Topic 10: CBT Myths & CBT Competence {by 12/1}

[CBT Myths] – (1) Identify at least one common CBT myth you have heard from other people/professionals.  What are your thoughts when you hear such comments?  (2) Why do you think some of these myths continue to exist?  (3) What can you do to help dispel some of these myths?

 

[CBT Competence] – (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?  (2) What are some possible indicators to determine if you are receiving quality CBT supervision?  What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?  (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills?

 

Your original post should be posted by 12/1.  Have your two replies posted no later than 12/3.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

37 Comments (+add yours?)

  1. Amanda Bara
    Nov 26, 2022 @ 11:23:35

    One CBT myth that I have heard from other people is that this type of treatment is only beneficial to individuals with high intelligence. When I hear this comment, I can understand where people are coming from as the treatment does challenge the mind to think in complex or different ways. However, I think that this myth like many others, comes from a lack of education about CBT and the strategies involved. People are unaware of the meaning behind evidence-based practice and the validity behind CBT therefore they tend to judge it by face value. Unless you are in the field of psychology, most people do not know what good practice is in therapy which can make it easy to form biases. In order to dispel these myths, I think it is important to educate individuals about the treatment of CBT and psychotherapy itself. Specifically, we should be educating others about evidence-based practices and what they truly mean.

    If a CBT therapist has a strong aversion to practicing CBT techniques on themselves it could be detrimental to their client’s treatment. They may not emphasis the importance of the techniques in therapy with clients which would stray away from meeting treatment goals. Having a strong aversion can prevent the therapist to become motivated in sessions and not thoroughly examine the client’s responses. In turn the client may not be motivated to complete the exercises as well making therapy ineffective and longer than needed. Overall, strong negative feelings toward CBT techniques will affect the therapist’s competence and quality of work.
    Some possible indicators to determine if you are receiving quality CBT supervision is that the supervisor is observing your sessions often, giving you feedback, and answer any concerns that you have. A good supervisor will respond to your concerns professionally and guide you to adhere to treatment standards. They will be easy to get in contact with and be present within the observed sessions to indicate areas of strength and also weaknesses. I think the best type of feedback from a supervisor that would be beneficial to my professional development as a CBT therapist is addressing the areas that I need to strengthen. Many people do not like to be criticized however, I think it is critical in this field in order to grow and strengthen your skills. If you do not stay up to date with CBT knowledge and skills you can be seen as an incompetent therapist and would be violating ethical codes. If you are not striving to be the best for your clients you could be doing harm to them or essentially not giving the quality care they deserve.

    Reply

    • Ashley Torres
      Nov 28, 2022 @ 16:00:20

      Hi Amanda, I agree with your response and an incompetence therapist consists of violating the ethical codes. Staying up to date on CBT knowledge and skills is necessary to deliver the most effective therapy. As time goes on, more research is performed and new changes emerge. New skills and techniques can be utilized to help support clients depending on their needs. Our education is valued but it is important for our client we deliver the most effective treatment. It would not be fair to treat a client with an old technique if a new technique has emerged and proved to work faster or more effectively.

      Reply

    • Teresia Maina
      Dec 03, 2022 @ 23:24:22

      Hi Amanda,

      I enjoyed reading your response! I agree that most of the CBT myths come from a lack of understanding or education. Not everyone is willing to use evidence-based practices meaning that other people/professionals may view them as a waste of time and not be willing to educate themselves. I like that you mention in order to grow in this field, it’s important to be open to criticism from your supervisor. Overall, fantastic post!

      Reply

  2. NikkiAnn Ryan
    Nov 26, 2022 @ 15:56:47

    One common CBT myth that I have heard is that CBT is “easy.” When I hear this, I think that the people or professionals who make such comments may believe that CBT is quick to learn and easy to practice because they may only understand the core components of CBT, specifically, the reciprocal nature of how thoughts, emotions, and behaviors influence each other and interact with the environment. If people think that understanding these principles is all that there is to understanding CBT, then they may think that it is quick to learn. However, CBT is more than just theory, it is a way of practicing therapy that involves various skills and techniques for proper implementation. I think that this myth, and numerous others, continue to exist because people do not understand the entirety of what is involved to practice CBT because it involves more than understanding certain concepts or simply addressing automatic thoughts and core beliefs. Rather, proper CBT implementation includes specific session structure, psychoeducation, homework assignments, and various other elements that require skill and practice. One of the primary ways to dispel such myths is by educating people, including other professionals, who may intentionally or unintentionally perpetuate these myths. In addition to incorporating information about CBT in college curricula, other professionals can learn more about CBT through training opportunities and continuing education courses that cover cognitive behavioral therapy. CBT-trained professionals can also, respectfully, address these comments when they hear them in order to promote awareness of the reality of implementing CBT.

    If a CBT therapist has a strong aversion to practicing CBT techniques on themselves, it can negatively influence their skills and competence as a CBT therapist. Practicing the techniques on oneself is a beneficial way to not only learn the techniques but also to develop empathy for their clients and to improve their awareness of potential challenges or obstacles their clients may face. It is also a bit concerning for a CBT therapist to ask clients to practice these techniques if they have a strong aversion to practicing them themselves whether it is due to concern that it does not work or that it is a waste of time and effort, especially considering they are evidenced-based techniques. As a therapist, asking clients to do something that they do not believe or would not do themselves may lead to being perceived as disingenuous and may ultimately reduce the therapist’s commitment to the CBT model. Supervision is an essential part of learning to become an effective therapist, especially when learning CBT skills. A quality CBT supervisor will make sure that you are adhering to the CBT model while ensuring the overall quality of treatment services provided. I think the most beneficial feedback is a combination of skills that you are already performing effectively as well as skills that you can improve upon because not only do I want to know the areas that could use more practice, but I also want to know what my strengths are so that I continue to incorporate them into sessions. CBT is an ever-evolving approach; therefore, it is vital to stay up to date with the knowledge and skills. If a therapist does not stay up to date, they may be missing a new way they could help their client or they may be perceived as ineffective if they are only relying on knowledge and skills that are outdated. This can damage the perception of themselves as a therapist and potentially their practice. Some people may believe that their years of experience supplement the need to continue their CBT education, however, continuing education helps to keep therapists up to date with changes in the field and new approaches to working with certain client populations, allows for learning from the experiences of other professionals, and provides the opportunity to practice CBT skills.

    Reply

    • Tom Mandozzi
      Nov 28, 2022 @ 22:14:30

      Hi NikkiAnn,

      I agree with your point that effective implementation of CBT involves much more than just implementing the techniques. CBT is heavily focused on the therapeutic process as well. There is a lot of skills and practice needed to effectively structure sessions appropriately according to CBT principles, as well as assigning and following up on homework and establishing rapport. I like that CBT involves both science and art aspects, and strengthening the therapeutic relationship through rapport building and communication is so important. This may seem simple on the surface, but it really does require a lot of skill and expertise to master these components of CBT and provide effective psychoeducation. Great post!

      Reply

  3. Tuyen Phung
    Nov 26, 2022 @ 21:38:09

    CBT Myths

    Like other approaches in the psychological field, people usually have myths about CBT. The most common one that I heard and wondered about until I learned this course is that CBT is only for intelligent and highly cognitive people. They seemed to think of high cognitive functioning and undermine behavioral perspective in people with cognitive impairment. To be honest, I have ever had this viewpoint when I first knew about CBT with a narrow view. After learning this course, I know that it is inappropriate because even people who have low cognitive functioning still have the potential to develop their own skills to control or regulate their behavior in an appropriate way. Moreover, CBT therapists can develop their conceptualization to adapt to the unique characteristics of the clients in their treatment plan. I think that people still have this myth because they only focus on the cognitive functioning of clients as the only factor to determine the outcome of treatment without mentioning the collaborative nature of CBT and valuing the learning capacities of the clients. In this case, I can show them various evidence on how CBT demonstrates effective treatment outcomes in various populations and mental issues.

    Furthermore, people have myths about CBT by assuming that CBT does not focus on past experience in the treatment. When I hear this comment, I can guess that people usually have a significant focus on the past when they practice therapy such as psychoanalysis. I think that they do not have a deep understanding of CBT. They usually see CBT therapists guide their clients to practice behavioral change. To dispel the myth, I will explain that CBT focuses on the past, present, and future. Past was used to help clients understand where and how their negative automatic thoughts and core beliefs come from and impact their present. Also, present distress was formed not only by past experience but also by ongoing experience. Therefore, they should learn more about CBT to decrease the myth.

    CBT Competence

    Just like a doctor not trusting in the effectiveness of their medicine on themselves, CBT therapists do not bring effective treatment for their clients if they have a strong aversion to the CBT technique on themselves but still practice it. It can be a problem because their disbelief in the techniques may reflect on their clients because of their own behaviors. Even though the therapists do not talk straightforwardly about their own attitude, their clients can still “feel” it through their own intuition. In contrast, when a therapist recognizes the effectiveness of the practice of CBT on themselves, they may have better guidance and self-disclosure for their own clients. Regarding effective CBT supervisors, it is necessary to see the characteristics of CBT in their practice, including having collaboration between therapist and client, focusing on the integrity of thoughts, emotion, and behaviors in treatment for their clients, and using homework as means of practicing new behaviors and promoting change. During internship and practice, it is good for me to receive feedback from supervisors, I think that the advice on how to help clients dig into their negative automatic thought and core belief as well as how to help them cope with and accept their valid thought is beneficial for me as a CBT candidate. Moreover, receiving updated knowledge in CBT is important to build competence in CBT practice. If I do not stay up to date with CBT knowledge and skills, I may not have caught up with changes in both realistic lives and the professional fields for better practice. Gradually, old skills and techniques may not effective for new living conditions of people.

    Reply

    • Ashley Torres
      Nov 28, 2022 @ 16:05:15

      Hi Tuyen, I really enjoyed reading your response. I also believe receiving advice on how to help clients dig deeper into their negative automatic thoughts and core beliefs are helpful. I also think it is helpful for our supervisors to inform us of our strengths and weaknesses. It is important to know what parts of therapy need improvement and how to approach it. If I am not performing well it may be due to lack of knowledge and I would hope supervisors suggest different ways to improve.

      Reply

    • Tom Mandozzi
      Nov 28, 2022 @ 22:00:57

      Hi Tuyen,

      I really liked your comparison between a therapist using CBT and a doctor trusting the medicine they use to treat patients. I completely agree, when we see a doctor, we hope that they trust their own medical knowledge and ability to treat medical conditions. Similarly, when clients come to see us, they are expecting that we have an understanding of what we are implementing. If we have an aversion to a technique (for example, the negative automatic thought record technique), we would not know how to appropriately instruct our clients to complete them. I also agree that a wide variety of clients and populations can benefit from CBT and it is not just for the clients that are highly intelligent. Great post!

      Reply

  4. Ashley Torres
    Nov 28, 2022 @ 15:45:07

    One common CBT myth I have heard is that the therapy is just positive thinking. CBT focuses on identifying and challenging negative thoughts which is why people think it is based on shifting negative thoughts to positive ones. People who lack education on CBT may believe that clients are just learning to think positively about their lives. CBT teaches clients to think more rationally about their life. If their perspective is distorted, then it would be beneficial to change the way they think so they engage in more accurate adaptive behaviors and consequences. In CBT clients learn to develop skills and frame thoughts to be more realistic or accept the rational negative thoughts. Educating people on evidence-based practice will be beneficial to help dispel this myth. People are not aware there is science behind the treatment and how it is used. I think it would be helpful to correct people that say CBT is positive thinking by informing it is helping the client think more rationally.

    It can be a problem if a CBT therapist has a strong aversion to practicing CBT on themselves because they need to be aware of what it is like to be on the receiving end to emphasize with the client. The therapist skills will also be affected because they are not delivering all aspects of the therapy or will lack self-awareness. If the therapist has strong negative feelings about CBT, their clients will pick up on their experience. As a result, the client will not trust your work and engage in the therapy session. This can cause more distress for the client because they are not receiving the proper treatment they need and may discourage them from future practices. Supervision is needed for early emerging CBT therapy to develop CBT competencies. A good supervisor will make sure their supervisee is focusing on CBT skills and theory. Quality CBT supervision will consist of live supervision whether it’s an earbud or one way mirror. Video or audio recorded sessions are also helpful and better than a verbal report. It is also important to receive feedback on supervision using the cognitive behavioral therapy supervision checklist. It helps monitor and evaluate CBT competencies. I think acknowledging my strengths and weaknesses would be good feedback that will help my professional development. I would like to know if I am mastering any CBT skills and focus on the ones that need more work. I would like my supervisor to elaborate on my strengths and weaknesses and give me advice on how to build on the weaker skills. It is important to continue CBT training post-graduation and supervision to deliver the most up to date therapy. If a therapist is not continuing learning about new CBT knowledge, they are giving their client a disadvantage. There may be new approaches or skills that can be implemented into practice that could help the client reach their goals. Overtime CBT skills may no longer be effective to the new generations or time period. Overall, a therapist not staying up to date may do harm to their clients because they are not delivering modern effective techniques.

    Reply

    • Bekah Riley
      Nov 29, 2022 @ 19:15:32

      Hi Ashley,
      I really enjoyed reading your post this week! I thought you did a great job at explaining how people may misconstrue CBT into just positive thinking. Specifically, I thought your explanation of why people may think this due to lack of education as well as how CBT is much more than positive thinking was very clear and concise! For example, you describe the benefits of changing the way an individual thinks if their perception is distorted. This describes a therapeutic approach that is not all about positive thinking and more directed at working towards a more adaptive way of thinking that will in turn create more adaptive emotions and behaviors.
      Overall, great post!

      Reply

    • Patricia Ortiz
      Nov 30, 2022 @ 00:44:59

      Hi Ashley, I really liked how you said that when therapists have strong negative feelings about CBT, the client may experience additional distress and become discouraged from seeking future therapy due to not receiving the necessary care; this is true, and therapists should consider this because, as a result, myths about therapy are formed. Some people have had bad experiences and then lost hope in therapy.

      Reply

    • Teresia Maina
      Dec 03, 2022 @ 23:36:37

      Hi Ashley, Amazing post! You did a great job of identifying a CBT myth and explaining why they still exist. I like that you mention how CBT therapists should practice the skills on themselves in order to empathize with the client. It is essential to practice what you preach. We can not expect our clients to complete an activity if we are not open to trying them. Overall, I enjoyed reading your post!

      Reply

  5. Tom Mandozzi
    Nov 28, 2022 @ 18:50:06

    I think one myth I have heard related to CBT, much like what Dr. V. mentioned in the lecture video for this week, is that CBT is too rigid or mechanical with little room for adaptation or personal flexibility on approaches to treatment. I think I can understand this comment, because before I began learning more about CBT, I can see where people are coming from in this way. Before this program, my only impression of CBT treatment was that it was very regimented, methodical, and worksheet based. While this can be true, I think I have learned that there is actually a ton of room for flexibility and movement based on the therapist’s personal preference and individual therapeutic approach. In rapport building, establishing therapeutic alliance, identifying strengths, and adapting communication styles that work best with each individual client, it is helpful for people to realize that there is a lot of flexibility and variation when utilizing CBT techniques and interventions. I think these myths continue to exist because people are simply uneducated and do not have any practical experience implementing the CBT approach. Until they practice the skills and techniques themselves, they will continue to believe these myths. What we learned in class this semester is that CBT incorporates both the scientific aspects of therapy, as well as the art of therapy. I think this a great way to describe it to people who believe the myth that CBT is too rigid and mechanical, because it describes CBT as evidenced based and scientifically appropriate, but also captures the creative and adaptable elements by describing it as an art.

    I think if a CBT therapist has a strong aversion to practicing CBT techniques on themselves, then it would be hard to expect their clients to be engaged in treatment. It seems a bit hypocritical to me for a therapist to expect their client to do the CBT worksheets if they are not willing to practice the techniques on themselves. Furthermore, I think they would be unprepared and incompetent if they were trying to explain a technique to a client when they themselves do not fully understand the concept themselves. I think some indicators of quality CBT supervision include a supervisor that is approachable, regular supervision meetings to review techniques and any issues or concerns from your caseload, and providing feedback related to any observed strengths and areas to improve upon. I think honesty and constructive feedback is important for my professional development as a CBT therapist. As beginning therapists, it is normal to expect to need to work on things and make improvements from field-related experience, so I would want feedback from my supervisor that would be supportive of this and provide me with appropriate guidance and advice to ensure I am performing to effective CBT treatment standards. I think we must be open to criticism and critique as beginning therapists to support the most personal and professional growth in the helping profession. I think possible negative outcomes of not staying up to date with CBT knowledge would be implementation of inappropriate interventions, inadequate case formulation, stagnancy in treatment progress, poor clinical judgement, and a lack of professionalism and competency. It is the ethical responsibility of the CBT clinician to continue to stay up to date with relevant CBT knowledge throughout their career.

    Reply

    • Bekah Riley
      Nov 29, 2022 @ 19:21:49

      Hi Tom,
      I thought you had a great post this week! I discussed the myth that CBT is too rigid and mechanical in my post as well. I also agree that since this is a manual-based treatment, I do understand why this myth may have started. However, as you mentioned, after learning more about CBT and the techniques that are implemented, it is clear to see that this form of therapy is both flexible and creative. In addition, I really resonated with you description of why it may be problematic for a therapist to have a strong aversion in terms of implementing CBT skills on themselves. I too find it to be very hypocritical that a therapist would implement these skills with their clients if they do not think they may benefit themselves!
      Overall, great post!

      Reply

    • Rylee L Ferguson
      Dec 01, 2022 @ 11:36:29

      Hi Tom, I enjoyed reading your response. I particularly liked what you said about supervisors being approachable. They too probably have a lot on their plate but as your supervisor it is their responsibility to make time for you. By being approachable they can ensure that you are willing to get guidance on tough situations and are not afraid to divulge information. Some content discussed with clients is sensitive and taboo but it is vital that you can still reach out to supervision about it. Without having proper communication with a supervisor, you cannot get accurate and informed feedback.

      Reply

  6. Bekah Riley
    Nov 29, 2022 @ 19:07:32

    There are a few myths regarding CBT that have been formed upon this theoretical therapeutic approach becoming more widely used. One in particular that I have heard more frequently is that CBT is too rigid and does not leave room for flexibility or creativity with each individual client. This myth has formed based on the notion that manualized-based treatments are too scientific of an approach and are not individualized to each client. When I hear these comments, I understand how the sound of a manualized treatment may sound challenging to make individualistic, but upon learning more about CBT, it is clear to see how there is room for both flexibility and creativity to allow for client centered care. In addition, CBT is both scientifically proven to be effective while also having an emphasis on the importance of the client-therapist relationship. However, despite the evidence of the effectiveness of CBT, these myths continue to exist because of the lack of understanding around this form of treatment. However, CBT tends to be better understood when individuals implement the techniques themselves and are able to learn the importance of an evidence-based practice treatment approach. In order to dispel some of these myths, it may be beneficial to explain the quality of care provided when implementing CBT or even allow other therapists to observe CBT sessions in order to have a more conceptual understanding of this form of therapy.

    When CBT therapists have a strong aversion to practicing CBT techniques on themselves, it can create a problem. When a therapist practices skills that they implement in therapy, it allows them to have both an increased level of insight in terms of the beneficial effects of each skill as well as increased self-awareness. This can in turn allow the therapist to be more competent in terms of implementing CBT skills as well as more empathetic to their clients after experiencing some form of distress and using CBT techniques to work through it. However, if a therapist has a strong aversion towards using evidence-based CBT techniques on themselves because they question if the techniques will work for them, their clients will most likely be able to pick up on that. This may lead the client to have less motivation and potentially even feel discouraged. It is important to truly believe that what you implement is beneficial, even for oneself. In terms of receiving supervision in CBT, it is important that one ensures that their supervision is quality. Specifically, it may be important for a supervisor to observe sessions at first rather than only basing supervision on verbal reports. This leaves no room for either forgetting important information or misinterpreting information from the session. In addition, CBT group supervision may also be beneficial in terms of practicing skills with other therapists, as well as improving upon technical skills, conceptualization, and treatment planning. In terms of what feedback would be most beneficial for my professional development as a CBT therapist, I think that addressing the therapeutic skills that could use improvement or strengthening would help. When considering keeping up to date with CBT skills, it is important to always continue training and education to provide the best possible care for clients. If one does not do this, negative outcomes may arise such as not providing quality care to clients or even causing more harm than good. If one technique is widely proven to be more effective than another in treating a disorder, it is important that a therapist educates themselves on the best possible technique and works to provide each client with the best care.

    Reply

    • Patricia Ortiz
      Nov 30, 2022 @ 00:37:07

      Hi Bekah, I totally agree with you. It is crucial that a therapist educates themselves on the best technique and works to give each client the greatest care if one technique is demonstrably more beneficial than another in treating a disorder. Also, the advancement of knowledge in current times imposes constant updating on therapists. Professional updating is very important since it allows us to think and act competitively, be true professionals, and obtain the latest tools to attend to clients successfully.

      Reply

    • Rachel Marsh
      Nov 30, 2022 @ 22:01:48

      Hello Bekah,

      I enjoyed reading your post! Specifically, I like what you said about clients having decreased motivation if the therapist does not endorse the use of CBT on themselves. If I had a therapist who didn’t trust the techniques, they expected me to use, I would be less inclined to engage in the therapy. This reminds me of a sales tactic we used at a clothing store I used to work at. At this store, we would have deals on key items on certain days. On these sales days, our company encouraged us to wear the product if we had it so customers could see what the items looked like on an employee and see how they might be styled in real-life. The primary reason for this sales tactic is to cultivate the customer’s trust in our clothes. If they can see that employees regularly wear the brand and integrate it into their daily wardrobe, then the customer would be more motivated to try the product for themselves. If someone was trying to sell me a product but didn’t trust the product themselves, I wouldn’t buy it from them. This makes me think about how if I were a client and my therapist did not trust the approach, they expected me to follow, I would stop seeing that therapist.
      Overall, great post!

      Reply

  7. Patricia Ortiz
    Nov 30, 2022 @ 00:28:13

    [CBT Myths] – (1) Identify at least one common CBT myth you have heard from other people/professionals. What are your thoughts when you hear such comments?
    I have always heard that CBT cures the symptom, but it returns. It is absolutely true that many clients present relapses and even that many others do not even respond to the treatment. This may be because certain disorders are often characterized by a predisposition to recurrence, and for many others, there are still no treatments that give effective responses. But, in many cases, such as anxiety disorders, it often happens that therapeutic achievements can often be generalized to other areas in addition to achieving symptomatic remission. For example, a client with panic disorder who manages to re-evaluate his catastrophic thoughts with respect to palpitations can achieve reassessment of other fears too.
    Also, that CBT Treats everyone equally but “does not respect the singularity of the client.” CBT has manuals or treatment protocols, which can lead to confusion that the same interventions are implemented with any client. Because of this, it would be pertinent to clarify that these are specific treatments for disorders with which, for example, the model used with a client with panic is not the same as that used with a depressed client. Even within clients with depression, for example, there is no equal treatment. Strategies usually follow a logical sequence, but the session’s content is rarely the same between different clients.
    (2) Why do you think some of these myths continue to exist?
    I think some of these myths continue to exist because sometimes people think about something without doing research, or sometimes they had a bad experience, and they generalize that experience. Also, therapy works differently for everybody, so it would not be fair to generalize. One profoundly rooted prejudice in society is that many people think that going to therapy is equivalent to being weak. However, contrary to this thought, it takes strength and courage to go to therapy. Acknowledging that we need help and requesting it is, on many occasions, the most intelligent path.
    (3) What can you do to help dispel some of these myths?
    I think the best thing I can do is to do a good job and always give a good service to clients and psycho-educate every client because some people may romanticize therapy and think that just going to a CBT session is going to solve all of their concerns and they sometimes do not realize that CBT is an ongoing process and it takes effort to get better.

    [CBT Competence] – (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?
    If a CBT therapist has a strong aversion to practicing CBT techniques on themselves, it says that something is wrong, and they should address it. When therapists practice the techniques on themselves, they can be more self-aware and also would know what to expect in therapy with their clients. It is beneficial in many ways. It also could be detrimental for their clients because if they have an unresolved issue, it can cause countertransference in therapy and damage the therapeutic relationship.
    (2) What are some possible indicators to determine if you are receiving quality CBT supervision? What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?
    An indicator that someone is receiving quality CBT supervision is that the supervisor creates sequential short-term goals, assesses interventions, objectively evaluates the problem situation, offers alternate interventions and/or conceptualizations of the client’s problems, assists in brainstorming potential solutions, and collaboratively develops growth strategies. The most beneficial feedback is one that helps one grow and helps improve the interventions and techniques.
    (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills?
    Some negative outcome of not staying up to date with CBT knowledge is not being able to attend to the variety of issues that people bring to therapy. Adapting to all the changes that occur in today’s world is essential; not updating knowledge translates into a stagnation of professional development. Also, I think that staying up to date with knowledge translates into bringing all the innovative and successful techniques to the clients and seeking their welfare.

    Reply

    • Rachel Marsh
      Nov 30, 2022 @ 21:46:06

      Hello Patricia,

      I loved reading your post! I especially like what you talked about regarding why CBT myths tend to exist. You make a great point in saying that the stigmatization of therapy can perpetuate some of these myths. People who may benefit from services may take the experience of someone who had a poor experience with CBT and generalizes it to all therapists. The stigma of therapy seems to compound the anxiety of having another bad experience with CBT. Because individuals have either had a bad experience with CBT or have heard of someone who has, they are even less likely to take a chance and try a different therapist.
      By working toward minimizing the stigma of going to therapy, we as a society can encourage more people who need services to go to therapy and also work toward minimizing some of the CBT myths.
      Additionally, I appreciate what you said about countertransference in therapy if CBT therapists are against practicing CBT techniques on themselves. To be an effective CBT therapist, it is essential to ensure that you resolve personal issues to prevent them from influencing the way you treat your clients. Practicing CBT techniques on the self does not have to be limited to doing worksheets on yourself. This can also include finding a therapist who practices CBT and receiving CBT services for yourself to resolve your issues. In this way of being a client of CBT as well as a provider, you can understand what it might be like to be a client who goes through CBT and learn how to be an effective therapist, as well as what not to do, from the perspective of a client. This can cultivate a deeper level of empathy toward the client as well as self-awareness of issues that may impact how you interact with and treat your clients. Being a therapist who also goes to therapy, can also send the message that even helpers need help and can help work toward minimizing the stigma around therapy.
      Overall, great post!

      Reply

    • Yoana Catano
      Dec 01, 2022 @ 15:10:13

      Hi Patricia,
      I agree with you that education is the best way to dispel some of these myths, not only educating clients or colleagues in CBT, but also encouraging them to do their own research about it. I also agree with the self-awareness as required to practice therapy properly. Great post!

      Reply

  8. Rachel Marsh
    Nov 30, 2022 @ 18:33:11

    CBT Myths
    Question 1
    One CBT myth that tends to stand out to me more is when people believe that CBT only focuses on cultivating positive thinking and optimism and does not allow individuals to acknowledge the negative. While it is true that CBT does not endorse a fully negative mindset, it also does not support a fully positive mindset. Rather, the goal is to promote thinking that is adaptive, realistic, and helpful.
    Something that comes to mind when I hear this myth is how CBT is often used to treat mania symptoms for individuals living with bipolar disorder. Individuals experiencing mania tend to have overly positive thoughts that may put them at risk of harming themselves (ex. “I am invincible”). If this myth were true, then CBT would not be useful for individuals experiencing such thoughts. However, CBT aims to frame thinking so it is realistic and useful. In this way, CBT can help clients acknowledge negative, neutral, and positive aspects healthily and adaptively. Going back to the mania example, the goal of CBT for an individual experiencing thought associated with mania would be to still allow positive thinking but be able to take responsibility for their shortcomings and accept negative aspects of their life as well.
    When hearing myths like these from providers, I tend to believe that these individuals lack proper education on the theory and application of CBT. Moreover, their theoretical orientation may oppose CBT or not favor the evidence-based practice. When hearing myths like these from people who have gone through therapy, I tend to believe that they had a poor experience with CBT or received services from an inadequately trained therapist. CBT takes a lot of time to master and practice efficiently. Some providers, even if well-intended, may have poor supervision or training, leading them to provide sub-par services for their clients. In part, this could perpetuate some of the myths that people tend to believe about CBT. Without supervision or feedback on CBT skills, there is the risk of leaving clients with the wrong impression of how CBT should be performed.
    Question 2
    Aside from the reason mentioned in the previous question, two other reasons that may perpetuate these myths are conflating CBT with behaviorism and lack of evidence-based practice. I think people tend to conflate CBT with behaviorism regarding rigidity and flexibility. For example, people tend to argue that CBT ignores emotions and does not consider the past as important. Classic behaviorism tends to focus only on contingencies that determine behaviors. CBT focuses on behaviors but also emphasizes the importance of the thoughts and emotions that lead to behaviors. In addition, one of the key ways to identify automatic thoughts is by eliciting strong emotions. People are not always aware of their thoughts but are aware of and can describe the emotions associated with them. This is integral to teaching clients the connections between thoughts, emotions, and behaviors.
    Another aspect that people tend to get wrong about CBT I think for this reason is that CBT does not consider the past important. Psychodynamic theorists tend to believe this myth the strongest. When looking at classic behaviorism, does not look too much at the past in terms of behaviors. While CBT does not consider the past to the extent that psychodynamic theory does, CBT does emphasize the importance of looking at precipitating factors that may have contributed to the development of problems and disorders.
    The other reason I believe people may continue to believe these CBT myths is they don’t favor the evidence-based practice. For example, most people who are not well-versed in CBT may argue that CBT disregards the importance of the therapeutic alliance. CBT argues that while Rogerian qualities are important in therapy, research has repeatedly shown that these qualities alone are not sufficient to produce significant therapeutic change. CBT does emphasize collaborative empiricism, which accounts for these characteristics as well as mutual trust from both client and therapist. Collaborative empiricism also emphasizes the integration of research and evidence-based practice. It recognizes the client as the expert and aims to include interventions relevant to the client’s life, but also ones that are supported by research.
    Question 3
    Several things that come to mind to contribute to minimizing these myths are striving to be well-versed in CBT, having trusted supervisors and colleagues that I can gain accurate feedback from, and educating others on CBT. To become well-versed in CBT, I can ensure that I follow evidence-based practice by staying up to date on current CBT practices. I can achieve this by staying current with treatment manuals, books, and articles. I can also continue my education by taking post-grad courses, attending research conferences, and participating in seminars.
    One reason I mentioned that I believe that some people may have the wrong impression of CBT is due to experience with poorly trained CBT therapists. If the only experience they have with CBT is an uneducated CBT therapist, they are likely to generalize that experience of CBT practice as a whole. Therefore, ensuring I have trusted supervisors and colleagues that I can gain accurate feedback from is a way I can ensure I am doing my best to do CBT well. Subsequently, I can help my clients have a positive experience with CBT and ensure they have an accurate conceptualization of what CBT is.
    Finally, I can educate both clients and other clinicians on CBT. With clients, this can be done through psychoeducation. Part of the therapy process in CBT is psychoeducation and teaching clients CBT skills. With clinicians, this could be done by researching and presenting at conferences, or even in treatment reviews with clients if we have differing theoretical approaches. By ensuring that I adopt the evidence-based practice and have trusted supervisors/colleagues who are well-versed in and perform CBT well, I can increase my ability to educate others on CBT.
    CBT Competence
    Question 1
    I find it concerning if a CBT therapist does not demonstrate an interest in practicing techniques on themselves because it destroys the credibility of CBT. If the therapist doesn’t have faith in these techniques to help them in their own lives, then the client is less likely to trust them. In addition, the therapist may not have an idea of what it is like to go through the process of some of these CBT techniques. Therefore, they would not have an accurate idea of some struggles that might come up when doing these techniques. This would prevent full self-awareness and empathy for the client.
    By doing some techniques on yourself, you can gain insight into what it might be like for a client to do these techniques as well. Some CBT exercises can be difficult and elicit strong thoughts and emotions. By being more aware of these, a therapist can be more prepared for what might come up in session, what might prevent clients from fully engaging in these exercises, and how to best work through some of those difficult moments with the client.
    Question 2
    Some characteristics of intense supervision are ensuring adherence to CBT theory and skills as well as treatment fidelity. This means the supervisor would not encourage a clinician to disregard what is suggested to do by research or treatment protocols or denounce the importance of adopting EBP. The supervisor would also be an empathic leader and demonstrate empathy to both clients and the people they supervise. In terms of supervision, this means they would be responsive to questions and issues and identify both strengths and weaknesses. They would also need to demonstrate empathy and have a strong relationship with their clients.
    If I were to receive feedback from a supervisor in terms of CBT, I would want to ensure that I am being empathic with my client and develop a strong rapport with my clients. This is something that I would value the most in terms of treatment. I would also want the supervisor to be someone who can provide resources for me to further my learning. Rather than just telling me what I need to work on, go the extra step and provide me with the resources and support I need to improve on those things.
    Question 3
    If I fail to stay current with CBT knowledge and skills, I would be worried about treating my clients inadequately. Given that CBT is based on research and EBP, it is always being refined to be more effective and helpful for clients. If I were to continue to practice at the same level and not focus on refining my technique, I would be doing a disservice to my clients.

    Reply

    • Tuyen Phung
      Dec 01, 2022 @ 21:43:01

      Hi Rachel,
      I found it interesting when you mentioned that a CBT therapist does not demonstrate an interest in CBT but in practice, this can lead to their lack of accurate idea of struggles in CBT practice of its techniques. I think that the therapist may not have deep knowledge and be well-trained in CBT. This can be harmful to their therapeutic relationship, and they do not bring effective treatment for their clients. With that said, I think they better practice their own interest in a specific therapeutic approach rather than CBT.

      Reply

  9. Tayler Shea
    Nov 30, 2022 @ 22:34:16

    One comment that I often hear people say in response to CBT is that it is mechanical, impersonal, and rigid. When I hear people describing CBT in these ways, I think that they must be uneducated. If they were educated, they would know that CBT has a lot of room for flexibility, change, and rapport building. Additionally, CBT is a very collaborative therapeutic approach. When I hear someone make a comment like that, I just note that they are not very educated on the topic. I think that these myths continue to exist because many people are often not educated specifically on CBT. Right now, there is also a lot of information on social media regarding therapy, much of that information being misinformation – I would be willing to bet that many people on the internet are not trained in CBT. I think that the increase in therapy-based discussions on social media and on the internet helps myths remain relevant. To dispel these myths, we must share as much information as possible regarding the truths of CBT. Educating our friends, family, and peers on CBT will help reduce the amount of misinformation.

    If a CBT therapist has a strong aversion to practicing CBT techniques on themselves then they should not be a CBT therapist. If they are unwilling to use these techniques on themselves then they must not believe in them. If the therapist does not believe in their skills, then the clients will pick up on that. Your clients will trust you less if they feel you don’t believe in your own practice, and they will become less hopeful and less motivated. Additionally, clients need a genuine relationship with their therapist and if the therapist is lying to them, then it is not genuine. A quality CBT supervisor is very important for a new therapist. You can determine if you have a good supervisor based on their investment in your training. A good supervisor will be interested in watching you in session, coming to your group, and observing what you do as a therapist. They should provide feedback and ensure that you are adhering to the CBT model techniques and skills. For me, I think the most beneficial feedback would be for my supervisor to tell me the things that he feels I could improve on and then share ways that I can improve, rather than just telling me. I would also benefit from hearing the things that I do best during the session so that I can continue to do those things. If you do not stay up to date on CBT research, you will get left behind. CBT is always evolving and becoming better. If you are not staying up to date on this, your techniques will be outdated, and you will be causing harm to your clients. A therapist who is relying on only older information is likely going to miss an opportunity to help a client.

    Reply

    • Rylee L Ferguson
      Dec 01, 2022 @ 11:31:42

      Taylor I am really glad you brought up the role social media can play in perpetuating myths about mental health. I had assumed many people adhere to the myths and then do not seek out alternative information. In reality though, apps like tiktok and instagram may be confronting them with false information even if they are not looking for it. This highlights how important it is to be aware of your sources. If you would not take medical advice from a stranger on the internet, you should probably be wary of mental health advice as well.

      Reply

    • Sam Keller
      Dec 01, 2022 @ 12:55:30

      Hi Tayler!
      I think you are right in saying that the supervisor’s level of investment is important to quality supervision. I would want them to want to take an active role in giving me guidance and seeing my work in person. That way I would know that they are likely doing their best to help guide me to be the best practitioner I can be. I have also heard that CBT can be rigid and inflexible. I think this comes from people being exposed to the different techniques without any of the education about how it is all supposed to fit together and be integrated into therapy. Great post!

      Reply

  10. Rylee L Ferguson
    Dec 01, 2022 @ 11:27:43

    I have heard that CBT is only focused on the present and ignores early experiences in childhood. I think this idea is an over-exaggeration of the change from psychoanalytic and earlier therapies where past experiences were a major focus to CBT where they play a lesser role. In CBT, past experiences are just one piece of the puzzle and thoughts, behaviors, and emotions are explored too. Focusing on more recent events can provide more palpable emotions and memories to work with. Additionally, CBT can be future focused in regards to changing behavior. However the past can still play important roles such as when exploring concepts like core beliefs as many of those develop in early childhood. CBT downsizes the role of past experiences and incorporates other important variables but I think it is inaccurate to say it treats the past as unimportant. I think these myths persist because people often do not seek out information to challenge their beliefs. If they are turned off by CBT because they think it ignores the past then they are unlikely to get involved with this type of therapy. They are not exposed to sources that would educate them on the reality of how CBT works. On the other hand, sometimes people who are reluctant to believe in therapy altogether will stand behind these myths to support their avoidance. If I hear this myth or others I can politely engage in conversation and try to dispel them through offering psychoeducation. I can explain what I know through my academic education and even offer resources. I would try not to jump to correcting them as this would come across as rude and condescending. I think it is important to hear people out with their concerns first so that when it is my turn to speak they too will give me the courtesy of listening.

    It can come across as extremely hypocritical if therapists are unwilling to practice what they preach so to speak. Clients may wonder if they really believe in the techniques of CBT or if the therapist just feels superior. Having a therapist who has gone through the techniques can provide comfort to a client and depict the therapist as an experienced guide. Not practicing the techniques may also prevent the therapist from fully understanding and relating to clients as they go through the process. First hand experience can make the therapist more empathetic and get a better perspective on the vulnerability required by the techniques. Therapists may also be reluctant because they have unresolved trauma or mental health issues. This is a red flag because therapists should have their emotions and mental wellbeing in check as much as possible before working with clients. Otherwise they risk letting their own issues negatively impact their ability to provide therapy.

    Having a supervisor with their own extensive experience is a good sign. This way they can draw on a wealth of information and experience to guide you. People with lesser experience may still be learning themselves and therefore could struggle to offer insight and act as a leader in this area. Another good sign of quality CBT supervision is a supervisor observing sessions live. This shows they are dedicated and want to get a full picture of your abilities so they can provide good feedback. Getting extensive feedback with concrete information on how to improve would be very beneficial for development as a therapist. Without hearing constructive criticism you’re not pushed to grow or expand your skills. It can also be great to hear what you are doing right and how to apply and expand that to better use CBT skills.

    Not staying up to date means you could miss out on new and improved assessments or CBT skills. You could also continue to use techniques that research has proven faulty or inadequate. Either way you are doing a disservice to your clients by not providing them with the best evidence based treatments available. In this way you have an ethical responsibility to your clients to remain up to date on knowledge and skills.

    Reply

    • Sam Keller
      Dec 01, 2022 @ 12:52:05

      Hi Rylee!

      I think you made a very good point about supervisors observing live sessions in order to give you the best feedback. We might not be giving the complete picture of everything we are doing in session or there could be things we are not aware of unless an outside observer is brought in. This gives the supervisor the opportunity to watch body language cues from both us and the client in order to judge the situation. I also liked talking about the importance of practicing what we preach. It is hypocritical if we aren’t willing to engage in these techniques ourselves and sets a bad example for out client. Good post!

      Reply

    • Tuyen Phung
      Dec 01, 2022 @ 21:56:45

      Hi Rylee,
      You did a great post this week. I like the way you mentioned psychoanalysis referring to the myths of ignorance of past experiences in CBT. I think that this can be a similarity between psychoanalysis and CBT regarding past experience. With psychoanalysis, past experience, especially from childhood is a foundation for their treatment; whereas, understanding past experience can be helpful in understanding core beliefs of clients. The difference is how much each approach emphasizes the importance of past experience. The positive view of CBT is the transition from past experience to behavioral change in the present and the future, leading to their recovery. I like the way CBT deals with not only past experience but also the presence and future because mental issues are not only caused by the past like a traumatic event but also how present contributing factors and worry about the future. It is interesting to know the way you deal with people who have this myth. I also think that effective treatment and outcome explain more clearly than any argument in this matter.

      Reply

  11. Sam Keller
    Dec 01, 2022 @ 12:48:15

    [CBT Myths]
    One CBT myth that I have encountered is that CBT is just doing exercises from manuals and doesn’t involve any of the soft skills needed to be an effective therapist. It makes me think that people who have this view definitely haven’t received a formal education in CBT. They might have just done an hour-long workshop or have only encountered the exercises themselves without knowing how they should be properly integrated into therapy.
    I think that some of these myths persist due to a lack of education or education that is too brief. If you haven’t dealt with CBT or have only taken a brief workshop on a specific CBT technique then it would be easy to assume that the exercises are all there is to it. Because exercises tend to be the focus when we are teaching people who don’t have the full formal education, it would be an easy assumption to make.
    When we teach aspects of CBT to colleagues or are explaining how it works, we should be mindful to include how these exercises blend with soft skills in order to aid the therapeutic process. We should not only teach techniques and how they can be done effectively. We should be talking about how these techniques can help the therapeutic process and enhance more Rogerian therapy styles. It might appeal to more people that way.

    [CBT Competence]
    I think it can be an issue if a CBT therapist is adverse to practicing CBT techniques on themselves. This could stem from a couple things. Reluctance like this could stem from a conscious or subconscious lack of faith in the effectiveness of said techniques. This is a problem because this could make you less likely to use these techniques with clients if that is truly what you believe. Another issue could be that you do not think you could personally benefit from doing these techniques on yourself. I believe that even if the technique is for a disorder we do not clinically suffer from there is always something more we can learn about ourselves. Doing these techniques personally also gives you empathy for clients when they experience barriers or struggle completing some tasks.
    Quality supervision for CBT techniques must come from someone who is accredited in those techniques. They must be intimately familiar with said techniques, enough that they can understand the entire process without having to rely on doing their own research beforehand. They should be able to identify the parts of the technique that went well and the parts that could be improved. Ideally they should have been using these techniques in their own practice so that they have firsthand knowledge of what it is like to implement these techniques with a client. The best feedback is the places in employing the technique that could have been done better or things the practitioner could have changed to make things easier for the client.
    If you do not stay up to date on CBT skills you could end up inadvertently doing harm if something ends up being proven to not be effective. You could also be less effective in helping clients as methods are constantly being improved and refined. It is much easier to cut wood with a sharp knife than a duller one. It takes significantly more time and effort to cut wood with a dull knife, and the same can be said for using outdated techniques.

    Reply

    • Yoana Catano
      Dec 01, 2022 @ 15:16:55

      Hi Sam,

      Very interesting how you bring the soft skills in the therapeutic process. It is definitely essential to put together all the competencies for a skilled therapist, not only Rogerian techniques but knowledge required to be effective. I also like your comment about having more empathy if the therapist has applied the techniques to themselves, that is also a good example in how the mixture of knowledge and soft skills build a good CBT therapist. Great post!

      Reply

  12. Yoana Catano
    Dec 01, 2022 @ 15:05:02

    [CBT Myths] Before entering the program, I believed that CBT didn’t care about past, however, with the program I understand how past is not denied in the formation of core beliefs. CBT considers exploring how the experiences have shaped core beliefs and explore this past in therapy. The difference with working on the past is making the past part of the present as a determinant, instead of working on what is possible to change now, making adjustment for the present, finding some validity for an opposite thought, or finding copying skills for what has already happened and is valid.
    I don’t think is difficult to have those thoughts about CBT, especially due to the history that has brought the discrepancy with the psychoanalysis and behaviorism. I think these myths are still in place because CBT was never separated from behaviorism, it seems that CBT is behaviorism that has evolved. But what I have learn, CBT is a very different approach from what behaviorism was at the time. The best way to help dispel these myths is to see CBT as a cognitive approach, but that is through education. Knowledge can help to see things different and have a better opinion or an informed opinion.

    [CBT Competence] It is hard to convince a client about the effectiveness of a treatment if I am not convinced that it works. If we have experienced the techniques, we could use some more ability to explain and provide examples, or help a client to identify their own thoughts, anticipate some challenges, and to have hope for change. It could be a strong opinion, but how can a therapist teach a client how to stop smoking if they are still dealing with the same? Coherency should be highlighted as a part of the therapeutic relationship. It doesn’t mean the therapist is not allowed to have problems or flaws, it means that the therapist is self-aware of their limitations and commits themselves to real efforts to be coherent. Supervision is an excellent way to be aware of those limitations, but also to utilize the treatment effectively with no harm. It is easy to tend to modify treatments during the individual process, because the therapist has more affinity with one technique than another one, but in order to be called CBT, we should follow the main principles. In this case, having another “set of eyes” from a supervisor in the therapeutic process, is necessary to provide the best treatment.

    Finally, as a science, CBT evolves. Research can show that certain modifications are necessary to increase validity. That’s why it is necessary to stay up to date. If not, the therapist would not be providing the best treatment available as it is required in our profession.

    Reply

  13. Teresia Maina
    Dec 01, 2022 @ 15:51:37

    [CBT Myths] One common CBT myth I’ve heard from others is that CBT only focuses on thoughts, not emotions. As Dr.V mentioned, the development of this myth may be an emotional response in and of itself. When I hear this comment, I can’t help to think that people have come to this conclusion due to the name of the treatment. The term explicitly mentions cognition and behavior but not emotions. Another common myth is that CBT is too rigid/ technique focused. I can understand where people come from when they think like this. Since CBT is a manual-based treatment, people who are not familiar with the treatment may not know how you could personalize therapy for each client while still upholding the basic principles. Overall these myths continue to exist due to a lack of education/understanding about CBT. What I can do to help dispel some of these myths is to use evidence-based practice in sessions and provide proper psychoeducation about CBT. As well as take the time to correct professionals/people who believe these myths.

    [CBT Competence] If a CBT therapist has a strong aversion to practicing CBT techniques on themselves, it could show that they genuinely do not believe in CBT. It’s essential to practice what you preach. You cannot ask a client to complete exercises and worksheets you dislike. Having a strong adversity towards CBT practices could be translated into therapy, and if clients catch on to those cues, they could lose motivation. Practicing these techniques helps you develop self-awareness because you can empathize with what it’s like being on the receiving end of these practices. A good indicator that you’re receiving quality supervision is that your supervisors ensure you stick to CBT theories and skills during treatment. They take the time to create short and long-term goals with you. It’s also important for a supervisor to be approachable, provide regular supervision and feedback on your strengths and weakness, and advise you on how to handle potential obstacles. Not staying up to date with CBT knowledge and skills can lead to you being labeled as an incompetent therapist. Over the years, some techniques may slightly change, and it’s essential to keep up with these changes so that you don’t cause your clients harm.

    Reply

  14. Kristin Blair
    Dec 01, 2022 @ 15:56:50

    One thing I have heard about CBT that stuck with me was that it was “unethical.” My first question, of course, was, how? I was told (and have read) that some people think it isn’t right to suggest that someone’s responses are “irrational” or have poor reasoning when therapists do not have the appropriate evidence to make such claims. Miranda Fricker is a big contender against CBT and other everyday practices that she deems unethical. She is a Professor of Philosophy at NYU and Co-Director of the National Institute of Philosophy. She calls her work “epistemic injustice.” She defines this as when someone from a marginalized group (in this case, someone who is mentally ill) is told that their claims are invalid. She is quoted saying, “Even worse, with CBT they are told this when they come seeking help. Troubling at best, unethical at worst.”
    I think this myth exists because, let’s be honest, it’s hard for people to be told they’re wrong or that their thoughts may not be correct. Moreover, when these thoughts are challenged and are told they are the reason for the negative ways we feel (or a mental health diagnosis), they feel wronged as “if they do not know.” It’s simply insulting to them. They also include poor reasoning, bias, and faulty beliefs are common among mentally healthy people. So if CBT is based on the idea of “faulty” reasoning and/or beliefs, how does CBT distinguish between a delusion and a strange belief in an individual with more obvious faulty thinking, like schizophrenia or psychosis? Those who hold this belief also argue the difference between delusions and those with conspiracy theories or beliefs in ghosts and the supernatural. These examples prove to them that “faulty thinking” clearly does not correlate with mental illness. *** if you want to learn more about Miranda Fricker’s stance, she is on Spotify and featured in many different podcasts speaking on this topic of “epistemic injustice.” One is called Five Questions featuring Miranda Fricker, among many others***

    I’m not too sure how I could help dispel this particular myth. But I guess I would simply educate anyone I came across with this belief in such a way that it was relatable and easier to understand. I feel this view on CBT must simply be from not having the appropriate information. However, I would like to think that a distinguished Professor of Philosophy from NYU would undoubtedly have the appropriate training and background to make a more informed opinion than perhaps many people. This leads me to think of my own theory; if we all take in the world, interactions, ourselves, others, etc… differently due to our own unique pasts, upbringing, childhood, traumas, environment, race, culture, etc… then perhaps that even with formal education one could interpret that education in their own way? Could it be that something about Miranda Fricker’s past, childhood, culture etc, tells her that rehabilitating and helping those with mental illness using CBT is wrong and unethical? That she just happens to be another brilliant mind in a similar field whose personal journey tells her to see CBT differently?

    If a therapist has a strong aversion to not using CBT techniques on themselves, that could negatively impact how they deliver therapy to clients. Not engaging in the same techniques you are offering to do for others would lessen the therapist’s competence and understanding of the techniques they are offering to others. Furthermore, it gives personal experience on both sides. This is helpful so the therapist can be familiar with any problems that come up for the client when they engage in the same techniques. Lastly, I just think that, in general, no one should be asking anyone to do something they wouldn’t do themselves. Point blank.

    Some indicators that you are receiving good supervision would be a lot of communication. Supervision should encourage questions of all kinds while also creating a space/setting a tone in which the trainee feels comfortable going to their supervisor for anything they feel they want to discuss or mention. It is also important that the supervisor be verbally clear about their goals for/during supervision and what the trainee can expect from their supervisors. Good supervision includes a lot of objective feedback, meaning more than just “good job” or “ don’t do that again.” Everything should be followed up with some specifics of those comments, especially those about a correction in performance. Ideally, this feedback should be done often. They should comment on treatment plans, management of their cases, their therapeutic relationships, how well they use specific techniques and homework assignments, clarity and thoroughness of session notes, demonstration of self-reflection, and their responsiveness to the feedback itself. Good supervision is more than just checking on the progress of the clients the trainees are working with. They should also promote professional development and offer many hands-on experiences while all giving corrective and supportive instruction.

    Keeping current with CBT knowledge changes is imperative since everything is always changing. Researchers are constantly conducting new experiments to address problems we already have “solutions” for simply because…we still don’t know everything there is to know. This will keep you relevant and informed and allow you to offer better help to your clients. People use the internet! If clients come to you asking for help with problems and they start mentioning techniques used in the field, and you can’t even speak on them because you are uninformed, that hurts your image as a well-informed, competent therapist. This could result in losing clientele and not being able to be as effective in helping others in your field. You should want to know the newest CBT knowledge just as much as you want the new iPhone 45!

    Reply

    • NikkiAnn Ryan
      Dec 02, 2022 @ 20:00:06

      Hi Kristin,

      I am still amazed by the content of this podcast. I think people like Miranda Fricker use flashy words like unethical to grab the attention of others which in this case may perpetuate myths about CBT. Also, I agree with your point about therapists who have a strong aversion to using CBT techniques on themselves could negatively impact the way they deliver therapy to clients. If they won’t practice techniques on themselves it is likely that they will not effectively present these techniques to clients or motivate them to try the techniques. And as you said, no one should be asking another person to do something that they won’t do themselves. I enjoyed reading your post!

      Reply

  15. Sarah Kendrick
    Dec 01, 2022 @ 23:05:32

    One common myth I have heard from others about CBT would be that it is quick to learn and easy to practice. One of my coworkers/friends who does not have a background in psychology has seen my school work and has made comments about how easy it seems and how they’re surprised that there’s a whole school program for something that seems like it can be learned through undergraduate studies or through trainings…This same individual has also admitted that they don’t understand what CBT is or how to use the specific skills identified in some individuals’ IAPs. I think it can be hard for people to realize that therapy is not just talking and that in CBT, there is indeed more structure and specific techniques/skills utilized. In my experience, my company doesn’t seem to have much guidance about specific trainings and a lot of them aren’t geared towards individuals who don’t want to be clinicians/therapists so I understand how confusing yet “easy” CBT/DBT may appear. I think education truly is key to helping dispel some myths, especially this one! I think my favorite situations have been when any of my coworkers have worked with an individual and didn’t even realize they were utilizing specific CBT/DBT techniques. Discussing this with them afterwards gives the psychology nerd in me joy to see their excitement and curiosity about learning more and the reasoning behind why what they did is so effective (yay empirical evidence!).

    It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves because there becomes a lack of self-awareness and difficulty in properly or empathetically working with individuals. If you don’t believe in the techniques you are teaching/using with individuals, how will they believe in them either? It’s difficult to become motivated to change if you are in an environment in which there is a lack of education/empirical support and reluctance from the provider themselves to share their motivation and commitment to treatment.

    Possible indicators to determine if you are receiving quality CBT supervision would be receiving appropriate feedback in regards to adherence of CBT skills/techniques from someone who is indeed more experienced who can help you to learn and master skills as opposed to someone who is only “familiar” and does not appear to have a focus or a deeper understanding of the CBT model. The most beneficial feedback from a supervisor would be to review both areas of strength and areas of improvement. For my yearly evaluations in the GLE, the individuals, other staff, and an outside provider are all asked about what they observe my strengths and areas of growth are. This helps me to know what I am doing correctly and affirm that I should keep doing, as well as informs me of what I may be lacking in and need more education or support in. Especially in a more professional environment in which you are working directly and one on one and learning more sensitive information about individuals, I would certainly hope that I can be appropriately guided towards the most effective approach. Having been told “keep doing what you’re doing” by someone when my staff team and I were burnt out and unsure of how to get the proper support for one of our individuals, I have truly appreciated actual feedback about what specifically is or is not working!

    Some negative outcomes if you don’t stay up to date with CBT knowledge and skills would be utilizing outdated approaches that are not as effective anymore, missing new interventions/techniques that could be more beneficial, and generally presenting as incompetent for not continuing to stay educated. I can only imagine how many people may have signed up for CBT and when met with an incompetent therapist thought that CBT wasn’t for them because the therapist was using outdated techniques or losing sight of the CBT model. It’s crucial to stay updated and continuing education so that we are most effectively supporting our individuals with evidence-based practices.

    Reply

    • NikkiAnn Ryan
      Dec 02, 2022 @ 19:32:51

      Hi Sarah,

      I have encountered similar experiences in which people refer to CBT as quick to learn and easy to practice. During meetings, I have heard people from other organizations talk about CBT as if it is something that can be turned on and off during the course of therapy when in reality, CBT is structured and ongoing. I agree that education is key to challenging these myths because I think people may jump to conclusions about the “easiness” of CBT when they do not know much about it, yet when they learn more about implementation they may no longer believe myths like this. Great post!

      Reply

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Adam M. Volungis, PhD, LMHC

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