Cognitive Restructuring — MRCPsych Paper B MCQ

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EasyPsychotherapyCognitive RestructuringMRCPsych Paper B

During cognitive behavioural therapy, a patient identifies the negative automatic thought, “I am worthless.” They examine the evidence for and against this thought and develop a more balanced alternative. Which therapeutic technique is being used?

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Correct answer: A — Cognitive restructuring

This is cognitive restructuring. The patient identifies a negative automatic thought, evaluates the evidence supporting and contradicting it, and generates a more balanced and realistic alternative. Mentalising concerns understanding one’s own and other people’s behaviour in terms of mental states. Behavioural activation targets avoidance and inactivity by scheduling activities associated with pleasure, mastery or valued goals. Exposure involves systematic confrontation with feared situations, sensations, thoughts or memories rather than cognitive reappraisal. Free association is a psychodynamic technique in which the patient verbalises thoughts without censorship. The explicit examination and modification of an automatic thought therefore identifies cognitive restructuring.

Reference: NHS. Cognitive behavioural therapy (CBT), section “What CBT sessions involve”. Reviewed 28 March 2025. https://www.nhs.uk/tests-and-treatments/cognitive-behavioural-therapy-cbt/