![What is the Theory of CBT?
For lasting improvement in patients’ mood and behavior,
cognitive therapists work at a deeper level of cognition: patients’
basic beliefs about themselves, their world, and other
people.
Modification of their underlying dysfunctional beliefs produces
more enduring change. For example, if you continually
underestimate your abilities, you might have an underlying
belief of incompetence.
Modifying this general belief (i.e., seeing yourself in a more
realistic light as having both strengths and weaknesses) can
alter your perception of specific situations that you
encounter daily. You will no longer have as many thoughts with
the theme, “I can’t do anything right.” Instead, in specific
situations where you make mistakes, you will probably think,
“I’m not good at this [specific task].”](https://image.slidesharecdn.com/cbt-refresher-240729161448-9f0a9f77/85/CBT-Refresher-basics-approach-in-CBT-for-14-320.jpg)
![ 6. Magnification/minimization: When you evaluate yourself,
another person, or a situation, you unreasonably magnify the negative
and/or minimize the positive.
Example: “Getting a mediocre evaluation proves how inadequate I
am. Getting high marks doesn’t mean I’m smart.”
7. Mental filter (also called selective abstraction): You pay undue
attention to one negative detail instead of seeing the whole picture.
Example: “Because I got one low rating on my evaluation [which
also contained several high ratings] it means I’m doing a lousy job.”
8. Mind reading: You believe you know what others are thinking,
failing to consider other, more likely possibilities.
Example: “He thinks that I don’t know the first thing about this
project.”
9. Overgeneralization: You make a sweeping negative conclusion that
goes far beyond the current situation.
Example: “[Because I felt uncomfortable at the meeting] I don’t
have what it takes to make friends.”
Common Unhelpful Thoughts](https://image.slidesharecdn.com/cbt-refresher-240729161448-9f0a9f77/85/CBT-Refresher-basics-approach-in-CBT-for-38-320.jpg)
![Behavioral Activation
Situation: Thinking about initiating an activity
[Common] Automatic thoughts: “I’m too tired. I won’t
enjoy it. My friends won’t want to spend time with me. I
won’t be able to do it. Nothing can help me feel better.”
[Common] Emotional reactions: Sadness, anxiety,
hopelessness
[Common] Behavior: Remain inactive.](https://image.slidesharecdn.com/cbt-refresher-240729161448-9f0a9f77/85/CBT-Refresher-basics-approach-in-CBT-for-49-320.jpg)
![Evaluating Thoughts
1. What is the evidence that supports this idea?
What is the evidence against this idea?
2. Is there an alternative explanation or viewpoint?
3. What is the worst that could happen (if I’m not already
thinking the worst)? If it happened, how could I cope?
What is the best that could happen?
What is the most realistic outcome?
4. What is the effect of my believing the automatic thought?
What could be the effect of changing my thinking?
5. What would I tell____________[a specific friend or family
member] if he or she were in the same situation?
6. What should I do?](https://image.slidesharecdn.com/cbt-refresher-240729161448-9f0a9f77/85/CBT-Refresher-basics-approach-in-CBT-for-52-320.jpg)
CBT Refresher basics approach in CBT for
- 1. James Ikonomopoulos Ph.D., LPC-S
- 2. Presentation Objectives Explain the connection between thoughts, feelings, and behaviors Develop a cognitive case conceptualization and understand its relationship to Cognitive Therapy Choose and apply cognitive interventions appropriate for use with children and adults Choose and apply behavioral interventions appropriate for use with children and adults
- 3. Outline of Presentation Introduction to CBT Basic principles and overview of treatment Cognitive Conceptualization The cognitive model The Evaluation Session Intake and assessment The Initial Therapy Session Treatment Planning The 2nd Session and Beyond
- 4. Outline of Concepts Behavioral Activation Identifying Automatic Thoughts Identifying Emotions Evaluating Automatic Thoughts Responding to Automatic Thoughts Identifying and Modifying Intermediate Beliefs Identifying and Modifying Core Beliefs Imagery Homework Additional Techniques
- 5. Introduction to CBT A revolution in the field of mental health was started in the 1960’s by Aaron T. Beck He began as a fully trained and practicing Psychoanalyst. He was a scientist at heart, believed theories should be empirically valid. Began studying depression, and results of his experiments lead him to pursue other explanations for depression.
- 6. What is CBT? Dr. Beck decided to test the psychoanalytic concept that depression is the result of hostility turned inward toward the self. He investigated the dreams of depressed patients, which, he predicted, would manifest greater themes of hostility than the dreams of normal control patients. To his surprise, he ultimately found that the dreams of depressed patients contained fewer themes of hostility and far greater themes of defectiveness, deprivation, and loss. He recognized that these themes paralleled his patients’ thinking when they were awake.
- 7. What is CBT? He identified distorted, negative cognition (primarily thoughts and beliefs) as a primary feature of depression and developed a short-term treatment, one of whose primary targets was the reality testing of patients’ depressed thinking. Aaron Beck developed a form of psychotherapy in the early 1960s that he originally termed “cognitive therapy.” “Cognitive therapy” is now used synonymously with “cognitive behavior therapy” by much of our field.
- 8. What is CBT? Beck devised a structured, short-term, present- oriented psychotherapy for depression, directed toward solving current problems and modifying dysfunctional (inaccurate and/or unhelpful) thinking and behavior (Beck, 1964). Since that time, he and others have successfully adapted this therapy to a surprisingly diverse set of populations with a wide range of disorders and problems. These adaptations have changed the focus, techniques, and length of treatment, but the theoretical assumptions themselves have remained constant.
- 9. What is CBT? In all forms of cognitive behavior therapy that are derived from Beck’s model, treatment is based on a cognitive formulation, the beliefs and behavioral strategies that characterize a specific disorder (Alford & Beck, 1997). Treatment is also based on a conceptualization, or understanding, of individual patients (their specific beliefs and patterns of behavior). The therapist seeks in a variety of ways to produce cognitive change— modification in the patient’s thinking and belief system—to bring about enduring emotional and behavioral change.
- 10. What is CBT? Beck drew on a number of different sources when he developed this form of psychotherapy, including early philosophers, such as Epicetus, and theorists, such as Karen Horney, Alfred Adler, George Kelly, Albert Ellis, Richard Lazarus, and Albert Bandura. Beck’s work, has been expanded by current researchers and theorists, in the United States and abroad.
- 11. Different Forms of CBT There are a number of forms of cognitive behavior therapy that share characteristics of Beck’s therapy, but whose conceptualizations and emphases in treatment vary to some degree. These include rational emotional behavior therapy (Ellis, 1962), dialectical behavior therapy (Linehan, 1993), problem- solving therapy (D’Zurilla & Nezu, 2006), acceptance and commitment therapy (Hayes, Follette, & Linehan, 2004), exposure therapy (Foa & Rothbaum, 1998), cognitive processing therapy (Resick & Schnicke, 1993), cognitive behavioral analysis system of psychotherapy (McCullough, 1999), behavioral activation (Lewinsohn, Sullivan, & Grosscup, 1980; Martell, Addis, & Jacobson, 2001), cognitive behavior modification (Meichenbaum, 1977), TF-CBT (Cohen, Mannarino, & Knudsen, 2004; Cohen,. Mannarino, & Staron, 2006), and others. Beck’s cognitive behavior therapy often incorporates techniques from all these therapies, and other psychotherapies, within a cognitive framework.
- 12. The Cognitive Model “Men are disturbed not by things, but by the view which they take of them.” - Epictetus “It’s not the situations in our lives that cause distress, but rather our interpretations of those situations.” – Aaron T. Beck
- 13. What is the Theory of CBT? The cognitive model proposes that dysfunctional thinking (which influences the patient’s mood and behavior) is common to all psychological disturbances. When people learn to evaluate their thinking in a more realistic and adaptive way, they experience improvement in their emotional state and in their behavior. For example, if you were quite depressed and bounced some checks, you might have an automatic thought, an idea that just seemed to pop up in your mind: “I can’t do anything right.” This thought might then lead to a particular reaction: you might feel sad (emotion) and retreat to bed (behavior). If you then examined the validity of this idea, you might conclude that you had overgeneralized and that, in fact, you actually do many things well. Looking at your experience from this new perspective would probably make you feel better and lead to more functional behavior.
- 14. What is the Theory of CBT? For lasting improvement in patients’ mood and behavior, cognitive therapists work at a deeper level of cognition: patients’ basic beliefs about themselves, their world, and other people. Modification of their underlying dysfunctional beliefs produces more enduring change. For example, if you continually underestimate your abilities, you might have an underlying belief of incompetence. Modifying this general belief (i.e., seeing yourself in a more realistic light as having both strengths and weaknesses) can alter your perception of specific situations that you encounter daily. You will no longer have as many thoughts with the theme, “I can’t do anything right.” Instead, in specific situations where you make mistakes, you will probably think, “I’m not good at this [specific task].”
- 15. What Does the Research Say? Cognitive behavior therapy has been extensively tested since the first outcome study was published in 1977 (Rush, Beck, Kovacs, & Hollon, 1977). At this point, more than 500 outcome studies have demonstrated the efficacy of cognitive behavior therapy for a wide range of psychiatric disorders, psychological problems, and medical problems with psychological components (see, e.g., Butler, Chapman, Forman, & Beck, 2005; Chambless & Ollendick, 2001).
- 16. Partial List of Disorders Successfully Treated by CBT Psychiatric disorders Major depressive disorder Geriatric depression Generalized anxiety disorder Geriatric anxiety Panic disorder Agoraphobia Social phobia Obsessive–compulsive disorder Conduct disorder Substance abuse Attention-deficit/hyperactivity disorder Health anxiety Body dysmorphic disorder Eating disorders Personality disorders Sex addiction Habit disorders Bipolar disorder (with medication) Schizophrenia (with medication) Couple problems Family problems Pathological gambling Complicated grief Caregiver distress Anger and hostility Chronic back pain Sickle cell disease pain Migraine headaches Tinnitus Cancer pain Somatoform disorders Irritable bowel syndrome Chronic fatigue syndrome Rheumatic disease pain Erectile dysfunction Insomnia Obesity Vulvodynia Hypertension Gulf War syndrome (PTSD and more)
- 17. General Principles of CBT Cognitive behavioral therapy is: Semi‐structured, time‐sensitive, active; Based on a case conceptualization; Focused on skill development; and Oriented toward a hypothesis‐testing approach. Clinician and client work collaboratively with a focus on a strong relationship. All interventions aim at cognitive change.
- 18. General Principles of CBT Principle No. 1. Cognitive behavior therapy is based on an ever-evolving formulation of patients’ problems and an individual conceptualization of each patient in cognitive terms. Principle No. 2. Cognitive behavior therapy requires a sound therapeutic alliance. Principle No. 3. Cognitive behavior therapy emphasizes collaboration and active participation. Principle No. 4. Cognitive behavior therapy is goal oriented and problem focused.
- 19. General Principles of CBT Principle No. 5. Cognitive behavior therapy initially emphasizes the present. Principle No. 6. Cognitive behavior therapy is educative, aims to teach the patient to be her own therapist, and emphasizes relapse prevention. Principle No. 7. Cognitive behavior therapy aims to be time limited. Principle No. 8. Cognitive behavior therapy sessions are structured.
- 20. General Principles of CBT Principle No. 9. Cognitive behavior therapy teaches patients to identify, evaluate, and respond to their dysfunctional thoughts and beliefs. Principle No. 10. Cognitive behavior therapy uses a variety of techniques to change thinking, mood, and behavior.
- 21. Importance of the Therapeutic Relationship Like most other therapies, the therapeutic relationship is a necessary and critical component of CBT: Empathic Understanding Warm Genuine Direct and sensitive
- 22. The Cognitive Model Your client has been sent to the office for the 4th time this week! The family has not returned your calls, and the client is refusing to talk to you. What do you think? How do you feel? What do you do?
- 23. The client no-shows for his session again The Situation The Beliefs The Consequences This kid is so frustrating! He isn’t even trying to get better! Feelings of Frustration His family situation is so tough right now, it’s really hard for him to get to sessions. Feelings of Compassion
- 25. Thinking, Feeling, and Behaving THOUGHTS FEELINGS BEHAVIORS
- 26. Situation Automatic Thought Feelings Behaviors Get a dirty look from another kid He thinks he’s tougher than me. I’ll have to show him I’m not a punk Angry and Offended Threaten the kid Punch the kid Refuse to back down
- 28. Cognitive Model: Situations A situation or activating event may be an internal or external event that prompts an automatic thought. External event: alarm clock ringing, being interrupted, called on in class Internal event: memory, thought, emotion, sensation
- 29. Cognitive Model: Beliefs AUTOMATIC THOUGHTS Quick evaluative thoughts INTERMEDIATE BELIEFS Rules or assumptions about life “If________, then_____.” CORE BELIEFS Deeply held, rigid beliefs about the self, others, and the world
- 30. Cognitive Model: Automatic Thoughts Quick, evaluative thoughts or images that are situation specific Automatic thoughts = interpretations We are more likely to be aware of the emotion that follows an automatic thought.
- 31. Automatic Thoughts When you notice a strong reaction (emotional, behavioral, physiological), ask yourself: “What was going through my mind just then?”
- 32. Eliciting Automatic Thoughts 1. Ask them how they are/were feeling and where in their body they experienced the emotion. 2. Elicit a detailed description of the problematic situation. 3. Request that the patient visualize the distressing situation. 4. Suggest that the patient role-play the specific interaction with you (if the distressing situation was interpersonal). 5. Elicit an image. 6. Supply thoughts similar or opposite to the ones you hypothesize actually went through their minds. 7. Ask for the meaning of the situation. 8. Phrase the question differently.
- 33. Intermediate Beliefs Attitudes, rules, or assumptions that stem from core beliefs and fuel automatic thoughts Commonly in the form of “if/then” statements If I can’t do this perfectly, then why bother trying? If I open up to people, then I will get hurt.
- 34. Core Beliefs MOST CENTRAL, FUNDAMENTAL BELIEFS ABOUT OURSELVES, OTHERS, AND THE WORLD Absolute and rigid beliefs (+ or ‐) in 1‐2 words “I’m worthless.” May result in biases in attention, information processing, and memory. When activated, we interpret situations through the lens of this belief. Not necessarily accurate or helpful
- 35. Sad, gives up, avoids studying, ultimately fails Core Belief: I am Smart Core Belief: I am Stupid Event: Hears that a hard math test is scheduled for next week Automatic Thoughts and Images “I’ll really have to pay attention and ask for help” “This is too hard, I’ll never understand this.” Feels determined, seeks out help, studies, passes Reaction and Behaviors How Core Beliefs Impact Thoughts
- 36. Inaccurate and Unhelpful Beliefs UNLOVABLE I am disgusting. No one wants me. People hate me. WORTHLESS I am bad. I am a waste. I am a burden. HELPLESS I am incompetent. I am vulnerable. I am not good enough.
- 37. 1. All-or-nothing thinking (also called black-and-white, polarized, or dichotomous thinking): You view a situation in only two categories instead of on a continuum. Example: “If I’m not a total success, I’m a failure.” 2. Catastrophizing (also called fortune-telling): You predict the future negatively without considering other, more likely outcomes. Example: “I’ll be so upset, I won’t be able to function at all.” 3. Disqualifying or discounting the positive: You unreasonably tell yourself that positive experiences, deeds, or qualities do not count. Example: “I did that project well, but that doesn’t mean I’m competent; I just got lucky.” 4. Emotional reasoning: You think something must be true because you “feel” (actually believe) it so strongly, ignoring or discounting evidence to the contrary. Example: “I know I do a lot of things okay at work, but I still feel like I’m a failure.” 5. Labeling: You put a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less disastrous conclusion. Example: “I’m a loser. He’s no good.” Common Unhelpful Thoughts
- 38. 6. Magnification/minimization: When you evaluate yourself, another person, or a situation, you unreasonably magnify the negative and/or minimize the positive. Example: “Getting a mediocre evaluation proves how inadequate I am. Getting high marks doesn’t mean I’m smart.” 7. Mental filter (also called selective abstraction): You pay undue attention to one negative detail instead of seeing the whole picture. Example: “Because I got one low rating on my evaluation [which also contained several high ratings] it means I’m doing a lousy job.” 8. Mind reading: You believe you know what others are thinking, failing to consider other, more likely possibilities. Example: “He thinks that I don’t know the first thing about this project.” 9. Overgeneralization: You make a sweeping negative conclusion that goes far beyond the current situation. Example: “[Because I felt uncomfortable at the meeting] I don’t have what it takes to make friends.” Common Unhelpful Thoughts
- 39. 10. Personalization: You believe others are behaving negatively because of you, without considering more plausible explanations for their behavior. Example: “The repairman was curt to me because I did something wrong.” 11. “Should” and “must” statements (also called imperatives): You have a precise, fixed idea of how you or others should behave, and you overestimate how bad it is that these expectations are not met. Example: “It’s terrible that I made a mistake. I should always do my best.” 12. Tunnel vision: You only see the negative aspects of a situation. Example: “My son’s teacher can’t do anything right. He’s critical and insensitive and lousy at teaching.” Common Unhelpful Thoughts
- 40. Coping Strategies Behaviors that the client engages in that either support or oppose beliefs Strategies may involve thinking or doing something.
- 41. Maintaining Strategies Support the Core Belief Opposing Strategies Try to prove the belief is wrong Avoiding Strategies Try not to activate the belief Behavior generally makes sense to the person doing it, based on how they see the world, others, and themselves. Coping Strategies
- 42. Maintaining Strategies Support the Belief Acting in a hostile manner Opposing Strategies Try to prove the belief is wrong People Pleasing Avoiding Strategies Try not to activate the belief Isolating Coping Strategies Belief I’m unlovable
- 43. Beliefs and Strategies NAME SOME CLIENT BEHAVIORS… What kinds of beliefs might be associated with these behaviors? WHAT KINDS OF BEHAVIOR MIGHT BE ASSOCIATED WITH THESE BELIEFS? I’m vulnerable. I have no control. Everyone is trying to hurt me.
- 44. Case Conceptualization Foundation of CBT treatment Brings together all the information into one coherent story Takes into consideration life experiences that lead us to think and behave in specific ways Based on here‐and‐now functioning and symptoms
- 45. Case Conceptualization Why use case conceptualization? To better understand behavior To increase empathy To identify ways to engage clients To identify targets for intervention To create a shared understanding of a child or adolescent
- 46. Case Conceptualization History: Critical and abusive family members, undiagnosed learning disability, neglect Core Beliefs: I’m worthless. I’m stupid. People are dangerous. Coping Strategies and Behaviors: Avoid challenging situations, aggression, isolation. Intermediate Beliefs: It is horrible to make mistakes. If I hurt people first, then they can’t hurt me.
- 47. Case Vignette: Michele Please read the vignette about Michele. When you are finished, please review the case conceptualization. WHAT ARE THE IMPORTANT FACTS FROM HER PAST? WHAT ARE HER BELIEFS? WHICH EMOTIONS AND BEHAVIOR DOES SHE HAVE, AND HOW ARE THEY RELATED TO HER BELIEFS? Please be ready to discuss with your group.
- 48. Session Structure Mood check & general assessment Bridge from the previous session Agenda setting Homework review Discussion of issues on the agenda Summary and feedback (periodic summaries and homework assignment)
- 49. Behavioral Activation Situation: Thinking about initiating an activity [Common] Automatic thoughts: “I’m too tired. I won’t enjoy it. My friends won’t want to spend time with me. I won’t be able to do it. Nothing can help me feel better.” [Common] Emotional reactions: Sadness, anxiety, hopelessness [Common] Behavior: Remain inactive.
- 51. Evaluating Thoughts Examine the validity of the automatic thought. Explore the possibility of other interpretations or viewpoints. De-catastrophize the problematic situations Recognize the impact of believing the automatic thought. Gain distance from the thought. Take steps to solve the problem.
- 52. Evaluating Thoughts 1. What is the evidence that supports this idea? What is the evidence against this idea? 2. Is there an alternative explanation or viewpoint? 3. What is the worst that could happen (if I’m not already thinking the worst)? If it happened, how could I cope? What is the best that could happen? What is the most realistic outcome? 4. What is the effect of my believing the automatic thought? What could be the effect of changing my thinking? 5. What would I tell____________[a specific friend or family member] if he or she were in the same situation? 6. What should I do?
- 53. Evaluation Session Client demographics. Chief complaints and current problems. History of present illness and precipitating events. Coping strategies (adaptive and maladaptive), current and historical. Psychiatric history, including kinds of psychosocial treatments (and perceived helpfulness of these treatments), hospitalizations, medication, suicide attempts, and current status. Substance use history and current status. Medical history and current status. Family psychiatric history and current status. Developmental history. General family history and current status. Social history and current status. Educational history and current status. Vocational history and current status. Religious/spiritual history and current status. Strengths, values, and adaptive coping strategies.
- 54. Goals of First Treatment Session Establish rapport and trust with clients, normalize their difficulties, and instill hope. Socialize clients into treatment by educating them about their disorder(s), the cognitive model, and the process of therapy. Collect additional data to help you conceptualize the patient. Develop a goal list. Start solving a problem important to the client (and/or get the client behaviorally activated).
- 55. First Treatment Session Initial Part of Session 1 1. Set the agenda (and provide a rationale for doing so). 2. Do a mood check. 3. Obtain an update (since the evaluation) 4. Discuss the patient’s diagnosis and do psychoeducation. Middle Part of Session 1 5. Identify problems and set goals. 6. Educate the patient about the cognitive model. 7. Discuss a problem. End of Session 1 8. Provide or elicit a summary. 9. Review homework assignment. 10. Elicit feedback.
- 56. 2nd Treatment Session & Beyond Initial Part of Session 1. Do a mood check. 2. Set the agenda. 3. Obtain an update. 4. Review homework. 5. Prioritize the agenda. Middle Part of Session 6. Work on a specific problem and teach cognitive behavior therapy skills in that context. 7. Follow-up discussion with relevant, collaboratively set homework assignment(s). 8. Work on second problem. End of Session 9. Provide or elicit a summary. 10. Review new homework assignments. 11. Elicit feedback.
- 57. Tips for Setting Homework 1. One Size Does Not Fit All. 2. Explain In Detail. 3. Set Homework as a Team. 4. Create a Win-Win Situation. 5. Start Homework In-Session. 6. Ask About and Review Homework. 7. Anticipate and Prepare for Problems.
- 58. Homework Example Session 1 Read this list twice a day; set an alarm to remember. 1. If I start thinking I’m lazy and no good, remind myself that depression makes it harder for me to do things. As the treatment starts to work, my depression will lift, and things will get easier. 2. Read goal list and add others, if I think of any. 3. When I notice my mood getting worse, ask myself, “What’s going through my mind right now?” and jot down the thoughts. Remind myself that just because I think something doesn’t necessarily mean it’s true. 4. Make plans with Friends. Remember, if they say no, it’s likely that they’d like to hang out with me but they’re too busy. 5. Read Coping with Depression booklet (optional).
- 59. Homework Example Session 2 1. Daily: When I notice my mood changing, ask myself, “What’s going through my mind right now?” and jot down my automatic thoughts (which may or may not be completely true). 2. If I can’t figure out my automatic thoughts, jot down just the situation. Remember, learning to identify my thinking is a skill I’ll get better at, like typing. 3. Ask Friend for help with studying. 4. Daily: Read therapy notes. 5. Continue running/swimming. 6. Plan two to three social activities. 7. Daily: Add to credit list (anything I do that is even a little difficult but I do it anyway). 8. (Tuesday morning): Review Preparing for Therapy Worksheet for 2 minutes.
- 60. CBT Professional Organizations Academy of Cognitive Therapy (www.academyofct.org) Association for Behavioral and Cognitive Therapies (www.abct.org) British Association for Behavioural and Cognitive Psychotherapies (www.babcp.com) European Association for Behavioural and Cognitive Therapies (www.eabct.com) International Association for Cognitive Psychotherapy (www.the- iacp.com)
- 61. Assessments The following scales and manuals may be ordered from Pearson (www.- beckscales.com): Beck Depression Inventory–II Beck Depression Inventory—Fast Screen for Medical Patients Beck Anxiety Inventory Beck Hopelessness Scale Beck Scale for Suicidal Ideation Clark–Beck Obsessive–Compulsive Inventory Beck Youth Inventories—Second Edition
- 62. References Alford, B. A., & Beck, A. T. (1997). The integrative power of cognitive therapy. New York: Guilford Press. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Antony, M. M., & Barlow, D. H. (Eds.). (2010). Handbook of assessment and treatment planning for psychological disorders (2nd ed.). New York: Guilford Press. Arnkoff, D. B., & Glass, C. R. (1992). Cognitive therapy and psychotherapy integration. In D. K. Freedheim (Ed.), History of psychotherapy: A century of change (pp. 657–694). Washington, DC: American Psychological Association. Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press. Beck, A. T. (1964). Thinking and depression: II. Theory and therapy. Archives of General Psychiatry, 10, 561–571. Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press. Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press. Beck, A. T. (1987). Cognitive approaches to panic disorder: Theory and therapy. In S. Rachman & J. Maser (Eds.), Panic: Psychological perspectives (pp. 91–109). Hillsdale, NJ: Erlbaum. Beck, A. T. (1999). Cognitive aspects of personality disorders and their relation to syndromal disorders: A psychoevolutionary approach. In C. R. Cloninger (Ed.), Personality and psychopathology (pp. 411–429). Washington, DC: American Psychiatric Press.
- 63. References Beck, A. T. (2005). The current state of cognitive therapy: A 40-year retrospective. Archives of General Psychiatry, 62, 953–959. Beck, A. T., & Beck, J. S. (1991). The personality belief questionnaire. Bala Cynwyd, PA: Beck Institute for Cognitive Behavior Therapy. Beck, A. T., & Emery, G. (with Greenberg, R. L.). (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books. Beck, A. T., Freeman, A., Davis, D. D., & Associates. (2004). Cognitive therapy of personality disorders (2nd ed.). New York: Guilford Press. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press. Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive therapy of substance abuse. New York: Guilford Press. Beck, J. S. (2001). A cognitive therapy approach to medication compliance. In J. Kay (Ed.), Integrated treatment of psychiatric disorders (pp. 113–141). Washington, DC: American Psychiatric Publishing. Beck, J. S. (2005). Cognitive therapy for challenging problems: What to do when the basics don’t work. New York: Guilford Press. Beck, J. S. (2011). Cognitive behavior therapy worksheet packet (3rd ed.). Bala Cynwyd, PA: Beck Institute for Cognitive Behavior Therapy. Bennett-Levy, J., Butler, G., Fennell, M., Hackman, A., Mueller, M., & Westbrook, D. (Eds.). (2004). Oxford guide to behavioral experiments in cognitive therapy. Oxford, UK: Oxford University. Benson, H. (1975). The relaxation response. New York: Avon. Burns, D. D. (1980). Feeling good: The new mood therapy. New York: Signet.
- 64. References Butler, A. C., Chapman, J. E. Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31. Chambless, D., & Ollendick, T. H. (2001). Empirically supported psychological interventions. Annual Review of Psychology, 52, 685–716. Chiesa A., & Serretti, A. (2010a). Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research. Chiesa A., & Serretti, A. (2010b). A systematic review of neurobiological and clinical features of mindfulness mediation. Psychological Medicine, 40, 1239–1252. Clark, D. A., & Beck, A. T. (2010). Cognitive therapy of anxiety disorders: Science and practice. New York: Guilford Press. Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy of depression. Hoboken, NJ: Wiley. Clark, D. M. (1989). Anxiety states: Panic and generalized anxiety. In K. Hawton, P. M. Salkovskis, J. Kirk, & D. M. Clark (Eds.), Cognitive-behavior therapy for psychiatric problems: A practical guide (pp. 52–96). New York: Oxford University Press. D’Zurilla, T. J., & Nezu, A. M. (2006). Problem-solving therapy: A positive approach to clinical intervention (3rd ed.). New York: Springer. Davis, M., Eshelman, E. R., & McKay, M. (2008). The relaxation and stress reduction workbook (6th ed.). Oakland, CA: New Harbinger. DeRubeis, R. J., & Feeley, M. (1990). Determinants of change in cognitive therapy for depression. Cognitive Therapy and Research, 14, 469–482. Dobson, D., & Dobson, K. S. (2009). Evidence-based practice of cognitive-behavioral therapy. New York: Guilford Press. Dobson, K. S., & Dozois D. J. A. (2009). Historical and philosophical bases of the cognitive-behavioral therapies. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (3rd ed., pp. 3–37). New York: Guilford Press. Edwards, D. J. A. (1989). Cognitive restructuring through guided imagery: Lessons from Gestalt therapy. In A. Freeman, K. M. Simon, L. E. Beutler, & H. Arkowitz (Eds.), Comprehensive handbook of cognitive therapy (pp. 283–