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11. Problems in Structuring Sessions M any clients become easily socialized to the usual structure of sessions. Educating clients about the structure and providing a rationale may be enough. But there are certainly times when you shouldn’t follow the usual str...

12. Identifying Automatic Thoughts T o review, the cognitive model suggests that the interpretation of a situation (rather than the situation itself), expressed in automatic thoughts or images, influences one’s emotion, behavior, and physiological response. It...

13. Emotions E motions are of primary importance in CBT. After all, a major objective of treatment is to help clients feel better by decreasing negative emotion and increasing positive emotion. Intense negative emotion is painful and may be dysfunctional if it...

14. Evaluating Automatic Thoughts C lients have hundreds or thousands of thoughts a day, some dysfunctional, some not, some relevant to treatment, others not. Part of the art of therapy is to conceptualize which thoughts are most important to address and how t...

15. Responding to Automatic Thoughts T he previous chapter demonstrated how to help clients evaluate important negative automatic thoughts and determine the effectiveness of their evaluation in session. But when these same thoughts arise in their minds during ...

16. Integrating Mindfulness into CBT M indfulness has been studied intensively, sometimes as a standalone intervention and sometimes as part of a psychotherapeutic modality. In fact, mindfulness has been practiced for thousands of years. Many researchers have ...

17. Introduction to Beliefs I n previous chapters, you learned how to identify and modify automatic thoughts, the actual words or images that go through a client’s mind in a given situation and lead to distress or unhelpful behavior. This chapter, and the next...

18. Modifying Beliefs I n the previous chapter, we discussed how to identify important positive and negative beliefs, how to explain beliefs to clients, and how to motivate them to modify their beliefs. When clients are in a maladaptive mode such as depression...

19. Additional Techniques W e’ve already covered many basic CBT techniques in this book, among them, psychoeducation, focusing on aspirations, values, and strengths; monitoring mood and behavior; cognitive restructuring; worksheets; behavioral experiments; and...

20. Imagery M any clients experience automatic thoughts not only as unspoken words in their minds but also in the form of mental pictures or images (Beck & Emery, 1985). As I’m sitting here now, I can recall several images I had today. As I read an email from ...

21. Termination and Relapse Prevention R esearch shows that sessions focused on relapse prevention help delay the onset of relapse and recurrence among depressed clients (de Jonge et al., 2019). The traditional objectives of CBT have been to facilitate a remis...

22. Problems in Therapy P roblems of one kind or another arise with many clients. Even experienced therapists encounter difficulties at times when establishing the therapeutic relationship, conceptualizing a client’s difficulties, or consistently working towar...

Appendix A. CBT Resources For principles of CBT, worksheets, videos, conceptualization diagrams, the case summary outline, and the Cognitive Therapy Rating Scale and manual, visit beckinstitute.org/CBTresources. TRAINING PROGRAMS The Beck Institute for Cogniti...

Appendix B. Beck Institute Case Write‑Up: Summary and Conceptualization PART ONE: INTAKE INFORMATION Identifying Information at Intake Age: 56 Gender Identity and Sexual Orientation: Male, heterosexual Cultural Heritage: American with European heritage Religio...

Appendix C. Steps in the AWARE Technique Accept anxiety. Anxiety is natural, normal, and necessary for survival. The sensations you experience are a normal part of anxiety, even when they become intense. Anxiety increases when you get anxious about feeling an...

Appendix D. Restructuring the Meaning of Early Memories through Experiential Techniques I have put techniques to restructure the meaning of early experience in an appendix because they are more advanced and may not apply to many of your clients. These Gestalt-...

References Abbott, R. A., Whear, R., Rodgers, L. R., Bethel, A., Coon, J. T., Kuyken, W., . . . Dickens, C. (2014). Effectiveness of mindfulness-­based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-­...

Index Abe (case example) Action Plan dealing with negative predictions, 153–154 dealing with procrastination, 157 final check on, 189, 190–191 first therapy session, 93–96, 114 preparing for a possible negative outcome, 148–149 provision of explicit instructio...