Topic 4: Experiencing CBT: Self-Practice & Self-Reflection {by 6/20}

Based on the readings due this week consider the following two discussion points: (1) As a therapist in training, what are your general thoughts about practicing CBT skills/techniques on yourself? (2) What technique/exercise provided you the most insight about yourself as a person or therapist (please only share information within your range of comfort; if it helps, focus on process rather than content)? Explain. Your original post should be posted by the beginning of class 6/20.  Post your two replies no later than 6/22.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

52 Comments (+add yours?)

  1. Brittany King
    Jun 16, 2017 @ 16:15:31

    1) As a therapist in training, what are your general thoughts about practicing CBT skills/techniques on yourself?

    The first thought that comes to mind is the saying “practice what you preach”. These skills and techniques we teach our clients and help implement in their lives are useful so we should be utilizing them. When we are practicing these skills, we learn a lot. We learn that implementing them can be really hard and it helps us see it from the client’s perspective. Also, we learn how valuable these skills are when we utilize them correctly. This also comes back to the idea of burn out and self-care. In order to keep ourselves from reaching the point of burn out or to help get us out of feeling burnt, we can implement CBT techniques to help us. The job itself is high stress at times and being able to utilize what we know best to help us reduce that stress seems like a “no brainer”. For me, I believe that we should be utilizing these skills on ourselves. How can I explain a technique to a client or try to teach it to them without ever trying it myself? For me, after doing something, I am better able to teach it to someone.

    (2) What technique/exercise provided you the most insight about yourself as a person or therapist (please only share information within your range of comfort; if it helps, focus on process rather than content)?

    The book discussed how behavioral activation is a useful exercise for managing uncomfortable mood states. It goes on to talk about how even if you are not depressed, many of us will struggle to do the things we like to do or are good at doing and struggle with what we have to do. The whole idea is to increase behavioral activation and decrease that avoidance. Being able to see a chart of your mood throughout the day and then what was happening around that time provides a lot of insight into what is going on. While going over the techniques and exercises, one that jumped out at me was the “Identifying Alternative Pleasurable and Necessary Activities” exercise within Module 3: Behavior Activation. I really enjoyed being able to visually see the things I enjoy while also having a list of the things I need to get done. Most of the time I am super focused on the things I need to accomplish, I forget about the things that bring me pleasure. Being able to then take those activities and create a hierarchy was eye opening for myself. I was tracking what activities were the easiest, medium difficulty, and most difficult for myself. I found that anything necessary was easy for me to engage in but anything else was medium to most difficult. I took it a step further and planned out my activities and tried to keep the necessary activities in but also mapping out when I can engage in activities that are fun. I realize that I actually do have time to do these fun activities if I actually just sit down and make time for them. This exercise was eye opening in the sense that I was able to really break something down and find a solution that worked for me. I really want to try to make a schedule like the one in the book for each week in order to make sure I am taking care of myself!

    Reply

    • Jacleen Charbonneau
      Jun 17, 2017 @ 14:03:31

      Brittany, I like your idea about how utilizing CBT can be a way to avoid burnout and engage in self-care. Often times we think of self care as activities such as proper eating, spending time with friends and family, forms of exercise, as well as others. Many of the suggested forms of self care relate to environmental change, yet the idea of changing cognitions as a form of self-care is never really emphasized in the field. I think this is a great way of thinking about self care!

      Reply

    • Emily Morse
      Jun 19, 2017 @ 09:29:53

      Brittany, reading your comments about how using CBT techniques on ourselves to avoid burn out really clicked for me. I never really thought of doing that, but like you said, it really is a no brainer. These methods have the empirical support to demonstrate their effectiveness, so why not put them to use on ourselves when we feel like we are approaching burnout? I also think that a lot of these CBT exercises can easily be used on ourselves (as shown in the second part of our blog posts here).

      Reply

    • Marisa Molinaro
      Jun 20, 2017 @ 11:05:50

      Brittany,

      I like how you went a step further and actually analyzed the amount of “free time” you may have in a day and then created smaller pleasurable tasks to complete during those times. I feel that when thinking about self-care, I imagine that we need to have this giant block of time set aside to only focus on ourselves when in reality you can simply set aside 10 minutes twice a day and focus on doing something that you enjoy and this can make all the difference. I worry about burnout as well because I know how I am and I am always putting everything and everyone else first. However, by making sure that we are scheduling in time to focus on ourselves, hopefully we won’t hit our burnout point for much much longer!

      Reply

  2. Emily Morse
    Jun 17, 2017 @ 10:18:55

    1. I think it is incredibly helpful as a therapist in training to practice CBT skills/techniques on ourselves. For me personally, I am much better at explaining something once I have done it. Obviously, a big piece of CBT is explaining what we are doing. For example, we are never going to give clients a homework assignment and be like okay, have at it! Actually doing the assignment ourselves will ensure that we truly understand how to explain the homework to clients in a way that they understand. Furthermore, practicing on ourselves will also help us troubleshoot. We may run into little problems while practicing a skill that our clients would run into. If we had not practiced these skills beforehand, we would not be able to troubleshoot as well before giving the homework assignment. When we can predict and troubleshoot what problems clients will run into BEFORE assigning homework or working on a skill, the client will most likely gain more from the activity (or even actually complete the activity). Additionally, I think it is so important as therapists to bring ourselves back to the client experience. I think it can be easy to get into a routine with clients and forget that they are people with personalized problems. Practicing these skills can remind us what the client experience is, thus increasing our empathy towards clients. Lastly, practice makes perfect, and who better to practice on than ourselves? Practicing these skills will only make us better at actually employing them.

    2. Being somewhat anxious myself, I found it incredibly helpful to do thought records to test negative automatic thoughts. I can often go back and forth in my own head with evidence for and against NATs, but putting them out on paper really helped me to see just how much more evidence against my NAT there was – it also helps that I’m a very visual person. For my example, I focused on a difficult process group that I ran last week. I had one individual who very obviously did not like or “get anything” from the process group (it just didn’t click for him and he wanted to do something else). My negative automatic thought was that I did a terrible job at running the group and nobody got anything out of it. There was some evidence for this thought – this individual didn’t share during group, the group talked a lot about surface things and didn’t get too deep, and the individual said at the end that he didn’t get anything out of the group. There was a lot more evidence against my NAT including: there weren’t too many silences, other people made connections with each other, some people opened up a little who are typically very quiet, I made some thoughtful responses throughout group, my supervisor told me I did very well, my supervisor told me I seemed very comfortable, and this individual was the only one who said he didn’t get anything out of group – the other 7 individuals said it was helpful in ways. Although I can do this in my head, like I mentioned before I usually do it in a very back and forth manner. Laying it all out in adjacent columns helped me visually see how the evidence against really outweighed the evidence for. It also helped me to think more and come up with more evidence against – for example, in my head I only kept thinking of the individual saying “no the group didn’t help me,” but when I was writing out evidence against, I started to think well yeah he said it didn’t help, but there were 7 other individuals in the group who were nodding their heads yes, that it did help them. This process helped me to modify my belief to be – there were things I could have done differently that I know now that I have experienced this, I did some things very well, and not everybody is going to find every group helpful, but it may be helping others. I like this exercise because it helped me come up with a more realistic/balanced thought. I didn’t go from “I did a terrible job” to “I did an amazing job,” but that wouldn’t be realistic for me. It isn’t about going from one thought to its polar opposite, and I think that’s really helpful (and far more realistic) for people.

    Reply

    • Jacleen Charbonneau
      Jun 17, 2017 @ 14:05:36

      Emily, I think you are right about the idea that it is easier to explain something once it has been done personally. As therapists, we are like teachers. I can imagine how it would be to be in a classroom with classroom teacher who has never fully engaged or learned his or her subject. I think of this in the same way as I think about CBT: we should only teach if we first learn.

      Reply

    • Lindsay Millerick
      Jun 18, 2017 @ 10:48:25

      Emily,
      I believe that your experience as a new clinician is very relatable not only to individuals in this program but to many individuals experiencing anxiety. CBT recognizes that it is very common for individuals to look only at the negative while ignoring the positive. For people in this profession, I believe that the anxiety about performance in the field often comes from the genuine desire to help others, and fear that you are unable to do so. I believe that this quality is a strength, rather than a weakness in an aspiring clinician as you are dedicated and passionate.

      Reply

    • Jill Harrison
      Jun 19, 2017 @ 21:02:13

      Emily, I really appreciate you sharing your own experience with negative automatic thoughts, as I have also benefited from this type of intervention. Being able to write down a visually see your thoughts on paper, and challenge them directly has given me a new perspective on the way that I think and function in my day-to-day life. I think that it also helps us identify issues that our clients may be experiencing because we have personal experience utilizing the techniques.

      Reply

    • Jackie Bradley
      Jun 20, 2017 @ 10:37:50

      Emily
      I can relate to your negative automatic thoughts regarding the group that you ran. I think it is very easy for us as new clinicians to minimize the good and maximize the bad when working with clients, running groups, etc., which can elicit those negative automatic thoughts. Like you said, I think that writing down the evidence for and against can really make things click for us rather than going back and fourth in our heads. It is easy to get lost in that form of thinking, proving actually writing and doing these exercises is beneficial for us as therapists.

      Reply

    • Taylor Gibson
      Jun 22, 2017 @ 16:28:50

      Emily,

      I agree with your statement that educating our clients about a skill or a technique is much easier when you fully understand it and that practicing the technique on ourselves is a way for us to solidify our understanding. I myself find that it is also much easier for me to explain something to someone when I have had the opportunity to practice it myself. I also had not considered and therefore, very much appreciate what you have said about troubleshooting a task. By leading the way for our clients and trying an activity prior to assigning it we can save them time and frustration by identifying problems or difficulties with the task.

      Reply

    • Meagan Monteiro
      Jun 22, 2017 @ 17:44:54

      Emily,

      I could not agree more. I like that you mention that learning the skills and doing the homework will help us to explain this better to our clients. I think having the perspective of having to complete homework and complete a task, such as self-monitoring is extremely helpful as we will fully know what we are asking of our clients.

      Reply

  3. Jacleen Charbonneau
    Jun 17, 2017 @ 14:46:22

    1. As a therapist in training, I think it is crucial that we practice CBT on ourselves. Thinking about classroom teachers, teachers must be skilled and competent in the subjects that they teach. I think this same idea applies to therapists: In order to truly learn the “subject” being taught (i.e., CBT), it has to first be fully learned, and part of this learning is experiencing CBT firsthand so that the therapist can truly know CBT instead of simply knowing about it. Moreover, if anyone is to practice CBT, it should be a therapist as he or she is an advocate for it. Although a very effective and evidence-based treatment, one criticism about CBT that pops up from time to time by clients is the idea that it is a lot of effort and takes a lot of time and work. Therapists should be able to engage in CBT and increase their motivation to do so so that they can tell clients firsthand that results far outweigh the workload involved.

    2. The technique that provided me most insight about myself as a person is the “Strategies to Achieve my Goals” chart. I often have a number of goals, sometimes too many, that I want to achieve, but often time these goals are just mere thoughts that never get carried out into actions. There is definitely a step that I am missing, which is breaking down my goals into smaller steps, as well as identifying what may get in the way of achieving my goals. I often only have a two-step process in my mind for goals: 1) think about the goal 2) fully achieve the goal. This open-ended chart allowed me to take a goal of mine and look at it in smaller steps. It also allowed me to problem-solve by looking at what may get in the way, and how I could overcome these barriers. Ultimately, this chart provides a comprehensive view of what goal-setting truly is, as well as the mental complexity that is involved in actually achieving goals. When trying out this exercise, I noticed the role of internal processes and external barriers in goal setting. It also provided me more rational thinking when it comes to goal achievement: often times, we want to give up when faced with a struggle, but everyone faces barriers when reaching a goal. Common cognitive distortions of mine, which I noticed when doing this exercise, include “should statements,” such as “reaching goals should be easy without problems” and magnification of the problems that I do face when trying to achieve goals. These cognitions lead to negative emotions and lack of action. Therefore, this exercise not only allowed me to problem solve, but to also alter thoughts which lead to an increase in positive emotion and self-efficacy to take on these goals.

    Reply

    • Lindsay Millerick
      Jun 18, 2017 @ 10:37:37

      Jacleen,
      I agree that it is extremely important for therapists to be knowledgable on the interventions they utilize in therapy. This gives therapists the opportunity to help clients gain an accurate understanding of the activities in which they are to engage. Further, it allows therapists to have reasonable expectations for their clients. For example, if the therapist is aware that a particular activity is time consuming and the client struggles with time management, then the therapist can anticipate an incomplete activity while feeling empathetic towards the client’s experience. Having first hand experience also helps therapists connect with their clients in a genuine way.

      Reply

    • Amina Lazzouni
      Jun 18, 2017 @ 18:57:58

      Jacleen,
      I haven’t used to “Strategies to Achieve my Goals” chat, but while reading about your description of how it has helped you, I realized I can identify with you and have a similar issue of having too many goals, and goals that at times seem too ambitious and can be overwhelming. I think it would benefit greatly from breaking down bigger goals into smaller goals, and maybe focusing more on more attainable goals, and I also think it would be very helpful to identify what gets in the way of achieving of my goals. “Should statements” was also a cognitive distortion that I noted having in my post, so I think this exercise would be especially helpful. Thank you for sharing! I’m definitely going to do this exercise and hopeful it will be beneficial for me like it was for you!

      Reply

    • Brittany King
      Jun 19, 2017 @ 15:26:30

      Jacleen,

      I appreciate the way you linked therapist’s practicing CBT with teachers being knowledgeable in the subjects they teach. I think it brings about a great point on how we need to know how to use the interventions we want our client to utilize. When teachers learn a subject and how to teach it, they understand what is difficult and how to help their students master it. The same thing could be said for us. We need to know what parts are hard and numerous ways to teach the interventions because what works for one client, will not work for another!

      Reply

    • Mark Joyce
      Jun 19, 2017 @ 17:12:56

      Jacleen, I am so glad to see that someone else sees the value of breaking things down into small and obtainable goals after this week’s readings. Goal setting is obviously very important in the work we do with our clients, but it should be very prevalent in our personal lives. For instance, when I was looking for my job I completed an activity very similar to this one that identified the key steps to finding the job I currently have. I took the time to identify smaller tasks towards the end goal, which included finishing my CV, reaching out to my references ahead of time, searching and actually applying to jobs, and practicing possible questions and responses for interviews. I broke these tasks down into a time based priority, as I find that I work much better working on one task at a time before moving to the next.
      It may be overwhelming to have many goals, but as long as you can approach each one logically and with some sense of what you’re getting into, the goals should be obtainable!

      Reply

    • Jill Harrison
      Jun 19, 2017 @ 20:58:29

      Jacleen, I really appreciated your comments about setting smaller, more manageable goals for yourself, as I have also struggled with this. As someone who often takes on too much at one time, this strategy has helped me stay organized and on task, even when I was feeling completely overwhelmed. Understanding how to implement this intervention for ourselves, only makes us more competent and empathetic therapists when we can help and guide our clients with the understanding of our own personal experience.

      Reply

    • Jackie Bradley
      Jun 20, 2017 @ 10:45:19

      Jacleen
      I thought that your comparison to teachers and mastering the subjects they teach was a really good way to look at things. You made a really great point when you said in order to truly know the subject (CBT) you are going to teach, it is super important to have personal experience utilizing the skills and techniques. Continuing with your comparison, a math teacher who is teaching a new math skill would benefit from practicing that skill on her own before presenting it to her students. That way she knows exactly how to perform the skill, which can improve her teaching of it. The same thing goes for us as CBT therapists. Practicing the skills before we use them with clients will only benefit them.

      Reply

    • Stephanie Halley
      Jun 21, 2017 @ 21:23:00

      Jacleen,

      I really was drawn to your point relating to teachers. You’re so right! How bizarre would it be if we had a teacher who had no idea what they were talking about? I am sure the clients feel the same when they come into treatment: they want us to know what we’re talking about, too.

      I also agreed to your point about breaking down goals into smaller, more attainable goals. I also feel sometimes I bite off more than I can chew and get overwhelmed. Personally, when I have TOO much going on, I get so frustrated of not knowing where to begin, and don’t do any of it. Which is so counter productive. I feel an activity like this will really help me prioritize and allow myself to make it easier

      Reply

  4. Lindsay Millerick
    Jun 18, 2017 @ 10:30:24

    As aspiring clinicians, practicing CBT techniques on oneself can be beneficial in gaining self-awareness and competence as a therapist. Not even clinicians are immune to experiencing dysfunctional thought patterns or developing maladaptive core beliefs, therefore, one must identify and address issues that may conflict with the administration of effective therapy. For example, anxiety-provoking automatic thoughts may distract a therapist from listening to his/her client intently, which would diminish the therapist’s capacity to be receptive of information relevant to treatment planning/interventions and build rapport with the client. Since CBT relies on collaborative empiricism and appropriate interventions, it may be difficult for a therapist in this situation to conduct successful therapy. Having insight towards dysfunctional thoughts and distressing emotions gives clinicians an opportunity to work on themselves, which in turn, may help them become better therapists. Further, having experienced CBT activities first-hand helps therapists understand the process of engaging in the interventions, which allows them to connect with clients in a genuine way. Therapists who have themselves participated in interventions are also aware of the shortcomings and challenges associated with particular interventions and are more likely to be understanding of a client’s reluctance, or difficulty in completing activities.

    I found that my schedule of pleasurable and necessary activities provided significant insight regarding myself as a therapist as well as an individual. After planning my activities into a four-day schedule I found that I only followed through with one of the activities which was rated as the easiest level of difficulty. This implicates that on an individual level I am overly focused on mandatory activities while neglecting activities that I find enjoyable because I am determined to reach my academic/career goals. My determination and passion as a student and clinician can be considered favorable qualities, however, my tunnel vision and struggle to balance my schedule is causing me distress. What this means for me as a clinician, is that my failure to engage in self-care will facilitate the experience of burn-out which will significantly impact my functioning as a professional. Further, the exercise pointed out that I am far less likely to engage in an enjoyable activity after I have completed a work or internship but more likely to do so prior to these activities. Feelings of exhaustion and anxiety that manifest during these activities make it difficult for me for me engage, especially when the symptoms are experienced physically; headaches, stomach aches, etc. In order to minimize the anxiety, it is essential that I do participate in pleasurable activities following stressful situations. It is important that when I begin my career it does not interfere negatively with other domains of life, otherwise I will be experiencing significant distress. This activity has highlighted that although I am experiencing similar distress currently, with the utilization of CBT exercises I can correct my dysfunctional patterns to improve my overall well-being and prevent future difficulties.

    Reply

    • Amina Lazzouni
      Jun 18, 2017 @ 18:36:18

      Lindsay,
      I think you bring up a lot of important points in your thoughts on practicing CBT skills/techniques on oneself. I thought you brought up an important point when you said that not even clinicians are immune to experiencing maladaptive thoughts, and I like how you related to that to how they administer therapy and participate in the therapeutic relationship. I did think about how CBT could be beneficial for us as clinicians, but I didn’t think about how it could actually affect a client in the therapy process, so I do think you brought up an important point. I also mentioned in my post how doing the activities first-hand allows therapists to have a more genuine connection with their clients because they are able to empathize in a genuine way, having potentially experienced some similar emotions to the client, so I think you brought up another important point!

      Reply

    • Emily Morse
      Jun 19, 2017 @ 09:18:08

      Lindsay, in sharing your personal experience doing some CBT exercises, I think you bring up some very important points. It can be so easy to get tunnel vision, especially with how busy we are with classes, practicum, homework, work, that we can easily put aside those pleasurable activities. For me, sometimes I feel guilty doing pleasurable activities because there’s always something productive I could be doing for school/my practicum/work. As I mentioned in my post, I’m a very visual person, so laying it all out in a schedule like you did is a great way to see how much I am neglecting self care. I think exercises like this can help relieve that guilt because we can visually see ourselves neglecting self care and work to incorporate it more into our lives.

      Reply

    • Brittany King
      Jun 19, 2017 @ 15:39:42

      Lindsay,

      It looks like we did the same activity and had a similar experience. I struggle with scheduling things that “are not productive”. I feel like with being in school and working full time, it is so hard to do things that are not for either one. However, I also realize that I will burnout quickly. The activity helped me schedule the pleasurable activities but like you, I also struggled to follow through on them. It made me think about the roadblocks clients encounter and what they need to do to overcome them. For me, I had to schedule pleasurable activities that were quick and then I was able to do them everyday!

      Reply

    • Mark Joyce
      Jun 19, 2017 @ 17:05:58

      Lindsay, I really enjoyed your post because it is so true that it is hard to set aside time for the enjoyable activities that keep us sane. I didn’t use that activity, but thinking about scheduling time for my own activities seems to be something I haven’t really mastered yet. That’s not to say I don’t have time to relax, because I certainly do, but I find myself finding more joy in the little things and activities because it really is so hard to set aside time and money for larger relaxation activities that I thought of. One of the things that I tell myself is to keep enjoying all of the little things I can, no matter how brief because appreciating those little moments helps so much with the day to day drag of school, work, and life in general. Whether it means getting on the floor to play with the dogs or watering the garden, as long as I am mindful and in the moment I will release stress from the day. After a long day it really is important for us to come home and unwind, leaving our difficulties for work and work alone.

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    • Salome Wilfred
      Jun 20, 2017 @ 11:03:14

      Lindsay,
      I can really relate to how you struggle with following through with pleasurable activities. I also struggle with following through on engaging in pleasurable activities. I do notice that if I make the pleasurable activity meeting up with a friend I am a lot more likely to follow through because of the accountability. Unfortunately, this pressure to hangout with people or take a break makes the experience less enjoyable because all I can think about is all the work I have to do once I leave. I am hoping this changes once I finish classes and have a little less on my plate.

      Reply

    • Taylor Gibson
      Jun 22, 2017 @ 16:32:59

      Lindsay,

      What you have said about utilizing the mandatory vs. enjoyable activities exercise is very important and it can be a great tool for clinicians. When we are beginning to feel burnt out in our work I think that that exercise can be a way for us to notice what self-care is not being accomplished and reworking our schedule to accommodate the much needed enjoyable activities.

      Reply

  5. Amina Lazzouni
    Jun 18, 2017 @ 18:30:37

    As a therapist in training, I don’t think it hurts to practice CBT skills/techniques on myself, however, I think that if I really needed professional help for a concern and wanted to use CBT to make real progress, I would go to an actual, experienced CBT therapist. I do, however, see the benefit of practicing CBT techniques on myself both to get a better understanding of what my client will go through, and to have first-hand experience with some of the benefits of CBT techniques. In class last semester, I remember doing the automatic thought record and experiencing an element of anxiety that I wouldn’t have known a thought record would produce had I not done one myself. Knowing that a client may experience first-hand will allow me to be more empathetic towards the client and have a better understanding of his or her experience. I also felt like learning about automatic thoughts and core beliefs was eye-opening and helpful for me to examine my own thoughts and core beliefs and cognitive distortions that I didn’t know were cognitive distortions prior to learning about them. So, I do think there is definitely a benefit to practicing CBT skills/techniques, I think if I wanted to get help for a particular concern, while I would do some independent work, I do think it would be helpful to go to a licensed, experienced CBT therapist.

    The technique/exercise that provided me the most insight about myself as a person was identifying and modifying dysfunctional core beliefs, and cognitive distortions. I’ve always struggled with anxiety, and during certain situations, my anxiety is worse than in other situations, and sometimes seems unmanageable. Prior to learning about automatic thoughts, and the core beliefs they are based on, I couldn’t really pinpoint why I had anxiety or where it was coming from. It was extremely helpful for me to do the automatic thought record, and use the thought record to uncover a core belief that was causing me to feel anxious. Knowing what belief that anxiety comes from, and knowing that the belief is not true is very helpful in alleviating some anxiety in certain anxiety-producing situations. I also think learning about cognitive distortions was helpful for me, because I could relate to MANY of them. I didn’t realize how truly distorted my thinking was until I learned about cognitive distortions. I realized that I use all-or-nothing thinking, overgeneralization, catastrophizing, jumping to conclusions, should statements, labeling, etc. Needless to say, it was very eye opening for me to realize how distorted and dysfunctional my thinking really was, and I am grateful for learning about it because I have been able to many changes, and know what I need to work on to become a less anxious person. Prior to learning about the significant role that cognition plays in emotion regulation, I used to describe my anxiety as a disconnect between the logical side of my brain, and my emotions. I didn’t realize how connected they were, and I didn’t realize that I could use my way of thinking to make real changes in my life. I think core beliefs and cognitive distortions and the personal relationship I had with those aspects of CBT will help me be a better therapist because I experienced real change during what I considered to be a hopeless time in my life, and I hope that I can inspire change and give clients hope if they have had a similar experience to mine.

    Reply

    • Zachary Welsh
      Jun 22, 2017 @ 20:24:21

      Amina, I completely agree with your statement that if a therapist needs professional help, they should seek it from an experienced therapist instead of trying to treat themselves. I do think, however, practicing CBT techniques can help therapists with minor life stressors they may experience. Utilizing these techniques not only helps to improve their own lives, but helps to get a better understanding of what their clients may experience as well. It allows the therapist to practice what he or she preaches and experience some of the obstacles a client may encounter. Knowing these obstacles allows the therapist to better help the client.

      Reply

  6. Mark Joyce
    Jun 19, 2017 @ 16:59:24

    One of the reasons that I feel so confident providing CBT interventions to my clients is that I know they work, because I have used many techniques on myself. I’m obviously not talking about doing full blown weeks of cognitive restructuring, but over the course of the program I have found myself much more adept at catching my own negative automatic thoughts. I feel completely comfortable practicing these skills on myself and I find that I have reduced most of my perfectionist and catastrophizing tendencies. I think one of the best examples of this is my recent efforts renovating the house I’m renting. At the time that we started the project I had no idea how to do any woodwork or real handy work in general, and I would either beat myself up over a mistake or would be too afraid to try for fear of messing up. Utilizing those cognitive restructuring skills, it was pretty easy to acknowledge that it is irrational to expect myself to perform to the skill level of those around me with 40 years of skill. Letting the fear of failure and judging myself could’ve easily prevented me from being a part of the renovation, but I now feel confident that I won’t lose any limbs or sleep over house work!

    I think the activity that provided the most insight about myself as a therapist was the negative automatic thought activity. One current thought that I am having surrounds my capacity to be a competent clinician at my new job. Before any job I’ve started I have always experienced a feeling of doubt or worry about the unknown, but at least before I start this next job I have the skills to identify and alter those uncomfortable thoughts. The thought that’s popped up the most is whether I will be good enough at meeting the needs of a completely new population. The thing that I enjoy the most about this program and this exercise, is that I can stop these thoughts before they get out of hand and remind myself that I have the base skills to do the job and I wouldn’t have been hired if they didn’t think I could do the job. I’ve always been taught that good therapists often get therapy for themselves and at times it is acceptable to do some of that therapy on our own.

    Reply

    • Marisa Molinaro
      Jun 20, 2017 @ 10:54:18

      Mark,
      I have also found myself using these techniques on myself throughout this program, not just for this assignment. Catching my own negative thoughts has been one that has been very helpful, especially with my all-or-nothing thinking that I tend to have sometimes. I like your example of beating yourself up because you weren’t able to complete all your house tasks the right way the first time you tried them. I had a similar experience when I was trying to assist some friends in redoing their house recently to get ready to sell. I found that I just could not get the instructions for how to do some simple tasks and I was being really hard on myself because everyone else was getting it easier than me. I then used some cognitive restructuring skills to see that I was using both perfectionist thinking as well as some catastrophizing. Once I stepped back and worked on changing those actual thoughts I was able to continue assisting them with more optimal thoughts.

      Reply

    • Stephanie Halley
      Jun 21, 2017 @ 21:26:10

      Mark,

      I suffer from perfectionist mentality as well, so I totally relate when you were saying you avoid activities in the fear of failing. I do this often, and this is no way to be! I am glad it has worked out for you on a personal level, and I am excited to practice the skills more and more and utilize them on myself.

      Reply

    • Zachary Welsh
      Jun 22, 2017 @ 20:37:37

      Mark, I also enjoyed the negative automatic thought activity. I experience similar doubts and worries when I started my internship. I especially like this activity because it allows me to take an in depth look at the thoughts and see that there are flaws in my thinking. This process allows me to stop this negative thinking and feel better and more confident about my abilities to carry out my assigned duties.

      Reply

  7. Stephanie Halley
    Jun 19, 2017 @ 19:18:07

    1) As a training therapist, I think it is so important for me to practice CBT on myself. It is easy to preach textbook knowledge, but the saying is “practice what you preach” for a reason. For example, I can tell a client to do their homework or do a thought record, and I can just as easily get frustrated when it is not completed. But, if I do it myself, I can see what challenges may arise: was it too complicated? Was there too much? It allows for insight on the struggles that may arise when engaging in certain interventions. If the therapist can share the struggles, it may make the client feel better if the assignment was not completed to the best of their ability. In addition, it is also important for us as therapists to be self-aware of our own imperfections and habits. We may not realize we’ve fallen into a specific routine and need assistance recognizing it, and practicing CBT skills can allow for that.

    2) I felt the most helpful skill was identifying NAT’s. It allowed for me to really stop and think what these thoughts mean, are they true, and test the truthfulness. One core thought that has surfaced in many variations is anxiety about beginning my practicum this week and if I am cut out for it. I fear that first one-on-one session and if I can do it. So this activity allowed me to really question and challenge myself in an “okay…so what?” sense and bring me back to reality. It allowed me to remember i AM just beginning in this field and it is going to be okay if I mess up from time to time; it is the only way I will learn. This activity also reminded me I am human and negative thoughts happen to everyone; it is just how we handle it that makes it normal vs abnormal.
    This activity really brought more clarity to myself and my emotions and thoughts, which I think will allow me to be a competent therapist. Similarly to my point in question 1, how can I be a competent therapist if I don’t even know what is going on with my own life?

    Reply

    • Janean Desjardins
      Jun 20, 2017 @ 00:28:30

      Stephanie-
      I can definitely agree with you on “practice what you preach” and agree that doing homework assignments with clients can often be very helpful. Often doing the assignments during the week with them and comparing can be eye opening for both you and the client. It helps to also bridge the relationship together and continue to build rapport in a different way. If the client struggles like you point out in your example then maybe they full did not understand or know how to do it by just instructions. However, by seeing how you may have done yours it will give them the idea of how to do it next time. It also shows the clients that you are invested in the therapeutic relationship. I like how you point out as well that it does hold us accountable to be self-aware of our own imperfections and habits. We often slip into a lazy routine and cycle through, but committing to CBT models and practicing will help to keep us going and involved.

      Reply

  8. Jill Harrison
    Jun 19, 2017 @ 20:51:12

    While not the only reason, one of the reasons that I decided to go into the field of psychology was because I believed that not only could I help others, but that I could understand and help myself on some level. I completely understand that the therapeutic value of implanting CBT techniques on yourself is not the same as having your own therapist when you need one, but I think that if we want to be able to help others using CBT methods, that we shouldn’t be afraid to use them on ourselves from time to time. These are interventions that we know are effective and to not utilize those interventions when we feel like we need them would be very strange to me. I also think that using some of these skills on ourselves helps us place ourselves in the client’s perspective, which allows us to tailor and change any aspect that may not fit the exact needs of our clients, or to show us where our explanations or methods may need to be amended to be more effective. I also believe that some of the more intensive interventions should be left for an objective party to guide us (i.e. our own therapist). There are plenty of more simple techniques that are easy to apply to our own lives, but understanding when you need more professional, objective guidance or treatment is part of being a good therapist. Most of us will work in a high stress environment, which makes being insightful about our own needs very important to our practice and overall well being.
    In terms of CBT methods that have provided me the most insight about myself, I feel that I utilize goal setting interventions and cognitive restructuring the most. I am the type of person who enjoys setting goals and working toward them, but I often find myself starting on certain tasks to achieve those goals and working on something different before completing those tasks. I attribute this to having a lot of different things going on in my life at the moment and sometimes forgetting the importance of focusing on the task at hand before diving into the next. Learning to set smaller, more manageable steps to my overall goals has made me more productive and shown me the value of remaining organized in my thoughts and actions when working toward what I want to achieve. Cognitive restructuring is something that (without sounding cliché) has truly changed the way I function in my day-to-day life. I have had issues with anxiety since I was a teenager, and learning how to identify negative thoughts in the moment has changed how I react to stressful or provoking situations. Additionally, learning how to change those negative thoughts into more positive ones has helped me overcome very difficult moments that, in the past, would have completely overwhelmed me. Practicing this technique on myself also helps me understand the difficulty of implementation of this technique in general, and gives me empathy and patience if clients struggle to utilize this technique, as well as the understanding of how to best guide them through the process.

    Reply

  9. Meagan Monteiro
    Jun 19, 2017 @ 22:34:01

    1.) My general thoughts about practicing CBT skills on myself are that we all can benefit from these skills. This is a tough field, and can be particularly taxing in many aspects (physically, emotionally, etc.) My automatic thoughts affect how I interact with others and my worldview. By not being aware of them and working to process them and modify them, I am not helping myself or my clients. Not saying that we have to be perfect, but we should be aware of how our personal issues can affect the work that we are doing. I think that working on these skills provides an invaluable experience, for some time we become the client. By working on these skills to resolve personal problems, we experience the same process that we ask of our clients. This will help us to troubleshoot, relate to and guide our clients. Our clients will know that we are genuine, as we know exactly what we are asking of them. Using CBT skills on ourselves will also greatly contribute to self-care. Behavioral activation can be pleasurable activities that reduce stress and help us to recharge. Cognitive restructuring techniques can be used to help us process challenges or shortcomings, and help us problem-solve for the future. The practical applications of what we do are endless for both clinicians and clients.

    2.) The exercises that I found to be the most helpful were identifying my cognitive biases and exploring the maintenance phases of them. I found this to be helpful as it helps me to reflect more on my experiences in a concrete way. I had a sense of accomplishment by completing these exercises and it helped to break down information that can sometimes be emotional and overwhelming. I thought it was helpful to look at the patterns that maintain my unhelpful thinking as it helped me to build empathy for myself as I had a deeper understanding of why certain thoughts or feelings come to be. I find that working through these phases can help me to build evidence for a more adaptive thought, and can provide relief. During my internship, one of my clients committed suicide. I was her only therapist at the time, and it affected me greatly. One of the therapists that I worked with encouraged me to continually use cognitive restructuring on myself to get through some of the negative experiences I was having. It took some time, but processing this event in various ways helped me to overcome my thoughts that it was somehow my fault, that I did something wrong, I was not good enough or that I missed something. I definitely would not be in the space that I am in several months later if I had not taken this advice. Using CBT skills on ourselves is invaluable, and reminds us that we are only human.

    Reply

    • Janean Desjardins
      Jun 20, 2017 @ 00:46:47

      Meagan-
      I know how difficult that was for you and the situation around all of it. It seems as though CBT on ourselves really does work and is helpful in many ways. I hope that it is helpful for you to know that there was nothing for you to do to stop it and nothing that you did wrong. I’m glad that you were able to use the support around you in order to truly process what happened. I think we often feel as though we can handle everything and do not take advantage of what we have around us for support. It is helpful to find unhelpful thinking patterns that have been maintained overtime in order to restructure them into more useful and constructive ones. This is great that it was an exercise that was able to bring you empathy towards yourself. This will also provide you tremendous insight when using this exercise with clients in the future and what it may bring up for them. This may provide them with the same feelings or it may bring them in another direction completely. Either way the guidance and concrete knowledge in front of them will continue to guide them in the right path.

      Reply

  10. Janean Desjardins
    Jun 20, 2017 @ 00:19:50

    (1) As a therapist in training, what are your general thoughts about practicing CBT skills/techniques on yourself?

    As a therapist in training, I believe it is very important that we all practice CBT on ourselves. In order to understand what another individual is being asked to do we must first experience it. I feel as though this spills into therapists in training also being on the “other side of the couch” as well. In order for us to understand what it is like for our clients to be in the hot seat, do weekly homework, and go through the draining process of therapy we should too. We have studied for the past couple years what CBT is and how to implement the model in therapy. If we do not use the model on ourselves in order to truly understand how this process actually works how will we really get our clients to understand it. If we are able to explain the model and treatments to our clients with the knowledge that we have tried this ourselves they will be more apt to do the tasks we are asking of them. Clients will be more likely to want to try new things and be more engage in the therapy process when they know that you have not only studied these techniques, but also tried them yourself. Getting in and being hands on with your clients, as well as the process is the best way to continue to evolve in your learning.

    (2) What technique/exercise provided you the most insight about yourself as a person or therapist (please only share information within your range of comfort; if it helps, focus on process rather than content)? Explain.

    The best exercise for me is negative automatic thoughts right now. I am stepping into the role of a clinician that has recently left and she has “big shoes” to fill. This leaves some doubt if I am able to stand up to the task of being able to hand all of the roles she took on, which have now been passed on to me. I find it hard to walk in the light of someone that has been there for a number of years that excelled in their job and having to step up when I do not even officially have my master’s degree yet. Although I know that I am dedicated and hard worker, in the back of my mind I still question and have negative thoughts about whether I truly can do it. With new programs starting and having to take on multiple roles outside of just counseling it feels overwhelming for a position I am just starting out at. Seeing these thoughts on paper that I knew I already had just showed me that I am beating myself up way more than I thought I was though. It’s not a matter of it I can do the job however; it is the mindset behind it. I know I can do it and just need to get out of my own way.

    Reply

    • JULIA SHERMAN
      Jun 22, 2017 @ 10:52:56

      Janean,

      I like your point that letting our clients know that we ourselves have practiced these techniques may make them more likely to try them. I think that this is definitely an instance when a small amount of self-disclosure could be beneficial for therapy. I have found this to be especially true in my counseling with children, who are heavily reliant on modeling when it comes to managing their thoughts and behaviors. For example, I might say something like, “You know, I feel that way too sometimes–I think a lot of people do. When I feel that way, I just try to think ‘____’ to myself and it helps me feel better. Do you think you would be willing to try something like that next time you feel like that?” I think self-disclosing in this way not only helps to model how to manage certain negative thoughts, but also helps to normalize these thoughts for our clients.

      Reply

  11. Taylor Gibson
    Jun 20, 2017 @ 07:00:44

    1) I am interested in using CBT skills on myself for two primary reasons. The first being that I understand concepts better and am better able to explain them to others after having experienced working with them myself. Learning to implement CBT skills when I have previously only learned them on a theoretical basis, is something that I am struggling with. So, I am anxious to work through these skills in order to better learn them myself in the hopes that this will help me to implement these procedures and skills with my own clients. Secondly, this program opened my eyes to the time and effort that CBT requires, which I think I knew on an intellectual level but did not fully appreciate. I think I have a better understanding of what I can ask motivated clients to do and how I can make modifications for my less motivated clients in order to match CBT to their level.

    2) I started on module 1 before I looked back on the syllabus and realized I was doing the wrong chapter (whoops). But module 1 asks you to think about and select a challenging problem. I was struck by how uncomfortable it was for me to write down and in a way, validate, some uncomfortable thoughts about myself that had been bouncing around in my head for a while. It reminded me of one of my clients who I have been working with for a while and how uncomfortable and anxious she becomes when we talk about some of the core beliefs that she has about herself. I have much more sympathy for her after having worked through module one as even writing down negative thoughts that I don’t fully believe and can rationalize myself away from, I was uncomfortable and slightly upset. I think I have more sympathy for her the way that she struggled to verbalize her deeply upsetting beliefs about herself to me and the strength that took for her to do. On to the assigned portion of the book! It was very interesting to examine my own thinking and identify the biases that I tend to fall prey too. Through using the thought record I find that when thinking about my professional life I tend to minimize the importance of positive events and ruminate repeatedly on negative ones. I also found myself personalizing alot of issues that are occurring in my professional life; taking those issues onto myself. I would be curious to go through this book again using a personal issue and see whether I tend to fall into those same biases in personal situations as well. In particular, I found myself continually ruminating over one particular issue and kept coming back to it throughout the day and it often distracted me from what I was doing at work. Now that I have noticed I am doing this I am attempting to break that pattern by engaging in some other activity for a while to keep myself from continually turning this issue (that I have no control over) around in my head.

    Reply

    • Salome Wilfred
      Jun 20, 2017 @ 11:11:36

      Taylor,
      I had the same experience of struggling with validating some thoughts about myself. I did these activities alone and now have a newfound respect for my clients who are so willing to “jump in” and tell me some of their thoughts they are are uncomfortable with. I also hope I can now be more understanding with clients who struggle with expressing and telling me their uncomfortable thoughts since it is not an easy thing to do with someone they are still getting to know. Additionally, the idea that cognitive restructuring takes time really stuck with me. It is so apparent now that this part of treatment can be very time consuming and is something you have to constantly work on.

      Reply

  12. Marisa Molinaro
    Jun 20, 2017 @ 10:30:58

    1. I think that it is extremely important as well as helpful to be able to practice CBT skills/techniques on myself as a therapist in training. I feel that if we are expecting our clients to practice and master these skills, we should also have experience with them ourselves. This will give us more understanding in the best way to explain them, the best way to implement them, and the difficulty that may accompany following through with them. It is easy to fall into the trap of just the “teacher” when we are in a session and expecting our clients to go along with everything we are saying. However, it is always important to remember, especially with our clients who may be experiencing extreme distress, that these skills may be harder to develop and even harder to follow through with. It is my opinion that after practicing these skills on myself I have more of an understanding of the extreme commitment and motivation that goes along with completing these tasks. If we have a client who may be extremely depressed, they may not even have the energy to participate in pleasurable events, let alone these CBT techniques we are requesting them to complete. By participating in these tasks ourselves, we are gaining more knowledge of the sensitivity that we need to possess when implementing them into our sessions.

    2. The technique that I felt provided the most insight about myself was the goal setting task. I have a tendency of putting WAY too much on my plate at once and thinking that I can accomplish many things at the same time. When I fail at this, I find myself getting very discouraged which results in me feeling like a failure and then starting the cycle all over again. I know this about myself but still tend to overestimate the number of things that I can actually get done within the day. I feel that it is very important to be a motivated person, however I believe that this is both a blessing and a curse. By participating in this activity, I was able to visually see the goals that I have for myself and was able to break them down into smaller and more attainable goals. This allowed me to reduce the level of anxiety that I feel regarding getting everything done and also ended up making my short-term goals and long-term goals more defined and clear. I now feel that I will be more skilled in assisting my clients with this task, as well as with the other tasks that were assigned this week in the other modules.

    Reply

    • JULIA SHERMAN
      Jun 22, 2017 @ 11:01:02

      Marisa,

      I did not try the goal-setting techniques in the reading, but your post is definitely making me consider doing so for my own benefit. Especially with graduation coming so soon, engaging in goal setting exercises would be very beneficial for me right now. There are many short-term goals that I need to work on in order to reach my long-term goals when it comes to my career, but it all feels so overwhelming sometimes that I end up procrastinating all of it. I’m sure that putting it all down on paper would help to make it all feel much more manageable. Plus, doing so would of course be excellent practice for any goal-setting therapy sessions that I may have in the future.

      Reply

    • Emily Noyes
      Jun 22, 2017 @ 14:54:14

      Marisa- You’re right when you say that its so easy to fall into the “teacher” role. I think all of us can lose sight of the fact from time to time and that practicing CBT skills on ourselves can help us gain more awareness when it comes to that, and also provides for more effective therapy.

      Reply

  13. Jackie Bradley
    Jun 20, 2017 @ 10:31:05

    1. I think that it is really helpful and important for us as therapists to practice CBT skills and techniques on ourselves. Practicing these skills and techniques on myself will help me to gain a deeper understanding about what I am actually doing with my clients. When introducing new skills to clients, it will be helpful to have practiced those skills on myself because it will allow me to gain insight on what my client will be doing and can help me to best explain the reasoning and “how to” for new skills that are introduced in session. Another reason it is important for us to practice CBT skills and techniques on ourselves is the fact that it can help us in the same way it helps our clients, depending on the issue at hand. As a therapist, using the skills that you teach your clients on yourself is a healthy and helpful way to provide ourselves with self-care. Taking the time to complete the modules in the work book would allow us to to set aside time for ourselves. As we have discussed a lot in this class, this field can be very draining for clinicians and therefor there is always going to be a need for us to focus on ourselves at times. Using CBT skills and techniques that we teach our clients on ourselves enables self-care and will help us to be the best therapist we can be (for ourselves and our clients).

    2. The exercise that I enjoyed the most and found to be the most beneficial for me right now was the negative automatic thought exercise. As I have began my practicum, I have found that I am having consistent negative automatic thoughts surrounding my competency as a therapist. I am beginning to work with clients for the first time and have already faced some challenges (which is not surprising). These challenges elicit automatic thoughts regarding my capabilities and whether or not I am going to be helpful for my clients. I am also taking on a position in a school during my first internship semester, and I have noticed myself having negative automatic thoughts regarding whether or not I will be a good fit for this position at the school. Taking the time to identify these negative automatic thoughts and compare the evidence for and against allows me to step outside of my mind for a second and recognize how my negative automatic thoughts are affecting me.

    Reply

  14. Julia Sherman
    Jun 20, 2017 @ 10:34:49

    1) I think it is important for all of us to practice CBT techniques on ourselves, not only so that we have a better understanding of how our clients feel when we ask them to engage in these exercises, but also simply to help us engage in our own self-care. The mental health field is a stressful one, and it is important to practice different coping techniques so that we maintain our own mental health. We owe it to our clients to do this so that we in turn can administer the best treatment as possible. After all, this is one of the only human service fields where it is possible and acceptable to administer our own treatments to ourselves, and we should definitely take advantage of that. A medical doctor generally could not perform surgery on themselves or prescribe themselves medication–but counselors can test out many of their own prescribed CBT techniques.

    2) I definitely benefit a great deal from identifying and challenging my negative automatic thoughts. This is something that I try to practice mentally on a daily basis. We all experience negative automatic thoughts throughout the day, and no matter how insignificant those thoughts may be, identifying them can provide important insight into the origins of your thought processes. I try to do this even in situations when I easily dismissed the negative automatic thought without effort. For example, I will sometimes have negative automatic thoughts such as “That was such a stupid thing to say, I am such an awkward person,” but will find that I quickly move on from this thought. Then I will try to identify what the positive thought was that helped me move on (often it is something such as “Oh well, this awkward situation will at least make a funny story later,” or “They probably won’t even remember this situation by tomorrow anyways, so why worry about it.”). This not only helps me to hone my own skills by helping me remember these positive cognitions later on when I am struggling to dismiss a negative automatic thought, but also helps me to identify ways to challenge negative automatic thoughts that I can use in sessions with clients.
    However, it was definitely a different experience entirely to actually write these things down on a thought record and see a visual representation of my thought processes. Doing so definitely helped with the process of challenging these negative thoughts. By writing them down, it is much easier to look at them from an analytical point of view rather than an emotional point of view, and that makes it easier to use rational thinking to challenge these thoughts and reformulate them into positive thoughts.

    Reply

    • Emily Noyes
      Jun 22, 2017 @ 14:51:26

      Julia- I too experience similar automatic thoughts from time to time throughout my day. I find that challenging these thoughts is something that I find most helpful to help alter my negative/anxious thinking. It’s surprising how different it is when you actually writer them down, and how much easier it is to challenge them when you are looking at them written down vs. in your own head.

      Reply

  15. Salome Wilfred
    Jun 20, 2017 @ 10:36:42

    As a therapist in training I have learned that it is very important to practice CBT skills/techniques on myself. I have found that this is important not only for myself and self care but also because I am a lot more effective in teaching a skill when I have practiced it myself. I have unfortunately been in the position in session when I know a skill decently well compared to when I may have just learned a skill. I have noticed that I am a lot more comfortable explaining and practicing the skill with a client when I know it well myself. I am also able to explain the skill in different ways that may be more relatable to the client when I know it and have practiced it myself. Oppositely, when I am in session teaching a skill that I have not practiced myself I struggle with explaining it clearly and I tend to need more time in session to teach it as well as practice it. I also feel as if my clients might be less inclined to practice it if my explanation was not as clear. Further, practicing CBT skills and techniques on myself helps a lot with my emotion regulation. I have noticed in the past that when I am practicing CBT skills myself and engaging in the self-care I encourage my clients to engage in I experience less burn-out, have more energy, and can relate to my clients a lot more. Practicing these skills and techniques and experiencing that they actually work and help makes me a lot more convincing when I am trying to convince and explain to my clients that these are skills that actually work. Personal experience also makes it a lot more appealing to many of the clients that I have worked with.

    The techniques and exercises that gave me the most insight were the exercises that focused on thoughts such as the thought records and diary cards. Through this process I discovered that I struggle a lot more with the exercises that focused on reporting my cognition’s compared to exercises that required doing different behaviors. I found that I struggled a lot more than I anticipated describing my thoughts in relation to behavior. It helped a lot in understanding why clients that I have worked with struggle with identifying their thoughts associated with a behavior. Additionally, I noticed that I do not really have a toolbox of skills. I felt repetitive in how I cope in different situations. While I do know that my coping style is effective I feel like I should have a lot more skills accessible because I push my clients to have multiple coping skills.

    Reply

  16. Emily Noyes
    Jun 20, 2017 @ 15:19:27

    1.) I think that it is very important as therapists in training to practice CBT techniques on ourselves. It is one thing to learn something in the classroom, however, many things in therapy play out much differently in the real world. By practicing CBT on ourselves, we get to see how these interventions and thinking patterns can play out for our clients. In doing so, it gives us more insight to how these interventions can unfold in one’s mind and what struggles and obstacles they might be experiencing. This allows the therapist to be more effective with their clients and allow for a better understanding when they experience these struggles and roadblocks in therapy. I have had many experiences throughout my internship where I put myself down and doubted by abilities as a therapist. There were times where I was really hard on myself and would put myself down, which would then negatively impact my work. By practicing a variety of CBT techniques on myself, I was able to see the other side of the picture, and realize that I was being too hard on myself and provided myself with positive self talk that in turn benefited my work. By seeing this process unfold, I realized to some extent (considering that everyone’s experiences differ from one another) how this plays out for the client, which provided for a more collaborative therapeutic relationship.
    2.) The most helpful CBT techniques that I have used on myself are challenging my negative automatic thoughts. As noted before, I tend to have this bad habit of being too hard on myself, and blaming myself for things that go wrong in situations. I often over think my actions and think that things that I say or do look stupid to others. I try to tell myself that I am being too hard on myself, and tell myself that other people experience this type of negative self talk too. I also tell myself that there are probably countless interactions I have had with other people where they were telling themselves the same things that I was thinking, and it is likely that I didn’t even pick up on it, so how are my actions any different? I also try to challenge my automatic thoughts by asking myself what evidence is there for thinking this way? I often find that it is just me telling myself these things and that they aren’t actually true, and that it is just my anxiety getting the best of me. Overall, I have found this to be pretty effective in helping me overcome some of my irrational thinking that I experience.

    Reply

    • Meagan Monteiro
      Jun 22, 2017 @ 17:53:52

      Emily,

      I also thought that the negative automatic thought activities were extremely helpful. As grad students, we can all be hard on ourselves and it can be easy to get into a whirlwind of negative thoughts. I have found it useful to complete these activities within my work with my clients. When explaining negative automatic thoughts to my clients, it has been helpful to report what common cognitive distortions I have. I have found that clients are more prone to provide more of an answer when they know they are not the only ones with unhelpful thoughts.

      Reply

  17. Zachary Welsh
    Jun 20, 2017 @ 15:36:48

    (1) As a therapist in training, what are your general thoughts about practicing CBT skills/techniques on yourself?

    I think practicing CBT skills/techniques on myself is a great way to get a better understanding of the skills and techniques. This will help when working with clients and will allow me to better explain the skills and techniques to a client. If I am familiar with the process, I may know the possible difficulties and obstacles in completing the technique. Knowing these obstacles may allow me to better explain and prepare the client before they utilize the skills and techniques. Practicing these skills will also be beneficial to my own life. I feel that when I graduate and start working as a therapist, I may have some negative thoughts about my performance as a new therapist. These CBT skills and techniques will help me figure out if my thinking is distorted and how I can reframe my thinking.

    (2) What technique/exercise provided you the most insight about yourself as a person or therapist?

    Using thought records provided me with the most insight about myself. It allowed me to test my negative automatic thoughts and see that they were invalid. I really like the process of using Socratic questioning to get a deeper understanding of the automatic thought and why it occurred. It provides me with a clear example of how the thought is invalid and different ways to deal with the automatic thought. This is helpful for me in my life because I often struggle with negative automatic thoughts when I am at work or at my internship. I may not be totally confident in my abilities to complete a task and experience negative automatic thoughts surrounding my performance. This automatic thought record allows me to look at each of these thoughts and determine that they are invalid. Once the process of determining that the automatic thought is invalid is over, I feel more confident in my abilities to perform a task and succeed.

    Reply

  18. cpopores
    Jun 20, 2017 @ 17:38:43

    (1) As a therapist in training, what are your general thoughts about practicing CBT skills/techniques on yourself?

    I think it’s a great idea for therapists to practice CBT on themselves. For starters, it helps us sharpen our CBT skills, and understand the process involved in the processes and activities more in depth and from another perspective. Also, I think it can be a helpful addition to our self-care. It can help us think more about who we are as professionals and how that meshes (or doesn’t mesh) with who we are and our well-being outside of work. I recall reading an article about this method a few months ago when looking for articles about CBT competence. The article itself focused on how therapist beliefs about SP/SR and how they influenced what they got out of it. It stuck with me that how we approach doing CBT on ourselves can make it a good of bad experience. We think about this all the time when it comes to our clients. I feel like I’ve heard complaints about clients’ not completing homework, not showing up to appointments, or not being invested in their treatment. However, the authors point out that SP/SR can be time-consuming and an emotional, sometimes difficult, process. Now, I know that I am definitely a person who starts something and then loses momentum, so I include myself when I say that perhaps when therapists struggle to make time for their own SP/SR, find it too much of a burden, don’t see the point/give up on an outcome that is so far out…we should think about what we ask our clients to do every session.

    (2) What technique/exercise provided you the most insight about yourself as a person or therapist (please only share information within your range of comfort; if it helps, focus on process rather than content)? Explain.

    All of the exercises that I have tried in the book have brought a lot of insight about myself as a person and as a therapist. It was kind of weird doing the thought record with myself, because I’ve run through it with clients so many times. One thing I noticed is that I give about 100 answers to every question in every section, whereas my clients would provide very broad, surface level, and brief answers. Part of this is probably because I’m on my own, and it’s always way harder to do that sort of thing in from of someone else. I think I might be a little annoying to a therapist though—I feel like I have to fill everything out so thoroughly I’d probably take an entire session listing all the emotions associated with one event. Also, I noticed that although I think I go through thoughts related to certain troubling events, writing it down feels completely different. It felt like a sort of relief just to be able to sort out what was going through my head at the time. I guess I never really experienced this sensation before, and it gives me a different perspective about how many exercises that are aimed at changing beliefs over time also have many short-term positive benefits. Although it may be because of my limited experience in working with different clients, doing CBT exercises makes me feel apologetic and like I’m forcing them to do something they don’t want to do. This is directly related to the fact that most of my experience is with people with serious mental illness, and that I implemented a type of treatment that requires making the CBT therapy feel as little like therapy as possible. I think I was also probably a little scarred from having a client that would ask if we were done yet after about 5 minutes of starting a thought record—and also I’m a little biased because I’m so in love with doing CBT it’s no surprise that I enjoy doing the activities for myself. However, it does leave me with a more positive outlook to think that some clients may actually enjoy or at least experience positive benefits from some of the more traditional CBT exercises.

    Reply

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Adam M. Volungis, PhD, LMHC

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