Cognitive Behavioral Therapy (CBT) by Dr. James Ikonomopoulos

James Ikonomopoulos Ph.D., LPC-S

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

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 2

nd

 Session and Beyond

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

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.

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.

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.

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.

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.

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.

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.

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

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.

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].”

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).

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)

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.

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.

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.

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.

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

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?

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

Situation

Thoughts

 Feelings

Behaviors

Thinking, Feeling, and Behaving

THOUGHTS

FEELINGS

BEHAVIORS

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

Roller Coaster Example

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

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

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.

Automatic Thoughts



When you notice a strong reaction (emotional,

 behavioral, physiological), ask yourself:

“What was going through my mind just then?”

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.

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.

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

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

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.



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



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



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

Coping Strategies



Behaviors that the client engages in that either

support or oppose beliefs



Strategies may involve thinking or doing

something.

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

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

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.

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

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

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.

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.

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)

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.

Behavioral Activation

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.

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?

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.

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).

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.

2

nd

 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.

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.

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).

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.

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)

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

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.

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.

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–

297). New York: Plenum Press.