Chapter 7. Techniques of Cognitive-Behavioral Therapy

Richard A. Bermudes, M.D.; Jesse H. Wright, M.D., Ph.D.; David Casey, M.D.
DOI: 10.1176/appi.books.9781585623648.373980



One of the distinguishing features of cognitive-behavioral therapy (CBT) is that it is a direct outgrowth of the basic theories and experimental findings on cognitive and behavioral pathology in specific psychiatric disorders (see Chapter 6, "Theory of Cognitive Therapy"). Thus, cognitive-behavioral therapists implement procedures that are wholly consistent with core theoretical constructs. For example, the cognitive restructuring and exposure and response prevention interventions used for panic disorder with agoraphobia are designed to reverse pathologies of 1) overestimates of risk or danger in situations; 2) underestimates of coping abilities; and 3) avoidance of feared situations. CBT methods are also distinguished by the large amount of empirical data that support their efficacy (see Chapter 8, "Applications of Individual Cognitive-Behavioral Therapy to Specific Disorders: Efficacy and Indications"). Many outcome studies have found positive results for CBT for depression, anxiety disorders, eating disorders, psychosis, and a variety of other conditions.

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Figure 7–1. Two-column thought recording.Source. Adapted from Wright JH, Beck AT, Thase ME: "Cognitive Therapy," in The American Psychiatric Publishing Textbook of Clinical Psychiatry, 5th Edition. Edited by Hales RE, Yudofsky SC, Gabbard GO. Washington, DC, American Psychiatric Publishing, 2008, pp. 1211–1256. Used with permission.

Figure 7–2. Thought change record: an example.Source. Adapted from Wright JH, Beck AT, Thase ME: "Cognitive Therapy," in The American Psychiatric Publishing Textbook of Clinical Psychiatry, 5th Edition. Edited by Hales RE, Yudofsky SC, Gabbard GO. Washington, DC, American Psychiatric Publishing, 2008, pp. 1211–1256. Used with permission.

Figure 7–3. Mr. A's list of advantages and disadvantages for the belief "I must be perfect."

Figure 7–4. Examining the evidence for a delusional belief: people in red cars are trying to get me.

Figure 7–5. A symptom summary worksheet: early warning signs of hypomania and depression.
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Table 7–1. Methods of enhancing collaborative empiricism
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Table 7–2. Structuring procedures for cognitive therapy
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Table 7–3. Psychoeducational materials and programs for cognitive-behavioral therapy
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Table 7–4. Working with automatic thoughts
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Table 7–5. Cognitive errors
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Table 7–6. Methods for identifying and modifying schemas
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Table 7–7. Cognitive domains and cognitive-behavioral therapy methods for eating disorders


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