Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work

Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work

Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work

Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work

Synopsis

Following on the success of the bestselling Cognitive Therapy: Basics and Beyond, this groundbreaking book from Judith S. Beck addresses what to do when a patient is not making progress in cognitive-behavioral therapy. Provided is practical, step-by-step guidance on conceptualizing and solving frequently encountered problems, whether in developing and maintaining the therapeutic alliance or in accomplishing specific therapeutic tasks. While the framework presented is applicable to a range of challenging clinical situations, particular attention is given to modifying the longstanding distorted beliefs and dysfunctional behavioral strategies of people with personality disorders. Helpful appendices include a reproducible assessment tool, and the Personality Belief Questionnaire.

Excerpt

This volume by Dr. Judith S. Beck is a major contribution to the literature addressing cognitive therapy with patients who have difficult problems. Through her own work with patients and her supervision of other therapists, Dr. Beck has been able to delineate the typical problems that thwart the progress of therapy and discourage therapist and patient alike. Until fairly recently these problems were considered manifestations of “resistance,” “negative transference reactions,” or “passive–aggressive tendencies” by many therapists. In response, many therapists are inclined to simply throw up their hands in frustration, not knowing what to do next.

Instead of yielding to these obstacles in therapy, Dr. Beck has consistently reframed these difficulties as identifiable, well-recognized problems with specific boundaries and characteristics. By categorizing the problems into specific domains, she has provided a readily available key to their complexities. Dr. Beck has thus drawn on her vast experience to outline the appropriate approach for each of the difficulties: (1) conceptualizing the problem in terms of the patient's developmental history, core beliefs and assumptions, and dysfunctional cognitions and behaviors, and (2) designing relevant strategies and techniques to solve the problem. Since each problem is different, it is necessary for therapists to adapt their therapeutic strategies accordingly, as artfully outlined in this volume.

The burden on the therapist was not always as heavy. In the early years of cognitive therapy, we were able to focus simply on our patients' here-and-now problems and prescribe relevant techniques. For depressed patients, this consisted of behavioral activation through activity scheduling, completing dysfunctional thought records, and engaging in practical problem solving. In general, the depression (or anxiety disorder) had disappeared by the 10th session and we scheduled one more simply for relapse prevention (Rush, Beck, Kovacs, & Hollon, 1977). As time passed . . .

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.