5.2 Cognitive assessment methods
There are two main ways of cognitive assessment, one is ruler assessment. The other is through psychological questionnaire evaluation.
5.2. 1 scoring method
5.2. 1. 1 cognitive concept evaluation scale method
For the evaluation of cognitive concepts, in each stage of the consultation process, psychological counselors often ask visitors to evaluate their beliefs about their own ideas or beliefs, so as to evaluate the effectiveness of the conversation. Psychological counselors tell visitors in advance that they should express their belief in an idea or belief with a number of 0~ 100%. 0 means don't believe, 100% means completely believe, and 50% means with a grain of salt.
Cognitive change is the basis of other changes.
In the automatic thinking stage, the counselor will invite visitors to evaluate their beliefs about automatic thinking before intervention, and then re-evaluate their beliefs about automatic thinking and their beliefs about alternative thinking (that is, new ideas that replace the original automatic thinking) after intervention.
5.2. 1.2 Emotional Scale Evaluation Method
The change of emotional experience or the reduction of negative emotional intensity is the most direct embodiment of psychological counseling effect.
"We have an emotional scale here. Please use a number of 0~ 100% to indicate the degree of some emotion (such as disappointment) you are experiencing now. 0 means that there is no such emotion at all, and you are in a completely calm state; 100% shows that this emotion has reached an extreme state; 50% indicates that this emotion belongs to moderate intensity. The higher the intensity of emotional experience, the higher the score, the lower the intensity of emotional experience and the lower the score. "
5.2. 1.3 homework grading method
Homework is the characteristic of cognitive behavioral therapy, and it is also an important way for visitors to change their behavior.
Psychological counselors can not only understand the effect of conversation through cognitive concept evaluation and emotional intensity evaluation, but also evaluate the effect of counseling conversation through the willingness to change behavior.
5.2. 1.4 Subjective pain index
In the treatment of anxiety (such as generalized anxiety, panic attack, obsessive-compulsive disorder, phobia), cognitive behavioral therapy usually adopts exposure therapy. But before exposure, psychological counselors need to determine the intensity of anxiety and fear caused by various situations, and rank the situations according to the degree from light to heavy. After the ranking is determined, counselors begin to expose the situation with mild anxiety intensity, and continue to deal with the anxiety situation with greater anxiety intensity after completing the task of exposing the situation.
Subjective pain is used to describe the degree of anxiety and fear of patients. Usually we use a number from 0 to 10 to describe the intensity of subjective pain. The figures given by patients for various anxiety situations are called Subjective Pain Index (SUDs).
In all the situations listed below, you have experienced different degrees of pain. Please use a number of 0~ 10 to illustrate the difference in the degree of pain you have experienced in different situations. If you don't feel pain at all and feel very calm and comfortable, the score is 0; If you feel extreme pain, it may be something you have experienced or you can imagine, and it will be rated as 10. Please list the pain scores of each situation one by one. The more painful you are about this situation, the higher your score will be.
5.2. 1.5 Emotional thermometer
Emotional thermometer divides subjective pain into 0~8 grades and presents it as a thermometer. Patients can describe a situation with a certain scale of emotional temperature according to their own pain degree.
Psychological questionnaire evaluation
Emotional symptom assessment
Emotion is an indicator of mental health.
To evaluate the effect of psychological counseling, we can start with emotional evaluation.
Patients with psychological problems usually have two typical emotions (anxiety and depression) and their corresponding symptoms (emotional experience, physiological reaction, physical symptoms and cognitive symptoms).
Famous anxiety questionnaires include Baker Anxiety Questionnaire (BAI), Self-rating Anxiety Scale (SAS) and Hamilton Anxiety Scale (HRMA).
Famous depression questionnaires include Baker Depression Questionnaire (BDI), Self-Rating Depression Scale (SDS) and Hamilton Depression Scale (HRSD). In addition, there is an elderly depression questionnaire-Geriatric Depression Scale (GDS).
There are two ways to evaluate anxiety and depression questionnaire, one is self-evaluation and the other is other evaluation.
Self-rating anxiety scale, self-rating depression scale, Baker anxiety scale and depression scale are all self-rating scales, while Hamilton anxiety scale and depression scale are other scales.
Evaluation of 5.2.2.2's Cognitive Concept
(1) automatic thinking questionnaire
(2) Dysfunctional Attitude Scale
(3) Personality Disorder Belief Questionnaire
Social Function Assessment of 5.2.2.3
5.3 Application of Cognitive Assessment
Baseline evaluation and end evaluation
Cognitive behavioral therapy explains the effect of psychological counseling through objective data.
Process evaluation
Procedural evaluation usually evaluates the cognitive changes, emotional changes and behavioral changes brought about by psychological counseling.
5.3.3 Evaluation of Psychological Intervention Techniques
(1) Recognition and Evaluation in Automatic Thinking
Cognitive behavioral therapy needs to teach visitors to recognize their automatic thinking and emotions. After the consultation, the counselor will give the visitors homework and monitor their automatic thinking and emotions. That is, when visitors experience an emotion, they should record the specific situation that triggered the emotion and the thoughts that came to mind at that time.
Visitors should fill in a form to identify automatic thinking, such as situations other than date/time, automatic thinking and emotions. It is also required to evaluate the degree of confidence and emotional intensity of automatic thinking. Therefore, the table is also referred to as the three-column table.
Date: June 6, 2020
Situation: I went to dinner with my roommate and met my roommate's best friend on the way.
Automatic thinking (and its trust): I have few acquaintances and poor interpersonal skills /85%.
Emotion: Depression /75%
Automatic thinking has two characteristics, one is automatic emergence, and the other is complete acceptance.
(2) the evaluation in the thought record table
The function of thinking record is to teach visitors how to evaluate automatic thinking.
Compared with the automatic thinking monitoring table, the thinking record table has two more columns: "appropriate response" and "conclusion" Automatic thinking monitoring table is often called three-column table, and thinking record table is often called five-column table.
? 7 10
(3) Evaluation in behavior test
Cognitive behavioral therapy generally requires that the belief of the old belief is below 30% and the belief of the new belief is above 90%.
Tourists' old belief that flying is dangerous is 70%, and their new belief that flying is relatively safe is 50%. In this case, the psychological counselor invited the visitors to do behavioral experiments to test the rationality of the old and new beliefs and see which one is more in line with the objective facts.
The specific way is to invite tourists to randomly select three flights from the second day of the country every night, record them in the behavior test form, and then confirm whether these three flights are safe or crashed the next night.
(4) Evaluation of exposure technology
Exposure technique is an important technique to deal with anxiety disorder in cognitive behavioral therapy.
There are two forms of anxiety exposure.
The first form is constant exposure to anxiety. . This means that the single exposure time is longer, up to 10~25 minutes. The exposure of this situation can only stop when visitors report that the subjective pain index has dropped to 20%, or half of the original. Therefore, during the exposure process, the consultant will ask the visitors to report the subjective pain index once every minute, and monitor the change process of the subjective pain index, so as to judge whether the exposure lasts or not and evaluate whether the application of the exposure technology is successful.
The second form is to simply and repeatedly expose an anxious situation. In this exposure method, each exposure time is short (for example, 15~60 seconds), but the exposure should be repeated several times. Repeated exposure needs to wait until the subjective pain index reflected by visitors drops to 20% or half of the original. The consultant will ask the visitors to report the subjective pain index for each exposure, and the consultant will judge whether the exposure lasts or not and whether the application of exposure technology is successful from the change of the subjective pain index for each exposure.