Seven Tips for Becoming a Champion at CBT

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Sometimes transcripts of sessions with an experienced cognitive behavioral therapist sound so natural and easy, you can imagine the clinician as your best friend, chatting with you on a park bench. However, successful treatment takes foresight, and the use of these seven tips.

  1. Conceptualize a case adequately. Picture the way a client’s core beliefs lead to automatic thoughts, and then negative emotions, in specific kinds of situations—preferably on cognitive conceptualization diagrams, or some other structured form, which guide you in organizing data. Share this conceptualization with the client for feedback about its accuracy.
  2. Form a strong therapeutic alliance. Collaboration is central in cognitive behavior therapy (CBT), so negotiating the agenda for sessions, homework, and goals is essential. A strong therapeutic alliance also necessitates being competent, caring, and in tune with the client during treatment, even though we tend to associate such a stance with other kinds of psychotherapy.
  3. Make sure the client accepts the CBT mind-set. From the beginning, you need to educate clients about the CBT paradigm, so they have appropriate expectations, and agree to ground rules about problem solving and homework.
  4. Focus on priorities. Ideal CBT can accommodate crises, but sticks to a jointly created agenda. It is okay to interrupt a patient straying from the topic.
  5. Check your progress. Have you broken the client’s wish list into manageable sub-goals? Is homework covering the behavioral, as well as cognitive, front? Do you accomplish something in each session? Are you also focusing on your long-term objectives?
  6. Help clients get the most from treatment. Encourage clients to take notes, on paper or technological marvels, to remember ideas and skills after therapy ends.
  7. Remember, CBT, like the sonatas of Mozart, is deceptively simple. To paraphrase the great pianist, Artur Schnabel, CBT is deceptively simple: too simple for clients, too difficult for therapists. Use manuals, supervision, and conferences, as well as an abundance of free online resources, to improve your skills.