Cognitive Behavioral Therapy (CBT)
ABC Model
Worksheet
Activity Diary (Hourly Time Intervals)
Worksheet
Activity Diary (No Time Intervals)
Worksheet
Activity Menu
Information Handout
Activity Planning
Worksheet
Activity Selection
Worksheet
Alternative Action Formulation
Worksheet
An Introduction To CBT (Psychology Tools For Living Well)
Chapter
Anger – Self-Monitoring Record
Worksheet
Anger Decision Sheet
Exercise
Anger Diary (Archived)
Worksheet
Anger Thought Challenging Record
Worksheet
Anxiety – Self-Monitoring Record
Worksheet
Assertive Communication
Information Handout
Assertive Responses
Exercise
Attention – Self-Monitoring Record
Worksheet
Attention Training Experiment
Exercise
Attention Training Practice Record
Exercise
Autonomic Nervous System
Information Handout
Avoidance Hierarchy (Archived)
Exercise
Before I Blame Myself And Feel Guilty
Exercise
Behavioral Activation Activity Diary
Worksheet
Behavioral Activation Activity Planning Diary
Worksheet
Behavioral Experiment
Worksheet
Behavioral Experiment (Portrait Format)
Worksheet
Belief Driven Formulation
Worksheet
Belief-O-Meter (CYP)
Worksheet
Boundaries – Self-Monitoring Record
Worksheet
Catching Your Thoughts (CYP)
Worksheet
CBT Appraisal Model
Worksheet
CBT Daily Activity Diary With Enjoyment And Mastery Ratings
Worksheet
CBT Thought Record Portrait
Worksheet
Challenging Your Negative Thinking (Archived)
Guide
Checking Certainty And Doubt
Information Handout
Classical Conditioning
Information Handout
Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)
Information Handout
Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)
Information Handout
Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)
Information Handout
Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)
Information Handout
Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)
Information Handout
Cognitive Behavioral Model Of Fear Of Body Sensations
Information Handout
Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)
Information Handout
Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)
Information Handout
Cognitive Behavioral Model Of Insomnia (Harvey, 2002)
Information Handout
Cognitive Behavioral Model Of Intolerance Of Uncertainty (Hebert, Dugas, 2019)
Information Handout
Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)
Information Handout
Cognitive Behavioral Model Of Obsessive Compulsive Disorder (OCD: Salkovskis, Forrester, Richards, 1998)
Information Handout
Cognitive Behavioral Model Of Panic (Clark, 1986)
Information Handout
Cognitive Behavioral Model of Perfectionism (Shafran, Egan, Wade, 2010)
Information Handout
Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)
Information Handout
Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)
Information Handout
Cognitive Behavioral Model Of The Relapse Process (Larimer, Palmer, Marlatt, 1999)
Information Handout
Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)
Information Handout
Cognitive Case Formulation
Worksheet
Core Belief Magnet Metaphor
Information Handout
Court Trial Thought Challenging Record (Archived)
Worksheet
Cross Sectional Formulation
Worksheet
Decatastrophizing
Exercise
Demanding Standards – Living Well With Your Personal Rules
Guide
Depression – Self-Monitoring Record
Worksheet
Dissociation – Self-Monitoring Record
Worksheet
Evaluating Unhelpful Automatic Thoughts
Guide
Exposure And Response Prevention
Exercise
Exposure Practice Form
Exercise
Exposure Session Record
Worksheet
Facing Your Fears (CYP)
Exercise
Facing Your Fears And Phobias
Guide
Fact Or Opinion
Exercise
Fatigue Activity Diary
Worksheet
Fear Ladder
Worksheet
Flashbacks – Self-Monitoring Record
Worksheet
Friendly Formulation
Worksheet
Functional Analysis
Worksheet
Functional Analysis With Intervention Planning
Worksheet
Habituation
Information Handout
Health Anxiety Formulation
Information Handout
Health Anxiety Thought Record
Worksheet
Hindsight Bias
Information Handout
Hotspot Record
Worksheet
How Trauma Can Affect You (CYP)
Information Handout
Assessment
- Patient Health Questionnaire 9 (PHQ-9) download archived copy
- Montgomery & Asberg Depression Rating Scale (MADRS) download archived copy
- Brief Fear of Negative Evaluation Scale (Social Anxiety) download archived copy
- Bern Inventory of Treatment Goals download archived copy
Cognitive therapy competence / adherence measures
- Assessment of Core CBT Skills (ACCS) – Muse, McManus, Rakovshik, Kennerley
- Website accs-scale.co.uk
- Manual accs-scale.co.uk
- Feedback form accs-scale.co.uk
- Cognitive Therapy Rating Scale (CTRS) – Young & Beck
- Scale download archived copy
- Manual download
- Revised Cognitive Therapy Scale (CTS-R) – James, Blackburn, Reichelt
- Scale download archived copy
- Manual download archived copy
Case Conceptualization / Case Formulation
- The case formulation approach to cognitive behavior therapy | Jacqueline Persons | 2014 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- Case formulation in CBT | Caleb Lack download archived copy
- Developing a cognitive formulation | Michael Free download archived copy
- Dysfunctional assumptions ideas download archived copy
- CBT case formulation video | Jacqueline Persons youtube
Presentations
- Making CBT Work (Working with your CBT therapist / Making your CBT therapist work with you) | Paul Salkovskis
downloadarchived copy - The unified protocol for the transdiagnostic treatment of emotional disorders | Ellen Frank, Fiona Ritchey | 2015 download archived copy
- Transdiagnostic treatments for anxiety disorders | Martin Anthony | 2013 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- The role of a case conceptualization model and core tasks of intervention | Donald Miechenbaum | 2014 download archived copy
Recommended Reading
- Arch, J. J., & Craske, M. G. (2009). First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives. Psychiatric Clinics of North America, 32(3), 525-547
downloadarchived copy - Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive therapy and research, 36(5), 427-440 download
- Padesky, C. A., Mooney, K. A. (1990). Clinical tip: presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14 download archived copy
- A therapists’ guide to brief cognitive behavioral therapy by Cully & Teten download
This series of articles are good introduction to the basics of CBT. The authors have gone on to sell a branded form of CBT using some of these metaphors / explanation but the messages apply equally to generic CBT.
- Williams, C., & Garland, A. (2002). A cognitive–behavioural therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8(3), 172-179. download
- Garland, A., Fox, R., & Williams, C. (2002). Overcoming reduced activity and avoidance: a Five Areas approach. Advances in Psychiatric Treatment, 8(6), 453-462. download
- Williams, C., & Garland, A. (2002). Identifying and challenging unhelpful thinking. Advances in Psychiatric Treatment, 8(5), 377-386. download
- Wright, B., Williams, C., & Garland, A. (2002). Using the Five Areas cognitive–behavioural therapy model with psychiatric patients. Advances in Psychiatric Treatment, 8(4), 307-315. download
What Is Cognitive Behavioral Therapy?
Assumptions of CBT
- people actively process information;
- our appraisals (the way that we think and interpret events) determine how we feel;
- dysfunctional thinking and biases in information processing (cognition/thinking) are responsible for the problems that people experience;
- different problems are associated with different cognitive themes (cognitive specificity theory): depression is associated with loss and defeat; anxiety is associated with danger and threat; obsessive-compulsive disorder is associated with inflated responsibility; substance abuse is associated with permissive beliefs; eating disorders are associated with self-criticism; social anxiety is associated with fear of evaluation; and PTSD is associated with appraisals of immediate threat;
- the thoughts that we have can be ‘distorted’ or biased. Common biases include over-generalization, arbitrary inference, selective abstraction, and catastrophizing;
- changing how we think and act will impact how we feel: cognition, emotion, and behavior interact in a reciprocal manner;
- psychopathology is a result of an interaction between stress and vulnerability;
- cognition happens at multiple levels (Alford & Beck, 1997) and all can influence the way that we feel and behave: preconscious, unintentional, automatic (e.g., negative automatic thoughts); the conscious level (e.g., if a patient is asked to explain the meaning of an automatic thought); and the metacognitive level (beliefs about beliefs);
- experiences, memories, thoughts, attitudes, and beliefs are encapsulated as ‘schemas’ and which may become activated and influence our perceptions and behaviors.
Principles of CBT
Judith Beck (1995) identified 11 principles of the practice of cognitive behavioral therapy, and these were expanded by Wills (2009):
- cognitive behavioral therapists use formulation to focus their therapeutic work
- cognitive behavioral therapists use formulation to tackle interpersonal and alliance issues
- cognitive behavioral therapy requires a sound therapeutic relationship
- cognitive behavioral therapists stress the importance of collaboration in the therapeutic relationship
- cognitive behavioral therapy is brief and time-limited
- cognitive behavioral therapy is structured and directional
- cognitive behavioral therapy is problem- and goal-oriented
- cognitive behavioral therapy initially emphasizes a focus on the present
- cognitive behavioral therapy uses an educational model
- homework and self-practice is a central feature of cognitive behavioral therapy (incorporating the use of CBT worksheets)
- cognitive behavioral therapists teach clients to evaluate and modify their thoughts
- cognitive behavioral therapy uses various methods to change cognitive content including thought records, behavioral experiments, surveys
- cognitive behavior therapy uses a variety of methods to promote behavioral change including exposure, behavioral experiments, role-play.
Procedures and Techniques of CBT
- Data gathering and symptom monitoring are used to understand problems and to measure change. CBT is an evidence-based approach that relies upon accurate data gathering regarding symptoms and experiences.
- Behavioral activation is a set of techniques for encouraging engagement in meaningful activity and is an effective treatment for depression.
- Case formulation is a method for understanding the origin and maintenance of a problem in cognitive and behavioral terms. CBT therapists may use a mixture of cross-sectional formulation to understand difficulties in the here-and-now, longitudinal formulation to understand the origins and precipitants of a problem, and cognitive behavioral models to understand the mechanisms underlying a problem.
- Cognitive restructuring describes techniques for changing what we think. It often involves the use of thought records, behavioral experiments, data gathering, or psychoeducation.
- Exposure is a technique from behavior therapy that is extensively used by CBT therapists, particularly for the treatment of anxiety. ‘Facing your fears’ is an essential behavioral component of CBT.
- Problem solving describes a series of techniques that are often taught as part of a CBT intervention. Effective problem solving helps people to make adaptive choices.
- Socratic methods are used by CBT therapists to help their clients explore what they know, and to form their own opinions on a topic. Aaron Beck encouraged the use of Socratic-like technique in his original treatment manual “use questioning rather than disputation and indoctrination … it is important to try to elicit from the patient what he is thinking rather than telling the patient what the therapist believes he is thinking” (Beck et al, 1979).
References
- Alford, B. A., & Beck, A. T. (1997). The relation of psychotherapy integration to the established systems of psychotherapy. Journal of psychotherapy integration, 7(4), 275-289.
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
- Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
- Wills, F. (2009). Beck’s cognitive therapy. CBT Distinctive Features Series. New York: Routledge.