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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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100 of 303 resources

Cognitive Distortions – Unhelpful Thinking Styles (Extended)

Cognitive distortions (or ‘unhelpful thinking styles’) are ways that our thoughts become biased. Different cognitive biases are associated with di ... https://www.psychologytools.com/resource/cognitive-distortions-unhelpful-thinking-styles-extended/

Valued Domains

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ... https://www.psychologytools.com/resource/valued-domains/

Cognitive Distortions – Unhelpful Thinking Styles (Common)

Cognitive distortions (or ‘unhelpful thinking styles’) are ways that our thoughts become biased. Different cognitive biases are associated with di ... https://www.psychologytools.com/resource/cognitive-distortions-unhelpful-thinking-styles-common/

Exploring Valued Domains

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ... https://www.psychologytools.com/resource/exploring-valued-domains/

Window Of Tolerance

The window of tolerance concept was coined by Dan Siegel in his 1999 book The Developing Mind. Siegel proposes that everyone has a range of intensitie ... https://www.psychologytools.com/resource/window-of-tolerance/

Assertive Communication

Communicating and acting assertively is an interpersonal skill that helps people to maintain healthy relationships, resolve interpersonal conflict, an ... https://www.psychologytools.com/resource/assertive-communication/

Therapy Blueprint (Universal)

A therapy blueprint is CBT tool which summarizes the work a therapist and patient have completed together. It represents the past (the problems, what ... https://www.psychologytools.com/resource/therapy-blueprint-universal/

Values

Meaningful activity is value-driven. This ACT-informed worksheet explores the key domains of values and encourages clients to reflect upon what is imp ... https://www.psychologytools.com/resource/values/

Thought Record (Evidence For And Against)

CBT Thought Records exist in multiple variants, depending on the needs and abilities of the client. This Thought Record (Evidence For And Against) is ... https://www.psychologytools.com/resource/thought-record-evidence-for-and-against/

Vicious Cycle - Responses And Consequences

Formulation is a key component of talking therapies and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate ps ... https://www.psychologytools.com/resource/vicious-cycle-responses-and-consequences/

Embracing Uncertainty

Intolerance of uncertainty (IU) was first described in individuals suffering from Generalized Anxiety Disorder (GAD). Many behaviors associated with G ... https://www.psychologytools.com/resource/embracing-uncertainty/

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/

Before I Blame Myself And Feel Guilty

Guilt is a common post-traumatic reaction and is often the result of cognitive bias. This CBT worksheet explores common cognitive biases that have bee ... https://www.psychologytools.com/resource/before-i-blame-myself-and-feel-guilty/

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/

Assertive Responses

Being able to communicate assertively is an essential skill for developing and maintaining healthy relationships and positive self-esteem. Individuals ... https://www.psychologytools.com/resource/assertive-responses/

Unhelpful Thinking Styles (Archived)

NOTE: Two improved versions of this resource are available here: Cognitive Distortions – Unhelpful Thinking Styles (Common) and Cognitive Disto ... https://www.psychologytools.com/resource/unhelpful-thinking-styles-archived/

Theory A / Theory B

Human beings actively try to understand their world and what happens to them. However, these understanding can be inaccurate or unhelpful. Worse, unhe ... https://www.psychologytools.com/resource/theorya-theoryb/

Choosing Your Values

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, includin ... https://www.psychologytools.com/resource/choosing-your-values/

Activity Menu

Helping clients to choose which activities to target during behavioral activation (BA) can be accomplished in a variety of ways: activity monitoring c ... https://www.psychologytools.com/resource/activity-menu/

Thought Distortion Monitoring Record

Thinking is often biased in particular ways and individuals often have their own characteristic patterns of bias. The Thought Distortion Monitoring Re ... https://www.psychologytools.com/resource/thought-distortion-monitoring-record/

Worry Flowchart

Worry is a cognitive process that involves thinking about problems that might happen in a way that causes anxiety. Not all worry is problematic – we ... https://www.psychologytools.com/resource/worry-flowchart/

Social Anxiety Formulation

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/social-anxiety-formulation/

[Free Guide] An Introduction To Values

People’s lives feel unfulfilling or directionless if they’re not guided by values. An Introduction to Values is a practical self-help guide design ... https://www.psychologytools.com/resource/an-introduction-to-values/

Behavioral Activation Activity Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-diary/

Post-Traumatic Stress Disorder (PTSD) Formulation

This Post-Traumatic Stress Disorder (PTSD) Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supp ... https://www.psychologytools.com/resource/ptsd-formulation/

Examining Your Negative Thoughts

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

Using Behavioral Activation To Overcome Depression

Using Behavioral Activation To Overcome Depression is a guide written for clients who are currently depressed. It provides clear information about dep ... https://www.psychologytools.com/resource/using-behavioral-activation-to-overcome-depression/

Cross Sectional Formulation

Case conceptualizations (formulations) help therapists and clients come to a shared understanding of a problem. This Cross Sectional Formulation explo ... https://www.psychologytools.com/resource/cross-sectional-formulation/

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/

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/

Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format/

What Is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) is fundamentally concerned with the meanings which people make of their experiences. The insight of the CBT model i ... https://www.psychologytools.com/resource/what-is-cbt-worksheet-handout/

CBT Model – Maintaining Processes

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. Effective cognitive behavioral formulations ... https://www.psychologytools.com/resource/cbt-model-maintaining-processes/

Values: Connecting To What Matters

Values: Connecting To What Matters is a practical self-help guide which introduces the reader to a cornerstone of acceptance and commitment therapy (A ... https://www.psychologytools.com/resource/values-connecting-to-what-matters-full-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/

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/anxiety-self-monitoring-record/

What Keeps Generalized Anxiety And Worry 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-generalized-anxiety-and-worry-going/

Self-Blame

The Self-Blame information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively wi ... https://www.psychologytools.com/resource/self-blame/

CBT Model – Maintaining Processes – Past And Present

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. Effective cognitive behavioral formulations ... https://www.psychologytools.com/resource/cbt-model-maintaining-processes-past-and-present/

Worry Postponement

Worry postponement ("worry time") is often prescribed as an exploratory or standalone intervention relatively early in the treatment of GAD, but  ... https://www.psychologytools.com/resource/worry-postponement/

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/

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/

Vicious Cycle - Costs And Benefits

Formulation is a key component in talking therapies, and vicious cycles have long been recognized in psychotherapy as key mechanisms that perpetuate p ... https://www.psychologytools.com/resource/vicious-cycle-costs-and-benefits/

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/

Understanding Generalized Anxiety And Worry

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-generalized-anxiety-and-worry/

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/

Evaluating Unhelpful Automatic Thoughts

The Evaluating Unhelpful Automatic Thoughts guide is written for clients who struggle with negative automatic thoughts. It provides a comprehensive in ... https://www.psychologytools.com/resource/evaluating-unhelpful-automatic-thoughts/

Decatastrophizing

Catastrophic thinking (magnification) is characteristic of many anxiety problems. This CBT worksheet for decatastrophizing is a tool for cognitive res ... https://www.psychologytools.com/resource/decatastrophizing/

Simple Thought Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioral therapy (CBT). This Simple Thought Record is an exce ... https://www.psychologytools.com/resource/simple-thought-record/

Compassionate Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Compassi ... https://www.psychologytools.com/resource/compassionate-thought-challenging-record/

Exposure And Response Prevention

Exposure And Response Prevention (ERP, EX/RP) is an effective treatment for obsessive compulsive disorder (OCD). This CBT worksheet guides therapists ... https://www.psychologytools.com/resource/exposure-and-response-prevention/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Client Workbook. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-client-workbook/

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ... https://www.psychologytools.com/resource/behavioral-experiment/

Audio Collection: Psychology Tools For Mindfulness

The Psychology Tools For Mindfulness Audio Collection is the perfect way to introduce your clients to the practice of mindfulness. Developed by a clin ... https://www.psychologytools.com/resource/psychology-tools-for-mindfulness-audio-collection/

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/

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/

What Keeps Obsessive Compulsive Disorder (OCD) 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-obsessive-compulsive-disorder-ocd-going/

Understanding Low Self-Esteem

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-low-self-esteem/

What Keeps Depression 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-depression-going/

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/

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/

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/

Understanding Obsessive Compulsive Disorder (OCD)

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

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/

Pie Chart - Responsibility

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

Changing Avoidance (Behavioral Activation)

Behavioral activation (BA) is a structured psychotherapeutic approach effective for a range of disorders, including depression (Ekers et al., 2014), a ... https://www.psychologytools.com/resource/changing-avoidance-behavioral-activation/

Treating Your OCD With Exposure And Response (Ritual) Prevention (Second Edition): Workbook

Exposure and Response (Ritual) Prevention for Obessssive-Compulsive Disorder comes in two volumes. This page is for the Client Workbook. Click on the ... https://www.psychologytools.com/resource/treating-your-ocd-with-exposure-and-response-ritual-prevention-workbook/

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/

Uncovering Your Deeper Beliefs

Cognitive behavioral therapy (CBT) describes three levels of cognition: automatic thoughts, assumptions, and core beliefs. While CBT therapists do not ... https://www.psychologytools.com/resource/uncovering-your-deeper-beliefs/

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/

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/

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/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Therapist Guide. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-therapist-guide/

Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)

Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represent ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-low-self-esteem-fennell-1997/

Exposure Session Record

The Exposure Session Record is a tool for recording clients’ use of exposure. The worksheet guides clients to identify a specific fear they are will ... https://www.psychologytools.com/resource/exposure-session-record/

What Is A Panic Attack?

Panic attacks are single episodes of intense fear or discomfort that begin suddenly and reach a peak within minutes. The cognitive behavioral model of ... https://www.psychologytools.com/resource/what-is-a-panic-attack/

What Keeps Low Self-Esteem 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-low-self-esteem-going/

Understanding Depression

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-depression/

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/

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/

Activity Planning

Research suggests that an activity is more likely to be completed if it is planned and scheduled in advance. The Activity Planning worksheet can be us ... https://www.psychologytools.com/resource/activity-planning/

Core Belief Magnet Metaphor

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/core-belief-magnet-metaphor/

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model/

Understanding Social Anxiety

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-social-anxiety/

Catastrophizing

The Catastrophizing information handout forms part of the cognitive distortions series. It is designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/catastrophizing/

Understanding Post-Traumatic Stress Disorder (PTSD)

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-post-traumatic-stress-disorder-ptsd/

Understanding Health Anxiety

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-health-anxiety/

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/

Behavioral Activation Activity Planning Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-planning-diary/

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/

Audio Collection: Psychology Tools For Overcoming PTSD

The Psychology Tools for Overcoming PTSD Audio Collection is designed for anyone with post-traumatic stress disorder (PTSD). This skills development p ... https://www.psychologytools.com/resource/psychology-tools-for-overcoming-ptsd-audio-collection/

Thought Record (Considered Response)

Thought records exist in multiple variants, depending on the needs and abilities of the client. This Thought Record (Considered Response) is a cogniti ... https://www.psychologytools.com/resource/thought-record-considered-response/

"Should" Statements

“Should” statements (sometimes referred to as ‘musturbation’, ‘necessitous thinking’, ‘self-commands’, and ‘injunctions’) are char ... https://www.psychologytools.com/resource/should-statements/

Thought-Action Fusion

The Thought-Action Fusion information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/thought-action-fusion/

Activity Diary (Hourly 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-hourly-time-intervals/

CBT Thought Record Portrait

The CBT Thought Record is an essential tool in cognitive behavioral therapy. Thought challenging records help people to evaluate their negative automa ... https://www.psychologytools.com/resource/cbt-thought-record-portrait/

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/

What Keeps Social Anxiety 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-social-anxiety-going/

Thought Record – Courtroom Trial

Thought records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. The Thought Record – Co ... https://www.psychologytools.com/resource/thought-record-courtroom-trial/

Emotional Reasoning

The Emotional Reasoning information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effec ... https://www.psychologytools.com/resource/emotional-reasoning/

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

Worksheets

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.