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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

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95 of 295 resources

Self-Criticism - 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/self-criticism-self-monitoring-record

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

Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide

Cognitive Behavioral Treatment Of Childhood OCD: It’s Only A False Alarm comes in two volumes. This page is for the Therapist Guide. Click on the fo ... https://www.psychologytools.com/resource/cognitive-behavioral-treatment-of-childhood-ocd-its-only-a-false-alarm-therapist-guide

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

Exposures For Fear Of Illness

Fear of illness is a common and persistent fear that can result in significant functional impairment. Exposure is an effective treatment for health-re ... https://www.psychologytools.com/resource/exposures-for-fear-of-illness

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

What Keeps Body Dysmorphic Disorder (BDD) Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-body-dysmorphic-disorder-bdd-going

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

Worry Diary (Archived)

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

Facing Your Fears (CYP)

Graded or graduated exposure is a traditional way of overcoming fears and phobias. The therapist helps the client to draw up a list of feared situatio ... https://www.psychologytools.com/resource/facing-your-fears-cyp

What Is Social Anxiety Disorder?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-social-anxiety-disorder

Urges – Self-Monitoring Record

The Urges – Self-Monitoring Record worksheet is designed to help clients capture information about their urges and cravings. It includes columns to ... https://www.psychologytools.com/resource/urges-self-monitoring-record

Understanding Body Dysmorphic Disorder

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-body-dysmorphic-disorder

What Do People Think About Themselves (CYP)?

People are not born with low self-esteem. Instead, we develop ideas about ourselves and our place in the world as a result of our life experiences. Pe ... https://www.psychologytools.com/resource/what-do-people-think-about-themselves-cyp

Exposures For Fear Of Appearing Anxious

Concerns about appearing anxious in front of others plays a central role in social anxiety. Exposure is an effective treatment for tackling these fear ... https://www.psychologytools.com/resource/exposures-for-fear-of-appearing-anxious

Understanding Fears And Phobias

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-fears-and-phobias

Critical Care And PTSD

The Critical Care And PTSD information handout is designed to help clients to learn about the properties of critical care that can increase the likeli ... https://www.psychologytools.com/resource/critical-care-and-ptsd

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Individuals with body dysmorphic disorder (BDD) experience distress associated with their body image. The Cognitive Behavioral Model Of Body Dysmorphi ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-body-dysmorphic-disorder-bdd-veale-2004

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

What Are Safety Behaviors?

Safety-seeking behaviors (‘safety behaviors’) are actions that people take in response to a real – or perceived – threat. When a threat is rea ... https://www.psychologytools.com/resource/what-are-safety-behaviors

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

Understanding PTSD

Ehlers & Clark's cognitive model of PTSD outline key maintaining factors. Understanding PTSD is a simple pictorial explanation of the maintenance ... https://www.psychologytools.com/resource/understanding-ptsd

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

Trauma, Dissociation, And Grounding (Archived)

NOTE: An improved version of this resource is available here: Trauma And Dissociation. Older versions of a resource may be archived in the event that ... https://www.psychologytools.com/resource/trauma-dissociation-and-grounding

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

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

What Keeps Burnout Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-burnout-going

Activity Diary (No Time Intervals)

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/activity-diary-no-time-intervals

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

What Is Panic Disorder?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-panic-disorder

Understanding My Panic

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/understanding-my-panic

What Is Body Dysmorphic Disorder (BDD)?

Many people have concerns about how they look, but significant and persistent worry about one's appearance may be a sign of body dysmorphic disorder ( ... https://www.psychologytools.com/resource/what-is-body-dysmorphic-disorder-bdd

Understanding Psychosis

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-psychosis

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

Understanding Depersonalization And Derealization

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-depersonalization-and-derealization

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

Exposures For Fear Of Flying

Fear of flying is a very common fear, affecting up to 18% of individuals, and is characterized by intense and persistent fear during, or in anticipati ... https://www.psychologytools.com/resource/exposures-for-fear-of-flying

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

Disqualifying Others

This Disqualifying Others information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/disqualifying-others

Cognitive Behavioral Model Of Panic (Clark, 1986)

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-panic-clark-1986

Simple Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Simple Thought Challenging Record encourages clients to identify alternative perspect ... https://www.psychologytools.com/resource/simple-thought-challenging-record

Critical Illness Intensive Care And Post-Traumatic Stress Disorder (PTSD)

This is a free guide designed for people who have spent time in an intensive care unit and are experiencing symptoms of post-traumatic stress disorder ... https://www.psychologytools.com/resource/critical-illness-intensive-care-and-post-traumatic-stress-disorder-ptsd

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

Activity Selection

Activity selection is a technique for rating the difficulty of different activities. It is a helpful tool when clients have difficulty choosing betwee ... https://www.psychologytools.com/resource/activity-selection

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

Exposures For Fear Of Losing Control Of Your Mind

Fearful responses to benign physical sensations are common in several disorders, and interoceptive exposure (or ‘symptom induction’) is an effecti ... https://www.psychologytools.com/resource/exposures-for-fear-of-losing-control-of-your-mind

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-social-phobia-clark-wells-1995

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

Arbitrary Inference

Arbitrary inference is one of the earliest and broadest cognitive disotortions described in CBT. Beck defines it as "the process of forming an interpr ... https://www.psychologytools.com/resource/arbitrary-inference

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

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Insomnia is a highly prevalent sleep disorder characterized by difficulty initiating or maintaining sleep, or having non-restorative sleep for at leas ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-insomnia-harvey-2002

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

Alternative Action Formulation

The Alternative Action Formulation is a CBT case conceptualization (formulation) worksheet. Formulations help a client and therapist come to a shared ... https://www.psychologytools.com/resource/alternative-action-formulation

Anger Diary (Archived)

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

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Marlatt & Gordon’s cognitive behavioral model of relapse (1985) conceptualizes relapse as a “transitional process, a series of events that unf ... https://www.psychologytools.com/resource/cognitive-behavioural-model-of-the-relapse-process-marlatt-gordon-1985

Attention - 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/attention-self-monitoring-record

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

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

Cognitive Behavioral Model Of Fear Of Body Sensations

Fear of bodily sensations is present in a number of conditions, most notably panic disorder. The Cognitive Behavioral Model Of Fear Of Bodily Sensatio ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-fear-of-body-sensations

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

Belief-O-Meter (CYP)

The Belief-O-Meter is an engaging way of helping children and adolescents to relate to their thoughts differently. It is a form of cognitive restructu ... https://www.psychologytools.com/resource/belief-o-meter-cyp

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

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

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

Exposures For Fear Of Breathlessness

Fearful responses to benign physical sensations such as breathlessness are common in several disorders, most notably panic disorder (with and without ... https://www.psychologytools.com/resource/exposures-for-fear-of-breathlessness

Transdiagnostic Cognitive Behavioral Model Of Eating Disorders (Fairburn, Cooper, Shafran, 2003)

Fairburn, Cooper & Shafran (2003) argue that eating disorders such as anorexia and bulimia share common maintenance mechanisms despite difference ... https://www.psychologytools.com/resource/transdiagnostic-cognitive-behavioral-model-of-eating-disorders-fairburn-cooper-shafran-2003

What Keeps Anorexia Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-anorexia-going

What Keeps Psychosis Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, t ... https://www.psychologytools.com/resource/what-keeps-psychosis-going

Daily Monitoring Form

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/daily-monitoring-form

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

Symptom Tracker

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

An Introduction To CBT (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/an-introduction-to-cbt-psychology-tools-for-living-well

Understanding Anorexia

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-anorexia

Theory A / Theory B (Archived)

NOTE: An improved version of this resource is available here: Theory A / Theory B . Older versions of a resource may be archived in the event that the ... https://www.psychologytools.com/resource/theorya-theoryb-edition-1

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

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

What Keeps Bulimia Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-bulimia-going

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

Anger Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Anger Self-Monitoring Record. Older versions of a resource may be archived in the event ... https://www.psychologytools.com/resource/anger-self-monitoring-record-archived

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Anorexia nervosa is an eating disorder characterized by restriction of energy intake and intense fear of gaining weight. For women, the lifetime preva ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-anorexia-nervosa-fairburn-cooper-shafran-2003

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

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, a ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-depersonalization-hunter-phillips-chalder-sierra-david-2003

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

Exposures For Fear Of Heights

Fear of heights is a very common fear, characterized by an avoidance of high places including staircases, tall buildings, and bridges. Exposure is an ... https://www.psychologytools.com/resource/exposures-for-fear-of-heights

Classical Conditioning

Classical conditioning is a process by which stimuli become associated with responses. This information handout describes key principles of Classical ... https://www.psychologytools.com/resource/classical-conditioning

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

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

The Cognitive Behavioral Model Of Tinnitus identifies cognitive, behavioral, and perceptual changes which operate to maintain tinnitus perception and ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-tinnitus-mckenna-handscombe-hoare-hall-2014

Stimulus Discrimination (Audio)

The Stimulus Discrimination audio exercise is taken from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help people with ... https://www.psychologytools.com/resource/stimulus-discrimination-audio

Understanding Bulimia

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-bulimia

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

What Is Anorexia?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-anorexia

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Bulimia nervosa is an eating disorder characterized by binge eating followed by purging. Among young women, the point prevalence of bulimia is about 1 ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-bulimia-nervosa-fairburn-cooper-shafran-2003

What Is Bulimia?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-bulimia

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Persistent postural-perceptual dizziness (PPPD) is a form of dizziness which is thought to be maintained by psychological factors. This is a Cognitive ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-persistent-postural-perceptual-dizziness-pppd-whalley-cane-2017

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

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.