Making Cognitive-Behavioral Therapy Work: Clinical Process for New Practitioners

305 Pages·2018·2.166 MB·English

by  Deborah Roth Ledley, Brian P. Marx, Richard G. Heimberg

MAKING COGNITIVE-BEHAVIORAL
THERAPY WORK
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Making
Cognitive-Behavioral
Therapy Work
Clinical Process for New Practitioners
T H I R D E D I T I O N
DEBORAH ROTH LEDLEY
BRIAN P. MARX
RICHARD G. HEIMBERG
The Guilford Press
New York London
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These materials are intended for use only by qualified mental health professionals.
The publisher grants to individual purchasers of this book nonassignable permission
to reproduce the blank assessment report template. This license is limited to you, the
individual purchaser, for personal use or use with clients. This license does not grant
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error or changes in behavioral, mental health, or medical sciences, neither the authors,
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Library of Congress Cataloging-in-Publication Data
Names: Ledley, Deborah Roth, author. | Marx, Brian P. | Heimberg, Richard G.
Title: Making cognitive-behavioral therapy work : clinical process for new
practitioners / Deborah Roth Ledley, Brian P. Marx, Richard G. Heimberg.
Description: Third edition. | New York : The Guilford Press, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2018006155 | ISBN 9781462535637 (hardback)
Subjects: LCSH: Cognitive therapy. | BISAC: MEDICAL / Psychiatry / General. |
SOCIAL SCIENCE / Social Work. | PSYCHOLOGY / Clinical Psychology.
Classification: LCC RC489.C63 L44 2018 | DDC 616.89/1425—dc23
LC record available at https://lccn.loc.gov/2018006155
To Jenna, who shares my love of the written word
To Matthew, our inquisitive and empathic Junior Doctor
And to Gary, who supports me in everything I do
and whom I love to the moon and back
—D. R. L.
For Colin and Denise, both of whom teach me
something valuable every single day
—B. P. M.
To Chris, who always makes me proud
To Connor and Riley, who always make me smile
And, most of all, to Linda, who lights up my life
—R. G. H.

About the Authors
Deborah Roth Ledley, PhD, is a psychologist in private practice in sub-
urban Philadelphia. She spent several years on the faculty of the Uni-
versity of Pennsylvania’s Center for the Treatment and Study of Anxi-
ety. Dr. Ledley’s research has focused on the nature and treatment of
anxiety. She has published over 50 scientific papers and book chapters
as well as several books, including Improving Outcomes and Preventing
Relapse in Cognitive-Behavioral Therapy, Becoming a Calm Mom, and
The Worry Workbook for Kids. She lectures widely on the treatment of
childhood anxiety.
Brian P. Marx, PhD, is a staff psychologist at the National Center for
Posttraumatic Stress Disorder (PTSD), Veterans Affairs Boston Health-
care System, and Professor of Psychiatry at Boston University School of
Medicine. Dr. Marx has published numerous articles and book chap-
ters on behavior therapy and assessment. His research interests include
the assessment and treatment of PTSD, identifying risk factors for post-
traumatic difficulties, and the association between PTSD and suicidal
behaviors.
Richard G. Heimberg, PhD, is the Thaddeus L. Bolton Professor of Psy-
chology and Director of the Adult Anxiety Clinic of Temple at Temple
University. He is past president of the Association for Behavioral and
Cognitive Therapies (ABCT) and the Society for a Science of Clinical
Psychology (SSCP) and former editor of the journal Behavior Therapy.
Well known for his efforts to develop and evaluate cognitive-behavioral
vii
viii About the Authors
treatments for social anxiety and other anxiety disorders, Dr. Heimberg
has published several books and 450 articles and chapters. As an educa-
tor and mentor of clinical psychology doctoral students, he has received
awards from ABCT, SSCP, the Society of Clinical Psychology, and the
American Psychological Association of Graduate Students.
Preface
B
ack in 1999, when I (D. R. L.) was a postdoctoral fellow at Temple
University, Brian Marx (who was then an assistant professor), Richard
Heimberg (who was then my mentor), and I cooked up the idea of writ-
ing a book for beginning clinicians. Even at the fine training programs
with which we had been involved, we were struck by a gap in train-
ing. Although students knew a lot of facts about cognitive-behavioral
therapy and the disorders they were treating, they sometimes seemed lost
in the room with clients. And, as a new clinician myself, I often felt the
same way! There were so many “What should I do?” questions: What
should I do when a client asks me personal questions? What should I do
when a client gets angry during a session? What should I do with my
feelings of disappointment when clients discontinue therapy when I do
not think they are ready to do so? There were no books that addressed
these important questions. My own struggles, and the struggles of our
collective trainees, inspired us to write Making Cognitive-Behavioral
Therapy Work.
So much has changed since the first edition of our book was pub-
lished in 2005! I am no longer an inexperienced clinician, and over the
past decade or more, we have treated and supervised the treatment of
countless clients. This collective experience has led us to substantially
revise Making Cognitive-Behavioral Therapy Work for this third edi-
tion. In this new edition, we have included a chapter on working with
special populations. In that chapter (Chapter 9), we discuss the impor-
tance of providing culturally responsive cognitive-behavioral therapy
ix