Skip to main content

Cognitive Behavioral Therapy (CBT)

Cognitive behavior therapy (CBT) is a popular form of psychological therapy that works with our thoughts, feelings, and behaviors. CBT is an integration of principles from behavior therapy with theory and methods from the cognitive therapies developed by Aaron Beck and Albert Ellis. The CBT that is practiced today has evolved with new developments in basic and applied research; it is grounded in empirical research and clinical practice. CBT is a broad church: the family of ‘cognitive and behavioral therapies’ encompasses many approaches including cognitive therapy, acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and compassion-focused therapy (CFT). Beck’s cognitive model identifies different levels of human cognitions: automatic thoughts are the most superficial level of cognition and describe the thoughts, words, ideas, and images that seem to pop into our minds; rigid and over-generalized core beliefs about ourselves, the world, and other people; and intermediate attitudes, rules, and assumptions that are influenced by our core beliefs. The cognitive model proposes that how we feel emotionally, and how we act, are determined by how we interpret and think about a situation. It argues that psychological problems and disorders are the result of dysfunctional thinking, and are maintained by self-defeating behavior influenced by inaccurate beliefs. Cognitive behavior therapists understand that by changing the way we think and act in the here-and-now we can change the way we feel, and CBT often begins with a focus on what is maintaining a problem in the present. For lasting change, CBT therapists often work with the deeper levels of their client’s beliefs and assumptions. Read more
Cognitive Behavioral Therapy (CBT)
100 of 292 resources

Search

Language

Resource type

Problem

Therapy tool

100 of 292 resources
Order by

Fact Or Opinion

One cognitive error which commonly results in distress is to act on our opinions as though they were facts. This CBT exercise helps clients to practic ... https://www.psychologytools.com/resource/fact-or-opinion

Fatigue Activity Diary

Activity diaries are a crucial information-gathering tool. They can be used for activity monitoring during an assessment phase of therapy, symptom mon ... https://www.psychologytools.com/resource/fatigue-activity-diary

Fear Ladder

The Fear Ladder is a tool for exploring and ranking the contexts or situations in which a client experiences fear. It is designed to help the client a ... https://www.psychologytools.com/resource/fear-ladder

Flashbacks - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/flashbacks-self-monitoring-record

Fortune Telling

The Fortune Telling information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effective ... https://www.psychologytools.com/resource/fortune-telling

Friendly Formulation

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This simple CBT formulation worksheet ... https://www.psychologytools.com/resource/friendly-formulation

Functional Analysis

Functional analysis examines the causes and consequences of behavior. This classic A-B-C Functional Analysis worksheet can be used to collect informat ... https://www.psychologytools.com/resource/functional-analysis

Functional Analysis With Intervention Planning

This classic A-B-C functional analysis worksheet can be used to collect information about what came before a behavior (antecedents), the behavior itse ... https://www.psychologytools.com/resource/functional-analysis-with-intervention-planning

Habituation

The Habituation information sheets are designed to help clinicians to explain the concept of habituation and its role in exposure therapy. The handout ... https://www.psychologytools.com/resource/habituation

Health Anxiety - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/health-anxiety-self-monitoring-record

Health Anxiety Formulation

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/health-anxiety-formulation

Health Anxiety Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Health Anxiety Self-Monitoring Record. Older versions of a resource may be archived in t ... https://www.psychologytools.com/resource/health-anxiety-self-monitoring-record-edition-1

Health Anxiety Thought Record

Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables cl ... https://www.psychologytools.com/resource/health-anxiety-thought-record

Hindsight Bias

Hindsight bias describes the tendency that people have – once an outcome is known – to believe that they predicted (or could have predicted) an ou ... https://www.psychologytools.com/resource/hindsight-bias

Hindsight Bias (Archived)

Survivors of loss or trauma often think "If only …". Hindsight Bias is a cognitive bias / cognitive illusion which makes events seem more predictabl ... https://www.psychologytools.com/resource/hindsight-bias-archived

Hotspot Record

Enhanced 'reliving' in trauma-focused CBT for PTSD involves addressing the meaning associated with 'hot spots' of traumatic memory. This Hotspot Recor ... https://www.psychologytools.com/resource/hotspot-record

How Trauma Can Affect You (CYP)

Trauma can result in a wide variety of symptoms, experiences, and behaviors. As well as post-traumatic stress disorder (PTSD), prevalence rates of oth ... https://www.psychologytools.com/resource/how-trauma-can-affect-you-cyp

How Your Past Affects Your Present (CBT)

Cognitive behavioral therapy (CBT) describes three levels of cognition – automatic thoughts, assumptions, and core beliefs – which are influenced ... https://www.psychologytools.com/resource/how-your-past-affects-your-present-cbt

Identifying The Meaning Of Body Sensations

Some anxiety disorders (including panic and health anxiety), are concerned with body sensations and symptoms. The Identifying The Meaning Of Body Sens ... https://www.psychologytools.com/resource/identifying-the-meaning-of-body-sensations

Identifying Your Demanding Standards

Striving to meet demanding standards can be a rewarding process and lead to significant gains (e.g., praise, social status, financial rewards, etc.). ... https://www.psychologytools.com/resource/identifying-your-demanding-standards

Interoceptive Exposure

Misappraisals of body sensations trigger emotional and physiological reactions of fear and heightened arousal. These feelings motivate behavioral resp ... https://www.psychologytools.com/resource/interoceptive-exposure

Interpersonal Beliefs And Styles

Interpersonal issues and relationship problems form an important part of what clients bring to therapy: they might present as clients’ current conce ... https://www.psychologytools.com/resource/interpersonal-beliefs-and-styles

Intolerance Of Uncertainty

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives ... https://www.psychologytools.com/resource/intolerance-of-uncertainty

Intrusion Record

What differentiates intrusive congitions in OCD is the meaning that clients with OCD attach to them. The Intrusion Record is a CBT worksheet for captu ... https://www.psychologytools.com/resource/intrusion-record

Intrusive Memory Record

Intrusive (unwanted, involuntary) memories are a common feature of PTSD, but also depression and other conditions. This Intrusive Memory Record is des ... https://www.psychologytools.com/resource/intrusive-memory-record

Intrusive Thoughts Images And Impulses

Intrusive Thoughts, Images, And Impulses that are experienced as distressing are a feature of obsessive compulsive disorder (OCD). They are also a com ... https://www.psychologytools.com/resource/intrusive-thoughts-images-and-impulses

Jumping To Conclusions

The Jumping to Conclusions information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more ef ... https://www.psychologytools.com/resource/jumping-to-conclusions

Labeling

Identifying negative automatic thoughts and reappraising unhelpful thinking is a core element of cognitive therapy. Teaching clients to recognize the ... https://www.psychologytools.com/resource/labeling

Lapse And Relapse Management

Recovery has a fluctuating course and so Lapse And Relapse Management is necessary when learning any new skill. It is applicable to most CBT work, as ... https://www.psychologytools.com/resource/lapse-and-relapse-management

Longitudinal Formulation 1

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This case formulation worksheet is a t ... https://www.psychologytools.com/resource/longitudinal-formulation-1

Longitudinal Formulation 2

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This longitudinal case formulation wor ... https://www.psychologytools.com/resource/longitudinal-formulation-2

Low Self-Esteem - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/low-self-esteem-self-monitoring-record

Low Self-Esteem Formulation

Fennell’s cognitive behavioral model of low self-esteem proposes that negative beliefs about the self are maintained by biased information processin ... https://www.psychologytools.com/resource/low-self-esteem-formulation

Magnification And Minimization

The Magnification And Minimization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work ... https://www.psychologytools.com/resource/magnification-and-minimization

Managing Social Anxiety (Third Edition): Therapist Guide

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following ... https://www.psychologytools.com/resource/managing-social-anxiety-therapist-guide

Managing Social Anxiety (Third Edition): Workbook

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Workbook. Click on the following link t ... https://www.psychologytools.com/resource/managing-social-anxiety-workbook

Managing Substance Use Disorder (Third Edition): Practitioner Guide

Managing Substance Use Disorder comes in two volumes. This page is for the Practitioner Guide. Click on the following link to access the Workbook.&nbs ... https://www.psychologytools.com/resource/managing-substance-use-disorder-practitioner-guide

Managing Your Substance Use Disorder (Third Edition): Workbook

Managing Substance Use Disorder comes in two volumes. This page is for the Client Workbook. Click on the following link to access the Practitioner Gui ... https://www.psychologytools.com/resource/managing-your-substance-use-disorder-workbook

Mastery And Pleasure Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/mastery-and-pleasure-activity-diary

Mastery Of Your Anxiety And Panic (Fifth Edition): Therapist Guide

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying C ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-therapist-guide

Mastery Of Your Anxiety And Panic (Fifth Edition): Workbook

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-workbook

Mastery Of Your Anxiety And Worry (Second Edition): Therapist Guide

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying W ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-therapist-guide

Mastery Of Your Anxiety And Worry (Second Edition): Workbook

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-workbook

Maximizing The Effectiveness Of Exposure Therapy

Despite its position as the leading treatment technique for anxiety disorders, not all clients respond to exposure therapy and some individuals relaps ... https://www.psychologytools.com/resource/maximizing-the-effectiveness-of-exposure-therapy

Meaning In Tinnitus

The psychological approach to tinnitus proposes that it is the meaning attached to perceptions which gives rise to distress - this is similar to the a ... https://www.psychologytools.com/resource/meaning-in-tinnitus

Mental Filter

The Mental Filter information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/mental-filter

Mind Reading

The Mind Reading information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/mind-reading

Modifying Rules And Assumptions

Assumptions are often considered dysfunctional if they are inflexible, rigid, or lead to counterproductive behaviors. Modifying Rules And Assumptions ... https://www.psychologytools.com/resource/modifying-rules-and-assumptions

Negative Thoughts - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/negative-thoughts-self-monitoring-record

Nightmare Exposure And Rescripting

Imagery rescripting is an effective treatment for intrusive and unwanted memories. Nightmare Exposure And Rescripting employs similar techniques and c ... https://www.psychologytools.com/resource/nightmare-exposure-and-rescripting

Nightmare Rescripting (Audio)

Nightmare rescripting is an evidence based treatment for nightmares, with medium to large effect sizes on nightmare frequency, distress, intensity, an ... https://www.psychologytools.com/resource/nightmare-rescripting-audio

OCD Diary

Self-monitoring of thoughts, feelings and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). Clients will find ... https://www.psychologytools.com/resource/ocd-diary

OCD Hierarchy

Part of traditional CBT treatment for OCD is exposure to situations which trigger obsessions (classically accompanied by the prevention of the associa ... https://www.psychologytools.com/resource/ocd-hierarchy

Operant Conditioning

Operant conditioning / instrumental learning is a mechanism by which behaviors can be strengthened or weakened over time. This information handout des ... https://www.psychologytools.com/resource/operant-conditioning

Overcoming Depression (Second Edition): Therapist Guide

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-therapist-guide

Overcoming Depression (Second Edition): Workbook

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Client Workbook. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-workbook

Overcoming Eating Disorders (Second Edition): Therapist Guide

Overcoming Eating Disorders comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook.&nbs ... https://www.psychologytools.com/resource/overcoming-eating-disorders-therapist-guide

Overcoming Insomnia (Second Edition): Therapist Guide

Overcoming Insomnia comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook. It is ... https://www.psychologytools.com/resource/overcoming-insomnia-therapist-guide

Overcoming Insomnia (Second Edition): Workbook

Overcoming Insomnia comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying Therapist Guide ... https://www.psychologytools.com/resource/overcoming-insomnia-workbook

Overcoming Your Eating Disorder: Workbook

Overcoming Eating Disorders comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying Therapi ... https://www.psychologytools.com/resource/overcoming-your-eating-disorder-workbook

Overgeneralization

The Overgeneralization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effect ... https://www.psychologytools.com/resource/overgeneralization

Overview Of CBT

Cognitive behavioral therapy (CBT) is an effective treatment for a wide variety of mental and physical health conditions. This information handout des ... https://www.psychologytools.com/resource/overview-of-cbt

Pain Activity Diary

Activity diaries are a crucial information-gathering tool. They can be used for activity monitoring during an assessment phase of therapy, symptom mon ... https://www.psychologytools.com/resource/pain-activity-diary

Panic - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/panic-self-monitoring-record

Panic Attack Progress Record

Recovery often has a fluctuating course and it is important to monitor progress in cognitive behavioral therapy. Clients can use the Panic Attack Prog ... https://www.psychologytools.com/resource/panic-attack-progress-record

Panic Attack Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). The Panic Attack ... https://www.psychologytools.com/resource/panic-attack-record

Panic Diary

The Panic Diary is a cognitive behavioral therapy (CBT) diary for panic symptoms. Clients can record panic attack frequency along with information abo ... https://www.psychologytools.com/resource/panic-diary

Panic Formulation

The aim of a formulation is to help the client and therapist to come to a shared understanding of what a client is experiencing. The Panic Formulation ... https://www.psychologytools.com/resource/panic-formulation

Panic Symptom Tracker

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioral therapy (CBT). This symptom tracker helps clients to ... https://www.psychologytools.com/resource/panic-symptom-tracker

Perfectionism Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/perfectionism-self-monitoring-record

Permissive Thinking

The Permissive Thinking information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effec ... https://www.psychologytools.com/resource/permissive-thinking

Permissive Thinking – Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/permissive-thinking-self-monitoring-record

Personalizing

The Personalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/personalizing

Perspective-Taking

Cognitive restructuring techniques in CBT teach clients ways of analyzing situations in ways that might initially be unfamiliar. A simple way of intro ... https://www.psychologytools.com/resource/perspective-taking

Pie Charts (Archived)

NOTE: An improved version of this resource is available here: Responsibility Pie Chart. Older versions of a resource may be archived in the event ... https://www.psychologytools.com/resource/pie-charts-archived

Play The Script Till The End

Fears and worries can operate at different levels. Underlying one fear (e.g. "he won't turn up") can be deeper fears (e.g. "nobody will ever love me") ... https://www.psychologytools.com/resource/play-the-script-till-the-end

Positive Belief Record

Some cognitive change can happen quickly - for example challenging negative automatic thoughts. Other cognitive structures such as schemas are more de ... https://www.psychologytools.com/resource/positive-belief-record

Positive Core Belief Evidence Record

Core beliefs are deep-rooted, global, and absolute judgments about oneself, other people, and the world. According to the cognitive model, activated c ... https://www.psychologytools.com/resource/positive-core-belief-evidence-record

Positive Qualities Record

This Positive Qualities Record is a specific type of positive data log designed for working with clients with low self-esteem. It aims to help individ ... https://www.psychologytools.com/resource/positive-qualities-record

Problem Solving

Problem Solving is a structured worksheet which encourages solution-focused thinking. Clients are encouraged to identify a problem, identify multiple ... https://www.psychologytools.com/resource/problem-solving

Problem Solving (CYP)

Effective problem solving is an essential life skill and this Problem Solving worksheet is designed to guide children and adolescents through steps wh ... https://www.psychologytools.com/resource/problem-solving-cyp

Process Focused Case Formulation

The Process-Focused Case Formulation encourages clinicians to make hypotheses regarding mechanisms or processes which they believe may be maintainin ... https://www.psychologytools.com/resource/process-focused-case-formulation

Prolonged Exposure Therapy For PTSD (Second Edition): Therapist Guide

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/prolonged-exposure-therapy-for-ptsd-therapist-guide

Prompts For Challenging Negative Thinking (Archived)

NOTE: An improved version of this resource is available here: Prompts For Challenging Negative Thinking. Older versions of a resource may be arch ... https://www.psychologytools.com/resource/prompts-for-challenging-negative-thinking-archived

Prompts For Challenging Your Negative Thinking

Cognitive restructuring is an evidence-based intervention that involves identifying, evaluating, and modifying maladaptive cognitions, including negat ... https://www.psychologytools.com/resource/prompts-for-challenging-your-negative-thinking

PTSD And Memory

Alterations in the way the brain processes 'normal' vs. 'traumatic' material are thought to be responsible for the intrusive nature of memories in con ... https://www.psychologytools.com/resource/ptsd-and-memory

PTSD Formulation

This PTSD Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supported treatment for post-traumati ... https://www.psychologytools.com/resource/ptsd-formulation

Putting It All Together (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/putting-it-all-together-psychology-tools-for-living-well

Reciprocal CBT Formulation

CBT therapists often describe finding it difficult to apply CBT skills when clients bring relational problems to therapy. Familiar methods of visu ... https://www.psychologytools.com/resource/reciprocal-cbt-formulation

Reclaiming Your Life From A Traumatic Experience (Second Edition): Workbook

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/reclaiming-your-life-from-a-traumatic-experience-workbook

Responsibility Pie Chart

The Responsibility Pie Chart exercise is designed to guide clients through the process of clarifying and re-evaluating their responsibility for negati ... https://www.psychologytools.com/resource/responsibility-pie-chart

Rumination - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/rumination-self-monitoring-record

Rumination Diary (Archived)

NOTE: An improved version of this resource is available here: Rumination – Self-Monitoring Record. Older versions of a resource may be archived ... https://www.psychologytools.com/resource/rumination-diary-archived

Safety Behaviors

Safety behaviors are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, b ... https://www.psychologytools.com/resource/safety-behaviors

Safety Plan

The collaborative development of a safety plan is a brief psychosocial intervention for suicidal patients. The intent of a safety plan is to help ... https://www.psychologytools.com/resource/safety-plan

Schema Bias

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' or 'distort' disconfirmatory evidence. This inform ... https://www.psychologytools.com/resource/schema-bias

Schema Formulation

Beck's cognitive model proposes that cognition and perception in the here-and-now are influenced by our 'schemas', which shape our perception and info ... https://www.psychologytools.com/resource/schema-formulation

Schema Metaphors

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' or 'distort' disconfirmatory evidence. This inform ... https://www.psychologytools.com/resource/schema-metaphors

Self Critical Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Self-Critical Thought Challenging Record helps clients to identify and challenge thei ... https://www.psychologytools.com/resource/self-critical-thought-challenging-record

Self Practice Record

Out-of-session work (collaboratively generated and negotiated) is an essential component of effective CBT. This Self Practice Record helps clients to ... https://www.psychologytools.com/resource/self-practice-record

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

Cognitive therapy competence / adherence measures

Case Conceptualization / Case Formulation

Information (Professional)

Presentations

  • The role of a case conceptualization model and core tasks of intervention | Donald Miechenbaum | 2014
  • Transdiagnostic treatments for anxiety disorders | Martin Anthony | 2013
  • The unified protocol for the transdiagnostic treatment of emotional disorders | Ellen Frank, Fiona Ritchey | 2015
  • Making CBT Work (Working with your CBT therapist / Making your CBT therapist work with you) | Paul Salkovskis

Treatment Guide

  • A manual of cognitive behavior therapy for people with learning disabilities and common mental disorders | Hassiotis, Serfaty, Azam, Martin, Strydom, King | 2012

Video

  • CBT case formulation | Jacqueline Persons

Recommended Reading

  • 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
  • Schema change processes in cognitive therapy | Padesky | 1994
  • 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.
  • Williams, C., & Garland, A. (2002). Identifying and challenging unhelpful thinking. Advances in Psychiatric Treatment, 8(5), 377-386.
  • Garland, A., Fox, R., & Williams, C. (2002). Overcoming reduced activity and avoidance: a Five Areas approach. Advances in Psychiatric Treatment, 8(6), 453-462.
  • 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.
  • A provider’s guide to brief cognitive behavioral therapy | Cully, Dawson, Hamer, Tharp | 2021
  • Padesky, C. A., Mooney, K. A. (1990). Clinical tip: presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14
  • 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

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 integration7(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.