Beck Institute Blog

Special Announcement: CBT Training Scholarship Contest

February 4th, 2010

We will be awarding full tuition scholarships to our 3-Day Workshop, which runs periodically through the year. Graduate students, faculty, residents, and post docs of any mental health discipline, should email the following to education@beckinstitute.org:

- a letter (no longer than one page) describing their exposure to and experience in CBT and their involvement (if any) in CBT research. They should also describe how they intend to use CBT in the future. The letter should contain their name and email address.

- their CV/resume

The deadline is March 1, 2010. Winners will be notified within three weeks of that date.

Trainees in this program come from around the U.S. and abroad. They range from graduate students and faculty to mental health and health professionals who work in a wide variety of outpatient, inpatient, medical, and academic settings. Trainees’ prior experience and expertise in CBT range from basic to advanced.

Training is interactive and is conducted by Aaron T. Beck, M.D., Judith S. Beck, Ph.D., and other senior faculty. Trainees typically spend their time attending training sessions, viewing DVDs of patient sessions, participating in case discussions, roleplaying, and watching, and then discussing, a live patient session with Dr. Aaron Beck. Click here for complete details and dates, or visit www.beckinstitute.org.

Posted in Beck Institute, Cognitive Behavior Therapy, Cognitive Therapists, Cognitive Therapy, Cognitive Therapy Training for Professionals, Training | No Comments »

New Research Makes Important Steps in the Study of Emotion Generation

February 3rd, 2010

Past research has shown that the interaction of bottom-up and top-down processes is what leads to the development of emotions. Until recently, there have not been studies that look at bottom-up and top-down processes respectively. Neuroscientists have put their greatest focus on bottom-up processes’ involvement in perception, learning, and memory, but failed to focus on top-down processes. Because of this, there has not been a true understanding of how these processes, bottom-up and top-down, individually affect the brain activities involved in emotion.

A new study published by The Association for Psychological Science does just this. Using fMRI (functional magnetic resonance imaging), researchers studied whether common or distinct neural systems were involved in generating negative emotional responses via bottom-up versus top-down processing. They did this by showing participants aversive images for bottom-up trials, and neutral images which participants were asked to interpret in aversive ways for top-down trials.

Fundamentally, this study showed how there could be many possible appraisal processes that the brain goes through, and helped to define what mechanisms underlie the relevant forms of emotion dysregulation.

Ochsner, K. N., Ray, R. R., Hughes, B., McRae, K, Cooper, J. C., Weber, J, Gabrieli, J. D. E., & Gross, J. J. (2009). Bottom-up and top-down processes in emotion generation. The Association for Psychological Science, 20, 1322-1331.

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Note taking in Session

December 17th, 2009

Recently, there’s been an interesting discussion on the Academy of Cognitive Therapy listserv about the therapy notes patients take home with them to review. Here’s how I make sure a patient is able to remember important ideas we discussed in treatment, specifically the changes a patient makes in his thinking:

Generally, when I ascertain that the patient has modified his thinking during a session (e.g., following Socratic questioning, behavioral experiments, roleplaying, etc.), I’ll ask the patient for a summary. I might say:

• Can you summarize what we just talked about?
• What do you think it would be important for you to remember this week?
• What do you think the main message is?

If the patient comes up with a good summary, I positively reinforce him and ask whether he wants to write it down or if he would like me to do so. If his summary is not quite on point, I usually offer a revised version and ask the patient whether he thinks it might be helpful to remember it this latter way. If he agrees, he or I will write the summary down. At that point or later on in the session, I will ask the patient how likely it is that he will read these important therapy notes every day at home. If he’s not highly likely, I’ll ask him about what might get in the way.

I’ve found that most patients just don’t learn the skill of writing cogent summaries. They rarely write down complete ideas and they usually add in extraneous or less important material which dilutes what is really important; that’s why I’m nicely directive about what is written down. I want to be certain the patient has good notes to read this week and ten years from now, if a similar problem arises.

Posted in Academy of CT, Cognitive Behavior Therapy, Cognitive Therapy, Judith S. Beck | No Comments »

A Cognitive Behavioral Approach to Emotional Eating

December 17th, 2009

A therapist on a listserv I subscribe to asked for a book recommendation for her patient who struggles with emotional eating. I wrote the following reply:

If your patient doesn’t have an eating disorder, she might try the skills in one of the CBT books I’ve written for consumers on dieting and maintenance (www.beckdietsolution.com). People need the same skill set for resisting eating when it’s not a scheduled time to eat—regardless of whether the desire or impulse to eat has an emotional, physiological, environmental, social, or mental trigger.

For example, they need to learn how to continually motivate themselves to stick to a specific or general plan, how to label and monitor their experience without intervening with food, how to distract themselves (initially), how to accept the discomfort of not eating, how to give themselves credit to build their sense of self-efficacy, etc. Emotional eaters also need to respond to their beliefs about emotional eating. Two typical beliefs are “If I’m upset, I deserve to comfort myself with food,” and “If I’m upset, the only way I can calm down is by eating.”

I’ve found that my clients are often a bit stymied when I ask them how other people cope with distress without eating. Of course, it’s also helpful to use a standard CBT approach—having patients respond to cognitions associated with their initial distress, do problem-solving, etc. Learning all these skills takes concentrated effort—and therapists have to decide when in treatment to focus on emotional eating, particularly if the patient has a psychiatric or psychological problem

Tags: cbt, CBT for diet, CBT for weight loss, diet, emotional eating
Posted in Beck Institute, Cognitive Behavior Therapy, Cognitive Therapy, Dieting, Judith S. Beck | No Comments »

Hong Kong: Dr. Sokol Conducts CBT Training for Nurses

December 15th, 2009

Recently, Leslie Sokol, Ph.D., our Director of Education, was invited to conduct a 5-Day intensive Cognitive Behavior Therapy (CBT) training at the Hong Kong Polytechnic’s Institute of Advanced Nursing Studies. Dr. Sokol focused on depression, anxiety, personality disorders, substance abuse, anger, group therapy, bipolar disorder, and psychosis. The multi-day training included didactic presentations and experiential learning techniques such as roleplays, video demonstrations, and case discussions.

Here are some photos from Dr. Sokol’s training:

Posted in CT Worldwide, Cognitive Behavior Therapy, Cognitive Therapy Training for Professionals | No Comments »

CBT Found to Be Clinically Effective for Depressed Older Adults in Primary Care

December 14th, 2009

A new study published in the Archives of General Psychiatry investigated the clinical effectiveness of cognitive behavior therapy (CBT) for older adults in primary care. A total of 204 men and women aged 65 years or older with geriatric depression were randomly assigned to one of three groups: treatment as usual (TAU), TAU plus a talking control (TC), and TAU plus CBT. The CBT and TC treatments were offered over a period of four months and participants were followed up at 10 months. Depressive levels were measured with the Beck Depression Inventory-II (BDI-II) at baseline, at four months (the end of therapy), and again at 10 months. Based on BDI-II scores per session, a significant benefit of CBT versus the TAU and TC was observed, pointing to CBT as an effective treatment for depression in older adults.

This study was the largest CBT study conducted by general practitioner of their patients.

Posted in Cognitive Behavior Therapy, Cognitive Therapy, Depression, Older Adults, Research Results | No Comments »

Rewriting the Script of Flashbacks

December 11th, 2009

There was an interesting discussion on the Academy of Cognitive Therapy listserv about rewriting the script of flashbacks. I briefly described a related technique to help patients with traumatic memories. I use imagery to help patients change the meaning of a traumatic event (rather than changing, in imagery, what actually happened during the event). First we discuss the event at an intellectual level, identifying and modifying the core belief(s) that originated or became maintained as a result of the event. Then I have the patient relive the experience, as if she were the age at which it occurred and as if it’s occurring right now. I use Socratic questioning, couched in terms her younger self would understand, to identify thoughts, emotions, and beliefs. Next I ask the younger self what is happening immediately after the trauma. Usually she has retreated to a safer place. I then ask the younger patient if it’s okay for her older self to come to this place and explain to her what has happened. I facilitate a dialogue between the younger patient and her current self. Her current self helps the younger self change the meaning of the experience. This technique seems to help patients who have changed the meaning of the event intellectually but don’t yet believe it emotionally. I learned the fundamentals of the technique back in the 1980s from David Edwards and have described it in Cognitive Therapy for Challenging Problems.

Posted in Academy of CT, Cognitive Therapy, Post-Traumatic Stress | No Comments »

CBT for Soldiers: A personal message to professionals from Drs. Aaron and Judith Beck

December 3rd, 2009

Dear Colleagues,

We are trying to address a very serious problem: military personnel who need effective psychological/psychiatric treatment but who are not receiving it. To address this urgent problem, we have embarked upon a new initiative to offer partial scholarships to our Cognitive Behavior Therapy training programs for mental health professionals who treat soldiers, veterans, and their families (www.cbtforsoldiers.org).

Cognitive ehavior therapy (CBT) has been demonstrated in hundreds of controlled trials worldwide to be effective for a wide range of problems, including depression, suicide, post traumatic stress disorder, anxiety disorders, substance abuse, and many more.

The non-profit Beck Institute in suburban Philadelphia is recognized as one of the premiere training sites for this kind of psychotherapy. The application of cognitive therapy to the needs of our military veterans is clear. The RAND Corporation conducted a study for the military on Predicting the Consequences of PTSD, Depression and Traumatic Brain Injury. One of the study’s summary conclusions is that the capacity to provide evidence-based psychotherapies for PTSD and major depression (for example, CBT) would be important in closing the treatment gap.

We would like to bring our expertise to mental health professionals who treat soldiers, veterans, and their families. Please visit www.cbtforsoldiers.org.

Tags: CBT for soldiers, Post-Traumatic Stress, scholarships
Posted in Aaron T. Beck, Anxiety, Beck Institute, Cognitive Behavior Therapy, Cognitive Therapists, Cognitive Therapy, Cognitive Therapy Training for Professionals, Depression, Judith S. Beck, Military issues, Post-Traumatic Stress, Post-Traumatic Stress & Military Service, Suicide, Training | No Comments »

The Becks at ABCT 2009

December 1st, 2009

Pictured (left) are Judith S. Beck, Ph.D., Aaron T. Beck, M.D., and Daniel T. Beck, LICSW, at the Association for Behavioral and Cognitive Therapies, each representing a different mental health discipline. Judith and Daniel are two of Aaron Beck’s four children. Daniel is a Beck Institute Extramural Supervisor, teaches CBT at several Boston area universities and institutions, and is in private practice. He organized the largest ever meeting of social workers at ABCT this year.

Posted in Aaron T. Beck, Academy of CT, Beck Institute, Cognitive Behavior Therapy, Cognitive Therapists, Cognitive Therapy, Judith S. Beck | No Comments »

Cognitive Behavior Therapy Workshop for Professionals at Beck Institute: November 9-11, 2009

November 24th, 2009

(Left) Dr. Aaron Beck conducts a case review after participants observed (via closed-circuit television) Dr. Aaron Beck’s live patient session. Psychologists, psychiatrists, social workers, family therapists, and other professionals from mental health, medical, and related fields traveled from Canada, Indonesia, and eight U.S. states to participate in the Beck Institute Cognitive Behavior Therapy workshop.

(Right) Dr. Judith Beck conducts a roleplay with trainee Robyn Tzipora Koslowitz, Ph.D., a staff psychologist at the Center for Health, Education, Medicine, and Dentistry in New York. Participants received professional training in Cognitive Behavior Therapy from Aaron T. Beck, M.D., Judith S. Beck, Ph.D., Leslie Sokol, Ph.D., and Norman Cotterell, Ph.D.