CBT

CBT is theoretically backed by Aaron Beck’s cognitive-behavioral theory. Having been

trained as a psychoanalyst, Beck compared his observation of automatic thoughts to Freud’s
concept of the “preconscious.” Beck (1976) was interested in what people said to themselves
and the way they monitored themselves—their own internal communication system. From the
internal communications within themselves, individuals formed sets of beliefs, an observation
reported earlier by Ellis (1962). From these important beliefs, individuals formulated rules or
standards for themselves, called schemas, or thought patterns that determine how experiences
will be perceived or interpreted. So, first there are the underlying dysfunctional beliefs known
as depressogenic schemas which are rigid, extreme and counterproductive. An example of a
dysfunctional belief is if everyone does not love me then my life is worthless. Schemas: can
be adaptive or maladaptive (adaptive in some situations but when generalised become
maladaptive. For example: “my work defines me” motivates one to work more but post-
retirement may cause emptiness. Eg 2: Overgeneralisations of failure.

Young said the 5 schemas push one into negative automatic thoughts.

- Positive Schemas: Adaptive

- Active Schemas: govern everyday life whereas the inactive schemas are triggered only by
specific events

- Compelling vs. non-compelling schemas: compelling schemas are learnt in childhood and
are reinforced by parents, society etc. Have a lot of control over one.

- Changeable vs. non-changeable schemas (spectrum), example for most people, religious
schemas are unchangeable, body image can be changeable (not for people with body
dysmorphia)

This schemas are thought to develop during childhood and adolescence as a function of
negative experiences with parents and significant others. Although they may lie dormant for
years in the absence of significant stressors when dysfunctional beliefs are activated by
current stressors they tend to fuel the current thinking pattern creating a pattern of negative
automatic thoughts --- thoughts that often occurred just below the surface of awareness and
involve unpleasant, pessimistic predictions. This pessimistic predictions tend to centre on the
3 themes of what Beck calls the negative cognitive triad which include negative thoughts
about self (“I'm worthless”), world (“no one loves me”) and future (“it's hopeless because
things will always be this way”).
Beck also postulated that the negative cognitive triad tends to be maintained and influences
our thought pattern resulting in cognitive biases or errors or distortions. Cognitive distortions
appear when information processing is inaccurate or ineffective.

All-or-nothing thinking. By thinking that something has to be either exactly as we want it or

it is a failure, we are engaging in all-or-nothing, or dichotomous, thinking. A student who
says, “Unless I get an A on the exam, I have failed” is engaging in all-or-nothing thinking.
Grades of A– and B then become failures and are seen as unsatisfactory.

Selective abstraction. Sometimes individuals pick out an idea or fact from an event to
support their depressed or negative thinking. For example, a baseball player who has had
several hits and successful fielding plays may focus on an error he has made and dwell on it.
Thus, the ballplayer has selectively abstracted one event from a series of events to draw
negative conclusions and to feel depressed.

Mind reading. This refers to the idea that we know what another person is thinking about us.
For example, a man may conclude that his friend no longer likes him because he will not go
shopping with him. In fact, the friend may have many reasons, such as other commitments,
not to go shopping.

Negative prediction. When an individual believes that something bad is going to happen,
and there is no evidence to support this, this is a negative prediction. A person may predict
that she may fail an exam, even though she has done well on exams before and is prepared
for the upcoming exam. In this case, the inference about failure—the negative prediction—is
not supported by the facts.

Catastrophizing. In this cognitive distortion, individuals take one event they are concerned
about and exaggerate it so that they become fearful. Thus, “I know when I meet the regional
manager, I’m going to say something stupid that will jeopardize my job. I know I will say
something that will make her not want to consider me for advancement” turns an important
meeting into a possible catastrophe.

Overgeneralization. Making a rule based on a few negative events, individuals distort their
thinking through overgeneralization. For example, a high school sophomore may conclude:
“Because I do poorly in math, I am not a good student.” Another example would be the
person who thinks because “Alfred and Bertha were angry at me, my friends won’t like me,
and won’t want to have anything to do with me.” Thus, a negative experience with a few
events can be generalized into a rule that can affect future behavior.

Labeling and mislabeling. A negative view of oneself is created by self-labeling based on

some errors or mistakes. A person who has had some awkward incidents with acquaintances
might conclude, “I’m unpopular. I’m a loser” rather than “I felt awkward talking to Harriet.”
In labeling and mislabeling in this way, individuals can create an inaccurate sense of
themselves or their identity. Basically, labeling or mislabeling is an example of
overgeneralizing to such a degree that one’s view of oneself is affected.

Magnification or minimization. Cognitive distortions can occur when individuals magnify

imperfections or minimize good points. They lead to conclusions that support a belief of
inferiority and a feeling of depression. An example of magnification is the athlete who suffers
a muscle pull and thinks, “I won’t be able to play in the game today. My athletic career is
probably over.” In contrast, an example of minimization would be the athlete who would
think, “Even though I had a good day playing today, it’s not good enough. It’s not up to my
standards.” In either magnification or minimization, the athlete is likely to feel depressed.

Personalization. Taking an event that is unrelated to the individual and making it meaningful
produces the cognitive distortion of personalization. Examples include “It always rains when
I am about to go for a picnic” and “Whenever I go to the shopping center, there is always an
incredible amount of traffic.”

Young 1995 classified 18 schemas into 5 domains:

a. Disconnection and rejection: all those beliefs related to how much of our needs of care be
met, how much people around would care for you is unpredictable.

b. Impaired autonomy or performance: evaluating performance negatively continuously

based on one failure.

c. Impaired limits: Difficulty in respecting the rights of others, cooperating, restraining

oneself, for example just losing it when angry.

d. Other directiveness: putting the needs of others before oneself in order to be accepted

e. Over vigilance and inhibitions: in order for ones choices to be met, feelings are
suppressed. Over vigilance aka. High standards - “always”, “must” are all maladaptive.

Clark, Beck and Allport identified 5 types of schemas

1. Cognitive Conceptual Schemas: that guide storing and interpreting, making meaning of
experiences and the world around (core beliefs)
2. Affective Schema: feelings and emotions and their interpretation as positive or negative
3. Physiological schemas: interpretation of physiological responses
4. Behavioural Schema: How one acts and its interpretations eg: the act of running away
could be about urgency or escape.
5. Motivational Schema: How one initiates an action. Example: when does one start
studying, one eats due to hunger or the time schedule.
The role of the therapist is to identify the schema operating in clients and the resulting
feelings.

ASSESSMENT:

Careful attention is paid to assessment of client problems and cognitions, both at the
beginning of therapy and throughout the entire process, so that the therapist may clearly
conceptualize and diagnose the client’s problems. As assessment proceeds, it focuses not only
on the client’s specific thoughts, feelings, and behaviors but also on the effectiveness of
therapeutic techniques as they affect these thoughts, feelings, and behaviors.

Identify current thinking pattern and how that thinking is reflected in the behaviour.
Identifying the precipitating factors that influence her failure. Identify key developmental
events and critical events of a life.

In the initial evaluation the topics covered are similar to those assessed by many other
therapists and include the presenting problem, a developmental his- tory (including family,
school, career, and social relationships), past traumatic experiences, medical and psychiatric
history, and client goals.

In assessing thoughts, therapists may need to train their clients to differentiate between
thoughts and feelings and to report observations. Keeping notes of patients’ experiences,
emotions, and behaviors is very helpful. Judith Beck (1995) has developed a Cognitive
Conceptualization Diagram to organize patient data. Another method used to assess client
thoughts, emotions, and behaviors outside the therapist’s office is self-monitoring. Basically,
clients keep a record of events, feelings, and/or thoughts. This could be done in a diary, on an
audiotape, or by filling out a questionnaire. In addition to these techniques, previously
developed self-report questionnaires or rating scales can be used to assess irrational beliefs,
self-statements, or cognitive distortions (Whisman, 2008). Structured questionnaires have
been developed for specific purposes, such as the Beck Depression Inventory.
GOALS:

1. The basic goal of CBT is to make the client function more effectively.

2. Changing cognitive schemas can be done at three different levels (Beck et al., 2004).
The most limited type of change is schema reinterpretation. Here an individual
recognizes the schema but avoids or works around it. For example, a perfectionistic
person might not change the perfectionism, but rather work as an inspector where
these traits are valued and reinforced. In schema modification an individual makes
some but not total changes in the schema. Beck et al. (2004) give an example of a
person with paranoia who makes changes to trust some people in certain situations but
continues to be careful in trusting people in general. The highest level of schema
change is schematic restructuring. For example, a person with paranoia who became
trusting of others would have restructured his significant cognitive schema. Such a
person would believe that others would be trustworthy and not likely to attack him.
These three levels of schema change pro- vide a way to examine goals in cognitive
therapy.

PROCESS:

1. Beck’s (1976; Wills, 2009) view of the client–therapist relationship is that it is

collaborative. The therapist brings an expertise about cognitions, behaviors, and
feelings to guide the client in determining goals for therapy and means for reaching
these goals. The clients’ contributions to therapy are the raw data for change (thoughts
and feelings). They participate in the selection of goals and share responsibility for
change. The therapist shares the conceptualization plan, get feedback and then
collaboratively plans the treatment. Helps the client alleviate distress and elicit
important information, asking about their feelings & thoughts & beliefs & past
history.

2. This means that each therapy session, following on from the assessment of the client’s
problems will follow a predictable pattern. The session starts with finding out how
you have been feeling in the last week and anything that may have happened during
the past week you want to bring up. Setting An agenda which is a short list of items
that will be the focus of that particular session. A typical agenda looks like this:

 Reviewing homework
 Working on the client’s prioritized problem and other problems if there is time.
 Negotiating new homework
 Summarizing the session
 Feedback

Drawing up a list of problems and classifying as immediate goals or future goals. Clients are
prone to state their goals in vague (e.g. ‘I want to feel less disconnected from myself’) or
general terms (e.g. ‘I want to be happy in life’). The therapist would need to ask each client
what specific changes would have to occur in order for these goals to be operationalized (e.g.,
respectively, ‘I want to be more assertive at home in speaking up for what I want’ and ‘I want
to be in a relationship’). Goals should be positive. A case conceptualization is an
individualized and hypothesized understanding of a client’s problems within the cognitive
model of emotional disorders; in essence, it seeks to pinpoint the factors that maintain the
client’s current problems and uncover the underlying factors that predispose her to experience
these problems. Persons et al. (2001) describe the case conceptualization (or case formulation
as they call it) at three levels:

1. The case
2. The syndrome or problem
3. The situation -- client’s thoughts, feelings and behaviours in that situation.

These three levels can be tied together in the following example: a client who presents
with depression and withdrawal triggered by the end of a relationship (e.g. ‘Why did
he leave me? My life is meaning- less without him. What did I do to drive him away?
I can’t face seeing anyone without him’) may point to underlying intermediate beliefs
(e.g. ‘Unless I’m in a relationship, my life has no meaning’) and core beliefs (e.g.
‘I’m nobody on my own’) which are long-standing cognitive vulnerability factors
activated by the current stressors in the client’s life. These therapist-driven hypotheses
will need to be confirmed, modified or rejected based on information collected during
the course of therapy.

NATs are tried to pop up through questioning such as “What was just going through your
mind?’ Thoughts are evaluated in 2 ways:

Guided discovery. Sometimes called Socratic dialogue, guided discovery helps clients
change maladaptive beliefs and assumptions. The therapist guides the client in discovering
new ways of thinking and behaving by asking a series of questions that make use of existing
information to challenge beliefs. It puts clients in a position to do some working through,
provokes challenges to their beliefs, raises self-awareness, and develops a skill for
identification and amendment of irrational or harmful thoughts by linking thought with
emotion.

[Client:] I’ve been afraid that when I report to my new job on Monday, people will think I
can’t do the work.

[Therapist:] What does that tell you about the assumptions that you are making?

[Client:] Like I’m mind reading, like I know in advance what’s going to happen.

[Therapist:] And what assumptions are you making?

[Client:] That I know what my new colleagues will think of me.

Behavioural experiments: These are used to test the validity of clients’ automatic thoughts
and intermediate beliefs (assumptions and rules). Behavioural experiments are used in the
service of cognitive change. For example, a client who was very self-conscious about being
overweight was unhappy about not ‘allowing myself to go swimming’. If she went swimming
her prediction was: ‘People will stare at me and snigger and I won’t be able to stay there’ (the
client said she wanted to stay in the pool for at least thirty minutes). The client anticipated
that her level of anxiety would be 85 per cent in carrying out the experiment. Emphasising
the positive about the client and facilitating this changes between the sessions.

[Link] work in cognitive therapy takes place between sessions so that skills can be applied
to real-life settings, not just the office (J. S. Beck & Tompkins, 2007). Specific assignments
are given to help the client collect data, test cognitive and behavior changes, and work on
material developed in previous sessions. If the client does not complete the homework, this
fact can be useful in examining problems in the relationship between client and therapist or
dysfunctional beliefs about doing homework assignments (J. S. Beck, 2005). Generally,
homework assignments are discussed and new ones developed in each session. The therapist
and client review homework and collaborate to see how the client could get more out of it.
Usually, the major focus of the session is on the concerns the client raised at the beginning of
the therapy hour. Having dealt with specific items, new homework is assigned relevant to the
client’s chief concerns. Feedback from the client about the session is an important element of
the collaborative relationship between therapist and client.

[Link]. As early as the first session, termination may be planned. Throughout

treatment, therapists encourage patients to monitor their thoughts or behaviors, report them,
and measure progress toward their goals. In the termination phase, the therapist and client
discuss how the client can do this without the therapist. Essentially, clients become their own
therapists. Just as clients may have had difficulties in accomplishing tasks and may have
relapsed into old thought patterns or behaviors, they work on how to deal with similar issues
and events after therapy has ended. Slowly decrease the number of sessions. Commonly, the
frequency of therapy sessions tapers off, and client and therapist may meet every 2 weeks or
once a month. Termination is followed by one or 2 booster sessions for follow up.

TECHNIQUES

A wide variety of cognitive techniques are used in helping clients achieve their goals. Some
of the techniques focus on eliciting and challenging automatic thoughts, others on
maladaptive assumptions or ineffective cognitive schemas.

Understanding idiosyncratic meaning. Different words can have different meanings for
people, depending on their automatic thoughts and cognitive schemas. Often it is not enough
for therapists to assume that they know what the client means by certain words. For example,
depressed people are often likely to use vague words such as upset, loser, depressed, or
suicidal. Questioning the client helps both therapist and client to understand the client’s
thinking process.

[Client:] I’m a real loser. Everything I do shows that I’m a real loser.
[Therapist:] You say that you’re a loser. What does it mean to be a loser?

Challenging absolutes. Clients often present their distress through making extreme
statements such as “Everyone at work is smarter than I am.” Such statements use words like
everyone, always, never, no one, and all the time. Often it is helpful for the therapist to
question or challenge the absolute statement so that the client can present it more accurately,
as in the following example:

[Client:] Everyone at work is smarter than me.

[Therapist:] Everyone? Every single person at work is smarter than you?

Reattribution. Clients may attribute responsibility for situations or events to themselves

when they have little responsibility for the event. By placing blame on themselves, clients can
feel more guilty or depressed. Using the technique of reattribution, therapists help clients
fairly distribute responsibility for an event, as in this example:

[Client:] If it hadn’t been for me, my girlfriend wouldn’t have left me.

[Therapist:] Often when there is a problem in a relationship, both people contribute to it.
Let’s see if it is all your fault, or if Beatrice may also have played a role in this.

Decatastrophizing. Clients may be very afraid of an outcome that is unlikely to happen. A

technique that often works with this fear is the “what-if” technique. It is particularly
appropriate when clients overreact to a possible outcome, as in this case:

[Client:] If I don’t make dean’s list this semester, things will be over for me. I’ll be a mess;
I’ll never get into law school.

[Therapist:] And if you don’t make dean’s list, what would happen?

[Client:] Well, it would be terrible, I don’t know what I would do.

[Therapist:] Well, what would happen if you didn’t make dean’s list?

Cognitive rehearsal. Use of imagination in dealing with upcoming events can be helpful. A
woman might have an image of talking to her boss, asking for a raise, and then being told,
“How dare you even talk to me about this subject?” This destructive image can be replaced
through cognitive rehearsal. The woman can imagine herself talking to her boss and having a
successful interview in which the boss listens to her request. The cognitive rehearsal can be
done so that the woman presents her request in an appropriate way, with the boss not granting
the request in one instance and the boss granting the request in another. The therapist asks her
to imagine the interview with the boss and then asks the patient questions about the imagined
interview.

The ‘worst-case’ technique. People often try to avoid thinking about worst possible
scenarios in case doing so makes them even more anxious. However, it is usually better to
help the client identify the worst that could happen. Facing the worst, while initially
increasing anxiety, usually leads to a longer-term reduction because

1. the person discovers that the ‘worst’ would be bearable if it happened, and
2. realises that as it probably won’t happen, the more likely consequences will
obviously be even more bearable; or
3. if it did happen, they would in most cases still have some control over how things turn
out.

Role Play. This is used when clients have difficulty revealing salient cognitions in their
problematic relations with others. The therapist can play the person with whom the client
experiences interpersonal difficulties. It is important that the therapist takes on the
characteristics that the client ascribes to the other person if the role play is to have any
verisimilitude (e.g. if the client says that a work colleague is rude and abrupt then the
therapist should not play this person as polite and considerate as this will undermine the role
play).

Constructing alternative explanations. This technique shows clients that there is more than
one way of looking at a situation. Blackburn and Davidson suggest:

Asking the patient to list alternative interpretations of a situation and then establishing the
realistic probability of each interpretation is a powerful technique, as it does not reject the
original negative interpretation, unlikely as it might be, and contrasts it with more likely
interpretations. Asking “Is there any other way to view the problem?”

Thought record. It's a practical way to capture and examine your thoughts and feelings
about a situation, and your evidence for them in a detailed written account. Doing this can
help you understand how linked our thoughts and behaviours can be, and how they influence
each other.

The situation – what happened?

For example: "I am annoyed at myself for forgetting to run an errand."

2. My feelings – how this made you feel at first

For example: "Frustrated, stupid."

3. Unhelpful thoughts I had

For example: "I never get anything right. I'm useless and cannot be trusted with simple
tasks."

4. Evidence to support my unhelpful thoughts

For example: "It's not the first time I've forgotten something like this."

5. Evidence against my unhelpful thoughts

For example: "I remembered everything else I needed to do. I'm usually very reliable when it
comes to errands and don't put anything off."

6. Alternative, more realistic or neutral thoughts

For example: "I remember to do far more errands than I forget. It's happened before but not
often – it's just that the forgotten ones stick in my memory. Most of the time I am a
trustworthy and reliable person."
7. How I feel now – how your feelings have changed after completing your thought record

For example: "Calmer, more confident in myself – I am neither stupid nor useless. Accepting
that everyone forgets things from time to time."

Activity monitoring and scheduling. Activity scheduling is a core component of

behavioral activation, a therapeutic approach that focuses on increasing engagement in
activities to improve mood and reduce avoidance behaviors.
 Breaking the Cycle:
It helps individuals recognize and address the negative cycle of inactivity and avoidance
that can contribute to depression and other mental health challenges.
 Improving Mood and Energy:
By engaging in meaningful and enjoyable activities, individuals can experience
increased motivation, energy, and a sense of accomplishment.
2. Key Steps in Activity Scheduling:
 Activity Tracking:
 Daily Log: Individuals are encouraged to keep a daily log or diary to track their
activities, noting the time, duration, and perceived level of enjoyment or
accomplishment.
 Identifying Activities: The log helps identify activities that bring pleasure, a
sense of mastery, or are simply necessary for daily functioning.

Each day is usually divided into hourly periods of planned activity so clients do not have to
decide every hour what to do next. Clients are asked to rate on a 0–10 scale how much
pleasure and sense of accomplishment they have gained from each activity. This rating scale
helps clients to test their predictions that carrying out these activities will bring neither
pleasure nor accomplishment.

Sally: Yes, I spend more of my time in bed.

Therapist: Does staying in bed make you feel better? Do you get out feeling refreshed and
ready to go?

Sally: No, I still feel sleepy and down.

Therapist: I believe you used to spend time exercising, is that right?

Sally: Yes, I used to run or swim most mornings, but I’ve felt tired and didn’t think I’d enjoy
it.
Therapist: Would you like to plan some exercise, perhaps going for a short run or swim three
times a week?

Sally: Yes, I could commit to that.

Therapist: You could also give yourself credit for when you do such things.

Bibliotherapy. These are reading assignments which not only help clients to understand their
psychological disorders better but also the CT methods for tackling them. There is a
substantial CT self- help literature from which selected titles can be recommended to clients
such as Love is Never Enough by Aaron Beck (1988) for relationship problems, The Feeling
Good Handbook by David Burns (1989) for dealing with depression and anxiety,
Overcoming Anxiety by Helen Kennerley (1997), Overcoming Low Self-Esteem by Melanie
Fennell (1999) and Life Coaching: A Cognitive Behavioural Approach by Michael Neenan
and Windy Dryden (2002b) for developing greater personal effectiveness in one’s life. Self-
help literature is seen as an adjunct to therapy, not as a substitute for it.

Homework. Homework provides opportunities for clients to practise in everyday life the CT
skills they have learned in the therapist’s office. Homework allows clients to develop both
competence and confidence in tackling their problems, thereby reducing not only the chances
of a full-blown relapse but also the dangers of becoming dependent on the therapist for
answers to their problems. Monitor their automatic thoughts, track it in thought record,
imagine themselves coping in situations where they fear an unpleasant outcome, Graded task
assignments help clients to tackle their problems in small, manageable steps rather than
attempting too much too soon. A hierarchy of feared or difficult situations can be drawn up
with the client moving through the hierarchy at his own pace.

Thought stopping techniques. Thought-stopping techniques are cognitive strategies to

interrupt and redirect negative or unwanted thoughts, often involving recognizing the
thought, saying "stop" (mentally or verbally), and replacing it with a more positive or neutral
one.
Here's a more detailed breakdown of common thought-stopping techniques:
1. Verbal Interruption:
 Say "Stop":
Mentally or verbally state "stop" or a similar phrase when a negative thought arises.
 Auditory Cue:
Create a sound (like snapping fingers or clapping) as a cue to interrupt the thought.
2. Visual Cues:
  Stop Sign: Visualize a stop sign to signal the need to halt the unwanted thought.
 Other Visualizations: Imagine a barrier or wall to block the thought.
3. Physical Actions:
 Rubber Band:
Wear a rubber band on your wrist and snap it when you notice a negative thought.
 Grip/Bang:
Grip an object or bang a hand on a table to create a physical sensation that interrupts the
thought.
4. Cognitive Replacement:
 Positive Affirmations: Replace the negative thought with a positive or neutral
statement.

Letter writing. Write letter to important people, about past feelings, your needs. Read out to
the therapist & process those emotions, underlying thoughts, defenses, distorted beliefs.

 Cognitive distancing. A technique that helps individuals gain perspective on their

thoughts and emotions by observing them as mental events rather than facts, reducing
their grip on behavior and promoting psychological flexibility.
Techniques:
 Labeling thoughts: Identifying thoughts as "just a thought" or "I'm having the
thought that...".
 Using metaphors: Imagining thoughts as clouds or distant events.
 Mindfulness practices: Engaging in mindfulness exercises to observe thoughts
without judgment.

Using the pie technique. When client cant specify/ explain the problems writing our
thoughts down can be a helpful tool to gain perspective, and creating a visual
representation can be even more effective in impacting our unhelpful thought patterns.

This article will focus on how to use the pie technique to reevaluate how we make sense
of situations that don’t go the way we want. This technique is especially useful in
helping us rethink things we unfairly blame ourselves for.

Step 1: Identify the automatic thought that comes to your mind when you are being hard
on yourself for something going wrong. For instance, if you get a bad grade on a test,
you might have the thought, “I failed because I’m stupid.”

Step 2: Come up with a list of alternative explanations – as many as you can think of.
These need not be mutually exclusive explanations. In most cases, all of them probably
played some part in the outcome. For the example above, your list may include things
like:

The test was difficult.

I missed several classes.

I studied the wrong material.

The teacher rushed through the material.

Bad luck.

Step 3: Assign a percentage to each explanation. The percentage should reflect the
degree to which each explanation contributed to the situation. For instance, the
explanation “I missed several classes” might receive a 50% if a large portion of the test
was on material covered during the missed classes. However, if the classes missed were
not especially important, you might assign them less importance, like 15%. After
reviewing the alternative explanations list, assign a percentage to your original
automatic thought. Add up the percentages to make sure they add up to 100%. If they
don’t, reassign the percentages until they do.

Step 4. Finally, use the percentages to draw a pie chart.

Positive affirmations and mindfulness

STRENGTHS: It is structured, objective, gives power to the client, is validated and used in
multiple cultures, is effective for various disorders, is backed by well-established and
standardised clinical instruments, has a great amount of empirical validity.

WEAKNESS: Client should have insight, it is not effective for individuals with low
intelligence, psychotics, less focus on past and unconscious and biological processes and
developmental stages, needs highly skilled trainers.

CBT is problem focused, goal-oriented, emphasizes collaboration, active participation,

structured, time limited. Educative therapy as it teaches the client to become his own
therapist.