Judith S. Beck, PhD 

President, Beck Institute for Cognitive Behavior Therapy 

There are so many things that I enjoy about my work, and teaching CBT is near the top of the list. I teach CBT to psychiatry residents at the University of Pennsylvania, and I teach everyone from graduate students to highly experienced clinicians through our Beck Institute virtual training offerings. I’m periodically contacted by professionals and students who are new to the field. They ask for advice as they begin to navigate the seemingly daunting task of learning CBT and incorporating it into their practices so they can become competent and confident. I often tell clinicians that it actually takes a lifetime of learning to truly master CBT. Given all the new research and advancements in the field, I’m still increasing my own competence. Here are my top three pieces of advice.   

Treat every patient at every session for the rest of your career the way you would like to be treated if you were a patient. 

CBT is sometimes inaccurately criticized as being “cold” or “manualized.” That is certainly not true of CBT as developed by my father, Aaron Beck, and as taught at Beck Institute. Treatment manuals have their place in research settings and are very important when assessing the efficacy and effectiveness of CBT for a large range of populations and conditions. But in practice, I believe that clinicians should not use treatment manuals. Instead, they should incorporate the principles of evidence-based treatment manuals in their work, adapting treatment for each individual client. Effective CBT therapists also use excellent Rogerian counseling skills, adapting them as needed for some individuals. They demonstrate empathy and positive regard. They foster a strong therapeutic relationship, paying close attention to negative shifts in clients’ affect during sessions, and work through ruptures in the alliance. They welcome feedback of all kinds—but especially negative feedback, which presents an opportunity for reflection, change, and growth (for both clients and therapists). They admit when they have made a mistake and take care not to respond defensively if their own negative core beliefs become activated during sessions. Most importantly, they create a safe and judgment-free environment for their clients to heal and grow, learn new skills, and work to improve their lives and achieve their aspirations.   

I think seeking therapy is an act of courage for most clients. Evidence-based techniques and strategies must be implemented within the context of a supportive relationship built on empathy and trust. 

Develop a treatment plan based on a cognitive conceptualization for each client, considering their age, developmental level, gender, socioeconomic status, cultural background, and other individual characteristics. 

Like almost all of the social, behavioral, and medical sciences, psychological theories and treatments were historically developed by and tested on primarily Caucasian, middle-class individuals. But CBT has been refined and adapted ever since it was developed in the 1960s and 1970s. A great deal of work has been done by researchers and clinicians around the world to adapt and expand this treatment for people from different backgrounds, cultures, age groups, socioeconomic groups, religions, and other important individual characteristics. CBT has become significantly more accessible and more effective for populations that were originally unaddressed by the scientific community. It is so important for CBT clinicians to understand the role their clients’ histories and lived experiences play in the formation of their cognitions and coping strategies. Treatment must consist of culturally appropriate interventions. 

It is also important to understand how techniques from other evidence-based psychotherapeutic modalities can be used within the context of the cognitive model, for example, dialectical behavior therapy, acceptance and commitment therapy, interpersonal therapy, motivational interviewing, and others. I strongly encourage therapists to also learn about Recovery-Oriented Cognitive Therapy (CT-R), which was originally developed to help individuals diagnosed with a serious mental health condition build resilience, make connections, pursue their aspirations, and live lives full of purpose and meaning. This revolutionary approach was developed by Aaron Beck and colleagues now at Beck Institute and elsewhere. I believe incorporating CT-R techniques into treatment will benefit all clients, as they put a greater emphasis on clients’ aspirations and values, their strengths and resources—and less on their psychopathology. A great way to start incorporating CT-R into your practice is to complete a Strength-Based Cognitive Conceptualization Diagram and a Recovery Map for each client. 

Recognize that it takes a lifetime to master CBT, so plan to keep current with the research and seek opportunities to extend your learning. 

Not only do I enjoy teaching CBT, but I also find it incredibly rewarding to learn more about CBT myself. There is always new research being conducted, and I keep current by subscribing to and reading peer-reviewed journals and attending presentations of new research at conferences. I’m also so lucky to be able to discuss and get suggestions about my clients’ challenges in case conferences with other therapists at Beck Institute. You yourself might consider starting a CBT group with your colleagues to support one another, discuss research and clinically-oriented readings, report on presentations you’ve attended, and/or review your treatment of specific clients. If you are able, clinical supervision, like that offered by Beck Institute, is a terrific way to receive mentorship and practical guidance from an expert clinician. I always say that I am a much better therapist now than I was five years ago, and I hope in another five years, I’ll be an even better one. 

At Beck Institute, we are proud to support clinicians wherever they are on their journey. If you are looking to extend your learning, here are some great places to start: 

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