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Cognitive Explanations & Treatments to Phobias

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Ben Stockley

on 23 April 2013

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Transcript of Cognitive Explanations & Treatments to Phobias

Cognitive Explanations
&
Treatments To
Phobias Ben, Chantelle, Ayesha,
Thao, Lorna + Amy Cognitive Treatments Ost and Westling - Treating panic attacks Background The Model Clarke + Wells (2001) Cognitive Explanations ~ The cognitive approach argues that dysfunctional behaviour develops as a result of negative or irrational thoughts about situations.
~ It does also argue that not all phobias are irrational, e.g. the fear of something that threatens your survival, like a fire.
~The cognitive explanations looks at explaining what happens when the fear and avoidance behaviour becomes out of proportion to the threat.
~ Clark + Wells propose a cognitive model that attempts to explain what happens to the thought processes for social phobics that lead to irrational fears losing its proportion. ~ On the basis of early experiences, patients with a social phobia later develop a series of assumptions about themselves + their social world which can be divided into 3 categories:
- Excessively high standards of social performance, so you feel they can't show signs of weakness.
- Conditional beliefs concerning performing in a certain way, like you can't show disagreement at the risk of looking stupid.
- Unconditional negative beliefs about themselves, like feeling different about yourself.
~ These assumptions can lead to seeing certain social situations as dangerous + can cause patients to fail at achieving their desired level of performance + also interpret ambiguous social cues of negative evaluation by others. This therefore leads to social anxiety. Aim: To compare cognitive behavioural therapy with applied relaxation as therapies for panic disorder.

Method: A longitudinal study with patients undergoing therapy for panic disorder. Participants were randomly assigned to either cognitive therapy or applied relaxation.

Sample: 38 patients with DSM diagnosis of panice disorder with or without agoraphobia, recruited through referrals from psychiatrists and newspaper advertisements. 26 females and 12 males, mean age 32.6 years, from variety of occupations and some married, some single and some divorced. ~ When individuals with social phobias believe they're in danger of negative evaluation, they shift their attention to observing themselves. They then use this internal information by self-monitoring to infer how they appear to other people + what other people think of them. Through this, they become trapped in a social system in which most their evidence or fears is self-generated.
~ There are two types of internal information used to generate their negative self-impression:
- Feeling anxious is because of looking anxious which leads to marked distortions.
- Many patients with social phobias appear to experience spontaneously occurring images in which they see themselves as if viewed from another's perspective. The Processing of the Self as a
Social Object Procedure: Pre-treatment baseline assessments of panic
attacks, using a variety of questionnaires. Patients recorded in a
diary the date and situation for every panic attack. Each patient
was then given 12 weeks of treatment of 50-60 minutes, with
homework to carry out between appointments.
Applied relaxation was used to identify what caused the panic attacks,
and then relaxation training started with tension release of muscles.
This was gradually increased so that by session 8 rapid relaxation was
used and patients practiced their techniques in stressful situations.
Cognitive therapy was first used to identify the misinterpretation of body
symptoms and then to generate an alternative cognition in response, so
that participants would not feel panic when something happened, but
would come up with an alternative explanation. This was then tested in
situations where participants had panic attacks were induced and where
not allowed to avoid them, so eventually they had to accept that there
restructured thoughts were right. Patients were then reassessed on
the questionnaires. After a year, a follow up assessment using the
questionnaires was carried out. Cognitive Treatments of
Dysfunction What is CBT?

~ CBT is Cognitive Behavioural Therapy.
~ It is a way of talking about:
- How you think about yourself, the world and other people?
- How what you do affects your thoughts and feelings?
~ It can help you change how you think and what you do. These changes can help you to feel better about yourself.
~ Instead of focusing on the causes of distress from past experiences, it looks to the present and the future of how improve your state of mind; the 'here and now'. ~ CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias, stress etc. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue. When Does CBT Help? ~ CBT can help you make sense of overwhelming
problems by breaking them down into smaller parts.
This makes it easier to see how they are connected
and how they affect you. These parts are:
- A situation - a problem, event or difficult situation.
From this can follow:
- Thoughts
- Emotions
- Physical feelings
- Actions How Does it Work? Findings: CBT showed 74% panic free patients after the treatment and 89% were panic free after one year. Applied relaxation showed 65% panic free patients after the treatment and 82% were panic free after a year. Complications such as generalised anxiety and depression were also reduced to within the normal range after one year.

Conclusions: Both cognitive therapy and applied relaxation worked at reducing panic attacks, but it is difficult to rule out some cognitive changes in the applied relaxation group.
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