Topic 7: Experiencing CBT Self-Reflection {by 3/11}

Based on the readings due this week consider the following discussion point: (1) What technique/exercise from Bennett-Levy et al. (2015) 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 3/11.  Post your two replies no later than 3/13.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

49 Comments (+add yours?)

  1. Zacharie Taylor Duvarney
    Mar 08, 2021 @ 11:41:10

    Personally, modules 4 (Identifying Unhelpful Thinking and Behavior) and 5 (Using Cognitive Techniques to Modify Unhelpful Thinking and Behavior) benefitted me most. As someone who works in substance use, I deal with many high-risk clients who are often initially resistant to therapy. Furthermore, many clients at my internship site had bad experiences with former therapists, creating more resistance. Consequently, throughout my internship experience, I have periodically dealt with negative automatic thoughts (NATs) related to my competency as a therapist. As such, the 2 aforementioned modules were most helpful for me.

    Specific NATs I found myself dealing with included “I am not good enough to work with suicidal clients” and “I’m not doing enough to protect my clients”. I usually experience these thoughts whenever I am working with someone who is at high risk for relapse or self harm. After exploring these thoughts through the module 4 exercise, I determined that I was falling victim to personalization and minimization. I was assuming fault for the suffering of my clients that I had no responsibility for. I was also minimizing the progress and therapeutic gains they had made to that point.

    I personalized the suicidality of my clients. I assumed that because my clients are in therapy, they should be improving faster. Of course, there is not standard progression for treating suicidality, and so through Socratic questioning, I was able to challenge this thought. I reasoned that because my clients continue to attend therapy, and because I have strived to become more competent in risk assessment, I am doing all in my power to ensure the safety of my clients.

    Regarding my minimization of client progress, I realized that when working with chronically suicidal clients, or those at high risk of overdose, therapeutic gains are made marginally. I was minimizing the gains my clients were making and magnifying the unresolved issues they were dealing with. I failed to consider that through interventions such as behavioral activation, my clients were already making improvements in their daily functioning, despite the fact their chronic risk had not yet been addressed.

    Through this exercise I gained insight into how I perceive myself professionally. I realized that I am insecure in working with high-risk clients, and that this insecurity stems from my inexperience. It is difficult to work with chronically suicidal clients and those at risk of overdose, and the therapeutic gains made with these clients are not as obvious as those made with other clients. As such, I have been focusing on improving my risk assessment skills over the last two semesters. I have been working closely with my supervisor to become more competent in this area of practice. Of course, in tandem with training, I have been using Socratic questioning to challenge my NATs related to my professional practice. I realize now that I am doing everything in my power to be a competent professional, and that I should not be so insecure in my abilities as I am still learning. In this respect, modules 4 and 5 were helpful for me.

    Reply

  2. Katrina Piangerelli
    Mar 08, 2021 @ 11:58:37

    There were a few techniques and exercises from Bennett-Levy et al. that provided me with a lot of insight about myself as a person and/or therapist. I think one of the exercises that provided me with a lot of insight was in Module 3: Using Behavioral Activation to Change Patterns of Behavior, specifically the exercise that has you discuss the attitude you have towards yourself. I think this was something that allowed me to have more insight because I often look at the situation, thoughts, emotions, and behaviors, but rarely do I think about how this may be impacted by the attitude or view I have of myself. As it states in this module, it is easy for us to be hard on ourselves. I think this is something I have been guilty of for most of my life and I have always been one of my biggest critics. This module asks a few important questions in reference to this: “What has been your attitude toward yourself?” “Have you been self-critical either of what you have done or what you have not done?” “What alternatives might there be?” and “How would these serve your interests?” Each of these questions helped me think about the different aspects of my attitude towards myself and how this may be relevant to my thinking patterns as well. It also made me think about what alternatives there might be to thinking in this way and how this serves my interests as well. I think these are all important things to think about when you are evaluating your feelings, thoughts, and emotions as well as where they may stem from.

    Reply

    • Melissa Pope
      Mar 08, 2021 @ 18:27:09

      Katrina,

      That exercise pertains to me as well, although I did not touch upon it in my reflection. I like how the authors break down different parts of being self-critical. Alternative ways of view the situation and the associated thoughts, behaviors, emotions is always good. However, I always ask myself when reflecting, what good has being self-critical done for me. I tend to believe, which could be totally messed up, that being self-critical in the short term; despite getting down on myself and feeling crappy ends up rewarding me in the long term- with more motivation, perseverance, and overall learning that can be applied in the future. Sometimes it not changing the attitude completely, but learning to recognize the attitude when it arises and then giving yourself a little grace. Its nice to know that others struggle with this too-feels less isolating. Thanks for sharing

      Reply

    • Zacharie Duvarney
      Mar 10, 2021 @ 11:06:31

      Katrina,

      I found that exercise helpful as well. We often spend so much time analyzing the thoughts, emotions, and behaviors of our clients, yet we rarely examine ourselves. If you found module 3 particularly helpful, I recommend checking out Pope and colleagues “What Therapists Don’t Talk About and Why”. I know it is listed as a text on our syllabus. I think the first few chapters in particular relate to what you are talking about.

      Reply

  3. Melissa Pope
    Mar 08, 2021 @ 18:17:25

    In Module 5, the exercises that provide me with the most insight are “My cognitive biases”, and “selective attention”. They actually go hand in hand with me- I tend to hyper-focus when upset or dealing with an issue, that I become for lack of better words selectively attentive. Through examining my cognitive biases in a situation, I typically can use socratic questioning to understand it better. A good part of the time, just the knowledge that “this is a cognitive bias”, will help me feel better, and move me toward utilizing better coping methods. The question posed in the book for selective attention, works for both actually “what is the impact of____ on your experience of your problem?” Usually, the impact is a negative one, when it did not have to be. I would consider myself abnormally insightful about my own thoughts and emotions. I also, have the habit of challenging my thoughts (as if I am arguing in my head), and at times come up with way to modify my thoughts or behaviors to break the maintenance cycle- but honestly, it is usually short lived. This primarily pertains to myself as a person, and not as a therapist. It is as if I am able to separate myself into the two different roles, where I have a lot more motivation to change negative cognitions or unhelpful behaviors to better myself for the sake of others, but not for the sake of myself. Yes, yes, I know that statement there speaks volumes about me, especially if you put your nerdy therapist goggles on..…but I am working on it. The first part of the book focuses on self reflection, which is great-however I feel a good portion of issues are quickly sorted out- it is the second part of the book that will take more time for me, and provide a greater depth of insight into who I am, and who I can become.

    Reply

    • Katrina Piangerelli
      Mar 10, 2021 @ 11:13:20

      Melissa,

      I can relate to some of what you said especially the part of being different as a therapist versus my personal self. I think that there is a lot of overlap between myself as a therapist and my personal self in a few ways, but also some differences. One of these differences is doubting myself personally, but trying to be more confident in meetings or sessions with clients. This is something I have been working on for a little bit and continue to work on now.

      Reply

    • Adam Rene
      Mar 11, 2021 @ 11:53:31

      Melissa, I totally connected with what you are saying here. Thank you for sharing. I have definitely struggled with trying to better myself for others rather than bettering myself for myself. Bettering for others is admirable and we should do that, but ulimately if we better ourselves at all it’s going to have an impact on others. Brene Brown shared an interesting tidbit that i’m going to carry with me moving forward when it comes to struggling with inadequacy or worry regarding the job – “I’m here to get it right, not to BE right.”

      Reply

  4. Jess Costello
    Mar 09, 2021 @ 22:00:35

    The modules I found the most beneficial for my own personal reflections, both as a therapist and a person, were Module 3 (using behavioral activation) and 4 (identifying unhelpful thinking and behavior). It was helpful to identify particular NATs and connect them to cognitive distortions I was experiencing, then challenge them with the same styles of Socratic questioning I would provide to one of my clients. I had also never really considered avoidance/maintenance cycles in particular areas of my life before, so completing an exercise about that was eye-opening and gave me something to work on. As others have said here, I tend to be overly self-critical and perfectionistic, and these exercises helped shed some light on alternative solutions.

    Reply

    • Zacharie Duvarney
      Mar 10, 2021 @ 11:09:00

      Jess,

      It sounds as though you and I had a very similar experience. Given our tendency to be perfectionistic, we can fall victim to self-defeating cognitions when our clients do not make progress as we think they should. As I discussed, it is important we remember that treatment gains are nonlinear, and that as long as we adhere to best-practice, we cannot hold ourselves entirely responsible for the lack of progress in certain clients.

      Reply

    • Katrina Piangerelli
      Mar 10, 2021 @ 11:17:21

      Jess,

      I can relate to a lot of what you said in your response. I think that I often have self-defeating cognitions as Zach said. I also think it is positive that you were able to look at avoidance and maintenance cycles as it relates to your life. This is something that I have also worked on and I think it can be hard to find certain patterns when you are the person living with these patterns (if that makes sense). I can also relate to your statement about being overly self-critical and perfectionistic. I think this is something that many of us struggle with and could benefit from doing some of these exercises and modules in this book.

      Reply

    • Melissa Pope
      Mar 10, 2021 @ 11:33:33

      Speaking my language Jess. It is is very eye opening when you pay close attention to your own NAT’s and cognitive distortions. I also find it very helpful in therapy with clients, because examples come easier to share for clarification (without disclosure), and I can pick out clients cognitive distortions easier because of the NAT’s. They keep telling us, but it really does all go hand in hand in this profession. The maintenance cycles is what I need to focus on. Just can’t seem to break it, despite my insight. But all the more reason to work harder.
      And side note perfectionism is a B!!! I think it makes us more talented because of our dedication, but if we dont all work on it now, we are going to burn out real fast. And that is something that I do not want.

      Reply

    • Monique Guillory
      Mar 11, 2021 @ 18:35:47

      Jess,
      I also found using Socratic questioning on myself to be really helpful in challenging some of my NAT’s.

      Reply

  5. Paola Gutierrez
    Mar 10, 2021 @ 12:02:14

    I found Modules 4 and 5 most applicable and helpful for me both personally and professionally. Lately, I’ve noticed several negative automatic thoughts around my competence as a therapist and what that means about me as a person — getting into some core beliefs that I’m addressing. As others have mentioned, I lean towards perfectionism and self-criticism, which is especially salient when I think my clients aren’t improving as quickly or in the direction that I’d like them to. Using the exercise of identifying unhelpful thinking, I noticed a tendency to externalize clients’ progress (“Life circumstances changed for this person”) and internalize lack of progress (“I’m not doing this right”).

    Doing these practices on my own also made me think about how hard it is to challenge unhelpful thinking, especially long-held thoughts and beliefs. It takes a lot of effort and practice, which helped me shift my attitude around client progress and how sustainable change doesn’t happen overnight.

    Reply

    • Kara Rene
      Mar 10, 2021 @ 20:33:35

      Paola,

      I love what you said about how difficult it is to change patterns of thinking and how that softens your expectations for your clients. It is an incredibly valid point and one I plan to remind myself of as I interact with clients!

      Reply

    • Bianca Thomas
      Mar 11, 2021 @ 09:11:51

      Paola,

      I have found myself questioning some of those same things. I also find myself feeling as though I have to be perfect and engaging in a lot of self-criticism over that, especially when clients aren’t improving at the rate I hoped they would. I appreciate you recognizing the challenge in challenging those thoughts, and applying that to our clients.

      Reply

    • Anthony Mastrocola
      Mar 11, 2021 @ 15:38:06

      Hi Paola,

      You made a great connection at the end of your blog post. This perspective is great for when we work with clients. We cannot question our abilities as clinicians when we do not see immediate and measurable progress. I think reminding ourselves that modifying long-standing thoughts is a marathon and not a sprint is important, just like you said.

      Reply

    • Ashley Foster
      Mar 13, 2021 @ 17:53:08

      Hi Paola,
      I can relate to noticing and working through some “stinking thinking” and that module 4 was helpful in challenging and working through these thoughts and beliefs. I know for myself, I thought back to when we did these “assignments” earlier in the program and I find they are still useful today. I think a big part of these work sheets are continuously using them to not only help ourselves but also master these to better aid our current and future clients.

      Reply

  6. Kelsey Finnegan
    Mar 10, 2021 @ 13:28:24

    I found module 5 (using cognitive techniques to modify unhelpful thinking and behavior) to be most effective for me both personally and professionally. More specifically, identifying unhelpful repetitive thoughts that I have before and after a session, and then using Socratic questioning to help change my response to those thoughts provided me with a lot of insight about where some of my anxiety and insecurities as a therapist in training are stemming from. I was somewhat surprised by how harshly self-critical some of my commonly occurring negative automatic thoughts are. Coming up with more self-compassionate responses to these thoughts has helped alleviate some the unnecessary and excessive pressure that I put on myself to do everything “right”. I have also found it helpful to remind myself often that I am still in the early stages of practicing therapy, so mistakes are to be expected and welcomed as important learning experiences.

    Reply

    • Kara Rene
      Mar 10, 2021 @ 20:26:20

      Kelsey,
      I relate to the struggle you shared with being overly critical of yourself and expecting yourself to do everything “right”! I have also found it helpful to remind myself that I am in the baby stages of my career, that my supervisors have been happy with my work, and that I will continue to learn and grow and become more confident with time and effort!

      Reply

    • Jess Costello
      Mar 10, 2021 @ 22:00:28

      Hi Kelsey,

      Thanks for sharing! I can relate to being a little overly self-critical with my negative automatic thoughts about my work with my clients and particular sessions. I also really appreciate that you pointed out that the early career stages are meant to be full of growth and learning from our supervisors. This is something I often have to remind myself.

      Reply

    • Monique Guillory
      Mar 11, 2021 @ 18:33:07

      Kelsey,

      I can definitely relate to your post about how important it is to realize that as a new clinician we are going to make mistakes, but that is how we gain professional growth. I too find myself setting high expectations for myself, and I realize after completing module 5 that it is necessary to set more realistic expectations and go a little easier on myself..

      Reply

  7. Paul Avolese
    Mar 10, 2021 @ 18:26:39

    In terms of better understanding myself as a therapist, I have been utilizing Module 4 fairly regularly. I tend to develop a “work mode” mindset that can be fairly rigid and Module 4 has been helpful in deconstructing that mindset. As I understand connections between my thoughts, feelings, and behaviors, I am able to determine which variables need modification to help enhance my professional identity. I particularly appreciate the space given for “safety behaviors” within Module 4. I think a lot of the time I have engaged in coping strategies that are helpful, but still not optimal. Modifying these strategies has helped improve my performance and outlook as both a clinician and an individual. I feel better about myself as I challenge myself and succeed in what I set out to do (improving self-efficacy as well).

    Reply

    • Jess Costello
      Mar 10, 2021 @ 22:08:49

      Hi Paul,

      I’m glad that Module 4 was helpful in identifying some of your own unhelpful thought patterns and safety behaviors. This module highlighted some patterns I would like to change for myself, as well. It’s also a nice connection that you’ve been able to improve your self-efficacy as a result of pushing yourself to challenge these thoughts and behaviors.

      Reply

  8. Kara Rene
    Mar 10, 2021 @ 20:24:13

    I found Module 4 most helpful. They led me to reflect on my underlying thought that “I can’t do this, I am not capable of being a good therapist,” and how often that belief leads to feelings of doubt and anxiety at work or when reflecting on work. I found that I am prone to catastrophizing and personalizing- for example, catastrophizing when a client is struggling, and personalizing client progress and moods. Just this week my blood ran cold in a session when a client mentioned SI- but when processing my concerns and how I responded during supervision, I found that I had responded appropriately by reviewing the client’s safety plan and was catastrophizing the outcome. During the same session I felt guilty for ending the session even though we had run 15 minutes over and the client was not a safety concern- my supervisor reminding me that I need firmer boundaries highlighted for me that I was personalizing- imagining that my client may feel uncared for because I ended our session, when in reality, I was reminded that it is important for our clients to see boundaries and be socialized to respecting other’s time and organizing their speech to highlight what is most important!

    Reply

    • Bianca Thomas
      Mar 11, 2021 @ 09:09:53

      Kara,

      I really appreciate you expressing your underlying thoughts of “I can’t do this, I’m not capable of being a good therapist.” I definitely find myself in that same position sometimes and, as you do, find myself catastrophizing and personalizing when a client is struggling or not making the progress I believe they should be

      Reply

    • Adam Rene
      Mar 11, 2021 @ 11:55:54

      Kara, as someone who has also worked with SI in sessions (and we’ve talked about this together) it CAN be so scary and leaves us as the therapist in an emotional and vulnerable state. I know that when my client shared that with me, I immediately felt like I was now the most responsible person for this client’s safety – but after having gone through it myself twice now, you do realize that ultimately it is our client’s choice to do what they’re going to do. You follow through with protocol was the best thing you could’ve done for this client, you did right by them!

      Reply

    • Mariah Fraser
      Mar 11, 2021 @ 14:53:59

      Hi Kara,

      I can really relate to what you were saying about a client mentioning SI and how that can feel scary in the moment as the therapist. I had this happen yesterday, and I was caught off guard by it and was certainly catastrophizing as well. I, too, in that same session struggled to end the session, knowing I had a group to run right after; I also felt guilty having to end the session because I didn’t want the client to feel uncared for either. I like what you said about how it is important to show our clients healthy boundaries and for them to be socialized to respecting other people’s time! That makes a lot of sense!

      Reply

  9. Kara Rene
    Mar 10, 2021 @ 20:32:57

    Paola,
    I love what you said about how difficult it is to change patterns of thinking and how that softens your expectations for your clients. It is an incredibly valid point and one I plan to remind myself of as I interact with clients!

    Reply

  10. Bianca Thomas
    Mar 11, 2021 @ 09:07:36

    (1) What technique/exercise from Bennett-Levy et al. (2015) provided you the most insight about yourself as a person or therapist

    I think the technique that provided me with the most insight about myself as a person and as a therapist was in module 5, specifically “Addressing Problematic Underlying Patterns with Socratic Questioning.” I am definitely a person who uses emotion, rather than “logic and reasoning” sometimes when it comes to my thoughts or beliefs, so using this technique really helped me narrow down what my identified thought or biases are, picking specific questions to target those beliefs and then really utilizing the skill to respond or re-appraise the situation in a more beneficial way. I specifically used this with myself when dealing with the challenges and frustrations of my clients consistently not showing up for sessions. It really helped me see the situation from a different point of view and to not internalize it.

    Reply

    • Anthony Mastrocola
      Mar 11, 2021 @ 15:28:57

      Hi Bianca,

      I agree that it can be difficult to solely act based on logic and reason, excluding emotions. I liked how you mentioned using Socratic Questioning. I have been trying to develop this ability since practicum because it can be such a useful tool.

      Reply

  11. Adam Rene
    Mar 11, 2021 @ 11:50:26

    With regard to the readings in Bennet-Levy et al. (2015) I most certainly got the most out of Module 4 regarding unhelpful thinking and behavior. I had a particularly hot topic that I chose to reflect on regarding an interaction with a client’s parent that conflicts with my values but also how I made connections to my own feelings of insecurity as a therapist. It was really helpful to consider the cognitive distortions at play in that situation, as I found that I was mind-reading with the parent but also personalizing the outcome to myself. As I reflected I noticed that this poor interaction with this parent (whom I have had many poor interactions with in the past) has generalized in a way across my other cases in which I avoid checking in with parents sometimes out of fear of stirring up a negative reaction in me. Overall, this exercise helped me look at this situation from a different perspective and take some intentional time to work on improving this way of thinking and gives me something to review in supervision.

    Reply

    • Olivia L Corfey
      Mar 11, 2021 @ 13:42:16

      Adam,
      I most definitely can relate to some of the cognitive distortions you’re experience. Specifically mind-reading and personalizing a client’s negative outcome to myself. As I work with the SU population, it is difficult to not personalize a client’s relapse. This is something I must work on! I appreciate your vulnerability and insight with your thinking patterns and how you are working on identifying and modifying these thoughts!

      Reply

    • Olivia L Corfey
      Mar 11, 2021 @ 13:48:06

      Bianca,
      I appreciate your insight on how you use emotion rather than logic and reasoning when it comes to your thoughts and beliefs. I can also relate! It has been difficult to stop and recognize where this emotion has come from and how the thoughts behind the emotion are often distortions!

      Reply

    • Mariah Fraser
      Mar 11, 2021 @ 15:03:05

      Hi Adam,

      I can relate to what you said about mind-reading and personalizing. As with Olivia’s comment, when working with clients who struggle with SUD, it can be very challenging watching them experience a relapse, or having them step down from the program into a lower level of care, only to have them be re-admitted a few weeks later. Seeing clients return after a relapse can be challenging because I can’t help but feel, at times, like I should’ve done more, etc.

      Reply

  12. Olivia L Corfey
    Mar 11, 2021 @ 13:36:59

    This internship experience has been an eye opening experience. Thinking about the exercises and techniques Bennet-Levy provided, I think modules 4, 5, and 7 are the most helpful. I have notices a plethora of negative automatic thoughts in regard to my competence as a therapist. Identifying these thoughts and modifying them to be based in a sense of reality is a difficult task. However, working through the same thought-changing process as I hope my clients will work on is helping me to gain a better understanding of the emotional connection we have to our thoughts and the fact that these techniques take time, practice, patience and kindness toward ourselves.

    Reply

    • Kelsey Finnegan
      Mar 12, 2021 @ 19:54:19

      Hi Olivia,

      I too have noticed many negative automatic thoughts in regards to my competence as a therapist, and I agree that practice and patience are essential for cognitive restructuring techniques to be effective. It would be unrealistic to expect repetitive negative automatic thoughts/core beliefs to go away immediately after many years of believing them.

      Reply

  13. Anthony Mastrocola
    Mar 11, 2021 @ 15:26:04

    1.What technique/exercise from Bennett-Levy et al. (2015) provided you with the most insight about yourself or therapist (please only share information within your range of comfort; if it helps, focus on process rather than content)? Explain.

    The technique that provided me with the most insight about myself is the behavioral activation activities. There are a number of reasons as to why I believe the behavioral activation worksheets stood out to me. First, behavioral activation typically involves some of the first steps in therapy (particularly with depression), but can be so easy to forget to apply to my own life. Especially in COVID, when stressed from school and internship, it can be so easy to just remain in the motions of attending to responsibilities. Taking the steps of identifying activities that are perceived as pleasurable and provide a sense of accomplishment can be an eye opener for what needs to change weekly. So often I find myself in a routine of completing responsibilities for internship and school. I think that the connection between personal life and life as a clinician is important. My own sense of activity planning can be basic enough to help provide sufficient self-care to be more effective as a clinician. Since I read this chapter and started using some of the activity scheduling and monitoring principles for myself, I feel more genuine speaking to my clients about the benefits of such interventions. In a broader focus, this activity has helped remind me to periodically revisit some of the interventions I assign my clients to place myself in their shoes.

    Reply

    • Taylor O'Rourke
      Mar 11, 2021 @ 16:57:02

      Hi Anthony,

      I like your recognition of behavioral activation being more of a first-line treatment for our clients, I know I certainly always turn to this first with the majority of my clients in efforts to increase their motivation! Like you mentioned, with the COVID-19 pandemic, I think many of us have become quite robotic and run through the same daily schedule, so it is more important now than ever before to add those pleasurable activities into our schedules. I could definitely use some more time for self-care in my week, so I think this kind of a worksheet is definitely useful for ourselves and our clients.

      Reply

    • Paul Avolese
      Mar 11, 2021 @ 18:26:57

      Hi Anthony,

      I agree that the behavioral activation module was very helpful. Like you mentioned, it is nice to have a visual handwritten aid to help determine pleasurable activities in addition to responsibilities. In the past, I would throw myself into work more and more without taking space to recharge in hopes of some sort of accomplishment payoff (this never happened). Organizing my time has been much more beneficial from a holistic perspective. I also agree about the confidence instilled in myself for teaching these techniques to clients after learning and using them myself.

      Reply

    • Paola Gutierrez
      Mar 12, 2021 @ 18:33:53

      Hi Anthony – I’ve found myself in a similar boat trying to juggle several commitments. I especially liked what you said about doing the behavioral activation practice yourself helps you be more genuine when introducing and implementing this intervention with clients – you can speak to the benefit of this intervention, which likely increases your confidence when working with clients to increase their activity levels.

      Reply

  14. Ashley Foster
    Mar 11, 2021 @ 16:03:16

    The technique I found most beneficial was the identifying unhelpful thinking and behavior (Module 4), my thought record. I found that this thought record was personally helpful in decreasing my distress through distraction. I was able to work through the form it even though I was stuck on the topic of my automatic thought, it gave me the ability to focus on some of my attention to this exercise and rather on the thought. This was helpful as I was not fully immersed in my distress And I had to challenge my thinking and behaviors associated with the thought. I believe that doing this exercise better prepared me as a therapist to understand how helpful this can be for a client. As we all have negative automatic thoughts, this can especially help a client who is experiencing high levels of distress and analyzing what is really going and how to change it. By challenging the clients thinking patterns and in forcing them to complete Socratic techniques as a part of completing this form, it will give the client some insight on how there thinking can be changed, how to cope, or what may be fueling these thoughts in being rational or not. This will also consequently lower the level of distress that the individual is experiencing in that moment.

    Reply

    • Taylor O'Rourke
      Mar 11, 2021 @ 16:54:28

      Hi Ashley,

      I totally agree with what you said about this exercise being helpful by being distracting from the actual thought that was being exhibited. I think one of the best things we can do as humans is distract ourselves from our stressors (I suppose this is why things like behavioral activation work so well!), so this exercise was a great example of that at play. You are right; we all have negative automatic thoughts so now that we all have experience in filling out a worksheet such as the thought record, we have more hands-on experience that we can relay to our clients to make them more comfortable with the process when we ask them to fill one out too.

      Reply

  15. Taylor O'Rourke
    Mar 11, 2021 @ 16:49:13

    The technique that provided me the most insight about myself as a therapist is Module 4: Identifying Unhelpful Thinking and Behavior. I have definitely experienced my fair share of negative automatic thoughts surrounding my competency as a mental health counselor thus far and my overall level of confidence working in the field, especially as a master’s-level intern. By working through the negative automatic thought record, I was able to identify which situations with my clients are most likely going to trigger my negative automatic thoughts of not feeling good enough at certain therapeutic interventions. The thought record also allowed me to reflect on the emotions that I feel during these types of situations, which can range from disappointment to frustration. The downward arrow technique that is built into the last box of the thought record was helpful to me because I was able to realize that even if my worst case scenario were true, there was nothing so bad about that that I would not be able to come back from. It is not like my work as an intern and lack of experience compared to other therapists would leave me jobless after graduation, for example. This exercise helped with reassurance on my own skills and work as a counselor thus far and also helped me identify some of my avoidance and maintenance behaviors.

    Reply

  16. Mariah Fraser
    Mar 11, 2021 @ 17:28:52

    I found module 4 to be very helpful. I found that I personalize and mind read in a lot of situations both at internship and in my personal life. I find that there are tendencies to personalize when clients return to the agency; even though I know I’m not that influential to actually have any part in whether someone relapses or not because I see them for such a brief period of time, but I do feel badly about myself because I’ll wonder if there was more I could have done the last time around. I also find that I mind-read during team meetings and supervision as well. I draw conclusions and use selective attention to focus on evidence that supports my insecurities instead of absorbing all of the available information. I know that I’m a big one for using safety behaviors too, such as over-preparing for sessions or groups as a way to feel less anxious even though it actually makes me ore anxious.

    Reply

    • Paul Avolese
      Mar 11, 2021 @ 18:18:33

      Hi Mariah,

      I have also been slowly working on some of the same tendencies. I think it can be hard at first to make some of those changes because we tend to take our perceptions for granted (i.e., core beliefs). The work does become easier with some practice though. I have found that engaging in this sort of personal work has helped me develop more compassion and empathy for clients who are still new to engaging in personal growth and others who seem to be struggling.

      Reply

  17. Monique Guillory
    Mar 11, 2021 @ 18:27:40

    I found Module 3 and Module 5, to be most beneficial. The process of completing “My activity and mood diary” was more challenging than I anticipated, and I discovered that I needed more pleasurable activities vs necessary activities to balance out my day. I also noticed that my mood seemed to dip on the days where I did not set aside time to engage in at least one pleasurable activity. I really liked the technique of categorizing activities as pleasurable vs necessary, because there were some activities that I had once perceived to be pleasurable, when in fact they fit best in the necessary activities. When it came to activity scheduling I realized how challenging it was to alter the current pattern of my behavior, and the challenge allowed me to reflect on how difficult it may be to challenge my clients to engage in planned activities that deviate from the typical pattern of behaviors.
    When I started module 5, and completed the ATR, I was actually surprised how many negative automatic thoughts I was experiencing, since the last time that I had completed an ATR. Upon completing it, I noticed that I was more self aware and able to challenge the thoughts more readily during the day instead of allow them to just snow ball, without further investigation. I really liked the element of identifying vulnerability aspects that may have contributed to how I formulate problems on a day to day basis. Then to follow up the problem formulation by taking a strengths based perspective felt really motivating to remind myself of the resources I do have. I also found reading about “the process of reflection” to be most helpful because I never thought about allotting more time to reflect. I’ve always been a highly introspective individual, but I find that I spend less time creating moments when I can sit back and really unpack my feelings and thoughts to assess how to make them more helpful in attaining my future goals. I took this opportunity to reflect on life after graduation, and was able to identify where my focus would best serve me, and I also noticed some thoughts that I was experiencing and just avoiding.
    The main takeaways I experienced included realizing some of the barriers my clients may face when attempting to engage in behavioral activation, and I also realized how important it is to check-in with my self utilizing the very tools we give our clients to complete.

    Reply

    • Paola Gutierrez
      Mar 12, 2021 @ 18:28:41

      Hi Monique – what you wrote led me to think about how we might spend a lot of time thinking and reflecting about things (maybe even ruminating) but how we might not do so in an effective or helpful way – in other words, creating a space to analyze thoughts and feelings. It’s something I’m working on, too.

      Reply

    • Kelsey Finnegan
      Mar 12, 2021 @ 20:00:20

      Hi Monique,

      I too found Module 5 to be more challenging than I expected and was also surprised by the frequency/quantity of my negative automatic thoughts. I definitely agree that simply being more aware of my negative automatic thoughts prevented them from snowballing.

      Reply

    • Ashley Foster
      Mar 13, 2021 @ 18:03:55

      Hi Monique,
      I also found the same benefits you had talked about in your post about behavioral activation in “My activity and mood diary”. I think as a society, we are pushed to perform the “necessary” activities which gets in the way of the “pleasurable” ones. Further more, as a graduate student this hold even more so true as we have so much expectation and necessary activities we must perform to complete our degree. This is challenging to find the balance of the two as I know for myself, by the time I’m done with the necessary activities, I have no energy or motivation for the pleasurable ones.

      Reply

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Adam M. Volungis, PhD, LMHC

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