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Persons. J. B. Cognitive therapy in practice: A case formulation approach. H1 & H3. Psychological problems occur at two levels The case formulation model conceptualizes psychological problems as occurring at two levels: 1) overt difficulties, ‘real life’ problems, like depressed moods or panic attacks 2) underlying psychological mechanisms,the psychological deficits that underlie and cause the overt difficulties. They can often be expressed in terms of one (or a few) irrational beliefs about the self. Overt difficulties At a ‘macro’ level, overt difficulties include such things as depression, relationship difficulties, obesity and fears. These are problems as they might be described in the clients own terms. At a ‘micro’ level, problems can be described in terms of three components: 1) cognitions 2) behaviours 3) moods. All three components of problems usually reflect the irrational, maladaptive nature of the underlying mechanism. Cognitions A cognitive component can be found for nearly every problem clients report. Negative mood states usually involve negative automatic thoughts. Automatic thoughts are related to problematic behaviours. Cognitions can involve thoughts, images, (day)dreams and memories. Behaviour Three types of behaviours are considered in the case formulation model 1) overt motor behaviours, such things as spending hours in bed, overeating and arguing with others 2) physiological responses, such things as increased heart rate, dizziness, insomnia 3) verbal behaviours, like continual request for reassurance.Behavioural...
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