Vicious Cycle – Costs And Benefits

This Vicious Cycle - Costs And Benefits worksheet provides a client-friendly framework for exploring how certain coping strategies maintain or exacerbate problems. It helps clients examine the advantages and disadvantages of responses that might be contributing to their difficulties.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

Formulation is a key component in talking therapies, and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate psychopathology. Identifying and mapping out vicious cycles can serve many therapeutic functions including: simplifying complex difficulties, making them more manageable; illustrating how problems manifest in different ways; normalizing ways of coping with difficulties; identifying maladaptive responses that perpetuate problems; identifying adaptive responses that can be strengthened or shaped into more helpful strategies; helping clients to gain distance from their difficulties; pinpointing ways to intervene.

The worksheet is designed to help clients map out vicious cycles that are contributing to their difficulties. By evaluating the advantages and disadvantages of coping strategies and responses to these problems, clients can consider ways to break out of the cycles that perpetuate them.

Why Use This Resource?

The Vicious Cycle – Costs And Benefits worksheet helps clients explore how specific coping strategies might maintain and reinforce their difficulties.

Explores vicious cycles that exacerbate clients' problems.
Identifies maladaptive coping strategies that have negative, long-term consequences.
Highlights potential areas for intervention.
Supports collaboration and reflection in therapy.

Key Benefits

Insight

Promotes a deeper understanding of how certain coping strategies contribute to ongoing difficulties.

Change

Encourages clients to address these maladaptive responses to problems.

Structure

Provides a clear framework for developing effective formulations.

Who is this for?

Depression

Explore patterns of withdrawal that contribute to low mood.

Anxiety Disorders

Identify safety behaviors that reinforce anxiety.

Interpersonal Issues

Highlight ways of communicating and relating to others that lead to relationship problems.

Integrating it into your practice

Describe

Ask the client to describe the problem they are struggling with.

Identify

Clarify how they respond to the problem and try to cope with it.

Evaluate

Weigh-up the short-term benefits and long-term costs of these coping strategies.

Reflect

Explore ways the client can change the cycle for the better.

Theoretical Background & Therapist Guidance

Formulations, also known as case formulations, case conceptualizations, and working hypotheses, are essential components of most talking therapies. In Cognitive Behavioral Therapy (CBT), formulations serve various purposes, including understanding clients' difficulties, developing and testing working hypotheses, and guiding the treatment process.

Vicious cycles (also known as "maintenance circles," "self-fulfilling prophecies," and "reciprocal interactions") are recognized in CBT as key mechanisms that sustain psychological issues.

Identifying and mapping out these vicious cycles can help highlight maladaptive responses that perpetuate problems while also revealing adaptive responses that can be strengthened or developed into more effective strategies. Various factors can contribute to the formation of vicious cycles, such as avoidance, safety behaviors, and recurrent thinking patterns like worry and rumination.

Many of these responses are reinforced by short-term rewards, such as immediate relief from distress, even though they may lead to negative long-term outcomes. Examining these long-term consequences illustrates how these strategies maintain problems and helps motivate clients to tolerate the discomfort associated with reducing them.

What's inside

An comprehensive overview of formulation in CBT.
A structured resource for capturing vicious cycles, focusing on the role of maladaptive coping strategies.
Therapist prompts for creating this formulation with clients.

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FAQs

It's designed to help clients examine how their coping strategies may sustain their difficulties by highlighting the problematic consequences of these responses.

Yes, while grounded in CBT, it can be adapted for use in other therapeutic approaches, such as schema therapy.

Explore the immediate and long-term consequences of these responses, including the impact they have on other people.

How This Resource Improves Clinical Outcomes

This resource explains how certain coping mechanisms maintain or worsen problems. Additional benefits include:

Heightened client awareness of their difficulties.
More targeted treatment plans that address key vicious cycles.
Strengthened therapeutic alliances through collaborative formulation.

Clinicians Who Use This Resource Also Use

Vicious Cycle - Responses And Consequences

References And Further Reading

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Bakker, G. M. (2008). Problem‐maintaining circles: Case illustrations of formulations that truly guide therapy. Clinical Psychologist, 12, 30–39. https://doi.org/10.1080/13284200802069050
Barry, T. J., Vervliet, B., & Hermans, D. (2015). An integrative review of attention biases and their contribution to treatment for anxiety disorders. Frontiers in Psychology, 6, 968. https://doi.org/10.3389/fpsyg.2015.00968
Beck, A. T., Rush, J. A., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
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Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470. https://doi.org/10.1016/0005-7967(86)90011-2
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Dudley, R., & Kuyken, W. (2014). Case formulation in cognitive behavioural therapy: A principle-driven approach. In L. Johnstone & R. Dallos (Eds.), Formulation in psychology and psychotherapy: Making sense of people’s problems (2nd ed., pp. 18–44).
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Johnstone, L., & Dallos, R. (2014). Introduction to formulation. In L. Johnstone & R. Dallos (Eds.), Formulation in psychology and psychotherapy: Making sense of people’s problems (2nd ed., pp. 1–17). Routledge.
Kennerley, H., Kirk, J., & Westbrook, D. (2017). An introduction to cognitive behaviour therapy (3rd ed.). Sage.
Kuyken, W., Padesky, C. A., & Dudley, R. (2009). Collaborative case conceptualisation: Working effectively with clients in cognitive-behavioral therapy. Guilford Press.
Mennen, A. C., Norman, K. A., & Turk-Browne, N. B. (2019). Attentional bias in depression: Understanding mechanisms to improve training and treatment. Current Opinion in Psychology, 29, 266–273. https://doi.org/10.1016/j.copsyc.2019.07.036
Moorey, S. (2010). The six cycles maintenance model: Growing a “vicious flower” for depression. Behavioural and Cognitive Psychotherapy, 38, 173–184. https://doi.org/10.1017/S1352465809990580
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