The following is taken from an article co-authored by Dr. Judith Beck and published in the German journal Verhaltenstherapie und Psychosoziale Praxis (Behavior Therapy and Psychosocial Practice). Download the full article in German here.
Introduction
Beck Institute (BI) is a nonprofit organization in Philadelphia, Pennsylvania, USA, with a mission to improve lives worldwide through excellence and innovation in cognitive behavior therapy (CBT) training, practice and research. My father, Dr. Aaron T. Beck, and I founded the Institute in 1994. Since that time, we have trained thousands of health and mental health professionals in 130 countries through a wide variety of programs.
Dr. Aaron Beck is globally recognized as the father of cognitive therapy, after developing the revolutionary treatment at the University of Pennsylvania in the 1960s and 1970s, where he is currently Emeritus Professor of Psychiatry. A prolific and productive researcher and author, with a career spanning more than 70 years, he has published over 600 articles and authored or co-authored 25 books. At the time of Beck Institute’s founding, I had been working at the University of Pennsylvania for nearly two decades, and I continue my work there to this day, as Clinical Professor of Psychology in Psychiatry at the Perelman School of Medicine. During my career, I have written over 100 articles and chapters on different aspects of cognitive therapy, and authored the primary text in the field, Cognitive Behavior Therapy: Basics and Beyond, now in its third edition, along with six other CBT books for professionals and consumers.
Despite our success in research, clinical care, and training within the framework of academia, we saw a need for a free-standing institute that would provide state-of-the-art psychotherapy to clients and comprehensive training programs for health and mental health professionals. From the beginning, we established a tradition of offering low-fee treatment (when needed) and scholarships to clinicians and organizations in lower-resourced countries and communities. Over the past 26 years, Beck Institute has grown from a small treatment-focused setting with a staff of eight, to an international hub for CBT training and resources.
The Early Years
In the 1990s, interest in CBT was growing both in the United States and internationally. Dr. Aaron Beck and his team of researchers at the University of Pennsylvania, as well as researchers around the world, had spent many years studying the theoretical constructs of CBT, and investigating its efficacy and effectiveness in clinical practice; they then used the results of this research, and research in related fields, to refine theory and practice. The approach was increasingly gaining traction in mental health, medicine, and in the media. More and more individuals who suffered from depression, anxiety, substance use disorder, chronic pain and other conditions were seeking therapists who practiced this form of psychotherapy. When we opened in 1994, our vision was to become an international center for CBT training and research. Initially, clinical services comprised about 80% of our activities. By 1998, BI’s 11 clinicians had conducted over 4,800 patient evaluation and treatment sessions annually.
The other 20% of Beck Institute’s activities during this time involved funding and participating in research and conducting training programs for professionals. Our aim was to increase the number of competent CBT therapists, faculty, and supervisors–making effective CBT more widely available across the United States and in other countries. In the early 2000s, Beck Institute began to fulfill a growing need for CBT training within health and mental health organizations. In 2000, we trained staff at hospital units in New York, New Jersey, and Pennsylvania. In 2002, we partnered with the University of Louisville to train community mental health therapists in seven counties. In 2002, we trained and supervised 32 therapists from a hospital system in Detroit.
This was also a period of growing renown for Dr. Aaron Beck. In 2005, he participated in a series of historical meetings with His Holiness the 14th Dalai Lama in Goteborg, Sweden. During their hour-and-a-half public conversation, they discussed the similarities between cognitive theory and Buddhism, particularly the overarching theme of both systems of thought: that only the mind can cure the mind. Dr. Beck concluded that Buddhism is the philosophy closest to the underlying theory of cognitive therapy. The two maintained a rich correspondence for years following their meeting.
Dr. Beck was also honored with numerous prestigious awards during these years. In 2001, he received the Heinz Award for the Human Condition. In 2006, he was voted the Greatest Mind in Psychiatry at the Royal Institute in London; and received the Lifetime Achievement Award from the American Foundation for Suicide Prevention. In 2007, he received the Albert Lasker Award for Clinical Medical Research. The Lasker awards, often likened to Nobel Prizes, are given in recognition of “stunning” achievements in medical research. The chairman of the jury committee who selected Dr. Beck for the award stated that the development of cognitive therapy was “one of the most important advances – if not the most important advance” in the treatment of depression and anxiety in the last 50 years. The same year, Dr. Beck also received the Gustav O. Lienhard Award for Advancement of Health Care from the National Academy of Medicine, in recognition of his outstanding achievement in improving health care services in the United States.
It was around this time that Beck Institute started to diversify its training programs to include a broader range of offerings. In 2010, we established an annual workshop to teach the fundamentals of CBT for depression and suicide prevention to health and mental health graduate students, interns, post-doctoral students, and early career professionals. We have provided ten scholarships to this workshop every year and have attracted young trainees from all over the world. This has been an important investment in the future of the field.
A Period of Exponential Growth
2013 marked a change in direction for Beck Institute. Dr. Aaron Beck and I decided to tackle a problem in the field. Through decades of research, it was now firmly established that CBT was an effective treatment for many problems individuals were facing, from depression and anxiety to personality disorders, substance use, trauma, and suicide—but many people who needed help were faced with insurmountable barriers. Effective treatment was often not available in their locale; if it was, it was often not affordable, accessible, or appropriately adapted to patients’ culture, age, educational level, or other important characteristics. Many settings used manuals, created for research studies, which failed to consider co-morbidities, problems in the therapeutic relationship, or the need for treatment based on an individualized cognitive conceptualization. Many people received ineffective treatment, or worse, no treatment at all.
The Affordable Care Act had just been passed in the United States, encouraging the use of evidence-based treatments. CBT was the most highly-researched form of psychotherapy in the world, but there just were not enough well-trained cognitive therapists to meet the growing need. We decided it was time to engage with a broader audience. We knew that we had untapped potential to bring training out from behind our walls and into the places where it was needed most.
One major project was the development of BI’s first online CBT training program. The program originated in 2016 with a multi-week course in the Essentials of CBT, followed by additional multi-week courses in CBT for Depression, CBT for Anxiety, and CBT for Personality Disorders. The courses, which I scripted and taught alongside other Beck Institute faculty, included lectures, course manuals, recordings of full therapy sessions, clinical roundtable discussions, practice exercises, enrichment material, and an interactive forum where participants could engage with one another and with Beck Institute’s faculty members. These courses have now been taken by thousands of clinicians in 128 countries. Most of the practitioners who have taken these courses would never otherwise have been able to access this kind of in-depth training in CBT.
Another major initiative was to expand Beck Institute’s Training for Organizations program. This initiative allowed many professionals who worked in hospitals, residential settings, health systems, universities, mental health systems and agencies, and forensic settings to receive CBT training for the first time, which, in turn, allowed them to serve specific populations that had previously not had access to evidence-based therapy. And we were able to help many of these organizations foster sustainability through a train-the-trainer model, creating a pervasive culture change that benefited the organization’s staff and clients for years to come.
Throughout this period of rapid growth for Beck Institute, Dr. Aaron Beck had been collaborating with his team of researchers and clinicians at the University of Pennsylvania to develop and test an adaptation of cognitive therapy for individuals diagnosed with serious mental health conditions, some of whom had been institutionalized for decades. Recovery-Oriented Cognitive Therapy (CT-R), based on the Cognitive Model, is rooted in evidence-based principles of CBT and public health, and promotes connection, purpose, hope, empowerment, and resilience (Beck et al, 2020). In 2019, these researchers, faculty, clinicians, and staff started the Center for Recovery-Oriented Cognitive Therapy at Beck Institute. They continue to train teams of mental health professionals, paraprofessionals and peers across the country, adapting CT-R for forensic settings, state hospitals, programmatic residences, and community teams, in large state and municipal systems, as well as in specific agencies and services. Initial research supports the efficacy of this approach in treating individuals and preventing relapse (Grant, et al., 2012; Grant, et al., 2017).
Looking Forward
What is next for Beck Institute and the field of CBT? In 2021, Beck Institute re-launched all of its online courses, which have been revised to reflect the most current research. Another major initiative on the horizon for Beck Institute is to support and grow the adaptation of CBT for diverse cultures and populations, creating novel systems of delivery. In acknowledgement of a growing need, we plan to focus on meeting communities where they are, building competence among clinicians who treat impoverished clients. Along the same lines, we plan to build training programs to support the use of CBT interventions by a wide variety of people, in addition to psychotherapists, individuals such as caregivers, religious leaders, paraprofessionals, schoolteachers, occupational and physical therapists, hospice workers, and even prison guards. We have always emphasized providing CBT training tailored to health professionals who work in medical settings, both through workshops on treating chronic pain and other medical conditions, and through organizational training projects, where we have provided CBT training to medical professionals working with transplant patients and nursing students doing brief therapy, among others. We hope to expand upon this work, making CBT more widely available in health centers and primary care settings.
Most important, however, we plan to make excellent CBT training more accessible. Research shows that well-trained therapists produce better outcomes for their clients. Beck Institute, its leadership, board of directors, clinicians, faculty, and staff will continually build on our 30-year history of improving lives worldwide through excellence in CBT.
Learn CBT from the Source
Beck Institute was co-founded by CBT’s pioneering treatment developer, Dr. Aaron T. Beck. At Beck Institute, CBT is practiced and taught with fidelity to the model developed by Dr. Beck and tested in over 2,000 clinical studies. Dr. Judith S. Beck directs and guides our team.
Our Impact
Learn how Beck Institute fulfills its nonprofit mission of improving lives worldwide through excellence and innovation in Cognitive Behavior Therapy (CBT) and Recovery-Oriented Cognitive Therapy (CT-R).
References
Beck, A. T., Finkel, M. R., & Beck, J. S. (2020). The theory of modes: Applications to schizophrenia and other psychological conditions. Cognitive Therapy and Research, 1-10.
Brown, G. K., Newman, C. F., Charlesworth, S. E., Crits-Christoph, P., & Beck, A. T. (2004). An open clinical trial of cognitive therapy for borderline personality disorder. Journal of Personality Disorders, 18(3: Special issue), 257-271.
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(1), 17-31.
Carney, R. M., Blumenthal, J. A., Freedland, K. E., Youngblood, M., Veith, R. C., Burg, M. M., … & ENRICHD Investigators. (2004). Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study. Psychosomatic medicine, 66(4), 466-474.
DeRubeis RJ, Hollon SD, Amsterdam JD, et al. Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression. Arch Gen Psychiatry. 2005;62(4):409–416. doi:10.1001/archpsyc.62.4.409
Grant, P.M., Huh, G.A., Perivoliotis, D., Stolar, N.M., & Beck, A.T. (2012) Randomized Trial to Evaluate the Efficacy of Cognitive Therapy for Low-Functioning Patients With Schizophrenia. Arch Gen Psychiatry. 69(2)121–127
Grant, P.M., Bredemeier, K., & Beck, A.T. (2017) Six-month follow-up of recovery-oriented cognitive therapy for low-functioning individuals with schizophrenia. Psychiatric Services, 68(10), 997-1002.
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Salomon, R. M., O’Reardon, J. P., … & Gallop, R. (2005). Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of general psychiatry, 62(4), 417-422.
Lewis, C. C., Scott, K., & Marriott, B. R. (2018). A methodology for generating a tailored implementation blueprint: an exemplar from a youth residential setting. Implementation Science, 13(1), 1-13.
Mohr, D. C., Hart, S. L., Julian, L., Catledge, C., Honos-Webb, L., Vella, L., & Tasch, E. T. (2005). Telephone-administered psychotherapy for depression. Archives of general psychiatry, 62(9), 1007-1014.
Reilly, C. E., & McDanel, H. (2005). Cognitive therapy: a training model for advanced practice nurses. Journal of psychosocial nursing and mental health services, 43(5), 27-31.
Strunk, D. R., Brotman, M. A., DeRubeis, R. J., & Hollon, S. D. (2010). Therapist competence in cognitive therapy for depression: predicting subsequent symptom change. Journal of consulting and clinical psychology, 78(3), 429.
Wright, J. H., Wright, A. S., Albano, A. M., Basco, M. R., Goldsmith, L. J., Raffield, T., & Otto, M. W. (2005). Computer-assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time. American Journal of Psychiatry, 162(6), 1158-1164.