Skills in Cognitive Behaviour Therapy

203 Pages·2015·2.226 MB·English

by  Frank Wills

Skills
in
Cognitive
Behaviour
therapy
Series editor: Francesca Inskipp
Skills in Counselling and Psychotherapy is a series of practical guides for trainees and
practitioners. Each book takes one of the main approaches to therapeutic work or key
client groups, and describes the relevant core skills and techniques.
Topics covered include:
• How to establish and develop the therapeutic relationship
• How to help the client change
• How to assess the suitability of an approach or technique for the client.
This is the first series of books to look at skills specific to the different theoretical
approaches and is now developed to include skills specific to particular client groups.
It is an ideal series for use on a range of courses which prepare the trainees to work
directly with the clients.
Books in the series:
Skills in Counselling and Psychotherapy with Children and Young People
Lorraine Sherman
Skills in Gestalt Counselling and Psychotherapy, Third Edition
Phil Joyce and Charlotte Sills
Skills in Person-Centred Counselling and Psychotherapy, Second Edition
Janet Tolan
Skills in Psychodynamic Counselling and Psychotherapy
Susan Howard
Skills in Existential Counselling and Psychotherapy
Emmy van Deurzen and Martin Adams
Skills in Rational Emotive Behaviour Counselling and Psychotherapy
Windy Dryden
Skills in Transactional Analysis Counselling and Psychotherapy
Christine Lister-Ford
Skills in Solution Focused Brief Counselling and Psychotherapy
Paul Hanton
Second edition
Skills
in
Cognitive
Behaviour
therapy
Frank Wills
SAGE Publications Ltd  Frank Wills 2008, 2015
1 Oliver’s Yard
55 City Road First edition published 2008. Reprinted 2011, 2013
London EC1Y 1SP This second edition published 2015
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Library of Congress Control Number: 2014940144
Editor: Susannah Trefgarne
British Library Cataloguing in Publication data
Assistant editor: Laura Walmsley
Production editor: Rachel Burrows
A catalogue record for this book is available from
Marketing manager: Camille Richmond
the British Library
Cover design: Shaun Mercier
Typeset by: C&M Digitals (P) Ltd, Chennai, India
Printed in Great Britain by Henry Ling Limited at
The Dorset Press, Dorchester, DT1 1HD
ISBN 978-1-4462-7483-5
ISBN 978-1-4462-7484-2 (pbk)
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CONTENTS
List of Figures and Tables vi
About the Author and Acknowledgements viii
Companion Website ix
Introduction 1
1 Practising CBT Skills within their Knowledge Base 3
2 Skills for Assessing, Formulating and Starting CBT 17
3 Skills for Developing the Relationship in CBT 37
4 Skills for Working with Negative Thinking 58
5 Skills for Working on Changing Behaviour 88
6 Skills for Working with Emotions 112
7 Skills for Working with Enduring Life Patterns 132
8 Maintaining and Developing CBT Skills 153
Appendix 1 Resources for CBT Measures 173
Appendix 2 Other Cognitive Methods using Cost
Benefit Analysis and Pie Charts 174
References 178
Index 188
LiST Of figurES
aNd TabLES
LiST Of figurES
1.1 The principles of CBT 5
1.2 The ‘vicious cycle’ concept – two cycles compared 9
1.3 Vicious cycle with therapy targets 9
2.1 Questions to assess how therapy is going three to four sessions in 21
2.2 Assessment information 22
2.3 CBT formulation: parts and whole 27
2.4 Longitudinal formulation map: Dan 29
2.5 Brief written formulation: Dan 30
2.6 Questions to test a formulation 30
2.7 CBT session structure – post-assessment session onwards 31
3.1 Relational elements within the therapeutic relationship 42
3.2 Don’s CB formulation 45
4.1 The zone of proximal development 62
4.2 Continuum of cognitive interventions 63
4.3 GD/SD – process and exercise for suggestion 69
4.4 Clients’ reactions to whiteboard material 70
4.5 Mei’s whiteboard 72
4.6 Coexisting thoughts worksheet 73
4.7 Thoughts feelings ratings 81
5.1 Activity schedule with basic self-monitoring 97
5.2 Assertive communication template 107
7.1 Bruce’s assumptions flashcard 139
7.2 Continuum method (worked example) 147
7.3 Criteria continuum method (expanded worked example) 149
A.1 Pie chart 176
LiST Of TabLES
4.1 Problems and solutions for identifying negative thoughts 82
4.2 Seven-column thought record: worked example 85
••• List of figures and Tables •••
4.3 Problems and solutions in evaluating and
responding to negative thoughts 86
5.1 ABC analysis 91
5.2 Useful questions when formulating ABC analysis 93
5.3 Therapist skills for in vivo exposure therapy 103
5.4 Assertive situations hierarchy 109
6.1 Leahy’s emotional schemas 116
6.2 Matching therapist and client skills in emotion-focused work 119
7.1 Antoinette’s core beliefs and schemas 143
8.1 Stages in the development of CBT skills 156
A.1 CBA for the thought ‘I’m such a failure’ 175
• vii •
abOuT ThE auThOr
Frank comes from a working class family on the Wirral and takes any opportunity to
mention his beloved local football team, Tranmere Rovers FC. He has worked as a
psychological therapist over four decades and feels that he may now be getting the
hang of it. Working in a variety of roles and settings, he qualified as a counsellor in
1984, and as a cognitive therapist in 1994. After a brief ‘CBT evangelical’ period, he
saw the error of his ways and now firmly opposes Schoolism, believing that the
therapy profession should unite around the idea that we can all learn from one
another. He has learnt much from the psychodynamic and the humanistic approaches.
In his recent publication, Cognitive Behaviour Therapy: Foundations for Practice (SAGE,
2013) and in this volume, he illustrates how such learning can result in more inter-
personally sensitive and satisfying practice of CBT.
aCkNOwLEdgEmENTS
This book has evolved slowly and from interaction with many colleagues, students and
friends. I would like to thank them all because each discussion has added to the
strength and subtlety of my understanding of this work. I would like to name you all
but most will have to ‘know who you are’. A few, however, deserve special mention
on this occasion: my live-in style consultant, Annie, and the members of my CBT skills
development group – Christine Board, Liz Ford, Pamela Iles and Sarah Summers. It is
great to be part of the Sage family and particular thanks are due to the team who
managed me and this book: Susannah Trefgarne, Laura Walmsley, Rachel Burrows and
Sophie Richmond.
COmpaNiON wEbSiTE
Skills in Cognitive Behaviour Therapy, Second Edition, is accompanied by a companion
website with free online resources for students and lecturers.
Visit https://study.sagepub.com/wills to access the following resources:
Chapter 1
A Guide to the Basic Concepts of CBT
Teaching and Learning Exercise on Rationale Giving
PowerPoint Presentation on Practising CBT Skills within their Knowledge Base
Chapter 2
Different Formats for Formulation
� Sample Case Formulation – Bron
� Sample Case Formulation – Bes
PowerPoint Presentation on Skills for Assessing, Formulating and Starting CBT