CBT Formulation — MRCPsych Paper B MCQ
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Correct answer: A — Reciprocal links among thoughts, emotions, behaviours and bodily sensations
A CBT maintenance formulation collaboratively maps how thoughts or images, emotions, behaviours and bodily sensations interact in the present to perpetuate distress; therefore, A is correct. Situations or triggers are commonly added to this cycle. Early experiences may inform a broader longitudinal CBT formulation, but repeated early relationship patterns are more characteristic of psychodynamic formulations. Reciprocal roles are central to cognitive analytic therapy. Attachment styles belong primarily to attachment-based formulations, while unconscious defence mechanisms are concepts from psychodynamic theory. The key discriminator is the CBT emphasis on an identifiable, modifiable maintenance cycle linking cognition, affect, physiology and behaviour.
Reference: Oxford Health NHS Foundation Trust, Cognitive Behavioural Therapy (CBT), sections “The CBT approach to overcoming and understanding problems” and “What can I expect when I’m in therapy?”, 2024. https://oxfordhealth.nhs.uk/wp-content/uploads/sites/44/2024/05/OH-027.24-Cognitive-Behavioural-Therapy-CBT-Oxfordshire-Psychological-Therapies.pdf