A T H E R A P I S T ’ S G U I D E T O BRIEF COGNITIVE

A THERAPIST'S GUIDE TO

BRIEF COGNITIVE

BEHAVIORAL THERAPY

JEFFREY A. CULLY, PH.D. ANDRA L. TETEN, PH.D.

Published by the Department of Veterans Affairs, South Central Mental Illness Research, Education, and Clinical Center (MIRECC), 2008.

Suggested citation: Cully, J.A., & Teten, A.L. 2008. A Therapist's Guide to Brief Cognitive Behavioral Therapy. Department of Veterans Affairs South Central MIRECC, Houston.

To request a copy of this manual, please contact Michael Kauth at michael.kauth@

ACKNOWLEDGMENTS

We would like to thank the multiple individuals and organizations that supported this work. This project emanated from our passion for teaching and our desire to increase the availability and quality of cognitive-behavioral therapies in health care settings. Our mentors and colleagues were instrumental in their encouragement and feedback. We would like to give special thanks to the following individuals: Evelyn Sandeen, PhD and Melinda Stanley, PhD (expert consultants); Sparkle Hamilton, MA (project assistant); and Heather Mingus (Graphic Artist); Anne Simons, PhD (past CBT supervisor ? AT).

We are also grateful to the support of the Veterans Health Administration Office of Research and Development and Office of Academic Affiliations, South Central MIRECC and Baylor College of Medicine This work was supported by a Clinical Educator Grant from the South Central MIRECC.

THE BRIEF CBT MANUAL

This manual is designed for mental health practitioners who want to establish a solid foundation of cognitive behavioral therapy (CBT) skills. Concepts contained in the manual detail the basic steps needed to provide CBT ("Practicing CBT 101") with the intent that users will feel increasingly comfortable conducting CBT. The manual is not designed for advanced CBT practitioners.

Instructional material in this program is designed to be used within the context of a psychotherapy supervisory relationship to ensure appropriate application of the training materials and timely feedback, which are viewed as critical to the development of CBT skills. The content of this manual is a compilation of foundational works on CBT, such as Judith Beck's (1995) Cognitive Therapy: Basics and Beyond, with the addition of key skills needed for developing CBT therapists. The information is condensed and packaged to be highly applicable for use in a brief therapy model and to aid in rapid training.

TABLE OF CONTENTS

ESSENTIAL PSYCHOTHERAPY SKILLS

MODULE 1

TOPIC Introduction to Brief Cognitive Behavioral Therapy (CBT) .... 06

2

Using Supervision......................................................................... 10

3

Nonspecific Factors in Psychotherapy .................................... 13

4

Case Conceptualization and Treatment Planning .............. 18

ESSENTIAL CBT SKILLS

MODULE 5

TOPIC Orienting the Patient to Brief Cognitive Behavioral Therapy .. 28

6

Goal Setting ............................................................................. 32

7

Agenda Setting ........................................................................ 36

8

Homework .................................................................................. 40

9

Identifying Maladaptive Thoughts and Beliefs .................. 44

10

Challenging Maladaptive Thoughts and Beliefs .................. 54

11

Behavioral Activation ............................................................. 60

12

Problem Solving ....................................................................... 66

13

Relaxation ................................................................................... 73

14

Ending Treatment and Maintaining Changes ..................... 82

REFERENCES/SUGGESTED AND SUPPLEMENTAL READINGS ........................... 88 APPENDIX A: PATIENT HANDOUTS ...................................................................... 92 APPENDIX B: SAMPLE TREATMENT OUTLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

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