaded.
d. a child/adolescent.
13 59 (pp. 339-340, a)
Which of the following would be most useful for clients who believe there is nothing in their lives worthwhile?
a. Mastery and pleasure rating
b. Activity scheduling
c. Graded task assignments
d. Reattribution of responsibility
13 60 (p. 341, d)
Graded task assignments are most similar to
13-61 (p. 343, c)
Cognitive processing therapy was developed by Patricia Resick as an adaptation of cognitive therapy for treating
a. personality disorders.
b. severe depression.
c. trauma and stress disorders.
d. obsessive-compulsive disorder.
13-62 (p. 343, d)
Cognitive processing therapy combines elements of cognitive therapy and
c. response cost.
13 63 (p. 344, b)
_____ are blatantly false beliefs that people continue to hold despite contrary evidence.
c. Absolute thoughts
13 64 (p. 344, a)
In treating schizophrenic delusions with cognitive therapy, the therapist will
a. assess the strength of belief in the delusion.
b. vigorously challenge the veracity of delusions.
c. avoid establishing close relationships with clients.
d. wean the client off pharmacological interventions.
13 65 (p. 345, d)
_____ are false sensory perceptions that people experience as real.
b. Polarized thoughts
c. Absolute thoughts
13 66 (p. 345, c)
Treating auditory hallucinations with cognitive therapy involves challenging the content and _____ of hallucinatory voices.
13-67 (p. 346, a)
One important effect of cognitive therapy treatment for schizophrenia is a
a. reduction in suicidal ideation.
b. shortened treatment time.
c. decrease in medication use.
d. higher rate of socialization.
13 68 (p. 346, b)
A _____ is a broad, pervasive cognitive theme.
a. automatic thought
13 69 (pp. 347-348, d)
In schema-focused cognitive therapy, after identification, the schema is next
a. contradicted with therapist action.
b. made the target of a treatment plan.
c. explained in terms of maintaining conditions.
d. tested for strength of emotional response.
13 70 (p. 348, b)
Schema dialogue is one technique used to achieve the goal of
a. solidifying the therapist-client relationship.
b. distancing the client from the schema.
c. exploring present maintaining conditions for the schema.
d. explaining the behavior therapy process to the client.
13 71 (p. 348, a)
Life review is a process where clients
a. use evidence to support and contradict their schema.
b. investigate probable initiating causes.
c. explore topics eliciting emotional responses.
d. create alternate interpretations of relevant events.
13 72 (p. 352, b)
The philosophical position that people make their own realities is known as
c. relative realism.
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