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Assigning Homework in Cognitive Behavioral Therapy

It’s certainly true that therapy outcomes depend in part on the work taking place in each session. But for this progress to reach its full impact, clients need to use what they learn in therapy during their daily lives. 

Assigning therapy “homework” can help your clients practice new skills during the week. While many types of therapy may involve some form of weekly assignment, homework is a key component of cognitive behavior therapy. 

Types of Homework

Some clients may respond well to any type of homework, while others may struggle to complete or find benefit in certain assignments. It’s important for clients to step outside of their comfort zone in some ways. For example, it’s essential to learn to challenge unwanted thoughts and increase understanding of feelings and emotions, especially for people who struggle with emotional expression. 

But there isn’t just one way to achieve these goals. Finding the right type of homework for each client can make success more likely. 

There are many different types of therapy homework. Asking your client to practice breathing exercises when they feel anxious or stressed? That’s homework. Journaling about distressing thoughts and ways to challenge them, or keeping track of cognitive distortions ? Also homework.

Some clients may do well with different assignments each week, while others may have harder times with certain types of homework. For example:

• An artistic client may not get much from written exercises. They might, however, prefer to sketch or otherwise illustrate their mood, feelings, or reactions during the week. 
• Clients who struggle with or dislike reading may feel challenged by even plain-language articles. If you plan to assign educational materials, ask in your first session whether your client prefers audio or written media. 

When you give the assignment, take a few minutes to go over it with your client. Give an example of how to complete it and make sure they understand the process. You’ll also want to explain the purpose of the assignment. Someone who doesn’t see the point of a task may be less likely to put real effort into it. If you give a self-assessment worksheet early in the therapy process, you might say, “It can help to have a clear picture of where you believe you’re at right now. Later in therapy I’ll ask you to complete another assessment and we can compare the two to review what’s changed.” 

Mental Health Apps

Some people may also find apps a useful way to develop and practice emotional wellness coping skills outside of therapy. Therapy apps can help people track their moods, emotions, or other mental health symptoms. They can provide a platform to practice CBT or other therapy skills. They can also offer structured mindfulness meditations or help clients practice other grounding techniques. 

If you’re working with a client who’s interested in therapy apps, you might try using them in treatment. Just keep in mind that not all apps offer the same benefits. Some may have limitations, such as clunky or confusing interfaces and potential privacy concerns. It’s usually a good idea to check whether there’s any research providing support for—or against—a specific app before recommending it to a client. 

Trusted mental health sources, such as the American Psychological Association or Anxiety and Depression Association of America websites, may list some popular mental health apps, though they may not specifically endorse them. These resources can be a good starting place. Other organizations, including Northwestern University’s Center for Behavioral Intervention Technologies and the Defense Department of the United States, have developed their own research-backed mental health apps. 

You can also review apps yourself. Try out scenarios or options within the app to get to know how the app works and whether it might meet your client’s needs. This will put you in a position to answer their questions and help give them tips on getting the most out of the app. 

Benefits of Homework

Some of your clients may wonder why you’re assigning homework. After all, they signed up for therapy, not school. 

When clients ask about the benefits of therapy homework, you can point out how it provides an opportunity to put things learned in session into practice outside the therapy session. This helps people get used to using the new skills in their toolbox to work through issues that come up for them in their daily lives. More importantly, it teaches them they can use these skills on their own, when a therapist or other support person isn’t actively providing coaching or encouragement. This knowledge is an important aspect of therapy success. 

A 2010 review of 23 studies on homework in therapy found evidence to suggest that clients who completed therapy homework generally had better treatment outcomes. This review did have some limitations, such as not considering the therapeutic relationship or how clients felt about homework. But other research supports these findings, leading many mental health experts to support the use of therapy homework, particularly in CBT. Homework can be one of many effective tools in making therapy more successful. 

Improving Homework Compliance

You may eventually work with a client who shows little interest in homework and doesn’t complete the assignments. You know this could impede their progress in therapy, so you’ll probably want to bring this up in session and ask why they’re having difficulty with the homework. You can also try varying the types of homework you assign or asking if your client is interested in trying out a mental health app that can offer similar benefits outside your weekly sessions. 

When you ask a client about homework non-compliance, it’s important to do it in a way that doesn’t anger them, make them feel defensive, or otherwise damage the relationship you’re working to develop. Here are some tips for having this conversation:

• Let them know homework helps them practice their skills outside of therapy. In short, it’s helping them get more out of therapy (more value for their money) and may lead to more improvement, sometimes in a shorter period of time than one weekly session would alone. 
• Bring up the possibility of other types of homework. “If you don’t want to write anything down, would you want to try listening to a guided meditation or tips to help manage upsetting emotions?” 
• Ask about it, in a non-confrontational way. You might say something like, “Is something making it difficult for you to complete the homework assignments? How can I help make the process easier for you?” 

The prospect of homework in therapy may surprise some clients, but for many people, it’s an essential element of success. Those put off by the term “homework” may view “skills practice” or similar phrasing more favorably, so don’t feel afraid to call it something else. The important part is the work itself, not what you call it.    References:

• Ackerman, C. (2017, March 20). 25 CBT techniques and worksheets for cognitive behavioral therapy. Retrieved from https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets
• ADAA reviewed mental health apps. (n.d.). Anxiety and Depression Association of America. Retrieved from https://adaa.org/finding-help/mobile-apps
• Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research, 34 (5), 429-438. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939342
• Mental health apps. (n.d.). The American Institute of Stress. Retrieved from https://www.stress.org/mental-health-apps
• Novotney, A. (2016). Should you use an app to help that client? Monitor on Psychology, 47 (10), 64. Retrieved from https://www.apa.org/monitor/2016/11/client-app
• Tang, W, & Kreindler, D. (2017). Supporting homework compliance in cognitive behavioural therapy: Essential features of mobile apps. JMIR Mental Health, 4(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481663

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Cognitive Behavioural Therapy Worksheets and Exercises

The following Cognitive Behavioural Therapy – CBT worksheets and exercises can be downloaded free of charge for use by individuals undertaking NHS therapy or by NHS practitioners providing CBT in primary or secondary care settings. These worksheets form part of the Think CBT Workbook, which can also be downloaded as a static PDF at the bottom of this page. Please share or link back to our page to help promote access to our free CBT resources. 

The Think CBT workbook and worksheets are also available as an interactive/dynamic document that can be completed using mobile devices, tablets and computers. The interactive version of the workbook can be purchased for single use only for £25. All Think CBT clients receive a free interactive/dynamic copy of the workbook and worksheets free of charge.

Whilst these worksheets can be used to support self-help or work with other therapists, Cognitive Behavioural Therapy is best delivered with the support of a BABCP accredited CBT specialist. If you want to book an appointment with a professionally accredited CBT expert, call (01732) 808626, complete the simple contact form on the right side of this page or email [email protected]  

Please note: if you are a private business or practitioner and wish to use our resources, please email [email protected]  to purchase a registered copy. This material is protected by UK copyright law. Please respect copyright ownership.

Exercise 1 - Problem Statements

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Exercise 2 - Goals for Therapy

Exercise 3 - personal strengths / resources, exercise 4 - costs / benefits of change, exercise 5 - personal values, exercise 6 - the cbt junction model, exercise 7 - the cross-sectional cbt model, exercise 8 - the longitudinal assessment, exercise 9 - layers of cognition, exercise 10 - cognitive distortions, exercise 11 - theory a-b exercise, exercise 12 - the cbt thought record, exercise 13 - cognitive disputation "putting your thoughts on trial", exercise 14 - the cbt continuum, exercise 15 - the self-perception continuum, exercise 16 - the cbt responsibility pie chart, exercise 17 - noticing the thought, exercise 18 - four layers of abstraction, exercise 19 - semantic satiation, exercise 20 - the characterisation game, exercise 21 - speed up / slow down, exercise 22 - word translation, exercise 23 - the time-traveller's log, exercise 23a -the time-traveller's log continued, exercise 24 - leaves on a stream, exercise 25 - the traffic, exercise 26 - clouds in the sky, exercise 27 - taming the ape - an anchoring exercise, exercise 28 - the abc form in functional analysis, exercise 29 - pace activity exercise, exercise 30 - graded hierachy of anxiety provoking situations, exercise 31 - the behavioural experiment, exercise 32 - act exposures exercise, exercise 33 - worry - thinking time, exercise 34 - submissive, assertive & aggressive communication, exercise 35 - sleep hygiene factors, exercises 36 - 38.

(Abdominal Breathing, Aware Breathing & The Five-Minute Daily Recharge Practice)

Exercise 39 - Wheel of Emotions

Exercise 40 - linking feelings and appraisals, exercise 41 - personal resilience plan, exercise 42 - cbt learning log, act with choice exercise, angels and devils worksheet, transdiagnostic model of ocd worksheet, tuning in exercise, penguin-based therapy (pbt), big picture exercise, post-therapy journal, catch it-check it-change it exercise.

A brief cognitive change exercise for identifying and altering negative thinking

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Homework in CBT

Table of contents, why do homework in cbt, how to deliver homework, strategies to increase confidence.

Homework assignments in Cognitive Behavioural Therapy (CBT) can help your patients educate themselves further, collect thoughts, and modify their thinking.

Homework is not something that you just assign randomly. You should make sure you:

• tailor the homework to the patient
• provide a rationale for why the patient needs to do the homework
• uncover any obstacles that might prevent homework from being done (i.e. - busy work schedule, significant neurovegetative symptoms)

Types of homework

Types of homework assignments.

You should also decide the frequency of the homework should be assigned: should it be daily, weekly?

If your patient does not do homework, that’s OK! Explore as a team, in a non-judgmental way, to explore why the homework was not done. Here are some ways to increase adherence to homework:

• Tailor the assignments to the individual
• Provide a rationale for how and why the assignment might help
• Determine the homework collaboratively
• Try to start the homework during the session. This creates some momentum to continue doing the homework
• Set up systems to remember to do the assignments (phone reminders, sticky notes
• It is better to start with easier homework assignments and err on the side of caution
• They should be 90-100% confident they will be able to do this assignment
• Covert rehearsal - running through a thought experiment on a situation
• Change the assignment - It is far better to substitute an easier homework assignment that patients are likely to do than to have them establish a habit of not doing what they had agreed to in session
• Intellectual/emotional role play - “I’ll be the intellectual part of you; you be the emotional part. You argue as hard as you can against me so I can see all the arguments you’re using not to read your coping cards and start studying. You start.”

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Top 10 CBT Worksheets Websites

The best cognitive behavioural therapy resources, activities and assignments all in one place.

Hi, it’s Rosie here, Uncommon Knowledge’s content manager.  I’ve been hearing a lot from practitioners who use Cognitive Behavioural Therapy (CBT) and are on the lookout for new resources, especially CBT worksheets.

So to flesh out our resources, I’ve had this list put together, which features ten of the best websites featuring CBT worksheets.

Edit: We’ve recently added our own free therapy worksheets section, including a range of CBT worksheets .

Where to find CBT worksheets

CBT  is one of the most widely used therapeutic treatment approaches in mental health today. Because it is an action-oriented approach, homework is a key aspect of the change process. And CBT tools such as worksheets, activity assignments, bibliotherapy and guided imagery can all be useful homework assignments.

But finding those clinically-sound, cost-effective and easy-to-access resources can be the therapist’s challenge. There’s not always time to sift through books or surf the ‘net looking for those CBT worksheets or teaching tools that are “just right”. Aside from staying on schedule, you want to spend time with your clients, helping them achieve their goals.

So here’s a list of ten of the best CBT resource sites for you to use as a reference point for your practice:

1. Therapist Aid

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The site contains a huge selection of CBT worksheets as well as videos, guides and other resources. ‘The ABC model of CBT’ is a particularly good video to help clients understand the relationship between their thoughts, feelings and behaviours.

2. Psychology Tools

Psychology Tools is another one of those really great sites that has been created by practitioners for practitioners. It was designed as a way to share materials among therapists. The site offers a number of CBT-specific articles, assessments and tools for clinical use. There is also a self-help section.

One of the strengths of this site is that it offers resources for several other therapies including ACT, DBT and EMDR. Therapists can also submit their own worksheets or other resources for consideration of inclusion on the website.

3. Excel At Life

Guided imagery and mindfulness meditation are often used as part of a CBT approach to treatment. This site offers a range of free audio downloads for a variety of needs. These downloads can be used in the office or as part of a homework assignment.

This site offers several CBT resources for the practitioner as well as the client seeking self-directed support including informative articles and forms such as a mood diary and various questionnaires. This site is exceptionally user-friendly.

4. Living CBT

This site offers a number of worksheets and tools including diary forms, action plans and a number of helpful self-statements that are great for sharing with clients. The tools are mostly in PDF and are easy to download. The site also offers several self-help books for purchase.

Aside from the self-help section, this site also has a Free CBT Therapist Resources section. The tools available here are similar to those found in the general section but some are more appropriate for use in the clinical setting.

5. Veronica Walsh’s CBT Blog

This site is a great little gem chock full of CBT resources and downloads. Worksheets cover everything from a CBT journaling guide to incorporating mindfulness to using CBT with cyberbullying. Spend a little time on this site and you’ll find all kinds of useful tools that you and your client can work with. The owner of this site has put a lot of work into making a plethora of resources available to the user.

6. Specialty Behavioral Health

This site offers a variety of worksheets for the practitioner as well as worksheets specifically for CBT. They are well-designed and easily adapted to a variety of clients. Two worksheets to check out are the ‘Ways to Challenge Your Thoughts’ and the ‘Procrastination Profiles’, as well as accompanying ‘Task Master Worksheet (for Procrastination)’. These are nicely done and would be particularly useful with the client struggling to understand thought patterns and challenging negative thinking.

7. GetSelfHelp

This website provides a number of CBT self-help and therapy resources, including downloadable worksheets, information sheets and CBT formulations.

One of the standouts of this site is the 40-page CBT-based self-help course. It’s free and chock full of information and tools to help your clients understand and implement changes. You can find the course here.

8. Hertfordshire Partnership University NHS Foundation Trust

This is a 52-page fully downloadable CBT workbook from the Hertfordshire Partnership University NHS Foundation Trust. It is full of client-friendly descriptions, activities and tools for setting and achieving goals. This workbook is the kind of tool that can be used by the therapist with a client or as a self-help tool for self-motivated clients.

9. Martin CBT

This site is often mentioned when the question of CBT resources comes up. While not as extensive an offering as some sites, the forms and tools found here are well-produced, immediately usable and user-friendly.

One of the highlights is the ‘Cycle of Maladaptive Behavior’ sheet. Clients don’t always understand the cycle and how their behaviours manifest. This worksheet does a good job of describing the cycle and how it unfolds. The site also offers an excellent handout with examples and descriptions of cognitive distortions. Definitely worth a visit!

10. EPISCenter

A list of CBT worksheets would not be complete without including a few child specific resources. CBT has been shown to be effective with children, especially in trauma work.

This workbook is an excellent resource for CBT and trauma work with children. There are relatively few tools specifically designed for children. This workbook is particularly well-constructed and child-friendly.

So there you have it. Ten of the best sites out there for CBT resources and tools. Are there more out there? You bet! There are lots of great resources out there for every level of need and every type of problem. But these sites represent some of the best of what’s out there and will get you started in working with your clients using CBT worksheets. You’ll have more time with your clients and your clients will benefit from having some of the best tools out there.

Update: This post was so popular with readers we added another! Read 10 More Top CBT Worksheets Websites here .

Cognitive Behavioural Therapy is an important part of the treatment jigsaw and our co-founder Mark Tyrrell would want me to mention the following articles we already have available, in the spirit of setting it in a wider context:

• 3 Instantly Calming CBT Techniques for Anxiety
• The Sensible Psychology Dictionary defines CBT

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Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses .

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Using Homework Assignments in Cognitive Behavior Therapy

DOI link for Using Homework Assignments in Cognitive Behavior Therapy

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Homework is a central feature of Cognitive-Behavioral Therapy (CBT), given its educational emphasis. This new text is a comprehensive guide for administering assignments. The first part of the text offers essential introductory material, a comprehensive review of the theoretical and empirical support for the use of homework, models for practice, and systems for evaluating client compliance and therapist competence in administering assignments. Part two focuses on the role of homework in cognitive therapy, demonstrating successful methods of integration and discussing solutions to common barriers. Rather than offering one-size-fits-all, pre-designed tasks, this book illustrates application of a model with detailed case study and recommendations for adjusting administration methods for particular problems and specific client populations. Over the last nine chapters, homework administration is described within cognitive and behavioral therapy for anxiety and depression, chronic pain, delusions and hallucinations, obsessions and compulsions, marital and sexual problems, personality disorders, children and adolescents, group and family therapy, and older adults.

Readers are provided with a full range of knowledge to successfully incorporate individualized homework assignments into their practice to maximize the proven long-term benefits of CBT.

TABLE OF CONTENTS

Chapter 1 | 5  pages, introduction and overview, part | 2  pages, part i theoretical and empirical foundations, chapter 2 | 21  pages, theoretical foundations, chapter 3 | 21  pages, empirical foundations, chapter 4 | 11  pages, assessment of homework completion, part ii specific populations, chapter 5 | 16  pages, chapter 6 | 18  pages, adolescents, chapter 7 | 30  pages, older adults, chapter 8 | 15  pages, chapter 9 | 16  pages, part iii specific problems, chapter 10 | 22  pages, panic, agoraphobia, and generalized anxiety, chapter 11 | 14  pages, obsessions and compulsions, chapter 12 | 20  pages, chapter 13 | 16  pages, substance abuse, chapter 14 | 19  pages, delusions and hallucinations, chapter 15 | 17  pages, sexual problems, chapter 16 | 23  pages, borderline traits, part iv model for practice and conclusions, chapter 17 | 43  pages, a guiding model for practice, chapter 18 | 10  pages, summary and conclusion.

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Homework in Cognitive Behavioral Supervision: Theoretical Background and Clinical Application

1 Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic

2 Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic

3 Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic

4 Jessenia Inc. - Rehabilitation Hospital Beroun, Akeso Holding, Beroun, The Czech Republic

Ilona Krone

5 Riga`s Stradins University, Riga, Latvia

Julius Burkauskas

6 Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania

Jakub Vanek

Marija abeltina.

7 University of Latvia, Latvian Association of CBT, Riga, Latvia

Alicja Juskiene

Tomas sollar, milos slepecky, marie ociskova.

The homework aims to generalize the patient’s knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.

Introduction

The development of competent clinical supervision is crucial to effectively training new CBT therapists and supervisors and maintaining high therapy standards throughout their careers. 1 Clinical supervision is a basis for CBT training, but there are only a few empirical evaluations on the effect of supervision on therapists’ competencies. Wilson et al 2 in their systematic review and meta-analysis, synthesized the experience and impact of supervision for trainee therapists from 15 qualitative studies. Although supervision leads to feelings of distress and self-doubts, it can effectively support supervisees in personal and professional development. It could similarly harm supervisees’ well-being, clinical work and clients’ experiences. Alfonsson et al 3 published a study to evaluate the effects of standardized supervision on rater-assessed competency in six CBT therapists under protocol-based clinical supervision. This is one of the first investigations showing that supervision affects cognitive behavioral competencies. Although several works have studied the effectiveness of supervision on the therapist’s competence and for the therapist’s work with patients in qualitative studies, 3–7 there is still a lack of studies that dealt with the importance of homework in supervision.

Homework is a vital element of cognitive behavioral therapy (CBT) which distinguishes it from many other psychotherapeutic approaches. 8–10 Patients usually participate in therapy by completing homework assignments and taking responsibility for their course.

Assigning and discussing homework is one of the basic competencies of a cognitive-behavioral therapist and a supervisor in the context of counselling, psychology, therapy, and social work. The manuscript aims to refer to homework in several settings: homework in therapy, supervision of homework in therapy, using the homework by the supervisor for the supervisee, and homework in the training of supervisors.

Homework in Therapy

While specific recommendations for the practical usage of homework have been clearly articulated since the early days of CBT, 11 , 12 practitioners state that they do not follow these recommendations. 13–15 For example, many physicians admit that they forget homework or do not focus on standard specifications when, where, how often, and how long the task should last. Often reported non-cooperation in homework assignments may be due to the practice recommendations being too strict or because students think the amount of homework they can assign is limited. 16

The Sense of Homework in the Therapy

Patients verify methods and skills they learned during the session in real situations and the natural environment. 9 , 17 Through homework, patients also test hypotheses that emerged during the session with the therapist (for example, “If I went out on the street alone, I would be so weak that I would pass out or lose control completely”). Homework help that the important part of the therapy takes place between sessions and allows the patients to become independent and manage their problems even after the end of therapy. 10 , 18 Patients learn how to raise hypotheses and test them in real-life situations. Through completing homework persistently during the therapy, patients gain skills on how to plan their activities and gain new skills, and they also collect a rich source of therapeutic diaries. The investigations advocate that adding homework to CBT increases its efficacy and that patients who constantly complete homework have better outcomes. The outcomes of four meta-analyses highlight the value of homework in CBT:

• Kazantzis et al 10 inspected 14 studies that compared results for patients allocated to CBT without or with homework. The average patient in the homework group reported better results than about 70% of controls.
• Outcomes from 16 studies 17 and an updated analysis of 23 studies 19 discovered that higher compliance led to better treatment results among patients who received homework projects during therapy.
• Kazantzis et al 20 studied the relationships between quantity (15 studies) and quality (3 studies) of the homework to treatment results. The effect sizes were medium to large, and these effects remained fairly constant in a 12-month follow-up.

Therapists strategically create homework to reduce patients’ psychopathology and encourage them to practice skills learned during therapy sessions; nevertheless, non-adherence (between 20% and 50%) remains one of the most cited reasons for decreased CBT efficacy. 21 Several reasons for non-adherence to homework might be pointed out –the therapist does not regularly discuss homework with the patient, the patient no longer considers it important and stop doing it. 9 , 22 Discussing homework also allows the therapist to strengthen the patient’s belief in their ability to achieve certain goals. 23 The fact that the patient has completed the assignment must be properly acknowledged, and then therapists discuss the quality of homework separately. 24 Good questions might be, “How did you do your homework? Were there any difficulties in fulfilling them? What kind?” Furthermore: “How can you handle these problems next time? What did you learn while completing your homework? Can it help you cope with other issues?”

How to Increase the Effectiveness of Homework in the Therapy

Homework is the most effective, and it is most likely to succeed if: 19 , 25

• Follows logically from the topics discussed during the session and uses the methods that the patient learned during the session;
• they are clearly and concretely defined, so it is easy to determine whether or to what extent the patient has been successful in fulfilling them (eg, “Leaving the house alone for at least 30 minutes every day”, not “Starting to go out alone”);
• the patient clearly understands their meaning (“To verify your belief that you will faint on the street” or “See for yourself whether your anxiety will continue to rise, remain the same or subside after a certain time”), and they believe they can achieve the goals;
• homework is formulated so that failure is impossible because, in any case, the patient will learn something useful that will help them in therapy;
• the therapist anticipates and discusses obstacles that could hinder the fulfilment of homework and plans procedures to overcome them.

An important aspect of CBT is the patient’s independence. 10 , 18 Homework is typically determined by consensus. To increase the likelihood that the patient will complete the homework, the patient and the therapist should document their assignments in writing. Additionally, it is very convenient for the patient to record the homework, typically pre-prepared. 24 These records serve as a basis for discussing homework in the next session and also allow the therapist to assess the changes achieved during therapy (“A month ago, you were able to go out alone for only half an hour and your anxiety level previously reached level ‘9’, while now you were alone outside for more than an hour and your anxiety do not exceed ‘5’ rated subjectively”).

Because the goal of therapy is to help the patient experience success, the patient’s assigned homework must be feasible. 18 , 26 On the other hand, patients should improve their ability to cope with problems and unpleasant conditions during therapy, they need to exert significant effort to overcome certain unpleasant feelings and emotions. 19 , 20

Even if therapists follow all these rules, they will unavoidably find that sometimes the patient does not complete assigned homework. 20 , 23 In this case, it is required to find out why this happened:

• whether the patient understood what the task was and what it meant
• whether mastering this exercise is important and motivated
• whether unforeseen circumstances prevented them from fulfilling it
• whether the assigned exercise was not very demanding for them in their current mental state

Therefore, therapists do not consider the non-fulfilment of homework a priori as a manifestation of resistance or lack of moral qualities on the patient’s part, then as a problem that must be solved together.

However, if, despite a thorough discussion of homework and agreement on its completion, the patient repeatedly does not even attempt to complete it, does not bring records and fails to justify non-compliance, it is necessary to return to the problem analysis and goal-setting. We need to clarify with the patient whether the problem they are currently dealing with in therapy is really the most important for them, whether the goal they seek to achieve is sufficiently desirable, and whether the therapist offers to achieve is acceptable. 9 , 20

Most practicing CBT therapists report that they use homework and consider homework important for many problems 14 and believe in the role of homework in improving therapeutic outcomes. 24 , 27 Encouraging and facilitating homework is a basic skill of a CBT therapist; therefore, it is an important part of supervision. 19 , 20 , 26 Homework needs to be carefully assigned and discussed ( Box 1 ).

Case Vignette – Discussion About Not Completing Homework with an Anxious Patient

Kazantzis et al 28 advise examining the therapeutic relationship, which significantly impacts therapy adherence, to better comprehend non-cooperation with homework assignments. Data illustrating the therapist’s homework competence and the therapy outcome 29 , 30 show that the therapist is primarily responsible for their patients’ adhering to or failing to do homework. CBT therapists exhibit many interrelated automatic thoughts, assumptions, and behaviors during sessions that affect homework use in therapy. 8 , 15 In training, common negative attitudes for therapists include: “Homework will make patients feel like school and resent!” “They will feel too controlled and limited!”; “Homework will increase some ps’ sense of vulnerability!”; or “Homework will be even more stressful for stressed patients!” Another widespread belief is that the “structure” of CBT, whose homework is important, reduces spontaneity and worsens the therapeutic relationship. 15

In addition, there is some scientific support for these views of therapists’ attitudes toward homework concerning the therapeutic process. 31 The result of these attitudes is either a complete avoidance of homework assignments in a way that is not effective and consequently maintains these beliefs. 8 For example, common behaviors require supervision, such as rapidly discussing directions at the end of a session, neglecting to repeat homework, or failing to justify while designing homework. 9 The CBT Homework Project proposed a practice model 29 that emphasizes the importance of therapist beliefs, therapist empowerment, cognitive conceptualization, and the therapeutic relationship in enhancing homework practice. 23

Theoretical and empirical support for homework assignments in CBT leads most practicing CBT therapists to at least accept in principle that regular and systematic homework assignments will benefit their patients. 8 As a result, CBT therapists favour assigning homework in therapy. However, many beginning therapists encounter problems when they start designing homework (ie, selecting tasks and discussing them with the patient), assigning homework (ie, collaborating on practical aspects of completing homework), and repeating homework in sessions. 32 Incorporating homework into therapy is often superficial, hasty, poorly done, or forgotten. 16 Therefore, problems with using homework in therapy are a common supervision agenda of practicing CBT therapists.

Personal Training and Self-Reflection of the Therapist as a Supervision Intervention

CBT training students are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation in the CBT conceptual framework. 8 Suppose the therapist fails to develop this awareness. In that case, errors in clinical judgment may occur, adversely affecting the therapeutic relationship and course of therapy. 33 Self-exercise (practicing CBT techniques and interventions as a therapist) and self-reflection (ie, process reflection) are concepts developed by Bennett-Levy et al, 34 to operationalize a useful understanding of own processes in working with patients. CBT training students are asked to become accustomed to using self-exercise and self-reflection. In a few qualitative studies, self-exercise and self-reflection have proven to improve the therapist’s self-concept, ie, self-confidence, perceived competence in one’s abilities and belief in the effectiveness of the CBT model. 34–36 Calvert et al 37 study checked the use of meta-communication in supervision from supervisees’ perspectives using the Metacommunication in Supervision Questionnaire (MSQ). There were differences in the reported frequency with which the different types of meta-communication were used. It appears that meta-communication around difficult or uncomfortable feelings in the supervisory relationship occurs less often than other components of meta-communication. 1

Below are examples of self-exercise and self-reflective exercises. The following self-assessment is developed to shape thinking before a preliminary meeting with a supervisor. Earlier knowledge has shown that supervisees and supervisors do not always share common ideas about supervision. Therefore, the supervisee could finish this self-assessment as a homework exercise before supervision. A supervisee might want to identify conversation matters that may enable a supervisor to better comprehend their requirements and needs.

Before Starting

Questions regarding previous and desired experience in supervision.

What background information do you think your supervisor requires to understand you at the start? (This may include a curriculum vitae noting appropriate previous experience). What would be the best method to convey these details? Is there any distinction between what you desire from this placement and what you feel you need? What background details about this placement and this supervisor do you have? How does this make you feel? Exists any more information that you need? What do you want and expect your supervisor to concentrate on during supervision? What roles do you want your supervisor to play with respect to you and your work? What supervisory media do you want to experience (for example, taped, “live”, or reported)? What do you intend to do about your feelings? Consider how you feel about your supervisor evaluating your work at the end of the positioning process.

More Specific Questions

• What specific activities during supervision do you recall as being helpful?
• What conditions would be most convenient for you?
• What would you personally anticipate getting from being supervised?
• However, what would you want to receive from supervision prepared that will not be on offer?
• What could you do about this?

Several possible tough issues can appear in supervision. The following list includes concerns the supervisee might consider ( Table 1 ).

Difficulties in Previous Supervisions (Adapted According to Scaife 2019 38 )

In the next step:

• Recognize the two issues which seem to be the most important ones for you.
• What steps can be taken now to minimize the chances that these two concerns will seriously disrupt your cooperation?

Reflection on the Strengths

What are the top three strengths you want your supervisor to uncover as you enter this supervisory relationship?

List 3 points for your development that may or might not be obvious to your supervisor.

Reflection on Difficulties

Therapists regularly discover face-to-face contact with people labelled by society as coming from a specific sub-group.

Which sub-groups make you feel uneasy for whatever reason? Do you want to address this during supervision? 38

Examples of Self-Assessment in the Supervision Process

Exploring sources of stress from clinical work.

Check all that resonate for you. 39

❑ Perfectionism ❑ Fear of failure ❑ Self-doubt ❑ Need for approval ❑ Emotional depletion ❑ Unhealthy lifestyle

Which of them seems to have the greatest impact on your stress levels?

What supervisor has most regularly identified as weak points in your clinical work?

Processing Mistakes

When mistakes are processed in ways that lead to reflection, flexibility, and adjustments in how you function, it can result in learning and growth.

Consider a patient you are now working with (or have recently worked with) with whom you have experienced a therapeutic failure.

Answer the following questions while keeping this experience in mind:

• What are the signs of a therapeutic failure? How can you be certain that what you are doing is not beneficial on some level? What benefits might your patient derive from failure? When did things begin to deteriorate? Which initiatives have been most effective so far, and which have been least effective? How have you been careless?
• Examine your intervention choices as well as how they were carried out:
• What concerns or considerations did you overlook? What is impeding your ability to be more effective? How has your empathy and compassion for this individual been harmed? How can you use this experience to help you grow?

Reflection of Therapeutics Mastery Skills

Favorite techniques.

• Explain three things you have put off in your career or life because they appear risky—you have something to lose and gain.
• Which therapeutic strategies or interventions stimulate you the most?
• What would you call your “hidden weapon”?
• What kind of patients or presenting difficulties interest you the most?
• What would it take to incorporate more of the pleasure and satisfaction you receive when applying the strategies mentioned earlier into other aspects of your work? 39

The following examples from clinical supervision demonstrate how self-exercise and self-reflection can help participants understand their belief system’s impact on homework in CBT.

Supervision of Homework in Therapy

Supervision is classically mandatory for students in cognitive behavioral training and plays a crucial part in therapist development. 2 The typical structure of continuous supervision of one patient includes discussing questionnaires or scales used to measure the severity of the problem (like the Beck depression inventory), homework, events in therapy since the last session, and then discussing the agenda of the current supervision meeting (what will be done in the session, which problem will be addressed), work on a selected issue or problems, homework assignment, session summary and its evaluation by the supervisor. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself ( Box 2 ).

Case Vignette – Discussion About Patient´s Homework During Supervision

Whether and how the patient completes homework is a common supervisory issue ( Box 3 ). The therapist often complains that the patient refuses to do homework or rarely does it. 8 , 16

Recording of Paul’s Automatic Thoughts

The picture describes the vicious circle of countertransference reaction, where automatic thoughts lead to developing negative emotions, bodily reactions and behaviors. Any vicious circle components can alert the therapists that their countertransference reaction is taking place.

Case Vignette –Discussion of Setting Homework During Supervision

Homework in Supervision

Homework assignments are a common part of supervisory work. These may involve the patient’s management (eg noticing on their recording how often the therapist strengthens the patient and how and if it is rare to clarify where reinforcement would be appropriate), working on oneself (eg clarifying experiences and attitudes that lead to countertransference in a particular patient, awareness of which other patients may also occur) and theoretical study (the supervisor may advise the therapist to read a professional text that can help better understand and work with the patient). 40

The supervisor helps define a specific engagement, discusses specific therapeutic methods, touches on what methods the therapist has used and what else they may consider the role, for the most part, the implementation of strategies whose ability to use in therapy under supervision will be planned, as part of homework.

Homework assigned in supervision usually deals with mapping problems (supplementing the conceptualization of the case, evaluation, vicious circle of the problem with the patient, etc.), monitoring certain behaviors (mostly communication with the patient), or implementing new, behaviors in therapy (usually using therapeutic strategies). 12 Homework teaches the supervisee to work on self-reflection outside the supervision meetings. 41 Discussing the homework properly at the beginning of the session is important. The mentioned home exercises usually concern the work with the supervised case report of the patient. The basic questions concern homework results, discussing the obstacles in solving them and what the supervisee learned in homework. 8 The discussion gives the supervisor case management information and can point to important practice moments.

Homework Assignment

Before the end of the session, the supervisor and the supervisee agree on a homework assignment. It is optimal when homework arises from a problem addressed in the session’s main part. 8 At the beginning of supervision, proposals for homework assignments usually come from the supervisor and are discussed and recorded in writing. 40 During supervision, the supervisee creates homework assignments, and the content is discussed with the supervisee.

The Meaning of Homework

Homework must make sense for the supervisee; otherwise, he will have no motivation to do it. However, it is also important to make sense of the patient or patients and develop the therapist’s skills and competencies. It is desirable to discuss the meaning of homework in supervision.

Possible Difficulties When Completing Homework

It is advantageous to discuss the anticipated difficulties in completing homework. This has the advantage that the supervisee can prepare for possible difficulties, consider overcoming them and consult with the supervisor. Discussing difficulties helps the supervisee model and later develops the skill to discuss the patient’s homework difficulties.

The Impact of the Therapist’s Belief System

In some therapists, there can be reasons for a more complex level of conceptualization. 42 That is important when the therapist repeats certain mistakes even though they have repeatedly discussed them with the supervisor. At a directly accessible level, the situation with the patient can be described using a vicious circle. The deeper “hidden” level refers to the core beliefs and conditional rules activated in a specific situation with the patient. 40 , 43 A supervisor can use the “falling arrow” technique to map core beliefs and conditional assumptions. 43

One such way is the Therapeutic Belief System (TBS). 44 TBS is a theoretical model useful for understanding the specific beliefs, assumptions, and behaviors that therapists and patients commonly experience that could potentially affect the course of therapy. In line with the cognitive model, TBS provides a framework for identifying therapists’ and patients’ beliefs about themselves, each other, the treatment process, the emotions these beliefs can evoke, and typical behavioral reactions. For example, a therapist may see a patient as an “aggressor”, a “helpless victim”, or a “collaborator”. The participant’s own beliefs may supplement these beliefs about himself, such as “victim”, “co-worker”, “carer”, or “rescuer”. Homework assignments may be perceived by both the therapist and the patient as “hopeless”, “productive”, or simply maintaining the status quo and lead to a different emotional and behavioral response. 8 Thus, TBS can be introduced into supervision to guide the supervisee to consider whether he or she identifies with any of the therapists’ typical beliefs and behaviors outlined in the model. A simple awareness of such patterns can be a useful orientation when considering the role of attitudes and beliefs in integrating homework ( Box 4 ).

Case Vignette – Discussion About Supervisee Homework

The scheme broadly refers to mental structures that integrate and give meaning to events. 45 Schemes can be positive, negative or neutral. In CBT as a treatment for psychological disorders, we focus on dysfunctional patterns often associated with specific diagnostic presentations (for example, emotional vulnerability patterns are common in anxiety disorders). Schema is generally defined as a ubiquitous topic of cognitive functions, emotions, physiological feelings about oneself, and relations with others. 33

Therapists’ schemes run in specific therapies and do not usually signal mental health problems. 8 Therapists’ schemes are influenced by the following factors: training experiences, such as supervision and training phase, therapy model, peer group, clinical experience, and personal experience. 13 , 40 Once identified, the therapist’s scheme can be used in supervision as a starting point to discuss some of the practitioner’s views that may interfere with therapy. 8 Completing structured questionnaires can identify participants’ schemes, basic beliefs, and assumptions. Some examples of useful questionnaires are the Dysfunctional Attitudes Scale, 46 the Personal Faith Questionnaire, 47 the Young Schema Questionnaire 48 and the Therapists’ Schema Questionnaire. 49 Leahy’s Therapists’ Scheme Questionnaire is a relatively straightforward screening technique for identifying therapeutic patterns that could affect a therapeutic relationship. It consists of 46 assumptions related to the 14 most common therapeutic regimens.

Certain schemes are particularly common in CBT supervisees. These include “demanding standards”, “excessive self-sacrifice”, and “special superior person”. 49 Training therapists who identify with the “demanding standards” scheme have a somewhat obsessive, perfectionist, and controlling approach to therapy. These therapists usually have high expectations for keeping a patient’s homework and may not realize that non-compliance with homework is often part of the learning process. Therapists may expect that there is a “right” way to complete a homework assignment, leading to feelings of frustration when assignments produce different results. This may signify insecurity and a notion that if things break from the planned structure, the therapist will be exposed as “incompetent”. Many therapists identify with the “excessive self-sacrifice” pattern, the most commonly observed pattern in both novice and experienced therapists. 33 Leahy 49 proposes that these therapists overstate the importance of their patient relationships. They may fear leaving or feel guilty that they are or feel better than the patient. As a result, the therapist may engage in therapy-defeating behaviors, such as making the homework assignment to the patient’s various needs, having difficulty with appropriate assertiveness in discussing persistent patient non-cooperation, and having a tendency to avoid techniques. Such as exposure or opening of painful memories for fear that the patient will be upset.

Novice therapists who identify with the “special superior person” scheme see the therapeutic situation as an opportunity to achieve excellent results and have high-performance expectations. There may be a tendency for the patient to idealize or, conversely, to devalue or distance himself from patients who do not improve or do their homework. The presence of a “special superior” scheme can be seen as overcompensation in response to “demanding standards” and “excessive self-sacrifice”, which have the thematic connotations of “not being good enough”. The supervision session sets the supervisee in a situation where the supervisor supervises homework through videotaped therapeutic sessions utilizing a cognitive therapy scale (CTS). 50 Feelings of superiority and exceptionality can, in some cases, be a way of dealing with the feelings of inferiority that they experience, that their use of homework is judged in this way.

In addition to recognizing the general responses to the scheme that most training students encounter, the supervisor should help the supervisor become aware of his or her idiosyncratic beliefs and coping styles, which some patients may trigger ( Box 5 ). The supervisor should encourage the supervisee to pay special attention to the “overlapping patterns” in which the therapist’s scheme and the patient’s scheme overlap, leading to the over-identification of the therapist with the patient. 33

Case Vignette – The Supervisor Advises the Therapist to Work with Core Beliefs and Conditional Rules

Homework in Supervisor Training

For supervisors, their supervisors’ training is important. An important part of this training is the practice of self-reflection, which should be requested directly in the meeting and as homework. It can be a task to capture situations in supervision in which they do not feel comfortable using the vicious circle, cognitive restructuring of automatic negative thoughts in these situations, capturing thoughts, emotions, bodily sensations and behaviors in situations where they are aware that they are experiencing countertransference reactions to the supervised therapist. It is also important that in their homework, they reflect on their concentration level during supervision sessions and consider what supervision skills they have used or what they have learned for the next session. A typical complex homework in supervision training is a video recording of supervision sessions and their analysis. The recorded supervision and analysis are then analyzed in the next supervision training meeting.

This article is designed as an overview of views and experiences. Its important element is work samples. This is also a limitation of this article. Assignment of homework in supervision and therapist and supervisor training lacks scientific information about its effectiveness. Nevertheless, assigning homework is an important part of cognitive behavioral therapy. We know quite well about its meaning in prescribing for patients. Less is known about their meaning and effectiveness in supervision. The supervisee encounters problems completing homework assignments for her patients that she brings to the supervisee. Why the patient does not complete the homework may be his problem, but his therapist may also have a part in it his requirements, which include how the homework is assigned, its suitability for the given patient, timing, and complexity. Homework can also belong to the training of supervisors and the supervision of supervision. Here, we do not know any research evidence about their effectiveness in using the most important part of supervision, the patient; however, they are experienced by supervisors and supervisees as useful and meaningful.

Homework in supervision and supervision requires further reflection on their meaning and subsequent research, which should examine their significance for the supervisee’s competence (supervisee) and the ultimate impact on the patient himself.

Homework presents one of the cornerstones of cognitive-behavioral therapy, CB supervision and the training of CBT supervisors. If applied consistently and collaboratively, homework enhances therapeutic outcomes and increases the patient’s self-confidence. Setting and maintaining a fruitful working alliance for homework can be challenging – issues with homework present one of the common reasons to seek a supervisory consultation. Supervision then focuses on examining the specific case and experienced problems, factors in the interaction between the therapist and their patient, and the therapist’s automatic thoughts, schemas, and behaviors that might maintain the issue. There are several ways to address this topic in supervision. Homework is usually part of supervision because of its usefulness. The supervised therapist may be given similar tasks as the patient receives in therapy: to describe the automatic thoughts that occur to him while guiding the patient, to test them and look for a more rational response, to conduct behavioral experiments, to clarify the core beliefs and conditioned assumptions that influence the formation of the therapeutic relationship, experiments with adequate communication with the patient and others. A therapist’s self-experience through practice can help them improve their therapeutic work.

Acknowledgments

This paper was supported by the research grant VEGA no. APVV-15-0502 Psychological, psychophysiological and anthropometric correlates of cardiovascular diseases.

The authors report no conflicts of interest in this work.

A Comprehensive Model of Homework in Cognitive Behavior Therapy

• Original Article
• Published: 03 July 2021
• Volume 46 , pages 247–257, ( 2022 )

Cite this article

• Nikolaos Kazantzis   ORCID: orcid.org/0000-0001-9559-4160 1 , 2 &
• Allen R. Miller 2  

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This article contributes a comprehensive model of homework in cognitive behavior therapy (CBT). To this end, several issues in the definition of homework and homework compliance are outlined, research on homework-outcome relations is critiqued, before an overview of classical and operant conditioning along with various cognitive theories are tied together in a c omprehensive model. We suggest engagement represents a more clinically meaningful construct than compliance (or adherence). We describe how established behavior and cognitive theories are relevant for understanding patient engagement and what between-session and in-session processes are useful in a comprehensive model. Our primary conclusion from the review of this literature is that current research has focused on limited aspects of homework and missed theoretically meaningful determinants of engagement. Further, little research has sought to examine the role of the therapist in facilitating these theoretically meaningful determinants. The literature on homework is the most advanced of the process research in CBT; the comprehensive model presented here offers clarity for the practicing clinician and represents a testable model for researchers interested in quantifying determinants of homework engagement and the process of integrating homework into CBT.

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Kazantzis, N., Miller, A.R. A Comprehensive Model of Homework in Cognitive Behavior Therapy. Cogn Ther Res 46 , 247–257 (2022). https://doi.org/10.1007/s10608-021-10247-z

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What Is Cognitive Behavioral Therapy (CBT)?

Michela Buttignol for Verywell Mind / Stocksy

• Effectiveness
• Considerations
• Getting Started

Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change the destructive or disturbing thought patterns that have a negative influence on their behavior and emotions.

Cognitive behavioral therapy combines cognitive therapy with behavior therapy by identifying maladaptive patterns of thinking, emotional responses, or behaviors and replacing them with more desirable patterns.

Cognitive behavioral therapy focuses on changing the automatic negative thoughts that can contribute to and worsen our emotional difficulties, depression , and anxiety . These spontaneous negative thoughts also have a detrimental influence on our mood.

Through CBT, faulty thoughts are identified, challenged, and replaced with more objective, realistic thoughts.

Everything You Need to Know About CBT

This video has been medically reviewed by Steven Gans, MD .

Types of Cognitive Behavioral Therapy

CBT encompasses a range of techniques and approaches that address our thoughts, emotions, and behaviors. These can range from structured psychotherapies to self-help practices. Some of the specific types of therapeutic approaches that involve cognitive behavioral therapy include:

• Cognitive therapy centers on identifying and changing inaccurate or distorted thought patterns, emotional responses, and behaviors.
• Dialectical behavior therapy (DBT)  addresses destructive or disturbing thoughts and behaviors while incorporating treatment strategies such as emotional regulation and mindfulness.
• Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities: behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
• Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.

While each type of cognitive behavioral therapy takes a different approach, all work to address the underlying thought patterns that contribute to psychological distress.

Cognitive Behavioral Therapy Techniques

CBT is about more than identifying thought patterns. It uses a wide range of strategies to help people overcome these patterns. Here are just a few examples of techniques used in cognitive behavioral therapy. 

Identifying Negative Thoughts

It is important to learn what thoughts, feelings, and situations are contributing to maladaptive behaviors. This process can be difficult, however, especially for people who struggle with introspection . But taking the time to identify these thoughts can also lead to self-discovery and provide insights that are essential to the treatment process.

Practicing New Skills

In cognitive behavioral therapy, people are often taught new skills that can be used in real-world situations. For example, someone with a substance use disorder might practice new coping skills and rehearse ways to avoid or deal with social situations that could potentially trigger a relapse.

Goal-Setting

Goal setting can be an important step in recovery from mental illness, helping you to make changes to improve your health and life. During cognitive behavioral therapy, a therapist can help you build and strengthen your goal-setting skills .

This might involve teaching you how to identify your goal or how to distinguish between short- and long-term goals. It may also include helping you set SMART goals (specific, measurable, attainable, relevant, and time-based), with a focus on the process as much as the end outcome.

Problem-Solving

Learning problem-solving skills during cognitive behavioral therapy can help you learn how to identify and solve problems that may arise from life stressors, both big and small. It can also help reduce the negative impact of psychological and physical illness.

Problem-solving in CBT often involves five steps:

• Identify the problem
• Generate a list of potential solutions
• Evaluate the strengths and weaknesses of each potential solution
• Choose a solution to implement
• Implement the solution

Self-Monitoring

Also known as diary work, self-monitoring is an important cognitive behavioral therapy technique. It involves tracking behaviors, symptoms, or experiences over time and sharing them with your therapist.

Self-monitoring can provide your therapist with the information they need to provide the best treatment. For example, for people with eating disorders, self-monitoring may involve keeping track of eating habits, as well as any thoughts or feelings that went along with consuming a meal or snack.

Additional cognitive behavioral therapy techniques may include journaling , role-playing , engaging in relaxation strategies , and using mental distractions .

What Cognitive Behavioral Therapy Can Help With

Cognitive behavioral therapy can be used as a short-term treatment to help individuals learn to focus on present thoughts and beliefs.

CBT is used to treat a wide range of conditions, including:

• Anger issues
• Bipolar disorder
• Eating disorders
• Panic attacks
• Personality disorders

In addition to mental health conditions, cognitive behavioral therapy has also been found to help people cope with:

• Chronic pain or serious illnesses
• Divorce or break-ups
• Grief or loss
• Low self-esteem
• Relationship problems
• Stress management

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Benefits of Cognitive Behavioral Therapy

The underlying concept behind CBT is that thoughts and feelings play a fundamental role in behavior. For example, a person who spends a lot of time thinking about plane crashes, runway accidents, and other air disasters may avoid air travel as a result.

The goal of cognitive behavioral therapy is to teach people that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

CBT is known for providing the following key benefits:

• It helps you develop healthier thought patterns by becoming aware of the negative and often unrealistic thoughts that dampen your feelings and moods.
• It is an effective short-term treatment option as improvements can often be seen in five to 20 sessions.
• It is effective for a wide variety of maladaptive behaviors.
• It is often more affordable than some other types of therapy .
• It is effective whether therapy occurs online or face-to-face.
• It can be used for those who don't require psychotropic medication .

One of the greatest benefits of cognitive behavioral therapy is that it helps clients develop coping skills that can be useful both now and in the future.

Effectiveness of Cognitive Behavioral Therapy

CBT emerged during the 1960s and originated in the work of psychiatrist Aaron Beck , who noted that certain types of thinking contributed to emotional problems. Beck labeled these "automatic negative thoughts" and developed the process of cognitive therapy. 

Where earlier behavior therapies had focused almost exclusively on associations, reinforcements , and punishments to modify behavior, the cognitive approach addresses how thoughts and feelings affect behaviors.

Today, cognitive behavioral therapy is one of the most well-studied forms of treatment. It has been shown to be effective in the treatment of a range of mental conditions, including anxiety, depression, eating disorders, insomnia, obsessive-compulsive disorder , panic disorder, post-traumatic stress disorder , and substance use disorder.

• Research indicates that cognitive behavioral therapy is the leading evidence-based treatment for eating disorders .
• CBT has been proven helpful in those with insomnia, as well as those who have a medical condition that interferes with sleep, including those with pain or mood disorders such as depression.
• Cognitive behavioral therapy has been scientifically proven to be effective in treating symptoms of depression and anxiety in children and adolescents.
• A 2018 meta-analysis of 41 studies found that CBT helped improve symptoms in people with anxiety and anxiety-related disorders, including obsessive-compulsive disorder and post-traumatic stress disorder.
• Cognitive behavioral therapy has a high level of empirical support for the treatment of substance use disorders, helping people with these disorders improve self-control , avoid triggers, and develop coping mechanisms for daily stressors.

CBT is one of the most researched types of therapy, in part, because treatment is focused on very specific goals and results can be measured relatively easily.

Verywell Mind's Cost of Therapy Survey , which sought to learn more about how Americans deal with the financial burdens associated with therapy, found that Americans overwhelmingly feel the benefits of therapy:

• 80% say therapy is a good investment
• 91% are satisfied with the quality of therapy they receive
• 84% are satisfied with their progress toward mental health goals

Things to Consider With Cognitive Behavioral Therapy

There are several challenges that people may face when engaging in cognitive behavioral therapy. Here are a few to consider.

Change Can Be Difficult

Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to alter them.

CBT Is Very Structured

Cognitive behavioral therapy doesn't focus on underlying, unconscious resistance to change as much as other approaches such as  psychoanalytic psychotherapy . Instead, it tends to be more structured, so it may not be suitable for people who may find structure difficult.

You Must Be Willing to Change

For cognitive behavioral therapy to be effective, you must be ready and willing to spend time and effort analyzing your thoughts and feelings. This self-analysis can be difficult, but it is a great way to learn more about how our internal states impact our outward behavior.

Progress Is Often Gradual

In most cases, CBT is a gradual process that helps you take incremental steps toward behavior change . For example, someone with social anxiety might start by simply imagining anxiety-provoking social situations. Next, they may practice conversations with friends, family, and acquaintances. By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve.

How to Get Started With Cognitive Behavioral Therapy

Cognitive behavioral therapy can be an effective treatment choice for a range of psychological issues. If you or someone you love might benefit from this form of therapy, consider the following steps:

• Consult with your physician and/or check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a licensed professional in your area. You can also do a search for "cognitive behavioral therapy near me" to find local therapists who specialize in this type of therapy.
• Consider your personal preferences , including whether face-to-face or online therapy will work best for you.
• Contact your health insurance to see if it covers cognitive behavioral therapy and, if so, how many sessions are covered per year.
• Make an appointment with the therapist you've chosen, noting it on your calendar so you don't forget it or accidentally schedule something else during that time.
• Show up to your first session with an open mind and positive attitude. Be ready to begin to identify the thoughts and behaviors that may be holding you back, and commit to learning the strategies that can propel you forward instead.

What to Expect With Cognitive Behavioral Therapy

If you're new to cognitive behavioral therapy, you may have uncertainties or fears of what to expect. In many ways, the first session begins much like your first appointment with any new healthcare provider.

During the first session, you'll likely spend some time filling out paperwork such as HIPAA forms (privacy forms), insurance information, medical history, current medications, and a therapist-patient service agreement. If you're participating in online therapy, you'll likely fill out these forms online.

Also be prepared to answer questions about what brought you to therapy, your symptoms , and your history—including your childhood, education, career, relationships (family, romantic, friends), and current living situation.

Once the therapist has a better idea of who you are, the challenges you face, and your goals for cognitive behavioral therapy, they can help you increase your awareness of the thoughts and beliefs you have that are unhelpful or unrealistic. Next, strategies are implemented to help you develop healthier thoughts and behavior patterns.

During later sessions, you will discuss how your strategies are working and change the ones that aren't. Your therapist may also suggest cognitive behavioral therapy techniques you can do yourself between sessions, such as journaling to identify negative thoughts or practicing new skills to overcome your anxiety .

If you are having suicidal thoughts, contact the  National Suicide Prevention Lifeline  at  988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our  National Helpline Database .

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Lazarus AA, Abramovitz A. A multimodal behavioral approach to performance anxiety . J Clin Psychol. 2004;60(8):831-40. doi:10.1002/jclp.20041

Lincoln TM, Riehle M, Pillny M, et al. Using functional analysis as a framework to guide individualized treatment for negative symptoms . Front Psychol. 2017;8:2108. doi:10.3389/fpsyg.2017.02108

Ugueto AM, Santucci LC, Krumholz LS, Weisz JR. Problem-solving skills training . Evidence-Based CBT for Anxiety and Depression in Children and Adolescents: A Competencies-Based Approach . 2014. doi:10.1002/9781118500576.ch17

Lindgreen P, Lomborg K, Clausen L.  Patient experiences using a self-monitoring app in eating disorder treatment: Qualitative study .  JMIR Mhealth Uhealth.  2018;6(6):e10253. doi:10.2196/10253

Tsitsas GD, Paschali AA. A cognitive-behavior therapy applied to a social anxiety disorder and a specific phobia, case study . Health Psychol Res. 2014;2(3):1603. doi:10.4081/hpr.2014.1603

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Trauer JM, Qian MY, Doyle JS, Rajaratnam SMW, Cunnington D. Cognitive behavioral therapy for chronic insomnia: A systematic review and meta-analysis .  Ann Intern Med . 2015;163(3):191. doi:10.7326/M14-2841

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Carpenter J, Andrews L, Witcraft S, Powers M, Smits J, Hofmann S. Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials .  Depress Anxiety . 2018;35(6):502–14. doi:10.1002/da.22728

National Institute on Drug Abuse (NIDA).  Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine) .

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By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Behavior Therapy Methods: 12 Best Techniques & Worksheets

Attention is focused on observable behavior, unlike the subjective focus of psychoanalysis on “inner dynamics or mental concepts” (Sommers-Flanagan & Sommers-Flanagan, 2015, p. 225).

It has proven highly successful. Behavior therapy has helped treat diverse client populations across a range of psychological disorders and continues to evolve into a new range of treatments (Corey, 2013).

This article explores several of the best behavior therapy methods and introduces valuable techniques, worksheets, and exercises for work in-session or at home.

Before you continue, we thought you might like to download our three Positive CBT Exercises for free . These science-based exercises will provide you with detailed insight into positive Cognitive-Behavioral Therapy (CBT) and give you the tools to apply it in your therapy or coaching.

This Article Contains:

Best behavior therapy methods, 6 valuable techniques for your sessions, 6 worksheets to download today, fun games and exercises for your clients, positivepsychology.com’s resources, a take-home message.

Traditionally, “behaviorists strictly focus on observable behavior or materialistic concepts,” using scientifically derived therapeutic techniques (Corey, 2013, p. 225). Based on the view that all behavior is learned, the behavioral approach to human change has passed through three historical stages (Corey, 2013):

• Behaviorism as a scientific endeavor
• Behavior therapy
• Cognitive-Behavioral Therapy

Having evolved over time, the third wave of the behavioral approach to therapy now includes Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), mindfulness-based stress reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT; Corey, 2013).

These newer behavioral therapy methods center on five overlapping core themes (modified from Corey, 2013, p. 269):

• A more far-reaching, expanded view of psychological wellness
• A broader view of acceptable outcomes from treatment
• The role and importance of acceptance
• The value and benefits of mindfulness
• The importance of creating a life worth living

Mindfulness encourages nonjudgmental engagement and awareness during an activity. Clients develop an attitude of curiosity, intentionally focusing on the present experience.

Closely aligned with mindfulness, “acceptance is a process involving receiving one’s present experience without judgment or preference, but with curiosity and kindness” (Corey, 2013, p. 269).

Below is a brief description of five of the best (more recent) behavior therapy methods (Corey, 2013; Sommers-Flanagan & Sommers-Flanagan, 2015).

Acceptance and Commitment Therapy (ACT)

In contrast to many Cognitive-Behavioral Therapy approaches, ACT involves fully accepting the present while mindfully letting go of obstacles that stand in our way.

Rather than attempting to challenge and change thinking, clients are helped to become more aware and change how they relate to their thoughts. The client is then encouraged to commit to act in a way that promotes meaningful and valued living (Forsyth & Eifert, 2016; Corey, 2013).

Dialectical Behavior Therapy (DBT)

DBT blends behavioral and psychoanalytic techniques to treat borderline personality disorders. Acceptance and change-oriented strategies help clients transform their behavior and environment while adopting a state of acceptance.

Critically, the client learns the dialectical relationships between ongoing and opposing forces in their lives and how to regulate their emotions and behaviors (Corey, 2013).

Mindfulness-based stress reduction (MBSR)

MBSR recognizes that much of our stress comes from our ongoing wish that things are different from how they are, whatever our environment or situation.

While initially used with groups, it has since been practiced with various specific diagnoses and conditions in individuals, including people with cancer, eating disorders, and in medical, educational, and prison settings (Crane, 2009).

The approach helps people live in the present rather than maintain an ongoing focus on the past or future. Mindfulness is brought into multiple aspects of the client’s life to relate to both internal and external stressors in a more positive way (Corey, 2013).

Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness is a powerful tool for managing depression (Brown-Iannuzzi et al., 2014), especially when teamed with CBT. CBT offers a valuable framework that informs teaching.

MBCT integrates MBSR to inform its content, structure, and teaching style with CBT interventions in an eight-session program “to change clients’ awareness of and relation to their negative thoughts” (Corey, 2013, p. 272; Crane, 2009).

The therapist works with the client to formulate specific, clear, and measurable goals and subgoals alongside associated behaviors (Corey, 2013).

Behavioral analysis is a crucial aspect of therapy. The ABC model, in particular, includes identifying and gathering (Corey, 2013):

A – situational antecedents (what elicits the behavior) B – dimensions of the problem behavior C – the consequences of the behavior

Helpful techniques used across the various behavior therapy methods are wide and varied, offering powerful tools to encourage and evoke client change (Sommers-Flanagan & Sommers-Flanagan, 2015; Corey, 2013).

Self-monitoring

Being unable to observe the client’s behavior outside the session, therapists must rely on their self-reporting. Clients are trained to keep track of how they behave, such as when they get angry or how many cigarettes they smoke. Emotion and thought logs are used to record (Sommers-Flanagan & Sommers-Flanagan, 2015):

• Disturbing or upsetting emotional states
• The exact nature of the behavior at the time
• Thoughts that emerged alongside the emotions

Self-monitoring benefits from a lack of expensive equipment yet risks being inaccurate or incomplete.

Behavioral interviews

Within sessions, therapists may use behavioral interviews to (Sommers-Flanagan & Sommers-Flanagan, 2015):

• Observe client behavior
• Ask about antecedents
• Question problem behavior
• Agree on and define treatment targets and goals

The behavioral interview inquires beyond client statements such as, “I’m depressed,” digging into specific behavioral needs. For example, the therapist may ask, “What happens during the day when you are feeling depressed?” (Sommers-Flanagan & Sommers-Flanagan, 2015, p. 235).

Operant conditioning

In the tradition of Skinner, behaviorists attempt to modify behavior by manipulating the environment, rather than the mind or cognition (Sommers-Flanagan & Sommers-Flanagan, 2015).

The therapist usually begins by operationalizing target behaviors or objectives (for example, decreasing profanity, overeating, or smoking). Once the environment has been modified, it is necessary to perform ongoing monitoring to test the behavior.

Systematic desensitization

Based on classical conditioning , clients imagine increased “anxiety-arousing situations at the same time that they engage in a behavior that competes with anxiety” (Corey, 2013, p. 258). While time-consuming, systematic desensitization can successfully reduce maladaptive anxiety, anxiety-related disorders, and phobias, but also requires self-monitoring.

Progressive muscle relaxation (PMR)

PMR teaches people how to deal with stress through mental and muscle relaxation skills. The client lets go by contracting muscles (and feeling the intense pressure building up) then releasing them while performing deep and regular breathing. Once learned, the client must practice the skills to achieve maximum benefits (Corey, 2013).

Interoceptive exposure

Interoceptive exposure  teaches clients to handle the physical aspects of intense anxiety and panic. The client focuses on internal physical cues using interoceptive exposure tasks, such as (Sommers-Flanagan & Sommers-Flanagan, 2015):

• Hyperventilating
• Holding their breath
• Shaking their head
• Spinning in circles
• Breathing in the chest
• Breathing through a straw

With practice, clients become desensitized to physical triggers associated with anxiety and panic attacks.

Download 3 Free Positive CBT Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to find new pathways to reduce suffering and more effectively cope with life stressors.

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By filling out your name and email address below.

The following worksheets are taken from various theoretical standpoints under the term ‘behavior therapy,’ including its more recent variations.

While they differ considerably, each worksheet helps change behavior; achieve a better understanding of thoughts, emotions, or behaviors; or helps implement coping skills.

Challenging Emotional Myths

Emotional myths may impede helpful thinking and cause us to hold irrational beliefs.

Use the Challenging Emotional Myths worksheet to challenge your client’s thinking about feelings by considering a set of statements, including:

There is only one way to feel in any given situation. Letting others know how I feel will show my weaknesses. Painful emotions are just the result of having the wrong attitude. Painful emotions are not helpful and should be ignored. Extreme emotions get you much further in life than trying to regulate them.

Once completed, talk through each challenged statement and explore how all emotions can be valuable, helping us in different ways and times.

Checking Emotional Facts

Sometimes our emotions don’t represent what is really happening, but are influenced by other thoughts, assumptions, and beliefs.

Use the Checking Emotional Facts worksheet with clients to better understand their emotions and what else could be impacting them.

Clients are asked a series of questions, including:

What emotion would you like to change? (perhaps it is causing you problems elsewhere in your life, for example, envy, anger, or jealousy) What event triggered/prompted the emotion? Are you assuming a threat? Is there really a threat? If the threat comes true, what will really happen? Do your feelings (angry, sad, reluctant, suspicious, etc.) really fit the situation?

Once completed, talk through the client’s answers without judgment. Work with them to see that some emotions could be causing them unnecessary pain and may not be appropriate to the situation.

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STOP – Distress Tolerance

Sometimes it is not possible to make things better right away; it is helpful to develop skills to handle strong emotions and tolerate painful events.

Use the STOP – Distress Tolerance worksheet to learn how to use the STOP acronym to handle difficult situations:

• Stop Stop! Don’t just react; freeze. You may be about to act without thinking.
• Take a step back Take a deep breath and step back from the situation. Don’t let how you feel make you act impulsively.
• Observe Become aware of how you feel and your environment. What is the situation? What are you thinking? What are you feeling? What are others saying and doing?
• Proceed mindfully Move forward and act mindfully. Consider what actions will make things better or worse.

Remembering to STOP can be a valuable way to avoid an emotional response that worsens the situation and subsequent feelings of regret.

Resisting rather than acting on crisis urges

At times, we react poorly to unexpected or emotionally upsetting situations.

Use the Resisting Acting on Crisis Urges worksheet with clients to help them compare the pros and cons of acting on impulsive urges or resisting them.

Ask the client to think of a real situation that could have been handled better or an imagined one in the future.

Describe the pros and cons of acting on urges (those immediate, reactive, and often strong emotions). Describe the pros and cons of resisting urges.

Read through the pros and cons and consider how resisting urges could help them maintain control, reacting more in line with their values in future.

Value and Goals

Goal setting is a helpful way of living in line with values and overcoming obstacles along the journey.

Use the Value and Goals worksheet to help clients set a goal in line with their values and identify obstacles that might get in the way.

What important value does this goal work toward? What goals do I want to achieve? What are the obstacles and which strategies could help?

Getting to Know Yourself

We often spend more time on what is wrong with us than what is right. This can mean we lose track of important aspects of ourselves and our lives (Forsyth & Eifert, 2016).

Use the Getting to Know Yourself worksheet with your clients to help them remind themselves of who they are.

Dropping the anchor

This mindfulness exercise helps center clients and connect with the world around them.

Ask them to carry out the following steps:

• Close your eyes and take a few slow, deep breaths.
• Place your feet flat on the floor.
• Push down and notice the floor supporting your feet.
• Notice the tension in the muscles in your legs.
• Feel the weight of gravity flowing through your head, down through your body to your feet.
• Open your eyes and become aware of where you are through your eyes, ears, and bodily sensations.

Morning mindfulness

Ask your client to repeat the following mindfulness activity daily for maximum benefit:

Pick any activity or task from your daily morning routine, for example, taking a shower, brushing your teeth, or making a cup of coffee. Totally focus on what you are doing: the smells, sounds, and movement. As thoughts arise, acknowledge them but bring your attention back to the activity.

Drawing activities

Drawing can be a valuable exercise at any age but is particularly valuable behavior therapy with children .

Ask your client to:

• Think of an important person in your life and draw them performing a typical activity.
• Close your eyes and imagine sending them friendliness. Perhaps they are having a nice breakfast or doing something fun for the day.
• Next, draw a picture either of you sending them kindness and friendliness or the activity they may be doing.

17 Science-Based Ways To Apply Positive CBT

These 17 Positive CBT & Cognitive Therapy Exercises [PDF] include our top-rated, ready-made templates for helping others develop more helpful thoughts and behaviors in response to challenges, while broadening the scope of traditional CBT.

Created by Experts. 100% Science-based.

We have many resources available for therapists to help clients modify behaviors or manage unwanted and unhelpful thoughts.

Why not download our free CBT pack and try out the powerful exercises contained within? Some examples include:

• Solution-Focused Guided Imagery This exercise emphasizes people’s strengths and how they can be applied to the change process. Clients can rely on them to cope with a problem or obstacle they face.
• Reframing Critical Self-Talk Self-criticism is the opposite of self-compassion, taking many forms and often resulting in negative emotions (such as fear, shame, and guilt) that can underpin psychopathology.

Other free resources include:

• Progressive Muscle Relaxation This script outlines the basics of PMR and its value for helping clients relax and unwind, while keeping it simple for younger audiences.
• Problem-Solving Self-Monitoring Form The answers to a series of questions provide the therapist with details of the client’s overall and specific problem-solving approaches and reactions .
• Reactions to Stress This helpful form can be used as homework to capture stressful events and the client’s reactions. By recording feelings, behaviors, and thoughts, repeating patterns can be recognized.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit© , but they are described briefly below:

• Step one – Understand usual responses to emotions.
• Step two – Consider the opposite response and its potential impact.

Afterward, reflect on how successful the exercise was and how it could be helpful to choose the opposite of the usual response going forward.

• Wise Mind Chair Work In DBT, clients learn that there are three states of mind in which we operate: the reasonable mind, the emotional mind, and the wise mind.

The exercise begins by introducing each of the mind states, before performing an exercise that helps the client adopt each one in turn and understand its benefits and costs.

If you’re looking for more science-based ways to help others through CBT, check out this collection of 17 validated positive CBT tools for practitioners. Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.

Behavior therapy is a powerful tool for treating clients with unhelpful behaviors they wish to stop or replace.

If we assume that all behavior is learned, then we can accept that given the right conditions, we can adopt new skills and strategies and change how we act.

Over time, behavior therapy has adopted the latest psychological techniques based on scientific research, including mindfulness and acceptance. They expand our view of what psychological wellness truly means and what represents a positive outcome from treatment.

Mindfulness and acceptance approaches can change how we see the present, whether difficult or effortless. They help us accept our situation while exploring how to set goals and move toward a more valued and meaningful life.

Why not explore the newer, third-wave behavior therapy approaches – DBT, MBSR, MBCT, and ACT – and consider how you can use them to help your clients achieve their best lives? Each technique and worksheet included in this article is a valuable tool that can help address behavioral concerns that led to clients seeking help.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free .

• Brown-Iannuzzi, J. L., Adair, K. C., Payne, B. K., Richman, L. S., & Frederickson, B. L. (2014). Discrimination hurts, but mindfulness may help: Trait mindfulness moderates the relationship between perceived discrimination and depressive symptoms.  Personality and Individual Differences, 56, 201–205.
• Corey, G. (2013). Theory and practice of counseling and psychotherapy . Cengage.
• Crane, R. (2009). Mindfulness-based cognitive therapy . Routledge.
• Forsyth, J. P., & Eifert, G. H. (2016). The mindfulness & acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias & worry using acceptance & commitment therapy . New Harbinger.
• Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Study guide for counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (2nd ed.). Wiley.

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What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

It is important to emphasize that advances in CBT have been made on the basis of both research and clinical practice. Indeed, CBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CBT differs from many other forms of psychological treatment.

CBT is based on several core principles, including:

• Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
• Psychological problems are based, in part, on learned patterns of unhelpful behavior.
• People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CBT treatment usually involves efforts to change thinking patterns. These strategies might include:

• Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
• Gaining a better understanding of the behavior and motivation of others.
• Using problem-solving skills to cope with difficult situations.
• Learning to develop a greater sense of confidence in one’s own abilities.

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

• Facing one’s fears instead of avoiding them.
• Using role playing to prepare for potentially problematic interactions with others.
• Learning to calm one’s mind and relax one’s body.

Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.

CBT places an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behavior.

CBT therapists emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. A certain amount of information about one’s history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

Source: APA Div. 12 (Society of Clinical Psychology)

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Authority file   Subcategories This category has the following 28 subcategories, out of 28 total. Rivers in Ulchsky District ‎ (3 C, 2 F) Allakh-Yun River ‎ (3 F) Amgun ‎ (1 C, 15 F) Amur River ‎ (19 C, 172 F) Amur River in Khabarovsk Krai ‎ (7 C, 3 F) Anyuy River ‎ (2 C, 20 F) Beshenaya River, Khabarovsk Krai ‎ (6 F) Bikin River ‎ (7 F) Bolshaya Dyuanka River ‎ (4 F) Bureya River ‎ (3 C, 14 F) Gobilly River, Khabarovsk Krai ‎ (4 F) Gonam River ‎ (3 F) Gorelaja wetland, Ulchsky District ‎ (6 F) Inya (Sea of Okhotsk) ‎ (2 F) Khor River ‎ (6 F) Mati River ‎ (1 F) Maya River ‎ (1 C, 9 F) Maymakan ‎ (7 F) Nimelen ‎ (2 F) Okhota ‎ (3 F) River Gur Khabarovsk Krai ‎ (22 F) Sports tourism in Tuyun ‎ (5 F) Tumnin River ‎ (13 F) Tunguska EAO River ‎ (51 F) Tuyun River ‎ (1 C, 2 F) Uchur River ‎ (1 C, 3 F) Urak ‎ (2 F) Yudoma ‎ (7 F) Media in category "Rivers of Khabarovsk Krai" The following 37 files are in this category, out of 37 total. Rivers of Russia by region Rivers of Russia (asian part) Bodies of water in Khabarovsk Krai Uses of Wikidata Infobox Uses of Wikidata Infobox with subinfoboxes Uses of Wikidata Infobox with maps Pages with coordinates Navigation menu 398 IMAGES Tips for Easier and More Effective Therapy Homework Cbt Worksheets For Changing Core Beliefs Free Printable Cbt Therapy Worksheets 16 Cognitive Therapy Worksheets Adaptation Worksheets for Middle School Dbt Distress tolerance Accepts Weekly Schedule for Behavioral Activation (Worksheet VIDEO Behavioral Therapy and Health Equity #livingcorporate #equity #workplacediversity #workculture Future Planning #lifestyle #emotional #behavioral Why Your Physical Therapy Homework Is So Important Better Therapy Homework: Evidence-Based Practices for Better Outcomes Homework and its impact on the effectiveness of CPT 5 Ways to Overcome Procrastination! Kati Morton COMMENTS CBT Techniques: 25 Cognitive Behavioral Therapy Worksheets Here's a list of 25 cognitive behavioral therapy techniques, CBT interventions, and exercises. Try these worksheets in your own practice! CBT Worksheets CBT for Kids: Thoughts, Feelings, & Actions Cognitive behavior therapy (CBT) is an evidence-based treatment for many mental and behavioral health issues. Research has shown that CBT can be effective for children as young as 7 years old, if the concepts are explained in a simple and relatable manner. CBT WORKSHEET PACKET The nonprofit Beck Institute for Cognitive Behavior Therapy was established in 1994 by Dr. Aaron T. Beck and Dr. Judith S. Beck as a setting for state-of-the-art psychotherapy and professional training in CBT. How to Design Homework in CBT That Will Engage Your Clients We explore why homework in CBT is so essential and how to design engaging, effective CBT interventions using modern technology. Assigning Homework in Cognitive Behavioral Therapy Assigning Homework in Cognitive Behavioral Therapy Cognitive behavioral therapy (CBT) is known to be a highly effective approach to mental health treatment. Cognitive Behavioural Therapy Worksheets and Exercises Download free copies of the Think CBT Workbook and individual CBT worksheets. Cognitive Behavioural Therapy Experts, ready to take your call. CBT Practice Exercises Cognitive Behavioral Therapy (CBT) requires clients to have a strong understanding of the cognitive model before they attempt to identify and challenge their negative thoughts. This CBT worksheet will help you teach your clients about the relationship between thoughts, emotions, and behaviors through the use of several examples and practice exercises. Therapy Homework: Purpose, Benefits, and Tips This article explores the purpose of therapy homework, the benefits it can offer, and some tips to help you comply with your homework assignments. Homework in CBT Homework in CBT Why do homework in CBT? Homework assignments in Cognitive Behavioural Therapy (CBT) can help your patients educate themselves further, collect thoughts, and modify their thinking. How to deliver homework Homework is not something that you just assign randomly. You should make sure you: The New "Homework" in Cognitive Behavior Therapy The New "Homework" in Cognitive Behavior Therapy. By Judith S. Beck, Ph.D., and Francine R. Broder, Psy.D. Judith S. Beck, Ph.D. We've stopped using the word "homework" in CBT. Too many clients take exception to that term. It reminds them of the drudgery of assignments they had to do at home when they were at school. Top 10 CBT Worksheets Websites The best Cognitive Behavioural Therapy resources, activities and assignments all in one place Hi, it's Rosie here, Uncommon Knowledge's content manager. I've been hearing a lot from practitioners who use Cognitive Behavioural Therapy (CBT) and are on the lookout for new resources, especially CBT worksheets. Sending Homework to Clients in Therapy: The Easy Way Is Homework in Therapy Important? Cognitive-Behavioral Therapy has "been shown to be as effective as medications in the treatment of a number of psychiatric illnesses" (Tang & Kreindler, 2017, p. 1). Homework is a vital component of CBT, typically involving completing a structured and focused activity between sessions. Supporting Homework Compliance in Cognitive Behavioural Therapy Cognitive behavioral therapy (CBT) is one of the most effective psychotherapy modalities used to treat depression and anxiety disorders. Homework is an integral component of CBT, but homework compliance in CBT remains problematic in real-life practice. ... Using Homework Assignments in Cognitive Behavior Therapy Homework is a central feature of Cognitive-Behavioral Therapy (CBT), given its educational emphasis. This new text is a comprehensive guide for administering assignments. The first part of the text offers essential introductory material, a comprehensive review of the theoretical and empirical support for the use of homework, models for practice ... Homework in Cognitive Behavioral Supervision: Theoretical Background Homework presents one of the cornerstones of cognitive-behavioral therapy, CB supervision and the training of CBT supervisors. If applied consistently and collaboratively, homework enhances therapeutic outcomes and increases the patient's self-confidence. A Comprehensive Model of Homework in Cognitive Behavior Therapy This article contributes a comprehensive model of homework in cognitive behavior therapy (CBT). To this end, several issues in the definition of homework and homework compliance are outlined, research on homework-outcome relations is critiqued, before an overview of classical and operant conditioning along with various cognitive theories are tied together in a comprehensive model. We suggest ... Cognitive Behavioral Therapy (CBT): Types, Techniques, Uses Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change the destructive or disturbing thought patterns that have a negative influence on their behavior and emotions. Cognitive behavioral therapy combines cognitive therapy with behavior therapy by identifying maladaptive ... Behavior Therapy Methods: 12 Best Techniques & Worksheets Explore the best behavior therapy methods, valuable techniques, worksheets, and exercises for counseling work in-session or at home. What is Cognitive Behavioral Therapy? Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Russian T-72B3 tank at the Knyaz-Volkonsky training center in ... 315K subscribers in the TankPorn community. TankPorn is for all things Battle Tanks, Armored Fighting Vehicles, Armored Cars, Self-Propelled Guns and… Category:Water in Khabarovsk Krai There are no pages or files in this category. This list may not reflect recent changes ( learn more ). Wikipedia soft redirected categories Khabarovsk Krai Khabarovsk Krai (Russian: Хабаровский край, romanized: Khabarovskiy kray, IPA: [xɐˈbarəfskʲɪj kraj]) is a federal subject (a krai) of Russia. It is located in the Russian Far East and is administratively part of the Far Eastern Federal District. The administrative centre of the krai is the city of Khabarovsk, which is home ... Category:Rivers of Khabarovsk Krai Category:Rivers of Khabarovsk Krai From Wikimedia Commons, the free media repository Federal subjects of the Russian Federation: Republics: Adygea · Altai · Bashkortostan · Buryatia · Chechnya · Chuvashia · (Crimea) · Dagestan · Ingushetia · Kabardino-Balkaria · Kalmykia · Karachay-Cherkessia · Karelia · Khakassia · Komi · Mari El · Mordovia · North Ossetia — Alania ... essay homework paper phd project resume review study thesis