The cognitive-behavioral therapy (CBT) is a method used in contemporary psychology to help patients deal with negative attitudes towards events or perception of self. Wright, Brown, Thase, and Basco (2017) describe the basic strategies of the CBT, which includes an explanation of this method, its application, and expected outcomes for patients. The fact that the authors provide an assessment of the CBT’s origins referring to the recognition of the idea that a person’s cognition influences emotions and actions were discussed by ancient philosophers Seneca, Epictetus, and Cicero provides an understanding of the vast amount of existing evidence that supports the efficiency of CBT.
Figure 1-1, titled Basic cognitive-behavioral model, is a simplified representation of the four main elements of a person’s behavior, which are event, cognitive appraisal, emotion, and behavior. Figure 1-2 depicts the same model, with an example of frustrating thoughts one may experience when preparing to go to a party and the impact of these thoughts on a person’s behavior. By providing these figures, Wright et al. (2017) describe the significance of cognitive processing of different situations and their impact on human behavior. The vicious cycle that a person gets into as part of the negative thought leads to a strengthen anxiety and by addressing the three elements – cognitions, emotions, and actions a therapist can help a person develop better attitudes towards these events. To further the representation of this idea, Figure 1-3 provides an assessment of Martha’s automatic thoughts, which is a concept referring to reactions that an individual continuously has as a response to a particular situation.
Table 1.1 titled Cognitive Errors in the first chapter assesses the automatic negative thoughts that one can have, which helps address common issues experienced by patients through CBT. One of the examples, overgeneralizing, helps understand how some people can make conclusions based on a single event. Table 1-2 Adaptive and maladaptive schemas is an assessment of common patterns that people develop as a response to different situations. The contrast between good and bad thoughts provides a good ground for developing adequate responses. Table 1-3 is an assessment of information processing strategies, for instance, hopelessness or fears of harm, prevalent in patients with anxiety or depression. The final figure of Chapter 1, which is Table 1-4, describes the main methods of CBT, for example, uncovering schemas or orientation on problems, that are commonly used when working with patients. The first video of this chapter, Getting Started: BT in Action is a representation of CBT with a patient who is asked to discuss a situation and her feelings and thoughts, which is an excellent example of the real-rife CBT.
Hence, Chapter 1 serves as an introduction to the theory of the CBT, proving an assessment of the main concepts. The strength of this chapter is the fact that Wright et al. (2017) explicitly explain the development of the CBT theory throughout the centuries, referring to the ancient philosophers’ sayings, worlds of religious leaders, as well as works of physiologists and researchers in the field. This helps develop a cohesive structure and an understanding of the origins and theories of CBT, such as Beck’s three domains of thinking or Lewinsohn’s behavioral theory, as well as concepts developed by others. The learning exercise offered by Wright et al. (2017) is an excellent approach to reevaluating a situation and recognizing the automatic thoughts that affected its perception.
The second chapter of the book describes the aspect of collaboration that is a crucial feature of CBT. The first video offered by the authors is the same as in Chapter 1, it overviews the basic principles of CBT and provides a general overview of the significant technique – addressing patient concerns. The second video serves as an ideal illustration of the real-life work that one has to do when working with a patient since it provides an example of how negative automatic thoughts can be modified through CBT, which is the primary strength of this chapter since the text and the video visualization accompany each other, providing an excellent example of CBT. The case example of Mat, which follows the video provides some good insight into encouraging patients during CBT. This chapter does not contain any specific illustrations, figures, or tables, which can be considered its weakness since the strategies offered by the authors could be better comprehended if illustrated.
Structuring, as part of the CBT, is an essential element that allows a therapist to get a better understanding of the patient’s feelings when starting CBT, which is outlined in Table 4-1. Perhaps the most straightforward approach is goal setting, which is a clear identification of the objectives a patient aims to achieve. The case example in this chapter is focused on this technique and outlines goal-setting for Janet, which helps understand the need to direct a patient towards clearly identifying their expectations form the therapy. In this regards, Table 4-2 that provides recommendations on how to guide a patient through this process is very helpful.
The first video attached to Chapter 4 is an ideal scenario where a patient responds well to the suggestions and guidance of the therapist. One issue is that it is unclear how to work with patients who are not ready to set goals or who are unable to set clear objectives, regardless of the guidance form the therapist, and the lack of techniques, which is addressed in Video 3, while video 4 focuses on common issues that can arise as part of this process, with an accompanying Trouble Shouting Guide provided in the text.
Next, it is crucial to check the patient’s state using a measurable scale Table 4-3 is a list of self-reporting scales that can be used during the symptom assessment. Another stage of the CBT is providing feedback, which, according to Table 4-4, should help patients adhere to the chosen agenda. Table 4-5, 4-6, and 4-7 outline a session structure for different stages of treatment, suggested by Wright et al. (2017), which should enhance progress as each stage emphasizes different aspects of CBT. Finally, as part of the CBT, this chapter suggests that therapists have to work on educating their patients and teaching them better coping strategies, which is the focus of Table 4-8, Figure 1, and the Learning Exercise that allow a patient perform exercises during sessions do homework or use computer-assisted CBT.
The reviewed book provides a comprehensive assessment of the CBT history, theories developed over the years and helped therapists find an appropriate approach to different patient cases. Also, it suggests using empathy and kindness when guiding a patient through CBT, as part of the patient-therapist collaboration, which is the main strength of this book. However, the primary weakness is a lack of methods, techniques, and suggestions that would help recognize people who suffer from severe mental disorders and would not benefit from CBT. It is an essential part of working with patients sine a therapist should be able to recognize various issues and direct a patient to an appropriate specialist, which can be addressed through an assessment.
Reference
Wright, J. H., Basco, M. R., & Thase, M. E. (2017). Learning cognitive-behavior therapy (2nd ed.). Arlington, VA: American Psychiatric Publishing, Inc.