Topic 10: CBT Myths & CBT Competence {by 4/15}

[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 4/15.  Have your two replies posted no later than 4/17.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

69 Comments (+add yours?)

  1. Anna Lindgren
    Apr 09, 2021 @ 12:00:31

    [CBT Myths]
    One common myth about CBT is that since it is evidence-based it is not empathetic, and does not prioritize the therapeutic relationship with the client. My guess is that there are some in the field who think that because the overall timeline of CBT is shorter than other forms of therapy, there can’t be an empathetic and supportive relationship formed in that time. In my clinical work, I can emphasize the importance of the therapeutic alliance and practice empathy from the first session to help dispel this myth. I can also tell my clients (if they ask) that the reason we typically have shorter timelines with clients is that we are working at building skills that mean that they eventually will rely on therapy less and less until they don’t need it. Of course, they can always come back if they find that they are struggling again. But the point is that we don’t want them to be relying on a therapist forever. And I would argue that that is more empathetic and empowering to the individual than long-term therapy.

    [CBT Competence]
    It seems like it would be difficult to have empathy for a client going through the CBT techniques if you haven’t gone through them yourself. At first glance, the exercises may seem very straightforward. But when you’re going through them yourself and reflecting on your own patterns of thoughts, emotions, and behaviors, it can be very intense. Additionally, if therapists are not willing to do the work on themselves, their own unresolved issues may spill over into the therapeutic relationship and cause ethical issues.
    In my supervision, I would look for questions about how specific techniques went with my clients and suggestions on what CBT techniques might be better suited for certain issues. As most clients will have multiple presenting problems, the most helpful feedback would probably be what to focus on first, if it’s not clear to me. If I fail to stay up to date with CBT knowledge and skills, my treatment techniques may not provide the best outcomes. This could lead to clients seeing a different therapist or not improving as much as they could with a more up-to-date evidence-based technique.

    Reply

    • Pawel Zawistowski
      Apr 11, 2021 @ 21:47:30

      Anna,
      I think you pointed out some very useful ways to dispel the myth of CBT not being empathetic. I think it is important for us all to emphasize things such as therapeutic alliance and practicing empathy so that people receive an accurate representation in regard to CBT. Part of the goal of CBT is for it to be a collaborative process, this is hard to achieve without a therapeutic alliance and empathy.

      Reply

    • Tayler Weathers
      Apr 13, 2021 @ 12:22:34

      Hi Anna! I think questions are a good thing in supervision, too! They indicate that the supervisor sees the supervisee as a participant in the process, not an equal but maybe a partner? I think it speaks to the collaboration between the two, which in my opinion is crucial. I also think discussing different elements (like the various problems, and which should be priority) is very educational, because if they just give the answer, then it doesn’t help the supervisee understand how they got there and replicate it in their future work.

      Reply

    • Lilly Brochu
      Apr 13, 2021 @ 17:53:48

      Hi Anna,

      You made a good point about the overlap between a clinician’s own emotions and their clients’ distress that they may experience if they are conducting CBT techniques without ever having done them on their own time. I did not even think that could be a potential problem, but I can see how that can cause even bigger problems for the therapeutic alliance. I think that as a therapist it is important to be mindful about potential personal issues that may be triggered by sessions with our clients and working through those on our own time with a therapist of our own is important. Before this program, I was not familiar with some of these CBT techniques, and it was very eye-opening to see how they do not look like much, but the impact they have are incredible. I could not imagine working through the techniques before administering them to clients because then I would not necessarily know the reactions and responses that may come out of the exercises. Great post!

      Reply

  2. Pawel Zawistowski
    Apr 11, 2021 @ 21:40:37

    CBT myths

    1. A common myth I heard about CBT is that it is focused on changing your thinking to be more positive or to have a more positive outlook on life and that could not be further from the truth. CBT uses an evidence-based approach requires the client to be objective as they analyze their thinking patterns. CBT is not always all positive, it requires identification of cognitive distortions and at times it helps the client point out areas where they are too hard on themselves. Other times, the client may come to the realization that they are not being hard enough. It challenges client’s thoughts in many ways, and although it certainly is centered around have a more positive outlook, it is involved with many other processes as well. For example, therapists help clients make connections between thoughts, emotions, and behaviors that help the client have a greater understanding of oneself. In addition to cognitive restructuring, CBT also focuses on behavioral techniques that allow the client to work on overcoming fears and anxiety.

    2. I believe part of the reason why such myths exist is because people have not received accurate information regarding CBT. Additionally, the stigma associated with going to therapy may contribute to the misrepresentation of CBT.

    3. In order to dispel some of these myths surrounding CBT I believe it is important to spread awareness about the importance of mental health. Additionally, it is important to provide accurate facts to people about CBT. Also, we must begin working toward changing our culture toward having mental health resources being easily accessible at place of work, school, etc. and available for everyone.

    CBT Competence

    1. It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves because it displays a lack of confidence in empirically supported techniques. Practicing on oneself helps improve insight and self-awareness, in addition to being more familiar with the techniques. This can also be concerning and noticed by the client, resulting in reducing their hope and motivation for change and poor treatment outcomes

    2. A possible indicator to determine if I am receiving quality CBT is my supervisor’s experience with CBT and their ability to stick to evidence-based treatment. Having a supervisor who knows real CBT and does not deviate from treatment that is supported by research will ensure that my supervisor reinforces my learning and is able to guide my work experience in the right direction. Additionally, the feedback I receive will be accurate and help me enhance my CBT conceptualization skills.

    3. Some possible negative outcomes if I do not stay up to date with CBT knowledge and skills is that I will not be aware of current research and new techniques that are being developed. In addition, I may forget certain skills that I do not use as much or will not fully master the ones I already use. Lastly, not continuing to stay up to date with CBT knowledge will limit my skills and growth as a clinician.

    Reply

    • Tayler Weathers
      Apr 13, 2021 @ 12:26:29

      Hi Pawel! I think you’re right about the lack of accurate information regarding CBT. I grew up with a former therapist for a mom, and I saw multiple therapists myself, and I still don’t think I could have figured out what CBT was or how to identify good CBT in a therapist before this program. Part of that is, of course, not yet being an adult; the other part is that there is no general expectation for what a therapist does other than “help you.” I mean, look at the portrayals of therapists in popular culture – they don’t always come off as very CBT-oriented, or even that good! This definitely plays into the stigma you mention. And of course, I don’t think most people who haven’t been through therapy could even name 2 theoretical orientations for therapy, because that information is a bit niche. Maybe the question we should be asking is, how can we educate the public on what good therapy is, so they know what to look for (and what to avoid)?

      Reply

    • Lilly Brochu
      Apr 13, 2021 @ 18:26:56

      Hi Pawel,

      I think that the field of psychology in general may still resonate poorly with some individuals. For example, my entire dad’s side of the family are very skeptical of psychology, but still believe that Freud’s psychodynamic principles are what is predominately used in therapy today (which we know is completely not true). I think that for some, there is a level of ignorance of what really takes place in a therapist’s office. Going forward, I hope that I can bring more awareness to not only my clients, but to the general public and my own family as well.

      Reply

    • Michelle McClure
      Apr 13, 2021 @ 22:10:27

      Hi Pawel,
      I really liked how you brought up the myth of CBT being about changing people’s thinking to being positive or unrealistic when CBT is actually about changing people’s thinking to being more realistic. I think most people who are not trained in CBT do not understand how unrealistic their negative thinking patterns can be and that just by changing their unrealistic thoughts to something more realistic can make a huge change in their thinking, emotions and behaviors. It does not take unrealistic positive thinking, which can be in some cases almost or even just as harmful as unrealistic negative thinking. Looking at things realistically has the best overall outcomes.

      Reply

  3. Tayler Weathers
    Apr 13, 2021 @ 12:19:56

    [CBT Myths] 1. Honestly, I can’t say I’ve heard very many myths about CBT. One myth I’ve somewhat heard is that CBT is too scientific, technique-focused and rigid. Therapists at an internship site in undergrad (a rural counseling center) perpetuated this myth to justify using other techniques with their clients (weirdly, usually EMDR). When I heard this myth, my first thought was always “haha, no,” because I came from a very research-focused undergraduate program, so I didn’t (and couldn’t) see a scientific basis as a bad thing. I understood some of the concerns about rigidity, because the therapists were working with young children from low income backgrounds. I could see some of their clients struggling with certain elements of CBT. However, for me, it was kind of the same as a professor who struggles: if all your students are failing, that’s on you. If all your clients aren’t getting CBT when you try it, that’s on you. 2. I think these myths exist because the scientific approach to CBT does feel kind of rigid. We know that you can modify worksheets to make them more useful for a particular client (and some of us did in the role plays – woo!), but if a therapist just bought a manual or attended one course on CBT where they got a pack of worksheets, I can see how that would be intimidating. It doesn’t feel natural at first. So much of being a therapist, I think, is like acting: figuring out how to say the right lines in the most effective way. You’re not being ingenuine, but you have to own the words or they sound that way. Plus, I think many people who pursue becoming a therapist are a bit “touchy-feely,” in some ways. They want to help people, empathize with those around them, are told they’re “good listeners,” etc. So it feels awkward to seemingly abandon those people skills that seemed to work in favor of what feels stilted/scripted. I also see CBT pitched in a very scientific way (which sometimes means mitigating statements and not overstating or overpromising), and other techniques in a more approachable, sensationalized way. Like with marketing (think “Sham-wow”) it can be easy to swept up in the emotion of these other techniques and the sense of purpose and accomplishment from them. 3. As therapists, like Dr. V said, I think our practice will speak for itself in some ways. We can talk to others about the assessments and the data on how CBT works, but also about the technique itself, making it seem more familiar and less rigid. No one is going to want to change if you just confront them – it has to be a gradual, meaningful process that helps others see why CBT is not as the myths say, and why it’s useful.

    [CBT Competence] 1. Therapists who don’t want to practice CBT techniques on themselves either a. don’t believe they work or b. don’t have enough insight to know that they are necessary/would work. There might be a third option, but these stick out to me. Mostly, if a therapist isn’t confident in their technique, they aren’t going to use it on other people with as much confidence or effectiveness. If a therapist doesn’t believe the technique would work on themselves, why use it for clients? Either the therapist thinks they’re some exceptional, unique being, and/or they don’t have enough insight to see why they could use the technique. It could be that these therapists see themselves as not having the problems these techniques address, which I see as a kind of elitism. In any case, these therapists won’t practice as well because they don’t believe in, won’t test the techniques, and won’t work on themselves or their problems. 2. I think the main indicator of quality supervision is a good feedback rapport. Anyone can type some words or give a list of problems; constructive criticism and a discussion about how to fix it are what are actually useful. A good supervisor is on your team, working with you to improve your skills, not acting only as some cold, impartial evaluator. In addition, there has to be some trust between the supervisor and the supervisee that the problems won’t be “used against them” (without being discussed first) and that the supervisor won’t just decide the supervisee is hopeless and quit working with them. Of course, some supervisees might be genuinely problematic or terrible, but a good supervisor will still try to work with them (at least until they can’t). 3. The primary negative outcome of not staying up to date on CBT techniques is using outdated, ineffective techniques. This means that your clients aren’t receiving top-notch care, despite you perhaps saying that they are. Ultimately, it becomes an ethical issue: you promise something you can’t deliver, and you exploit the client’s expectations of a therapist for your own gain. It sounds extreme, but I think that’s the reality. A therapist who doesn’t keep up with techniques is more likely to miss something (maybe that what they were doing was actually harmful) and cause harm to their clients.

    Reply

    • Cailee Norton
      Apr 14, 2021 @ 12:14:33

      Tayler,

      Thank you for sharing your experience with your undergrad internship site. I think that that’s an interesting predicament (especially the use of EMDR over CBT, which I can’t really wrap my mind around), and I love the comparison you made to education. If we present material to clients, and many struggle or aren’t understanding, then it is clearly on us and our presentation of the materials. As we garner more experience in this field I think we will have a larger repertoire of information and “lines” as you’ve put it to take from to fit the needs of our clients. Getting to that point is the struggle, and frankly I think some don’t want to put the effort in to get there so they rely on other “easier” methods. I agree with your ideas on improving these myths, and talking about the techniques openly and honestly and challenging others on what basis they have for their techniques is the only way to improve the mental health field as a whole, not just CBT or not CBT clinicians.

      Reply

    • Laura Wheeler
      Apr 15, 2021 @ 22:40:48

      Hi Tayler, I think you made a great point about the ethical concerns regarding not staying up to date with CBT training. I hadn’t really thought about it that way, but you’re absolutely right, without staying afloat of what new research is available, you could be using ineffective techniques that could ultimately cause harm. I was glad to be reminded in class tonight about how many employers will pay or reimburse for continuing education, definitely helps to keep up the motivation and drive to keep learning.

      Reply

    • Anne Marie Lemieux
      Apr 16, 2021 @ 20:59:05

      Tayler, Thank you for your input. Your post made me remember some comments I have heard from professionals about how doing strict CBT is too rigid. They have expressed that it does not allow for other evidence based techniques such as mindfulness. However, they have said this but then appear to be primarily doing CBT techniques. However, they have put their personality into it and may assume they are no longer doing CBT because their techniques are not being implemented with the exactness that was taught to them.

      Reply

  4. Lilly Brochu
    Apr 13, 2021 @ 17:40:38

    [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?

    I have heard that CBT is both “too rigid” and technique focused as well as CBT not considering one is past to be of relevance to their current problems or distress. CBT can be flexible and creative, but also focuses on the source of the distress through the techniques or exercises used within or outside therapy sessions. I think that the techniques and exercises within CBT are what make it very helpful and what separates it from other therapeutic approaches. As for people thinking that CBT does not take one’s past into consideration, that is not true. Within CBT, it is important to identify past experiences or behaviors that may have continued to maintain the client’s present distress or maladaptive thoughts and behaviors in order for change to happen.

    I think that people would rather listen to other people’s experiences rather than sit in on a CBT session themselves. Some individuals are quick to believe everything they hear and do not think or experience things for themselves, which contributes to the cycle of myths and disbelief when it comes to CBT.

    As a future therapist, it is important that within practice, I point out and disregard any of the CBT myths to bring awareness and quality care to my clients. It is important to utilize evidence-based practices (as they are supported by research to be effective) as well as educating colleagues or other therapists about the accuracies of CBT rather than focusing on false perceptions of it.

    [CBT Competence] –

    1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?

    It would not make sense to have all of your clients practice utilizing CBT techniques in moments of distress without practicing them on yourself first. Practicing and understanding how these techniques work can give the therapist a greater level of awareness and understanding of some of the thoughts, feelings, and behavioral responses clients may have when completing some of the exercises on themselves. Moreover, if clients notice that their therapist does not seem enthusiastic or passionate about carrying out CBT exercises or techniques, it may come off that their therapist is not being genuine or true to their clients and may result in your clients being less motivated or likely to want to participate in those activities.

    (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?

    I think some possible indicators to determine if you are receiving quality CBT supervision would be related to the supervisor’s overall knowledge and skills of CBT as well as their general attitude, values, and have acquired a general level of competency to be of help to a supervisee. If a supervisor were unsure about any questions, I had regarding some of the CBT key principles or techniques, it would be concerning to know that I could possibly be conducting them incorrectly. Also, having a supervisor that works collaboratively with you, wants the best for you going forward, and shares similar values and attitudes to my own are what I would look for in a supervisor. Personally, I tend to perform worse or am more insecure in my abilities if I have a superior who talks down to me, micromanages, or nit-picks every decision or action of mine. Moreover, I would hope to receive all sorts of feedback from my supervisor because as a therapist, we are constantly growing and learning from our experiences, and it is not plausible to already know everything in the beginning. Regardless of my own sensitivity, I think that any criticism would be accepted and taken into consideration because this type of work is constantly evolving, and it is important to acknowledge any areas of weakness and improve upon them going forward.

    (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills?

    CBT is heavily evidence-based, and it is important to stay up to date with current research to utilize any new techniques to help individuals cope with their distress, or if there are any breakthroughs in an understanding of a certain disorder, treatment, or interventions, etc. The field of psychology is ever-changing, and it is hard to say that we understand the human mind completely at this point. I think that by staying informed on up-to-date knowledge and skills allows for the therapist to throw out any techniques that are outdated or just plain ineffective at targeting clients’ distress.

    Reply

    • Michelle McClure
      Apr 13, 2021 @ 22:18:48

      Hi Lilly,
      I have also heard that CBT is too rigid and that CBT is not considering the past to be of importance. The reason I was originally drawn to CBT is that it is flexible and creative. I agree with you that the techniques and exercises that are so much a part of CBT are helpful and make it different from other therapeutic approaches. I also like how CBT helps you to process past experiences or behaviors but does not stay stuck in the past and instead has a more future focused lens. I think these things make CBT a very effective form of therapy for most people. I hope you have an amazing week!

      Reply

    • Cassandra Miller
      Apr 13, 2021 @ 22:50:53

      Hi Lilly,

      I really like that you brought up this idea regarding the influence of clinicians not practicing their own CBT techniques on clients in moments of distress. It is hard to know the right thing to say to another in a moment of intense emotional expression if you have not tested out the benefits and downfalls of your own techniques on yourself first. In addition, it does take away a certain degree of passion from you as a therapist that may become obvious to the client and decrease your rapport with them. I like that you drew the conclusion that this in-genuine expression may be transferred to the client and in turn influence their own motivation to use your techniques to work on themselves. Thus, to be as forthcoming, honest, and genuine as possible the clinician really needs to conduct these techniques on themselves first.

      Reply

  5. Michelle McClure
    Apr 13, 2021 @ 22:03:51

    CBT Myths
    1. I have heard that CBT ignores emotions or does not give enough time to emotions. I had already had some knowledge of CBT when I heard this, so I knew it was not true. I remember thinking that does not make sense, according to what I knew about CBT. So I guess my first feeling was confusion. As I continue to learn CBT I feel more confident that some people just do not understand what CBT actually is and how it works. I have also heard the myth that CBT is not effective at working on past trauma because of the future focus. I would disagree I think CBT is effective at working on past issues, it just does not work by going over and over and over it, it works by acknowledging it, processing it and then moving past it and improving the future. I think that makes more sense because nothing, no therapy or therapist can change the past, what happened, happened. I actually like CBT because of the focus on changing the thoughts about what has happened in the past and by doing that changing them for the better. 2. I think that some people just do not understand what CBT is actually about and how it works and why it works. I think people that do not have experience with CBT are more likely not to understand it. In my experience some people have very negative beliefs about therapy, not just CBT but including CBT. 3. I think if someone believes that something is negative it will take the willingness to learn more about it and some people are not. I think as a therapist we have to defend our belief in the therapeutic process in a non-threatening and empathic way and that includes our belief in CBT. I think by offering non-believers in the therapeutic process accurate information in an easy to understand way that gets the best results. I think the final way to fight the misunderstood myths of CBT is to be a good and effective CBT therapist.

    CBT Competence
    1. I think it is a problem if a CBT therapist is not willing to practice CBT techniques on themselves because these techniques are sometimes hard for the client to complete for various reasons. I think it is important for a CBT therapist to understand that and have empathy and patience with their clients. Also if a CBT therapist is not motivated to use these techniques themselves it makes other people, including clients, question that therapist’s belief in the technique’s value.
    2. Some possible ways that I will know that I am receiving good CBT supervision are supervisors that have a background in CBT and use the techniques regularly themselves. If the supervisor wants to view some of your sessions and give you feedback based on what they observed. Good supervision is often recorded but can also just be observed by the supervisor and then feedback is given. Good supervision also includes group supervision by your direct supervisor who also gives feedback. I think that feedback is important from a good supervisor. I would prefer for a supervisor to tell me what I am doing well as well as what I am not doing well so I can improve. I would also appreciate a supervisor telling me what they would like to see more of or how I could change something I am already doing to be more effective. A good supervisor should be supportive and informative.
    3. I think that in order to be good and knowledgeable about any subject you have to keep up to date on the information available on that subject. A possible negative outcome if you do not stay up to date with CBT techniques and skills is that, “if you don’t use it, you lose it”. You will not feel as confident as a CBT therapist if you are not constantly using your growing CBT skills. If new techniques or ways of doing techniques are modified and you are not keeping up with the information you will be using outdated skills and miss out on important changes/ new information.

    Reply

    • Cassandra Miller
      Apr 13, 2021 @ 22:42:49

      Hi Michelle,

      The first myth that you brought up is an interesting one because it is also something I have heard previously and now seems so silly because CBT puts such an emphasis on validating the clients’ emotional experience. I also like how you brought up the fact that these myths stem from a lack of true understanding because it is often easier to just label something without really having to look into it. People are more likely to believe a headline in this day in age, than to really do the research to check a claims validity. I also like that you bring up CBT being able to study aspects of past issues without overly focusing on them. These issues can be useful to reflect on, but what is directly influencing the client currently should be more of the focus (as this work is more beneficial to them in the present).

      Reply

    • Cailee Norton
      Apr 14, 2021 @ 12:09:12

      Michelle,

      I think you make an excellent point in your response to the CBT techniques being used in a personal capacity. If we ourselves don’t use these techniques, it sends a message to our clients that says we don’t care, we don’t really buy into what we’re selling, and can come off very poorly. I approached this question as a why wouldn’t you try it, what is the harm. I think we sometimes are so focused on clients, we can forget about our own mental health and areas for improvement, and by adding these techniques into our schedules and practices in our personal lives we become better therapists for it. In some ways it can help raise questions clients may bring up, and we can actually provide an answer. Great job!

      Reply

    • Christina DeMalia
      Apr 15, 2021 @ 20:45:05

      Hi Michelle,

      When I thought of some issues with a therapist having an aversion to the using the CBT techniques of themselves, I definitely thought about being able to motivate the clients to complete the activities themselves. However, I hadn’t really considered the empathy that can be formed when completing these exercises. I know completing some exercises on myself for this class, I was surprised by how time consuming some could be, as well as how emotionally challenging it could be to complete them. Before this, I might have made the false assumption that a client didn’t finish an exercise for homework because they weren’t committed or got lazy. However, going through these exercises myself, I’m far more likely to have empathy for my clients and understand that these exercises can be mentally and emotionally draining at ties, especially for someone already struggling with mental illness.

      Reply

    • Anne Marie
      Apr 16, 2021 @ 21:04:41

      Michelle, I appreciated your point about the myth that CBT is not emotional enough. Even in the role play there were times that I wanted to delve into the emotional aspects more. However, I was grateful for the worksheets because it was able to keep me on track. Unfortunately, just talking about our feelings does not create change which is the goal. I can imagine that rehashing negative outlooks and discussing uncomfortable feelings at length will actually keep a client very stuck in their negative automatic thinking. I am grateful to be learning effective evidence based techniques.

      Reply

  6. Cassandra Miller
    Apr 13, 2021 @ 22:35:26

    One common CBT myth that I have heard about from other professionals is that therapy should not require homework and worksheets to fill out if you are just dealing with clients that schedule for problems as they come. After taking many of my CBT graduate courses, I have realized just how false this information is, as well as maladaptive for potential clients to hear. It is a therapist’s job to help the client weed out similar thought patterns and help them understand that there are certain thought repetitions that have a tendency to reoccur (often stemming from core beliefs). Furthermore, if a client keeps coming to you with issues, it means they are struggling to handle these negative thoughts, feelings, and behaviors themselves (which means you as the therapist need to provide them with the tools to do so on their own, even if the events seem different on the outside). Many of these myths continue to exist to create an excuse for therapists to not have to go the extra mile with their clients, as well as providing them with enough “reason” to continue conducting therapy in a subjective way that does not emphasize evidence-based techniques. Clinicians can be very resistant to changing their therapeutic style and may falsely ridicule the use the evidence-based therapies such as CBT for appearing rigid and mechanical to hide the gaps in their own style. I can work to dispel some of these myths by providing a proper psychoeducation to the client, so that they understand the importance and benefit of these techniques. I can also explain to them the importance of collaborative empiricism so that they understand why they have to complete so much of this therapy on their own time and why this is more like a partnership than a one man show. I can also show the client evidence of the effectiveness of CBT using data samples.

    It can be a significant problem when CBT therapists have a strong aversion towards practicing these techniques on themselves because then they are not truly able to empathize with the client’s experience. They are also not being genuine with the client when they are explaining the benefits of these techniques if they are not willing to try them on too. In addition, they will be less knowledgeable about what might work best for each individual client, due to a lack of true experience. To effectively participate in collaborative empiricism the client and therapist must be in a partnership where they explore together in an honest and open way. The clinician cannot do this effectively if they themselves have not tried the techniques. Some possible indicators that you are receiving quality CBT supervision would include the supervisor: setting a plan for each session, clearly recapping on what the client has previously worked on and following up on their homework, providing continuous assessments to conduct with the client, and providing you with the opportunity to observe more in the beginning (to gain these skills) and then slowly allowing you to conduct more on your own (once they are confident you can do this appropriately). The supervisor should also be attentive and genuinely care about your experience with the clients, as they will want to make sure therapy is being conducted appropriately and effectively. I think it would be beneficial for my supervisor to check in frequently on my meetings with my clients and to let me know what areas I need to work on. In addition, they should check up on the progress I make with my clients through my assessments of them and help me adjust certain areas of my treatment if significant changes aren’t being made with them. If I do not stay up to date with my CBT knowledge and skills I will be losing effectiveness in my own treatment of clients. I will not be able to recognize what constitutes good CBT therapy as well and thus not be able to make as many improvements to my own therapeutic approach. It is important to always stay up to date so that you can try as many beneficial techniques with clients as possible, as well as to be on your toes to provide the best therapy that you can.

    Reply

    • Elizabeth Baker
      Apr 14, 2021 @ 15:08:47

      Hello Cassandra,
      I am enjoying reading these posts a bit too much haha, but I absolutely agree with your thoughts for this post! I like how you said clinicians can be resistant to changing their therapeutic style, since it is absolutely true. I feel that some people, once they feel content in how they are going about their daily life, social, or occupational goals, start to become static in their improvement. By that I mean, and exactly as you said, they begin to resist any new or improved way of going about these goals. Self-improvement is essential to an adaptive lifestyle and being able to continuously grow, instead of being your own obstacle for improvement, is the skill to open opportunities for self-improvement and to enhance these skills.
      Doing these activities was honestly a more introspective experience than I thought it would be. Besides it being sometimes tedious, challenging, and difficult (as it was hard coming to terms with my thoughts and feelings), it was such a knowledgeable experience. If we had not tried these activities on our own we would absolutely lack the insight of which activities will be beneficial to support our clients through their distress, and this true empathetic response to our client’s reactions. As Dr. V, and any adult in my life has advised, ALWAYS practice what you preach. It is like advising a friend to do something that will benefit them, and not trying it yourself if you find you are having a similar problem (and I am sure some of us struggle with taking our own advice, I know I sometimes do). Practicing these skills on ourselves not only gives us insight into what our clients may be experiencing, but also helps define our own skills. We are able to test these skills and exercises on ourselves, and improve our ways of communicating and supporting our clients through these activities so we can facilitate increasingly beneficial therapy sessions. Excellent post!!

      Reply

    • Althea Hermitt- Mcpherson
      Apr 14, 2021 @ 23:14:40

      I liked that you choose this particular CBT myth because after seeing all the information that can be garnered from completing these worksheets I am mind blown as to why someone wouldn’t want to use them. I can attest to the fact that they do work because I have been living my life having these thoughts and core beliefs and not recognizing how they are affecting my overall behaviors and emotions. I think these worksheets serve to tie everything together beautifully. I agree if a client hears this before noticing the benefits it can be difficult to get them motivated to complete homework. For me, I am pretty open-minded to clinical approaches and therapeutic modalities because there is no one size fit all therapy.

      Reply

    • Christina DeMalia
      Apr 15, 2021 @ 20:50:53

      Hi Cassie,

      I definitely agree with the homework concern with CBT being a common myth, especially because this was a concern of mine when I first started learning about CBT. In my mind, homework had a somewhat negative connotation, being pointless busy work that takes up someone’s time. I thought of myself and my very busy schedule and how if a therapist kept giving me homework assignments I’d feel frustrated and like my time wasn’t being respected. However, after learning so much about CBT and the exercises used, I definitely see not only the usefulness, but the need for these activities. I realized it was easy to judge it just off of hearing the word “homework” without realizing what it entailed. I realize that of course clients should be continuing work on their own at home, in order to support the collaborative nature of CBT and support the role the client plays in their own progress. I also realized that CBT is flexible enough that for a client with a schedule as busy as mine, adjustments could be made to make some exercises less time consuming, or doing some of them while in session. Realizing that CBT can be tailored to fit the need of each individual client definitely helps to dispel not only this myth, but many of the misconceptions about CBT.

      Reply

  7. Cailee Norton
    Apr 14, 2021 @ 12:05:47

    CBT Myths:
    One common myth I’ve heard about CBT that others have expressed to me in the past is that CBT is super scientific and therefore cold (a buy one get one special of myths). I think that like Dr. V’s said in the past and in the lecture videos, people that say these types of comments about CBT have very little knowledge about what it actually is, and therefore have an ignorant view of it. I also think that theoretical orientation is a bit of a horse show in that my horse is bigger than your horse, so a lot of these comments and myths are based out of insecurities in disciplines with less evidence for their successes and effectiveness. Those who perpetuate these types of stereotypes are biased that their approach is best, and while on the same note I’m clearly biased towards CBT, I have the ability to explain the effectiveness and usefulness of the techniques and beliefs. In regards to the concept that CBT is cold and lacking empathy for clients, this clearly reiterates a lack of knowledge about the foundations of CBT and the techniques we use. CBT pays special attention to the therapeutic alliance component, and we continuously validate our clients emotions and thoughts, but eventually we do challenge our patients to do better, to think differently, behave differently, and cope differently all in the name of living a bit better off than when you came in the door. I can help to dispel some of the myths I’ll be presented with by challenging those who express a dislike of it for reasons that have been shown to be myths. I’ll also do my best to use CBT as effectively as possible in practice and provide education about its purposes, how it is conducted, and what it really is.

    CBT Competence:
    1. It can be very problematic if therapists show an aversion to practicing CBT techniques on themselves. This shows a lack of willingness that shouldn’t be present in a clinician, and begs the question of why not. If you’re not willing to put in the work, test it out, and see how effective it is, how can you be a competent CBT based therapist. It’s one of those things too that why wouldn’t you just try it? What’s the big deal in trying something out. There are things in life that are probably best not to try out, but something like trying out a technique is “harmless.” It may make you uncomfortable, it may push you, and it may even hurt your feelings in some way, but this provides a level of equality with our clients the allows for a stronger alliance and mutual respect. Why would anyone endorse something that they don’t apply to themselves or believe in for themselves? As a client I would think that’s super weird, and would place a lot of doubt in my mind about the effectiveness of the techniques and push me away.
    2. I think one way to tell if you’re receiving good supervision is if your supervisor is actually supervising you or if they’ve thrown you into just doing therapy. Quality supervision is an opportunity for learning, so if they’re not giving you good opportunities of that (through literally observing sessions with others lead for example) or if they aren’t providing you with constructive feedback with areas to improve on, I’d say that you’re probably not getting the greatest experience. While getting nice and good job type of feedback is nice, if you aren’t getting areas that you need improvement on or exposure to a new perspective you don’t really improve your skill set. We need someone to challenge us and our perspectives to get better, and good supervisors are able to do that for you. While it could be hard to hear at some points, a good supervisor will encourage you and provide opportunities for you to get back up and implement therapy differently rather than just kicking you to the curb.
    3. Some negative possible outcomes would be you’re simply behind in techniques and knowledge, and perhaps you could be using another technique much more effectively with your clients by doing it another way or trying something else completely different. With CBT the constant focus is evidence, so how can you be a true CBT therapist if you’re not continuously keeping up with what that evidence is. Perhaps new research will say that this technique isn’t proven to work well with this type of disorder, if you aren’t in that loop you may continue to use that technique and not make much progress when you could have used a better more recent technique. Ultimately our clients are the ones who suffer by our continuous use of outdated material, so by continuing our CBT education and learning new skills and what’s out there we are really providing the best care possible for our clients.

    Reply

    • Elizabeth Baker
      Apr 14, 2021 @ 14:39:00

      Hello Cailee,
      I like how you were honest in saying how you are currently biased towards CBT, of course we all might be as well since, as you said, it is something that we have been learning and know the overall benefits. I think it is also important for us to understand that CBT is not the only effective way of therapy, and to educate ourselves on other structures (just so we are aware of their benefits and can inform inquisitive clients). Of course, we would still practice and facilitate CBT-focused sessions, but it is helpful to be aware of these other ways of facilitating therapy sessions. I think informing clients that you are trained in CBT and still being able to communicate benefits of other therapies, and can (if you can) direct them to another therapist if they have further questions about therapies aside from CBT, shows your level of confidence, expertise, and professionalism.
      I also absolutely agree with honestly everything you have written in your post, especially regarding receiving quality therapy. I feel that some supervisors do not know how important their jobs are to their supervisees, and being able to note strengths and challenge both strengths and weaknesses is an essential part of learning. It is like school if you will; if we only have teachers/professors who say “good job” to our efforts and not challenging us to improve ourselves and identify areas of improvement, then we would not learn nor advance in our skills. This quality support follows us in every aspect of our lives, and we need it to thrive in this world full of challenges. Excellent post, thank you for your thoughts!

      Reply

    • Beth Martin
      Apr 14, 2021 @ 17:13:01

      Hi Cailee,

      You make an excellent point on the importance of being challenged by our supervisors. I think you’re right in that it’s something that can be difficult to get used to (constructive criticism can be scary and feel like an attack if you aren’t used to it), but it’s absolutely vital in getting us to rethink and perfect our strategies. I absolutely loved your “horse show” comments too; there really does seem to be some serious “my way is better” nonsense in the psychological/scientific community, and I’ve definitely heard “professionals” put down other therapeutic techniques simply due to the fact that they aren’t the ones doing it.

      Thanks for sharing!

      Reply

    • Abby Robinson
      Apr 14, 2021 @ 17:46:47

      Hi Cailee!
      I like how you describe the therapeutic alliance being an important part of CBT, which helps disregard the myth that CBT is cold and not personable. I think the the therapeutic relationship is one of the most important first steps to CBT in that the client should feel comfortable working with their therapist and feel that they are in a situation that is suitable for them. CBT is flexible and malleable in its treatment plans and goals so it shows that it is specific to each client, which stems from the therapeutic alliance!
      See you in class 🙂

      Reply

    • Laura Wheeler
      Apr 15, 2021 @ 22:43:34

      Hi Cailee! I loved the point you made about supervision being an opportunity to learn and grow as a therapist. I have definitely had supervisors in the field that go into supervision just wanting you to spit out a quick list of immediate concerns and thats it- no feedback, just crisis control. I think youre right thought, supervision should allow you to learn and improve, especially with constructive feedback on areas that you could benefit from changing, practicing more, or changing all together.

      Reply

  8. Elizabeth Baker
    Apr 14, 2021 @ 14:05:30

    [CBT Myths]
    I have not heard anyone around me nor professionals downplay the benefits of CBT specifically, however, I think I understand why these myths developed misunderstandings of CBT. In general, and especially how some movies I have seen and how a handful of my friends talk about therapy, I feel that therapy comes across as something that may not truly treat the source of the presenting problems. Maybe this misunderstanding reaches towards any aspect of therapy, especially CBT since one of its therapeutic goals is to understand and potentially modify how one cognitively and behaviorally responds to encounters in one’s environment. People may believe that is all CBT does, focusing and modifying how clients interact with their environment without addressing the core features (e.g., mental disorders/psychiatric history, negative past experiences, etc.). Of course, this is an incorrect assumption, but I assume that this misunderstanding is due to hearing this myth from others, as some individuals live off the words of others; viewing therapy videos that do not properly explain the holistic benefits of CBT therapy, as some of these therapy videos may be biased to a specific type of therapy, and there are so many videos that may give false information; and generally, not being properly educated on CBT. I strongly believe that these misunderstandings derive from an ignorant mindset and false information from uneducated individuals and biased therapists from the media. To help dispel some of these myths I am going to do my absolute best to practice and educate myself on CBT (as we are now), and to communicate the well-rounded CBT approach to confused/misinformed clients and client’s families. I would also educate my supervisors and colleagues, as they may have clients or guardians that ask about CBT. This way they would be able to inform individuals who question the purpose of CBT, and could correct their own potential misunderstandings.

    [CBT Competence]
    1) CBT therapists, as well as any therapist or individual in any field for that matter, should always practice and foster their learned skills. These skills are not only to educate ourselves, but to educate colleagues and clients/patients. I think completing and reflecting on the various exercises/activities has provided a truly insightful and personal experience. That is, we have experienced emotions, thoughts, and behaviors that our clients may internalize and/or express while completing these exercises/activities; something of which we would not obtain without having a personal experience with these exercises/activities. Having this insight makes our responses more empathetic when we are psychoeducating and encouraging our clients to try these exercises because we are aware of the benefits and challenges from our own experiences, and might have an idea of what our clients will undergo. There are individuals who can tell when people are ‘phonies’, and this sensor is especially high when searching for quality therapists. If CBT therapists are adamant about practicing their skills on themselves, that may negatively influence the therapeutic experience. If clients are not turned away by this lower sense of empathy and are unaware of the true benefits behind CBT by the first session, then they may feel the lack of this honest, empathetic, self-improving/self-empowering, and supportive environment, and may eventually discontinue therapy. This may also set a lowered expectation of therapy, may lower clients’ confidence of being able to modify their behavior and restructure their lives, and may encourage them to not seek professional help.

    2) Some indicators that show we are receiving quality CBT supervision is if we are granted access to client- and supervisor-consented recordings of sessions, live sessions, and verbal advice. Having access to session recordings and live sessions allows permanent visual and direct support in improving our therapeutic skills, as we can keep reviewing and observing these sessions. Having a supervisor that continues to support the improvement of our skills by identifying and enhancing our strengths and identifying and addressing our ‘weaknesses’ is also an indicator. Yes, it is great to have our strengths and areas of improvement pointed out, but receiving advice and resources on how to improve these areas and skills is widely essential. Unfortunately, there may be supervisors who hold on to their title and do little to nothing with advising their supervisees. Searching and being persistent with wanting advice from supervisors, and receiving both positive support and critiques is a huge benefit to improving and honing CBT skills.

    3) Therapy is an endlessly evolving profession in which new research and new and more beneficial ways of facilitating therapy sessions and skills are continuously developed and produced. It is important to inform ourselves of these endless improvements so we are not facilitating our sessions using old and less effective habits/skills. Additionally, the human mind and life experiences are also ever-shifting, and we need to be prepared to effectively respond to these new hardships and positive experiences. We need to make sure that we understand these new skills and ways of facilitating sessions, so we provide the most effective and beneficial therapeutic experience for our clients.

    Reply

    • Beth Martin
      Apr 14, 2021 @ 17:09:13

      Hi Elizabeth!

      I liked your inclusion on how we need to keep up-to-date on CBT/psychoeducation due to the ever-changing nature of conditions! I hadn’t previously thought of that, but it’s such a good point. We need to make sure that we’re constantly learning and developing ourselves for the inevitability that someone may one day present with difficulties we don’t feel particularly strong in etc., or that a client will have a change in their symptoms. Being able to call back on research and training we’ve done is bound to have a huge positive impact on the therapeutic relationship, rather than us struggling to think of what to do and having to do a bunch of research after the fact.

      Thanks for posting!

      Reply

  9. Beth Martin
    Apr 14, 2021 @ 17:05:52

    CBT Myths

    One of the most common CBT myths I’ve heard from professionals and people looking for therapy is that it’s far too rigid and manualized. There’s a belief that, due to it being heavily based in evidence and having set techniques, it’s not flexible or individualized to the client. I’ve heard the last part plenty from those who’ve gone through CBT with a less than great therapist, as they’ve felt like just another nameless patient. It makes me sad, quite honestly, when I hear things like this, as I know that a) it’s untrue and b) enough therapists are out there bad-mouthing something they don’t understand, or practicing it so an extent that their clients are left with a poor impression of it.

    I think the main reason these myths continue to exist is down to the fact that there are professionals out there who may be intimidated by the thought of CBT and talk badly about it, or are poorly trained and don’t understand that CBT is highly focused on the client and can be incredibly flexible. This perpetuates the myth further, in that clients get a poor experience and believe that it’s incredibly regimented/not for them.

    To dispel these myths, I think the best way forward is to become a competent CBT professional myself. Making sure that I’m someone a client will have a good experience will at least end the contribution to the myth on my front. Furthermore, I can really focus on adding quality psychoeducation on the CBT process to clients; even if they don’t complete therapy with me, they know what to look for going forward, and can hopefully spread the message that CBT isn’t cold, clinical, and inflexible. I can also work to make sure that all of my colleagues in future workplaces understand the nuance of CBT if they aren’t practitioners of it themselves, alongside dispelling any myths. This will involve me being up-to-date and well-versed on CBT (which is something I should be doing anyway), and essentially deliver psychoeducation to them too, to make sure that they aren’t perpetuating any negative talk about CBT to their clients and circles.

    CBT Competence –
    Therapists being unwilling to practice any CBT techniques on themselves can be a problem, especially if it’s picked up by clients. Believing that a particular aspect of CBT (daily activity schedule, for example) won’t work for you, or isn’t a good technique can seep into your sessions. Clients can pick up on this lack of belief, which in turn can lead them to think that you aren’t being genuine with them, that you’re recommending techniques you don’t believe in, and reducing their overall hope and motivation for change. An unwillingness to practice CBT on oneself can lead to poorer therapeutic relationships in the future, and worse treatment outcomes.

    Some indicators to determine that you’re receiving quality CBT supervision include someone who is able to observe your sessions live (or recorded if possible), group supervision where an individual can watch others tackle CBT and pick up techniques, and observing other practitioners in general. I think the type of supervision that would be most beneficial to me would be live observation. Prior to coming back to school, I was a child research interviewer for a large lab, and I found that this form of supervision really forced me to be present and cognizant of everything I was doing. Supervisors were able to see how I was working in the moment, and during breaks could point out areas for improvement. I struggled a bit more with verbal reports etc., as I would 100% forget aspects of a session when I had 3 or 4 4-hour sessions a day. There’s also a form of comfort that comes with being observed from behind a one-way mirror too; if something started to go really wrong, there was someone else ready to step in. I believe that this could perhaps be used as a bit of a crutch if I wasn’t confident, but it helped me relax and be more genuine with children knowing I had support if I had a difficult client etc.

    CBT, and therapy in general, is not some fixed profession that is perfect. It is constantly being developed and researched further, and therefore it’s crucial for a therapist or clinician to stay on top of new research and techniques being “released” to the profession. Not keeping up with the updates and improvements can have numerous consequences, but the key ones are that a therapist may be using techniques that are outdated and no longer considered gold-standard for their particular client, or they may be using measures etc. that have been recently shown to be ineffective or harmful to a certain population. Not knowing that there’s a better assessment tool for depression, for example, than one a therapist is currently using can lead to individuals not being assessed thoroughly. There’s also a possibility that one can use a method that was previously shown to be effective, but more research has shown that it may have malingering effects in specific populations. Not being in the loop means that clients don’t get optimal therapy, and it increases the risk of doing harm too.

    Reply

    • Abby Robinson
      Apr 14, 2021 @ 17:50:08

      Hi Beth!
      I think it’s important that you mentioned if a therapist isn’t convinced of using certain techniques on themselves, then it will spill over into their therapeutic relationship with their client. The client will loose hope that the technique will actually work and may lesson their motivation. This will make it difficult to modify any thoughts or behaviors in the future!
      See you in class 🙂

      Reply

    • Brianna Walls
      Apr 14, 2021 @ 19:14:37

      Hi Beth! I completely agree with you, having my supervisor watch me live and then give me feedback works best for me also. I also found it difficult for verbal reports as I too would forget important details of a session. I also find it helpful talking face to face with my supervisor, I believe I get the most out of the feedback this way rather than an email/written report, that way I am able to ask questions and clarify things I do not understand.

      Reply

  10. Abby Robinson
    Apr 14, 2021 @ 17:40:00

    [CBT Myths] –
    1) One common CBT myth we hear often is that CBT is a cold, not personal experience where the therapist only focuses on techniques for treatment. This myth basically says that the relationship between the client and therapist is all technical and there isn’t any personal connection between the client and therapist. When I hear this myth it makes me think that others believe there is no therapeutic relationship between the client and therapist. This myth makes me think that others believe CBT is not malleable or flexible between clients and that all the treatment is the same for everyone. (Even though I know otherwise)
    2) I think that this myth continues to exist because CBT is strongly evidence based treatment, making it sound “too scientific” to be able to talk about thoughts and feelings. I think the wording of “evidence based” makes others think that CBT follows one pathway in treatment because that was what the research found.
    3) To dispel some of these thoughts about CBT being too cold and rigid for therapy, we could educate others and explain that yes CBT is evidence based treatment but that every client is different and that treatment plans and goals are flexible and personalize for every client. We could explain to those people that CBT isn’t a one fix all treatment for clients. Rather every client goes through the CBT process differently and their therapist is flexible in their treatment planning.

    [CBT Competence] –
    1) If a CBT therapist has strong aversions to practicing CBT techniques on themselves, they most likely will have little hope the techniques will work on their client. This will make the client feel as if their own therapist doesn’t have hope for them and this will negatively effect the relationship. If the therapist isn’t motivated by using these techniques on themselves, they most likely won’t be motivated to use them on their client.
    2) Indicators that you are receiving good CBT supervision when the supervisor is well versed in using CBT and that they believe in CBT as a therapeutic orientation. I think how you experience the supervision matters such as an audio recording or a live video. Getting supervision in a live setting would be beneficial because the therapist is there with you or watching you, and can help you in a time of need. OR at the end of the session let you know their immediate thoughts and reactions. Feedback that will be beneficial from the supervisor would be comments and advise for their intern would be helpful because they can learn from their mistakes or learn from the supervisor’s personal experience. I think that using personal experience and advise would be beneficial to the intern because it creates a connection as well as real life experience rather than just reading or hearing about it from a textbook.
    3) Negative outcomes if you don’t stay up to date CBT knowledge and skills be the lack of understanding the most current information about CBT. Since this is always changing and adapting to new generations, being up to date helps the therapist understand why they are doing it a certain way. If the therapist is not up to date on the CBT skills and knowledge currently, they still may be using skills that have since changed or evolved which wouldn’t be as beneficial to their client.

    Reply

    • Brianna Walls
      Apr 14, 2021 @ 19:06:55

      Hi Abby! I too have heard this myth plenty of times; especially now that I am going to grad school for a CBT-based program. Honestly, it makes me so frustrated when I hear people say this, but I know that this myth isn’t true and it gives me the opportunity to clearly define how CBT works. Also, I find it frustrating because you have the people who say it is too evidence-based but then the same people say that psychotherapy isn’t evidence-based at all…CBT is the whole package and they don’t understand that! Okay, rant over (:

      Reply

    • Nicole Giannetto
      Apr 18, 2021 @ 15:07:39

      Hi Abby! I think it is a good idea to ensure that we highlight to people that CBT is an evidenced-based that is also flexible and can be customized to fit the needs of the client. By explaining it this way, I think it hits on both the fact that this type of approach is well supported and can be trusted, but it also dispels the myth that it is rigid since it is an approach that can be flexible based on the client.

      Reply

  11. Brianna Walls
    Apr 14, 2021 @ 19:00:23

    1. One common CBT myth that I have heard is that CBT is a rigid, one size fits approach where a clinician applies a specific technique to a specific problem. However, this is not true because CBT manual-based treatments have enhanced flexibility, creativity, and innovation for a variety of disorders across diverse client populations. It is not one size fits all; the therapist conceptualizes a treatment plan that works specifically for their client. Yes, there are specific techniques for specific problems, but, therapists use these techniques in a way that is helpful for their client.
    2. I believe some of these myths still exist because of the stigma that still surrounds therapy and mental illness. It is getting better, but a lot of people still do not believe in therapy and mental illness. These people have yet to be educated about CBT and therefore they still portray these myths to their peers.
    3. One thing I can do to help dispel some of the myths is to educate my family and friends. Hopefully, if I can educate them they can better understand CBT, and maybe one day they can educate one of their family members or friends who do not fully understand CBT who will then continue to educate others and so on.
    1. It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves because if you do not believe in what you teach why teach it at all? I believe it is important to experience what it is like to be on the receiving end of some CBT techniques. This will help provide the therapist with greater self-awareness and insight and they can use that to translate into greater skill competency and empathy when working with their clients. Also, if you don’t ‘practice what you preach’ and you find some of the CBT techniques stupid, you may make it noticeable to your clients that you are being disingenuous and, in turn, you are reducing their hope and motivation for change which in exchange will lead to poor treatment outcomes. I am grateful that Dr. V had us practice some CBT techniques on ourselves; I believe it helped me tremendously in getting a better understanding of how they work on clients.
    2. Some possible indicators to determine whether or not you are receiving quality CBT supervision is making sure your supervisor isn’t just ‘familiar’ with CBT skills but they practice them daily and inform you that theoretical orientation is important to them. It is very important that you get feedback from your supervisor so that you can get the most benefits from your supervision. I believe constructive criticism is the best feedback you can get from a supervisor; this allows you to work on the skills you are least confident in so you can become the best CBT therapist you can be.
    3. Some possible negative outcomes that could happen if I didn’t stay up to date with CBT knowledge and skills are I may not be able to provide the best possible treatment my client needs. It is important to attend professional conferences, read peer-reviewed articles, books, and treatment manuals, etc. Overall, a competent CBT therapist is able to stay up to date with evidence-based practices so that they can provide the best quality treatment to their clients.

    Reply

    • Yen Pham
      Apr 15, 2021 @ 03:30:09

      Hi Brianna,
      Thank you for your posting!
      Like you, I have heard is that CBT is rigid; one size fits approach where a clinician applies a specific technique to a specific problem. I agree with you that some of these myths continue to exist because of the stigmas that persist and surround psychotherapy as well as people who have yet to be educated about CBT. However, I think these myths continue to exist because CBT is not doing well for everyone, so not all customers have a correct understanding of CBT’s value. Therefore, CBT’s education of values is important to dispel misunderstandings about CBT. I believe it would be very helpful to not only give CBT education to therapists but instead, also educate CBT for clients and those related to them.

      Reply

  12. Alexa Berry
    Apr 14, 2021 @ 20:15:47

    CBT Myths

    A CBT myth I have heard in the past that I would consider common, although not discussed in the CBT myths chapter relates to the nature of people who seek this type of therapy. To elaborate, when an individual shares something “socially deviant”, reflecting distress, or a statement indicative of past trauma/ difficulties/ mental health situations, they are typically met with the response “you need therapy”. This may be more of a misconception than a myth, but it is always something that has rubbed me the wrong way. People seek out therapy, even CBT specifically, for a variety of reasons and it is both stigmatizing and misleading to imply that anybody who deviates from the norm or faces mental health struggles automatically needs therapy. Some people may have processed and moved on from their past traumas/ mental illness/ etc and feel comfortable enough to share it, but then are shamed with the implication that therapy is only for people who have something “wrong” with them psychologically. This myth further contributes to stigma surrounding therapy and mental illness and may perpetuate patterns of individuals feeling uncomfortable seeking help. I think it is very important for people to discuss their experiences with therapy to help normalize the experience and dispel any misconceptions others may hold. Although times are changing and thoughts around therapy are evolving, speaking freely about mental illness and CBT is still at times considered a taboo subject. Personally, I try to educate friends and family as much as possible, especially when I hear a misrepresented or misleading view of CBT.

    CBT Competence

    It can be problematic if a CBT therapist has strong aversions to practicing CBT techniques on themselves because there are various associated outcomes with not seeing the benefit of using empirically supported techniques on yourself. Using CBT techniques on yourself contributes to greater self-awareness and insight that can enhance skill competency and empathy for work with clients. In contrast, an aversion to using techniques is likely to be noticed by clients, which can result in them not having confidence in your ability to help them. In other words, this self-aversion while still using the same techniques in session can come off as disingenuous and can contribute to poor treatment outcomes resulting from a lack of hope and motivation from clients who notice this.
    An indicator of receiving quality CBT supervision is having your own sessions (live or video) supervised by a CBT trained supervisor. It is important to make sure your supervisor has CBT training, so they are able to provide accurate and appropriate assessments and feedback with respect to this theoretical orientation. Some feedback I hope to receive, especially in an internship setting, is feedback on my assessments or any other written parts of case conceptualizations, as well as feedback on my in-session skills.
    Some possible negative outcomes that can result from not staying up to date with CBT knowledge and skills include using outdated skills that may have been modified, as well as neglecting newer techniques that have come out. It is clear that the nature of therapy is always evolving with the development of effective and empirically based techniques and research.

    Reply

    • Althea Hermitt- Mcpherson
      Apr 14, 2021 @ 23:22:46

      Hi Alexa, I am hoping my supervisor is really able to guide me in the right direction and provide feedback and support throughout the practicum and internship process.
      It difficult not to have a CBT therapist for a supervisor but I’m hoping the years of training she has can help me to be an equally wonderful therapist. I agree with you that it is important to make sure your supervisor has CBT training, so they are able to provide accurate and appropriate assessments and feedback with respect to this theoretical orientation. However, CBT therapists are not prevalent in all organizations, and if they are they are working on licensure so not allowed to offer supervision. I am super excited to get on-the-job skills training.

      Reply

  13. Althea Hermitt- Mcpherson
    Apr 14, 2021 @ 23:04:27

    [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?
    One myth that I have come across is that CBT does not address past behaviors. When I hear this I immediately realize this is not true due to the courses I have taken. Even though CBT is more present-focused and utilizes a problem-oriented strategy to focus on the current problems, it also looks at the past to gain an understanding of current thoughts, feelings, and behaviors.CBT also is utilized to address many problems associated with thoughts and beliefs and these can be deep-rooted in childhood experiences.

    (2) Why do you think some of these myths continue to exist?

    People continue to have this viewpoint because CBT looks for ways to improve a client’s state of mind and their immediate distress instead of dwelling in the past. Also, a lack of education on what therapy entails, not to mention CBT therapy, continues to fuel these myths. The old way of doing talk therapy also contributes to people’s perceptions.

    (3) What can you do to help dispel some of these myths?
    I can become a myth buster. Who addresses and psychoeducate people who have false narratives about CBT. I can also show people why CBT works and enlighten them about the wonderful possibilities and the enormous reach of the CBT treatment modality.

    [CBT Competence] – (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?

    I think that if a CBT therapist has any aversion to practicing CBT techniques on themselves this may be apparent to their clients. The therapist may seem duplicitous because they are not practicing what they preach and would also lack insight into what the client is thinking or feeling. Also if you have never completed the technique on yourself it might be difficult to explain and implement the techniques on others. The therapist will not be able to put him/herself in the client’s shoes and therefore won’t be able to be empathetic towards the clients.

    (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?

    I think quality CBT supervision should entail being able to have a safe environment to share with your supervisor any and all difficulties you might have without judgment. I think that a supervisor should be equipped with the necessary skills to be able to effectively help a supervisee. I also feel like constructive feedback would be essential, supervisors should provide proper guidance and be able to highlight when a supervisee is on track or off track by reviewing records or observing sessions and providing guidance.

    (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills?

    A major negative outcome of not being up to date on CBT knowledge is that the therapist might not be providing the most effective or evidence-based treatment to the client. CBT is evidence-based and due to constant advancement and new research findings, it is vital to stay up to date on CBT practices in order to provide the best possible care and the best possible outcome for the client. For example, If a therapist utilizes an outdated technique or assessment tool this can result in subpar care and potentially harmful outcome.

    Reply

    • Yen Pham
      Apr 15, 2021 @ 03:30:52

      Hi Althea,
      Thank you for your posting!
      I agree with you that there is a safe environment to share with your supervisor any difficulties you may encounter without judgment, which is the possible indicator to find out if you are receiving quality supervision from CBT. The more experienced your supervisor is in CBT, the greater potential for you to learn and master CBT skills. I also agree with you that it would be most beneficial to your professional development as a CBT therapist when you receive good feedback from your supervisor. But to get good feedback from supervisors I think it depends not only on the ability and experience of the supervisor, but it also depends on how you record the reports of each session. Therefore, any type of live/recorded session is better than a verbal report because it can provide more contextual information and allows for continuous assessment of therapeutic skills and self-reflection. If we provide this record to our supervisor, we will receive better feedback rather than we provide our supervisor verbal reports, because it can result in forgetting important information, misinterpreting information, and the desire to present oneself in a positive light.

      Reply

    • Nicole Giannetto
      Apr 18, 2021 @ 15:10:26

      Hi Althea! I also mentioned in my post that it is important as clinicians to continue practicing these techniques that we hope to teach our clients. I liked that you included how it is important to stay updated on any changes within CBT or the psych field in general. There is always new research coming through and it is important to be as current as we can so that our clients can receive the best possible care.

      Reply

  14. Yen Pham
    Apr 15, 2021 @ 03:33:31

    [CBT Myths]

    (1) I have heard that CBT is a rigid, one-size-fits-all approach where a clinician applies a specific technique to a specific problem. Hearing such comments, I have some thoughts. I think that although CBT has structured protocols for various disorders, it is not an inflexible treatment that ignores the individuality of the client. CBT requires clinicians to have a detailed and in-depth understanding of every client and their individual needs. Because, of course, everyone is different. Each person has a different history, different circumstances, different qualities and characteristics, and different factors that sustain their symptoms. CBT allows for nuance.

    (2). I think some of these myths continue to exist because some therapists not familiar with CBT have a false belief that too scientific and approach means no flexibility, creativity, or innovation in therapy. Besides, it should be noted that CBT is not doing well for everyone, so not all customers have a correct understanding of CBT’s value. Hence they easily misunderstand CBT.

    3. I can do something to help dispel some of these myths. First, it is especially important that those entering training in CBT are made aware of such myths to avoid any possible self-fulfilling prophecies and/or negatively biased influences. These myths are truly myths – that is, they are not true. Second, I think each therapist must have a good education about CBT and know how to use it, and apply it while working with clients. Third, the therapist should realize that CBT there is a balance between the science and the art of therapy. The priority is not put on how creative therapists feel about themselves but, the priority is put on providing the best possible care for clients based on evidence-based practice.

    [CBT Competence]

    1. It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves because it shows a lack of confidence of the therapist in the evidence-based practice. To increase the competence of therapists in using the CBT techniques, therapists should consider being in the client’s chair to be on the receiving end of therapy with a CBT therapist. By being a client, therapists can learn what they find helpful and what they did not find helpful, ranging from basic therapeutic alliance skills to specific CBT skills. Therapists may consider modifying their therapeutic approach after having more awareness of particular experiences from their clients’ perspectives. They also consider managing their distress as good for their personal growth and the well-being of their clients. Like learning any new skill, therapists will learn the most through continuous practice and application. Just like with their clients, if there is some initial anxiety (which is completely normal!), “confront” your apprehension by gradually integrating new behaviors/skills into their daily practice. I believe that with time and support (i.e., supervision), they will find that their anxiety will decrease while their self-efficacy as a CBT therapist increases.

    (2) There are some possible indicators to determine if I am receiving quality CBT supervision. First, I must receive CBT supervision as part of my training and post-graduate practice. Second, the more experienced my supervisor is in CBT, the greater potential for me to learn and master CBT skills. I think would be most beneficial to my professional development as a CBT therapist when I receive good feedback from my supervisor. So, ideally, it is best to have my supervisor observe my sessions live (e.g., one-way mirror, video feed, or ear bud). If this is not possible, then video or audio recorded sessions are also appropriate. Often, verbal reports can result in forgetting important information, misinterpreting information, and the desire to present oneself in a positive light. Therefore, any type of live/recorded session is better than a verbal report because it can provide more contextual information and allows for continuous assessment of therapeutic skills and self-reflection.

    (3) There are some possible negative outcomes if I do not stay up to date with CBT knowledge and skills is that I might have low self-efficacy, I then might misunderstand clients’ problem. In other words, it due I do not stay up to date with CBT knowledge and skills, clients’ problems and associated distress are not appropriately assessed. Therefore, I might less capacity to apply the best treatment for my clients. Receiving feedback from my supervisors and other experienced CBT therapists on my CBT case formulation is a great way to enhance my CBT conceptualization skills.

    Reply

    • Pawel Zawistowski
      Apr 16, 2021 @ 22:52:10

      Sr. Yen,
      I really like that you mentioned self-efficacy as a reason to stay up to date with CBT. I can see how not being up to date with CBT knowledge and skills could hurt your confidence and belief about your own abilities. In addition to that, I think that staying up to date helps you understand newest research and techniques that are being developed which will allow you to continue to better yourself as a clinician.

      Reply

  15. Connor Belland
    Apr 15, 2021 @ 13:52:27

    1. The myth about CBT that I seem to remember the most is that it is all about positivity and changing negative thoughts into positive thoughts when in reality that isn’t the goal. The goal is to get the clients to be having more neutral thoughts and feelings if anything. Not getting clients to become happy but more just not be sad. Most People just aren’t aware or are fully educated on what CBT really consists of which is why we continue to see misconceptions about it. We need to educate people around us if they do not understand what CBT is and if they have misconceptions about it. We can also describe the basics of what CBT is as sort of psychoeducation to our clients at the beginning of therapy to give them a basic understanding of what CBT is.
    2. If therapists don’t want to practice CBT methods on themselves then they won’t have an accurate understanding of how they work. Doing these methods helps them to see how it makes them feel and how they impact them which will better help them explain it to their client as well as relate to their clients. Of course it will also greatly help the therapist empathize with their clients and understand what they might be going through when going through some of these CBT techniques in therapy sessions and when doing homework CBT activities. I think the best supervision is constructive and helps you grow as a therapist. I would want to be told by my supervisor what I could improve upon or incorporate that is CBT related without just having me copy exactly what they do in therapy, because every therapist has a different style and what they do might not work the same for me. Also visual and real time examples are what people learn the best from not just hearing about what to do, they learn the best from actually doing them. A good supervisor is always looking to grow themselves too and learn new aspects of becoming a better therapist. It is important to always stay up to date on the CBT world because it is so important to always be learning and growing as a therapist. CBT is a science and things are always changing and new discoveries are always being made that could improve therapy or even help teach you things that could make someone a better therapist or even stop them from doing a technique that might be shown not to be as effective anymore. The world is always changing as well and therapists need to adapt their styles to the ever changing societal factors.

    Reply

    • Maya Lopez
      Apr 15, 2021 @ 15:34:55

      Hey Connor,

      I think at one point in my life I used to believe this myth that therapy was all about making the client happier but it’s rather getting the client to think logically, rationally, and improve their functioning. As we have learned in class, this is accomplished by examining and challenging our thoughts, emotions, and behaviors. Perhaps some people think CBT just attempts to change a client’s thinking so that it is all positive but that is not realistic. I agree that these misconceptions stem from a lack of education therefore increasing psychoeducation with clients, colleagues, friends, etc, will help decrease perpetuating the myth. Also, I like how you mentioned a good supervisor will be looking to still grow. This is so important because although the supervisor will know more than me, I would hope they do not think they know everything because they should be open-minded too and continuously aim to learn more and improve themselves as well.

      Reply

    • Zoe DiPinto
      Apr 15, 2021 @ 20:10:07

      Hey Connor!

      Your phrase “CBT is a science” stuck with me. It makes me think about the myths around psychology as a whole. I’ve had some friends challenge me in conversation and say “psychology isn’t hard science.” Many colleges call psychology a “soft science.” What does this really mean? Does it mean psychology isn’t as valid as chemistry, biology, or physics? I’ve thought a lot about the psychology stigma and how it refuses to fit into the “science” or “humanities” category. Many people have an aversion to psychology because they are off-put by the lack of concrete data, testing, and results. However, CBT values qualitative evidence to a scientific point. Due to psychological evidence being more qualitative than quantitative, people are less likely to see it as “valid.” At first, I believed CBT to be trying to close the gap between hard sciences and psychology by trying to make results or quantitative. As I learn more about evidence based practices, I discover that CBT is more-so proving that qualitative evidence IS valid itself.

      Reply

  16. Carly Moris
    Apr 15, 2021 @ 14:31:09

    CBT Myth
    1. One myth about CBT that I’ve heard is that CBT is more technical and that it puts little value on the client therapist relationship. That it uses more rigid and mechanical techniques that do not allow the client and therapist to establish a close relationship. When I hear comments like this it makes me think that the individual saying them is uniformed about what CBT actually is, and that they are just operating based on their preconceived notions about the techniques. This is because CBT techniques are useless if you do not establish a strong therapeutic relationship. The client needs to trust the clinician and feel like they can open up to them for these techniques to be effective.
    2. I think that some of these myths continue to exist because a number of professionals in the field are uninformed about CBT, and they have made assumptions about CBT based on little information. I also think that some professionals may feel defensive about their own techniques and practices when they hear that CBT uses evidence based techniques. They may feel that this is an attack on their more traditionally oriented techniques, like for psychoanalysis.
    3. I think one way to help dispel these myths is to be open to talking to other professional counselors from different theoretical backgrounds about different therapeutic styles and techniques. It is important to have open and honest conversations about how CBT works, as well as listen to other professionals about the benefits of their techniques and theoretical ordinations. By being open to hearing about others approach to therapy they are more likely to be willing to hear about CBT. This can be helpful because we can learn about other approaches and helpful techniques as well. I also think that recommending or getting involved in continuing education credits/classes that talk about or teach CBT techniques can be a good way to spread accurate information about CBT to other professionals. It is also important that we are willing to talk to the general public and answer questions people may have about what CBT is and how it can help.
    CBT Competence
    1. It is important for CBT therapists to be willing to practice CBT techniques on themselves. Practicing these techniques on yourself is a great way to gain a greater understanding of these techniques and potential challenges your clients may face when completing them. This allows you to be more competent in these using these techniques. As well as, enable you to be better able to collaborate with a client when using the technique. Completing these exercises also allows you to have a greater empathy for the client, and an understanding that these exercises can be challenging or distressing. Practicing CBT on yourself can also help you monitor your own mental health, and help ensure you are not bringing your own issues into therapy with a client.
    2. One possible indicator that you are receiving good CBT supervision is that the supervisor is using a standardized form or checklist like the Cognitive-Behavior Therapy Supervision Checklist to monitor and evaluate our progress. As we have learned it is important to use standardized assessments in order to competently, accurately, consistently assess clients. The same rules apply to supervisors assessing us and our skills in CBT. A standardized assessment of us will help ensure that the supervisor is assessing a number of important skills and areas for competent CBT. This standardized feedback will also help us see our own progress; what areas are our strengths; and where we need improvement. I feel like I would like my supervisor to let me know what I am doing well with, as well as areas that I can improve, and advise on how to do so.
    3. If I do not stay up to date with my CBT knowledge and skills the techniques I am using may become outdated and not as helpful to clients as the could be. CBT is based on evidence based practice so it is important to stay up to date on new research and developments to ensure you are using techniques based on relevant research and information. It is important to be up to date on any relevant changes in the field so that you can modify your practice to fit any new standards to help ensure you are providing the best quality of therapy to your clients. Also if you do not stay up to date on your CBT skills and do not receive accurate CBT supervision, overtime your CBT skills may deviate from standard CBT practices without you realizing. This means that you can be providing inadequate treatment to your clients. As well as, possibly misrepresenting your skills and practice.

    Reply

    • Lina Boothby-Zapata
      Apr 15, 2021 @ 21:15:17

      Hi Carly,

      I totally agreed with you that people can perceive CBT just as a technique and I also think can be a risk for the therapist, who can become a technician instead. One of the elements that I learned watching the role-plays is that the techniques are only instruments that support and enhanced the therapeutic process between the counselor and the client. Hence, the methods, techniques, and forms are one of the features in the therapeutic process, but it is not everything. It’s a piece of the puzzle. I agreed with you that the therapist needs to establish a positive building rapport and at the same time, the therapist needs to create a collaborative environment with the client to obtain successful therapeutic effects and insights from the client. Otherwise, it can become a therapist’s monologue.

      Reply

  17. Zoe DiPinto
    Apr 15, 2021 @ 15:05:06

    1)One of the myths that I have heard about CBT (as also mentioned in the lecture) is that CBT is only focused on thoughts and behaviors and does not value emotions. At first glance, I can understand how this myth evolved from people’s perceptions of behavioral therapy. I learned in some of my undergraduate classes that CBT is a modernized version of behavioral therapy. I also learned that behavioral therapy challenges psychodynamic theory by valuing the present moment over the past. I believe this aspect of the therapy still remains true. However, CBT is much more than only examining and changing behavior. 2) I believe a lot of these myths continue to exist because therapy is difficult to understand for many people. There are still many individuals who cannot understand that a professional may be able to guide them to have a healthier mind. Many people in my life have challenged the idea of therapy– jumping at the chance to argue that it isn’t a hard science and therefore isn’t based in anything true. 3) I believe we are able to dispute these myths with education about the different goals of therapy. I also believe it is more important than ever to continue doing research to provide evidence for therapeutic practices that support positive change in people and decrease the mental health stigma.

    It can be a large problem if a CBT therapist has a strong aversion to practicing CBT themselves. The saying “practice what you preach” has meaning in our field. One wouldn’t want to have a surgery that the surgeon would not want to receive if the roles were reversed. Our future client’s mental health is fragile and very important. A good therapist will believe in what they are teaching. A therapist who has aversion to their practice is less likely to care about their patient’s well being and put in a full effort. 2) A good supervisor will give continuous feedback about ways to connect and progress with clients. A supervisor with experience in CBT may have genuine well-researched input to implement. Feedback that is specific to CBT techniques and generalizable to many clients may be very beneficial in the future. 3) If one does not stay up to date with CBT knowledge and skills, they are at risk of falling behind other emerging clinicians and practicing techniques that may not be the most beneficial to their client or outdated compared to new techniques.

    Reply

    • Maya Lopez
      Apr 15, 2021 @ 15:26:54

      Hey Zoe,

      I certainly agree most people have these myths due to a lack of proper education of what CBT is and you have a good point that since it derives from behavioral therapy there wouldn’t be a huge emphasis on emotions, and I can see just by the acronym CBT it doesn’t even mention emotions like CBET or something like that so it makes sense people may believe this myth. That being said, it appears the best way to combat the myth would be just to educate others that it is not true and the ways emotions are very involved in CBT. I also liked the analogy you gave that a surgeon not wanting the same surgery would be a little suspicious. And the same is for therapists who fail to see the use of practicing CBT techniques on themselves or even therapists who look down on other therapists for receiving therapy! That drives me nuts because it perpetuates the negative stigma!

      Reply

  18. Maya Lopez
    Apr 15, 2021 @ 15:17:21

    (1) Identify at least one common CBT myth you have heard from other people/professionals. What are your thoughts when you hear such comments?

    The myth that CBT only focuses on thoughts and excludes emotions is not true as emotions are often what clients are most comfortable stating early in therapy and are less aware of their thoughts. Emotions and feelings are continuously relevant to therapy as therapists tend to check in with their clients about how they feel throughout the therapeutic process and will ask them to rate their distressing emotions and even physiological feelings. It makes me question why people say emotions are not emphasized much in CBT. I don’t feel offended or anything when I hear that myth because I know it is false and someone saying that likely just doesn’t understand CBT very well. It also would be harder to steer away from emotions even if a therapist tried to, emotions are so intertwined in our thoughts and behaviors it would be impossible to exclude them completely.

    (2) Why do you think some of these myths continue to exist?

    Perhaps some therapists do not do a good job of validating how clients are feeling and they may then feel their emotions are not being recognized, heard, or relevant? Or perhaps due to the heightened emphasis on thoughts and behaviors, emotions are easy to feel like they are being overlooked.

    (3) What can you do to help dispel some of these myths?

    I suppose a way to help dispel these myths is to address them openly, using psychoeducation in therapy with clients who are suspicious and may believe these myths and explaining to them why they are false could be helpful, or holding a seminar addressing common myths could be helpful in educating more people especially other therapists and coworkers.

    (1) How can it be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves?

    It can be problematic because these therapists are not aiming to foster more self-awareness, empathy for their clients, or insight into their own thoughts. It impacts the effectiveness of their therapeutic techniques as well. It also could affect a client’s motivation if they notice the therapist doesn’t even believe in the techniques enough to use them themselves, it may come across as disingenuous.

    (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?

    Good quality supervision should come from a trained CBT-oriented therapist, they should take the time to watch a live session or obtain video sessions to observe properly. Beneficial feedback for my professional development would be hearing about what needs to be improved upon during individual stages of each session but also the overall therapeutic process with a client. I also would expect feedback upon my case formulation and treatment plan. It would also be helpful to know what is effective so that I can continue to do those things.

    (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills?
    Some negative outcomes, if I don’t stay updated with new CBT knowledge and skills, could be not providing effective treatment for clients, falling behind when discussing cases in meetings, decreasing positive client outcomes, and general incompetent feelings within the field.

    Reply

    • Zoe DiPinto
      Apr 15, 2021 @ 19:47:41

      Hi Maya!

      I agree that a great way to confront myths about CBT is to use psychoeducation with clients and colleagues. I’ve been thinking about the use of psychoeducation with colleagues vs clients. As a beginning clinician, I fear I will be too timid to correct my colleagues on the practice of CBT. I will likely be starting an internship soon at a facility that is not focused in CBT. I feel comfortable staying quiet and learning from those around me for a while, but I have been worried about the future in which I may want to practice CBT techniques with my clients. I wonder if it is common for supervisors to advise against CBT techniques if they aren’t familiar with them? Should I be prepared to defend what I am learning at assumption to my supervisors? If I want to practice CBT after graduation, will I need to find an organization that specializes in it? Or are many organizations open to all kinds of counselors?

      Reply

  19. Christina DeMalia
    Apr 15, 2021 @ 15:51:07

    (1)
    One common myth I’ve heard about CBT is that it can be more rigid or cold than other forms of therapy. I think that CBT does offer a lot of structure and is and evidence based practice, and therefore might be more formal than some other forms of therapy offered. However, I know that CBT relies on similar principles to other therapies, including genuineness, empathy, and unconditional positive regard. Therefore, thinking that the structure of CBT makes it cold or rigid is incorrect.
    (2)
    I think some of these believes may continue to exist because people have not experienced CBT first hand, or they are not willing to be trained in CBT. For someone who has been a practicing therapist using another theoretical approach, they could be hesitant to make any changes. Even if they look at some parts of CBT, they may still view them as too rigid or structured if they don’t put all of the different elements together to fully understand the purpose of each individual aspect of CBT.

    (3)
    One thing that I already do to dispel some myths is to tell others about CBT in the way I understand it. Any time one of my friends or family is looking to receive therapy, I always highly suggest CBT, along with detailed explanations as to why I support that approach to therapy. By explaining the proven effectiveness and efficiency of CBT, I help people around me to look into CBT and better understand it. As a professional working in the field, I can utilize all of the various elements of CBT effectively so that my clients are educated about CBT, see how it works, and can experience its effectiveness while still having a kind and caring therapist.

    [CBT Competence] – (1)
    An important part of CBT, and many forms of therapy, is genuineness. It can be very hard for a therapist to genuinely suggest exercises to clients and explain their effectiveness if the therapist themselves wouldn’t complete them or doesn’t find them helpful. There is also a good chance that if the therapist had an aversion to using the techniques on themselves, that the therapist may not fully understand how to adapt and fit some of the techniques to fit the needs of each individual. If a therapist cannot see the use in a CBT technique, it is unlikely that they would be able to provide psychoeducation to the client about the exercises usefulness.
    (2)
    One indicator might be if the supervisor is unaware of CBT techniques, if they are aware but don’t think it is important to use them, or if they are using them incorrectly. If a supervisor is doing things like not telling the client their own diagnosis, not structuring sessions and instead just catching up with the client each session, or assigning homework but not following up, those are all red flags. If a supervisor is unable to use CBT effectively, it is unlikely that they will be able to offer helpful insight on implementing CBT. In terms of feedback from a supervisor, I think that thoughtful, constructive feedback would be the most useful. Although negative feedback can sometimes be hard to hear, a supervisor who only ever gave positive comments and said I was doing great would not be helpful at all and I likely wouldn’t be able to learn anything from the experience. However, it would also be difficult to gain confidence in my skills if everything I said or did was harshly criticized by my supervisor. Therefore, I think a good supervisor will be able to prioritize what areas should be focused on most, and give feedback around those areas before moving on to smaller details and areas to work on.
    (3)
    Psychology in general, as well as therapy, is a constantly growing and developing field. New studies are published every day that give us more information and a better understanding of mental health, and its treatment. Because of this, it wouldn’t be useful to learn about CBT once and continue to use the exact same knowledge to practice for the next 40 years. If a therapist does not stay up to date on new knowledge and skills, they risk using outdated methods on their clients. As a therapist, we will have an obligation to offer our clients effective care and do what will benefit them. Using outdated and possibly less effective care could result in worse outcomes for the clients, ranging from little-to-no improvement in their presenting concerns to even worse outcomes than when they entered therapy

    Reply

    • Lina Boothby-Zapata
      Apr 15, 2021 @ 21:07:07

      Hi Christina,

      One of the myths that strongly stick to me is that CBT can be a recipe cookbook, this is because CBT has a significant role in implementing techniques, as we see in this class. Hence, therapists have the risk of using the CBT as a manual, looking in the client’s symptoms, and applying techniques appropriate to their needs. The result is that the therapist can overlook the client as a human being. What are your thoughts about this myth? I appreciate the way that you tried to dispel those myths and explain to family and friends about CBT. Personally, in my social work field what I do is to make sure that the children and youth that I referred to outpatient services due to their traumatic experiences are receiving TF-CBT or at least have a CBT orientation.

      Reply

  20. Laura Wheeler
    Apr 15, 2021 @ 15:57:52

    [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?

    The two main myths I have heard about CBT are that it does not focus on emotions, and that it does not care about the past (particularly, trauma). In part, I understand where these myths came from and why people think they are true. However, I have learned extensively through the program that CBT requires the inclusion of emotions- as we practiced in the methods of exploring both automatic thoughts and core beliefs, these things are uncovered through the elicitation of intense emotions. As for CBT not focusing on the past, again, I understand to a degree. With that being said, I have since learned that CBT is really deeply focused on helping clients to find solutions and greater adaptive functioning and that the past is involved primarily when it is relevant to the problem the client is facing.

    I think some of these myths continue to exist because of either: clients who felt as though they had a negative experience and then share that with others, or those who are not trained in CBT sharing things that they perceive to be true but are not actually informed on. Other myths we have read about, such as CBT being too rigid or mechanical I think continue to exist because there is some truth to it on paper if you don’t understand the rest of the process or are not trained.

    I think all of us, when we are officially trained and licensed professionals, can speak to our clients and prospective clients about what CBT truly entails, talk to them about the myths or concerns that they’ve heard, and do our best to practice true and effective CBT, which does not legitimately support any of the common 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?

    I think it would be really problematic if a CBT therapist had a strong aversion to practicing CBT techniques on themselves. I personally found that practicing the activities and worksheets was not only helpful to me personally (because these techniques obviously work) but also in that I will be able to understand and appreciate the value in what I am asking future clients to do. If a medical doctor prescribed me a medication and then told me that they themselves would never take that medication, I would be deeply concerned and would not want to take it myself. As the professional, I think it is important that we stand behind the things we are asking of our clients and we shouldn’t be asking them to do something we wouldn’t be willing to do ourselves. In addition to the sort of moral/ethical/professional aspect of it, I think that it is of the utmost importance that we have a very clear understanding of what the experience of CBT is like for clients.

    I think helpful feedback from my supervisor would be in regard to strategies that I could improve upon, and methods to accomplish that. I think it would be important to have a supervisor who is well trained in CBT and able to help me increase my skills.

    I would be afraid that if I didn’t keep up to date with CBT knowledge and skills that I would not stay current on new developments, such as more culturally sensitive assessments. It is important to maintain a level of education in order to always be making progress.

    Reply

    • Connor Belland
      Apr 16, 2021 @ 09:45:15

      Hey Laura,
      I think a therapist not practicing what they preach would definitely be problematic like you said. I really like your example of a medical doctor prescribing medicine and then saying that they wouldn’t take it. It just isn’t as believable for the patient and would not help the client trust their doctor or therapist in this case. A therapist needs to know how CBT truly works and the only way they can achieve that understanding is if they have practiced it on themselves.

      Reply

  21. Timothy Cody
    Apr 15, 2021 @ 16:00:52

    [CBT Myths]
    I have heard the myth that CBT is a fancy approach to positive thinking. I believe I first heard this rumor from some professors at Assumption during my undergrad who are not in the psychology department (I believe from the Philosophy Department). While CBT does what it can to improve the morale, thoughts, and emotions of the individual, it does not discount negative thoughts and emotions. As we have learned in Dr. V’s class, some negative thoughts are valid, and it is very common to feel negative emotions. If a client is dealing with the death of a loved one and is not feeling sad, then I would be more concerned. CBT focuses on realistic or rational thinking and emotions in a particular given situation. I think people believe therapy in general helps people to feel better and there for feel more positive, so they do not dispel these rumors but rather feed into them. I would do my best to use psychoeducation those around me, even those professors and professionals I disagree with.

    [CBT Competence]
    Clients learn by example. If they do not see the therapist regularly practicing CBT techniques on themselves, they may not see the rime or reason to do it either. Clinicians who regularly check in on their own mental health through the practice of CBT and evidence-based techniques will not only be able to learn more from their own experience, but be able to build rapport with the client and develop a strong therapeutic relationship. Therapists who have a strong aversion against some of the techniques they are requesting their clients to perform will not be able to effectively implement the technique well. CBT Supervision is a key part of becoming a good CBT clinician. Not only do you develop a strong relationship with your client, but with your supervisor as well. They should take an interest in your performance, not just through a verbal or written report, but through reviewing live sessions or co-running them with you. This shows that they have taken an interest in your career, want to see you succeed, and are ensuring that you are using the necessary skills to adapt to a CBT Professional relationship. The feedback you receive should be a mix between positive and critical. Clinicians should not feel like they know everything after their years of education and experience, but rather should be looking to gain new skills from their supervisors and advisors. If they do not seek to improve their trade and practice over time, they become arrogant and selfish in their careers.

    Reply

    • Connor Belland
      Apr 16, 2021 @ 08:49:46

      Hey Tim, I had heard a similar myth about CBT that everything is positive and you are trying to make the client feel happy. But I like what you said about getting the client to thing more logically and rationally instead of trying to make them happy, you made a good example of a client mourning a family member, we wouldn’t want to try and make them feel happy because that wouldn’t be right, just to think more rationally.

      Reply

    • Alexa Berry
      Apr 17, 2021 @ 15:27:34

      Hi Tim,

      I think something that could have contributed to the myth of CBT being positive thinking is the rise of the positive psychology movement. While it is certainly interesting, and includes empirically based techniques as well, I see why someone who is not in the field may be confused. Naturally, people who don’t know the basics of CBT themselves are the ones to perpetuate falsehoods and misrepresentations, which is why I agree with you when you imply it is important to utilize psychoeducation with those who may hold misrepresented views.

      Reply

  22. bibi
    Apr 15, 2021 @ 16:11:19

    [CBT myths]
    1. One myth that I remember hearing about CBT was that there was no flexibility in it, that CBT sessions were structured really specifically and did not allow any room for clinical judgement or flexibility because of the way that each session is structured.
    2. I think that this myth exists just based on how generally CBT sessions can be structured. It seems like there are a lot of things to get through to cover skills for CBT so it would appear that sessions were rigidly structured. However, contrary to this myth, the sessions are really client driven and the there is a lot of room for clinical judgement still.
    3. I think the main way to dispel this is just through information. I think that just talking to people about what CBT actually entails is important and letting them know how sessions are actually structured it what it will take to dispel the myths.
    [CBT competence]
    1. I think that, based on being in this program, the best way to learn the skills is to practice them on yourself. If you’re scared to practice on yourself, how are you supposed to understand the client perspective? I think that clinicians who don’t practice on themselves really cheat themselves out of knowing the client experience.
    2. I think that constructive criticism is incredibly important. I don’t think a supervisor that just tells you all of the good things they did helps at all. I need to know what I did wrong and how I can improve on it to really get the most out of supervision situations. I have a supervisor right now in ABA and I think the most helpful thing about our supervision is that I can ask her a million questions and she is willing to demonstrate the proper techniques to me which is helpful.
    3. CBT is an evidence driven treatment. If you fail to stay up to date in the field, you aren’t staying up to date with the latest evidence for or against certain skills. I think that it is super important to keep up to date with emerging research to be able to provide the best information to clients as well as to teach them the most effective skills.

    Reply

    • Tim Cody
      Apr 15, 2021 @ 22:36:00

      Hi Bibi,

      Thank you for sharing your thoughts on CBT Myths. I agree that I had originally thought that the sessions were set in stone and rigorous. However, after learning more through the program, I believe there is room for flexibility based on the client’s needs and their control of the sessions. By the way, I watched your Role Play today, and I think you did a great job in allowing for the client to take control of the therapy session. You allowed Alexa to share her thoughts and emotions frequently throughout the session and that showed that you were interested in her well being above anything else.

      Reply

    • Alexa
      Apr 17, 2021 @ 14:51:06

      Hi Bibi,

      I agree with your rationale for why some people think that CBT is very rigid, or lacks room for flexibility. Something that helped me put this in perspective was the skills we learned in Dr. Stoner’s class last semester. You make a good point that CBT is still client driven, because as a CBT therapist it wouldn’t make sense to be assigning a client homework who isn’t ready for it yet. I think something that contributes to this myth is managed care, so I’m glad that therapy is evolving to become more accessible. I can imagine that being told you only 8-10 sessions to work through something distressing can also make it feel like there isn’t any room for flexibility.

      Reply

  23. Anne Marie
    Apr 15, 2021 @ 17:15:28

    When I was young I thought the goal of CBT therapy was to get happy. I believed it to be positive thinking despite the stressors of life. I did not realize that the ultimate goal was to assist people to have coping strategies to manage with life events adaptively. In addition I think there is a myth that CBT therapy is an easy, quick therapy to learn and implement. For example, I have heard people describe it as just learning how to think it, feel it, act it. These myths continue to exist due to a lack of education about what CBT is. I can help dispel these myths by providing education to clients and other professionals in a constructive manner.

    I have no idea why a future therapist would be averse to practicing CBT techniques on themselves. If anything I would think it is safe and practical to practice skills on themselves verses initially practicing on clients with limited skills. I may assess quality CBT supervision, if they are using evidenced based practices including assessments. I am able to accept feedback fairly well and I would want a supervisor to give me honest feedback about my strengths and challenges. I think it is essential to stay up to date with CBT knowledge and skills as there is ongoing scientific evidence supporting skills. Generally, as time goes on we get smarter about the best way to do things and it is essential to stay relevant.

    Reply

    • Lina Boothby-Zapata
      Apr 15, 2021 @ 20:51:29

      [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 heard a lot of myths about CBT. One that sticks to me and I have been trying to figure out is that CBT is systematic, and therapists treat the clients only with techniques. Hence this is an issue because CBT therapy can become a recipe cookbook. This means that CBT has the risk of being reduced to a technique instead of a theory, and CBT only addresses symptoms and doesn’t look at the human being.

      (2) Why do you think some of these myths continue to exist? I think that CBT therapists may fall into this category if they are not aware of this risk. The therapist may become skillful about implementing the techniques and forget about the client. Another reason is that people tend to generalize, and they don’t have information or knowledge about what CBT is. They can assume that it is a technique or is just someone that gives you homework for home.

      (3) What can you do to help dispel some of these myths? One of the elements that I learned watching the role-plays is that the techniques are only instruments that support and enhanced the therapeutic process between the counselor and the client. Hence, the methods, techniques, and forms are one of the features in the therapeutic process, but it is not everything. It’s a piece of the puzzle. Furthermore, I also learned that the therapist needs to establish a positive building rapport with the client to engage him in exploring his Automatic thoughts and core beliefs. In other words, the therapist needs to create a collaborative environment with the client to obtain successful therapeutic effects and insights from the client. Otherwise, it can become a therapist’s monologue.

      [CBT Competence] –
      (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves? I have never participated in CBT therapy, but how can we promote something that we have not experienced or have an aversion to doing? It is like asking our clients to do something that we don’t believe in or dislike. I think this will negatively impact our clinical practice. Contrary, what can be helpful is to have the best knowledge of completing these techniques by ourselves. Identifying our negative automatic thoughts and core beliefs will equip us with a better understanding of what we are looking for when we are trying to identify the clients’ NAT and CB. The expectation is that as a therapist, we will skillfully drive these techniques to implement with the client. At the same time, the therapist must provide psychoeducation to the client to understand the goal, purpose, and activity. Again, the therapist needs to be skilled in applying these techniques and the best way to do it is to integrate theory and practice, the practice on applying these exercises by ourselves.

      (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? One of the first steps that I am taking for my internship is looking at the agencies’ options and research Linkedln the number of people that the agency hires Counselors from Assumption University. This first step will guarantee that at least when I do my application, it is high probability of obtaining a Supervisor with CBT orientation. During the interview, I can express my interest in having a CBT Supervisor. During the Supervision, I think I will be looking into clinical case presentations and discussions with my Supervisor, her/his recommendations, suggestions, and clinical observations. I will also be expecting to talk about techniques, assessments, and case formulation. I will say that this will be my signs to initially looking for a positive and productive Supervision

      (3) What are some possible negative outcomes if you do not stay up to date with CBT knowledge and skills? CBT therapy is based on science, and science is constantly changing, advancing, and providing new alternatives, techniques, and interventions to the CBT. For example, it could be a better technique to treat panic attacks in the short future than the In Vivo Exposure can be created with more effective results. Our responsibility as therapists is to provide the best for the client based on the client’s needs and the techniques that the CBT offers at the moment

      Reply

    • Timothy Cody
      Apr 15, 2021 @ 22:31:04

      Hi Anne Marie,

      Thank you for sharing your experiences with regard to the CBT Myths. I had some similar experiences in regards to positive thoughts and emotions. After a while a realization came to me: what would a therapist say to a tragedy in their client’s life? The correct reaction would be for them to feel emotional and sorrowful and have a number of negative thoughts going through their heads. I think this is a healthy reaction to a tragedy, and the CBT therapist should not attempt to stop the sadness. Instead, they should give their clients the tools as to how to manage and cope with their loss in a healthy manner so no maladaptive behavior becomes of the situation.

      Reply

  24. Nicole Giannetto
    Apr 17, 2021 @ 23:45:58

    (1) Identify at least one common CBT myth you have heard from other people/professionals. What are your thoughts when you hear such comments?
    One common CBT myth that I have heard is that this type of treatment does not address emotions, and is also quite rigid compared to more traditional psychodynamic therapies. I think in many ways people still view therapy as being a 45 minute- hour session dedicated to a client getting to vent about problems and having a therapist listen and offer support. While this is still true to an extent in CBT, this type of practice integrates techniques that may be viewed as rigid as it calls for the client to engage in “work” in addition to being able to release all of their feelings. In reality, it consists of a balance of the classic conversational therapy combined with the integration of CBT techniques.

    (2)I honestly believe not enough people know about CBT and other therapies such as DBT to begin with. In my own experience, I was working with a client and asked this person if they had any prior experience seeing a therapist. This client said they had been seeing the same therapist for well over a year and had seen no progress. This patient explained that they felt this therapist was good to vent to, however, they felt they needed more from the relationship than just sympathy. This is where I jumped in and mentioned CBT and DBT, and other therapies, that add a whole other level to the conversation-based therapies that we commonly think of when we imagine therapy in action. I explained to this patient that therapies like CBT are great for when we are ready to ‘put the pedal to the metal’ in regards to bettering ourselves. This patient had never been introduced to CBT, but after I provided them with a brief overview of what its function is and explained that there are therapists that specialize in this kind of therapy, they seemed to be motivated to learn more.
    (3)
    To dispel some of these myths, I can continue learning about CBT and sharing my knowledge with others. I think that through practicing CBT techniques on myself, I will be able to better explain this therapeutic approach and can come off to people as being relatable since I am speaking from real experience and not just from what I have read.

    [CBT Competence] –
    (1)
    If CBT therapists have a strong aversion to practicing CBT techniques on themselves it will be likely that they will not be as effective in helping patients than they could be if they actively engaged in these techniques themselves. There’s something to be said about “practicing what you preach”. When we do this, not only do we become more knowledgable and more comfortable in what it is that we are trying to teach/preach, but the individual(s) that we are teaching will be able to tell that we as clinicians are confident and competent in what it is that we are engaging in.
    (2)
    I would feel that I am receiving quality CBT supervision if I am consistently meeting with my supervisor to review my performance in terms of my counseling skills, specifically my ability to put my knowledge of CBT into practice. Feedback I would want to receive from a supervisor would be on identifying what kinds of interventions I should implement with clients depending on their presenting problem.
    (3)
    As a clinician, if I don’t stay up to date with my knowledge about CBT and related skills then I risk losing my credibility which would direct how effectively I can work with clients. I think that through being consistent with engaging in CBT techniques, I will become even more comfortable in teaching my clients how to practice the skills themselves. I would also be able to pick up on things that may be helpful or unhelpful when it comes to working on CBT techniques.

    Reply

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Adam M. Volungis, PhD, LMHC

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