Title Details

Paul Stallard is Professor of Child and Family Mental Health at the University of Bath and Head of Psychological Therapies (CAMHS) for Oxford Health NHS Foundation Trust. He has contributed to the development of CBT in many countries and has provided workshops for clinicians around the world.

About the author xiii

Acknowledgement xv

Online resources xvii

1 Cognitive behaviour therapy: theoretical origins, rationale, and techniques 1

The foundations of CBT 2

First wave: behaviour therapy 2

Second wave: cognitive therapy 3

The cognitive model 4

Third wave: acceptance, compassion, and mindfulness 5

Core characteristics of CBT 7

CBT is theoretically determined 7

CBT is based on a collaborative model 8

CBT is time-limited 8

CBT is objective and structured 8

CBT has a here-and-now focus 8

CBT is based on a process of guided self-discovery and experimentation 8

CBT is a skill-based approach 8

The goal of cognitive behaviour therapy 9

The core components of CBT 9

Psycho-education 10

Values, goals, and targets 10

Acceptance and acknowledgement of strengths 10

Thought monitoring 10

Identification of cognitive distortions and deficits 10

Thought evaluation and developing alternative cognitive processes 10

Development of new cognitive skills 11

Mindfulness 11

Affective education 11

Affective monitoring 11

Affective management 11

Activity monitoring 11

Behaviour activation 12

Activity rescheduling 12

Skills development 12

Behavioural experiments 12

Fear hierarchy and exposure 12

Role play, modelling, exposure, and rehearsal 12

Self-reinforcement and reward 12

The clinician’s toolbox 13

2 The process of cognitive behaviour therapy 15

Therapeutic process 15

Phases of CBT 16

Relationship building and engagement 16

Psycho-education 17

Promoting self-awareness and understanding 17

Enhancing skills and development 18

Consolidation 18

Relapse prevention 19

Adapting CBT for young people 19

Cognitive vs behavioural focus 20

Therapeutic partnership 20

Language 20

Dichotomous thinking 21

Verbal vs non-verbal materials 21

Technology 21

Common problems when undertaking CBT with young people 22

Limited verbal skills 22

Limited cognitive skills 22

Lack of engagement 23

No responsibility for securing change 23

Difficulty accessing thoughts 23

Failure to undertake home assignments 24

Focus shifting 24

Working with egocentricity 24

Significant family dysfunction 25

‘I get it, but I don’t believe it’ 25

3 Thinking good, feeling better: overview of materials 27

Value yourself 29

Summary 29

Worksheets 29

Be kind to yourself 29

Summary 29

Worksheets 30

Be mindful 30

Summary 30

Worksheets 31

Getting ready to change 31

Summary 31

Worksheets 31

Thoughts, feelings, and what you do 31

Summary 31

Worksheets 32

The way you think 32

Summary 32

Worksheets 32

Thinking traps 33

Summary 33

Worksheets 33

Change your thinking 33

Summary 33

Worksheets 34

Core beliefs 34

Summary 34

Worksheets 34

Understand how you feel 35

Summary 35

Worksheets 35

Control your feelings 35

Summary 35

Worksheets 36

Problem-solving 36

Summary 36

Worksheets 37

Check it out 37

Summary 37

Worksheets 37

Face your fears 38

Summary 38

Worksheets 38

Get busy 38

Summary 38

Worksheets 39

Keeping well 39

Summary 39

Worksheets 39

4 Value yourself 41

How does self-esteem develop? 42

Can you change self-esteem? 42

Find your strengths 43

Use your strengths 44

Find and celebrate the positive 45

Look after yourself 46

Diet 46

How much sleep do I need? 47

I’m not getting enough sleep 48

I can’t get off to sleep 48

Alcohol 49

Physical activity 50

5 Be kind to yourself 57

Eight helpful habits 58

Treat yourself like you would treat a friend 58

Don’t kick yourself when you are down 59

Forgive mistakes 59

Celebrate what you achieve 60

Accept who you are 61

Speak kindly to yourself 61

Find the good in others 62

Be kind to others 63

6 Be mindful 69

Mindfulness 70

Focus, observe, be curious, and use your senses 70

Mindful breathing 71

Mindful eating 72

Mindful activity 73

Mindful observation 74

Suspend judgement 75

Mindful thinking 75

7 Getting ready to change 81

What you think 82

How you feel 83

What you do 83

The negative trap 83

Good news 84

Are you ready to try? 85

My goals 85

The miracle question 86

8 Thoughts, feelings, and what you do 93

How does the negative trap happen? 94

Core beliefs 94

Assumptions 94

Unhelpful beliefs 95

Beliefs are strong 96

Turning your beliefs on 96

Automatic thoughts 96

How you feel 97

What you do 98

The negative trap 98

9 The way you think 103

Hot thoughts 104

Helpful thoughts 104

Unhelpful thoughts 105

Automatic thoughts 105

The negative trap 106

10 Thinking traps 111

Negative filter 112

Negative glasses 112

Positive doesn’t count 112

Blowing things up 113

Magnifying the negative 113

All-or-nothing thinking 113

Disaster thinking 113

Predicting failure 114

The fortune teller 114

Mind reading 114

Being down on yourself 115

Dustbin labels 115

Blame me 115

Setting yourself to fail 115

Should and must 116

Expecting to be perfect 116

11 Change your thinking 121

Catch it 121

Check it 121

Challenge it 122

Change it 123

What would someone else say? 124

Dealing with worries 125

Why do we worry? 126

Keep worries under control 126

Make worry time 127

Delay worry 127

Solve the worries you can do something about 127

Accept the worries you can do nothing about 127

12 Core beliefs 133

Core beliefs 133

Finding core beliefs 134

Challenging core beliefs 137

Is it always true? 137

If it doesn’t work? 138

13 Understand how you feel 143

Body signals 143

Feelings 144

How do your feelings change? 145

Why me? 146

14 Control your feelings 153

Relaxation exercises 153

Quick relaxation 155

Physical activity 155

4-5-6 breathing 156

Calming images 157

Mind games 158

Change the feeling 158

Soothe yourself 159

Talk to someone 159

15 Problem-solving 167

Why do problems happen? 168

Problem-solving 169

Break it down 171

16 Check it out 177

Experiments 178

Be open-minded and curious 180

Surveys and searches 181

Responsibility pies 182

17 Face your fears 189

Small steps 190

Make a fear ladder 191

Face your fears 192

18 Get busy 197

Getting busy 198

What you do and how you feel 198

Change what and when you do things 200

Have more fun 201

19 Keeping well 207

What helped? 207

Build them into your life 208

Practice 209

Expect setbacks 210

Know your warning signs 210

Watch out for difficult times 211

Be kind to yourself 212

Stay positive 212

When do I need to get help? 213

References 217

Index 221