______________________ Cognitive-Behavioral Therapy: Theory, Techniques, and Applications, 3rd Edition
Technique: Note the Common Theme (J. S. Beck, 2020) Through therapy, the therapist may note a common theme in the client’s automatic thoughts. This observation can be reflected to the client, and their thoughts on its validity can be elicited. Example: T: I’ve noticed that in response to several different situ- ations, you often find yourself thinking, “I’ll never find a partner.” Is it possible that you have an underlying belief or rule that you must have a partner to be happy? C: Yes, I think I do believe that I have to have a partner to be happy [rule]. If I had someone to spend my time with, then I would feel better [assumption]. Technique: Ask the Client (J. S. Beck, 2020) The therapist can ask the client directly about what their beliefs are regarding specific issues. Example:
C : That I can’t always predict the future or read some- one’s mind. Technique: Restate Belief in Terms of an Assumption (J. S. Beck, 2020) The therapist can assist the client in addressing maladap- tive intermediate beliefs by having the client restate them as assumptions that can be tested. The example includes ratings about the degree the client believes their rules/assumptions (introduced previously under “Automatic Thoughts”). Example: T: So, you’ve shared that you believe that you need a partner to enjoy yourself. How strongly do you believe this rule right now? C: About 80%. T: Is it possible that this belief you have is really more like an assumption rather than a reality, that you are assuming you need a partner to be happy? Have you ever been happy doing an activity by your- self? [testing the assumption] C: Yes. My ex-husband didn’t enjoy gardening, so I did it by myself. I found it very rewarding. T: How strongly do you believe your rule now? C: About 50%. T: What accounts for the difference in the strength of your belief? C: Well, I guess it’s just not true all the time. Maybe I would enjoy something more with a part- ner, but that doesn’t mean I wouldn’t enjoy some- thing at all if I had to do it alone. Technique: Substituting a New Belief (J. S. Beck & Beck, 2011) The therapist can determine if there is an alternative belief that would be more functional and healthy for the client. Remem- ber, the therapist does not impose this belief on the client but assists the client in determining this new belief through the techniques addressed earlier in the course. Example: T: OK, so we’ve determined that you believe you should do well at everything you try, correct? C: Yes, and the evidence for and against that belief. T: Right. So, how would you summarize where you are right now? C: Well, it is not always reasonable to expect that I
T : What is your belief about failing in school?
C : Failing is horrible! [attitude] If I fail a class, then I am a failure [assumption].
Evaluating and Modifying Intermediate Beliefs
Interventions for evaluating and modifying intermediate beliefs may be used once intermediate beliefs have been identified. Technique: Evaluating and Challenging Cognitive Distortions (Leahy, 2017) As discussed under automatic thoughts, challenging cogni- tive distortions can also be used as a technique to address intermediate beliefs, especially when intermediate beliefs are represented through such a distortion. Example: T : Did I hear you say that you believe you should have known Bob would say “no” to your dinner invitation?
C : Yes, I should have known.
T : Would everyone see it this way?
C : Probably not.
T : How would someone else see this situation?
C : Well, they might think that you can’t always tell how people are going to react, I suppose.
T : What would that mean in your situation?
should be good at everything right away. T: What would be a healthier belief, then?
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