Assessment
- Patient Health Questionnaire 9 (PHQ-9) download archived copy
- Montgomery & Asberg Depression Rating Scale (MADRS) download archived copy
- Brief Fear of Negative Evaluation Scale (Social Anxiety) download
archived copy
- Bern Inventory of Treatment Goals download archived copy
Cognitive therapy competence / adherence measures
- Assessment of Core CBT Skills (ACCS) – Muse, McManus, Rakovshik, Kennerley
- Website accs-scale.co.uk
- Manual accs-scale.co.uk
- Feedback form accs-scale.co.uk
- Cognitive Therapy Rating Scale (CTRS) – Young & Beck
- Scale download archived copy
- Manual download
- Revised Cognitive Therapy Scale (CTS-R) – James, Blackburn, Reichelt
- Scale download archived copy
- Manual download archived copy
Case Conceptualization / Case Formulation
- The case formulation approach to cognitive behavior therapy | Jacqueline Persons | 2014 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- Case formulation in CBT | Caleb Lack download archived copy
- Developing a cognitive formulation | Michael Free download archived copy
- Dysfunctional assumptions ideas download archived copy
- CBT case formulation video | Jacqueline Persons youtube
Presentations
- Making CBT Work (Working with your CBT therapist / Making your CBT therapist work with you) | Paul Salkovskis download archived copy
- The unified protocol for the transdiagnostic treatment of emotional disorders | Ellen Frank, Fiona Ritchey | 2015 download archived copy
- Transdiagnostic treatments for anxiety disorders | Martin Anthony | 2013 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- The role of a case conceptualization model and core tasks of intervention | Donald Miechenbaum | 2014 download archived copy
Recommended Reading
- Arch, J. J., & Craske, M. G. (2009). First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives. Psychiatric Clinics of North America, 32(3), 525-547 download archived copy
- Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive therapy and research, 36(5), 427-440 download
- Padesky, C. A., Mooney, K. A. (1990). Clinical tip: presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14 download archived copy
- A therapists’ guide to brief cognitive behavioral therapy by Cully & Teten download
This series of articles are good introduction to the basics of CBT. The authors have gone on to sell a branded form of CBT using some of these metaphors / explanation but the messages apply equally to generic CBT.
- Williams, C., & Garland, A. (2002). A cognitive–behavioural therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8(3), 172-179. download
- Garland, A., Fox, R., & Williams, C. (2002). Overcoming reduced activity and avoidance: a Five Areas approach. Advances in Psychiatric Treatment, 8(6), 453-462. download
- Williams, C., & Garland, A. (2002). Identifying and challenging unhelpful thinking. Advances in Psychiatric Treatment, 8(5), 377-386. download
- Wright, B., Williams, C., & Garland, A. (2002). Using the Five Areas cognitive–behavioural therapy model with psychiatric patients. Advances in Psychiatric Treatment, 8(4), 307-315. download
When faced with a difficult or unknown situation, do you tend to focus on the worst-case scenario? Our thoughts are extremely powerful and influence how you handle situations. If the lens through which we see the world is tinted with negativity, it may be hard to see anything else. Sometimes the way in which we view situations in our lives contributes to how much anxiety or stress we endure before we even attempt to handle the problem or situation. Cognitive distortions are ways in which our mind convinces us that something is true when in reality, it isn’t. Everyone engages in some cognitive distortions but when they are too frequent or extreme, they can be harmful to our mental health and have great impact on our lives. This type of inaccurate thinking reinforces our negative thought processes and emotions. It may make us think something sounds rational and accurate but it only serves to keep us subconsciously feeling bad about ourselves in some way.
The tendency to exaggerate the importance of a problem or situation or assuming that the worst possible outcome will be true is called catastrophizing. This is a very common cognitive distortion especially with individuals who suffer from depression and anxiety. The difference between anxiety and catastrophizing is that anxiety can play a positive role in a person’s life at times. For example, anxiety can help to protect oneself in a dangerous situation or be a motivating factor to achieving your goals. Catastrophizing doesn’t usually have any benefits and often keeps us in a negative mental space, which takes away from our ability to focus on the reality of the situation. Catastrophizing thoughts can make us feel hopeless and can lead to depression. By learning to recognize these types of thoughts, you are able to challenge them and change them to a more fitting narrative that doesn’t leave you feeling hopeless or anxious.
Some examples of catastrophizing are:
- “If my partner leaves me, I will never find anyone else and I will never be happy again.”
- “If I fail this test, I will flunk out of school and I will be a total failure in life.”
- “If I make a mistake at work, I will be fired and no one will ever hire me again.”
- “If I don’t get that job I applied for, I’ll never be hired anywhere.”
- “They haven’t answered me, they must not like me.”
One way to decatastrophize your thoughts is to put your thoughts on trial by challenging them with evidence. Take what you are worrying about and think about how likely it is that your “worst” worry will come true based off of past experience or other evidence. If your “worst” worry does come true, what are the chances that you will be okay in a week, in a month, or even a year. Now think about if your worry does come true what is “most likely” going to happen based off of past experiences or other evidence and how likely will you be okay after a week, a month, or a year. For example, if you don’t get the job that you applied for how likely is it that you will actually never be hired anywhere? This is probably very unlikely based on the fact that there are many other jobs out there. What is most likely to happen if you do not get that particular job is that you will have to apply to other places, and even though it may take you a little longer you will find a job. If you do not get this particular job, how likely are you to be okay after a week, a month or a year? This helps you to keep the problem or situation in perspective and helps you to focus on the reality of the situation as opposed to catastrophizing the outcome or what it will take for you to get through it. This also helps you to channel the appropriate amount of energy to the situation in order for you to handle it appropriately without making it harder for yourself.
Stressing about the worst case scenario only makes it harder to face the situation. Many catastrophizers view the world and themselves through a negative lens which can have a huge impact on our thoughts. As previously mentioned, our thoughts are extremely powerful and they can convince us that the worst case scenario is surely what is most likely to happen. Due to this negative lens, many catastrophizers also struggle with self-worth and trusting themselves. This may be why it can be difficult to prevent themselves from ruminating about the uncertainty of the future. Trust in yourself and your ability to handle difficult situations because you have had a lifetime of experience that shows you that you can make it through adverse situations. Don’t let catastrophic thinking be a barrier to your happiness or make you feel like you are stuck because you are stronger than whatever situation that you face. Allow yourself to think about situations realistically and have faith in yourself to overcome your hardships.