Setting the Agenda in session

A frequent question I’m asked by clinicians who are not cognitive therapists is why we set agendas toward the beginning of sessions with patients. They often think that doing so will result in their missing out on important information. I tell them that we’ve found the opposite to be generally true.


We ask patients, “What problems do you want my help in solving today?” and guide them into naming the problems (as opposed to giving us a full description at that moment). Then we ask them to prioritize the problems and let us know roughly about how much of the session they’d like to devote to each one. When clinicians don’t set agendas, they deprive the patient of the opportunity to think through what is most important to them to spend time on in session.

-Judith S. Beck, Ph.D.

Women War Vets with PTSD improve through CBT

In the U.S., post-traumatic stress disorder (PTSD) is more prevalent among women than men, and is especially prevalent among women in the military. This February 28th JAMA study is the first to examine PTSD treatment for this population – female veterans and women in active duty. Read more

Cognitive Therapy for Schizophrenia

Here’s what Kevin Benbow emailed to us about his experience supervising a clinician with her first schizophrenia patient:

As a clinical supervisor for a small, rural mental health clinic in Arizona I get the opportunity to supervise and train behavioral health technicians.  Such individuals have a wide range of experience and education levels and are allowed to practice under Arizona State law if they receive supervision from a licensed Behavioral Health Professional.

One of these clinicians has been particularly receptive to the cognitive model and has been helping many of her clients identify their automatic thoughts and subsequently test them.  Recently she assessed a client who was subsequently diagnosed with schizophrenia.  She had only weeks before experienced her first psychotic episode.  Read more

Recalling Recent Experiences in Session

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I do many things at the beginning of therapy sessions, one of which is to ask patients about their experiences since I last saw them. Depressed patients routinely report only negative incidents. I then ask them what positive things happened, or what was going on during the better parts of their week. One reason I do this is to collect data that may be contrary to their globally negative thinking. (“No one likes me.” “It isn’t worth doing anything.” “Everything is terrible.”)


Another reason I do this is to allow the session to be a little more conversational, a little lighter in tone. I also find that having patients recall positive experience lightens their mood and makes it easier for them to take a more realistic (less negative) view of their problems. A recent study confirms the importance of doing so. When people are depressed, their thinking is more rigid and ruminative when stimuli are negative, which translates into greater difficulty in solving problems.  

-Judith S. Beck, Ph.D.

“My Adventures in Psychopharmacology”

There’s a great article in New York Magazine about a young woman whose psychiatrist started her on a roller coaster of medications at the age of 16. She found out about Cognitive Behavior Therapy (CBT) several years later when she read an article her parents had mailed to her. She said that CBT was:

“…a treatment Dr. Titrate [not his real name] had always dismissed. After I read it, I set up an appointment.  Read more

Patients with Hypochondriasis Respond to Cognitive Behavior Therapy

In a recent study, patients with Hypochondriasis were randomly assigned to either Cognitive Behavior Therapy (CBT), Paroxetine (i.e. Paxil) or a placebo. All patients completed a self-report measure prior to treatment, and after 16 weeks of treatment or placebo. Read more

Does Cognitive Therapy = Cognitive Behavior Therapy?

There seems to be a lot of confusion about the difference between Cognitive Therapy (CT) and Cognitive Behavior Therapy (CBT). Why? Well, sometimes the two terms are used interchangeably… and sometimes they’re not.   Read more

How Thinking Can Change the Brain

Sharon Begley’s article about changing your brain appeared in the Wall Street Journal a few weeks ago -you can read it here, and you can also listen to Sharon Begley discuss the mind’s ability to reshape the brain on NPR.

Begley talks about the fact that thoughts can alter and shape the brain’s structure and circuitry – you can actually change your brain with your own mind.  Read more

Cognitive-Behavioral Therapy Shows Promise for Children with Mental Illness – JAMA Article

 

The numbers are astonishing:

20% of children in the U.S. have some form of mental illness.

Only 1 in 5 receives treatment. Read more

Interview with Aaron Beck on the History of Cognitive Therapy

 Dr. Beck was originally trained in psychoanalysis in the 1950s. How did he transition from psychoanalysis, the predominant methodology of that time period, to developing Cognitive Therapy?

Here’s an excerpt from a great interview Dr. Beck gave in 2004.

Interviewer: Can you reminisce about your role as a psychoanalyst?

Dr. Beck: Let me respond with a clinical illustration. A woman patient is on the couch and she spends the entire time talking about her sexual escapades.  At the end of the session I do what I think analysts are meant to do – I ask her how she feels.  “Very anxious,” she responds.  Read more