Archive for the 'Cognitive Therapy' Category

Oct 13 2009

Here Are the Most Common Goals I Suggest During the Beginning of Couples Therapy

Goals for Couples

1.    Learn and use a structured communication model with strict rules about speaking and listening.

2.    Learn and correct mistakes related to speaking, including judgment focus, generalizing, blaming, criticizing, mind reading and ambushing.

3.    Learn and correct the mistakes related to listening, including defensiveness, personalizing, maintaining a negative filter, ambushing, criticism, contempt and reactivity.

4.    Learn and understand the impact of facial expressions, tone of voice, body language and other non-verbal cues in effective communication.

5.    Learn the importance of accepting responsibility for self-care and self-soothing. (We are all responsible for ourselves.)

6.    Learn to use the Cognitive Restructuring written tool and other Cognitive Therapy methods found in the Smart Recovery Tools and Homework website ( to correct distortions and errors in thinking and communication, both in and out of session.

I will discuss and explain these concepts in further posts.

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Oct 12 2009


Practice makes perfect and helps train the brain…it all gets easier the more you do it.Turning down the volume of conversations will help too. We can hear each other pretty well, if we feel like raising our voices, it is likely a time for a time-out. Have a cup of tea, do some breathing, then come back later to the conversation.

When I do listening exercises in session with couples, it helpfsto reduce the levels of conflict and create a warmer space for them to be with each other. There is a little hope that things can get better at home.

At the end of the communication exercise, I ask couples to give each other feedback about what they liked about this new way of talking with each other.

Here are some of the things that couples say to each other:

“I liked the way you expressed your feelings so directly.”

“you listened carefully to what I was saying”

“I liked hearing you reflect back what I was saying to you”

“hearing my words reflected back gave me a chance to hear what I was saying…I could evaluate and clarify my words, so I could say what I really mean”

“when I was listening, I realized how much I would argue and try to win the debate, rather than really listen to what you were saying”

“I realized how much what I usually say is blaming…I am not really talking about what I think, feel and want…rather how much I try to make to blame for my unhappiness”

Using words connected to honest feelings is the only way to create an intimate relationship.

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Sep 02 2009

Dogs, painful electric shocks, and explanatory style: What does the research tell us about feeling discouraged and helpless? (Part 1)

It’s pretty simple. The research shows us that when people feel discouraged and helpless, they are more likely to become depressed. There are several landmark studies conducted by Martin Seligman and Steven Maier describing the phenomenon of learned helplessness using dogs and the effect of exposing the dogs to unpleasant electrical shocks while in a harness.

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Aug 04 2009

Victories of the Heart: Ethics of Marketing and Clinical Models (4)

Briefly, I am noting the positive effort of VOH to name the various psychotherapy models such as psychodynamic, cognitive therapy, jungian, and gestalt, upon which they base their programs.

Click here to read how the website description discusses these ideas.

While there is also a section “for only professionals“, I am only evaluating what is open and transparent to the public. I have already mentioned this “for professionals only” section seems like a bad idea, and some might call it elitist. It is bad marketing for sure.

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Apr 08 2009

Evaluating Chronic and Acute Pain Interview

If you are experiencing pain, here is an evaluation form to help you begin to better understand the complex issues.

Here is the evaluation:

Pain Interview

How can we be helpful? (Presenting Concerns)

Describe what your pain feels like and where you experience it in your body. Does it travel? Is it on the surface of your skin or deeper? (Pain Experience)

When did this pain begin and how do you think it was caused? (Onset)

If you could paint a picture/photograph of your pain when it is bad, what would it look like? (Imagery)

What seems to help your pain feel better/bring relief? If you could take a photograph of what brings you relief, what would it look like?  What seems to block you from having the pain relief you want? (Relief factors/Imagery)

What activities, time of the day, situations make the pain get worse? (Triggers)

How bad is your pain right now using a 0-10 scale where 10=worst pain imaginable? How does it interfere with your life? What changes, losses have it created? (Severity)

What does your support system look like? How has it changed? (Support)

What are you most afraid of now?
What was the most anxious, fearful experience of your life?
When were you the most sad or depressed?
When were you the happiest?
When were you the most proud?

Has anything like this ever happened before to you? Have you been mistreated, physically, emotionally or sexually abused as a child, teenager or adult?
(Past Vulnerability)

Who else have you asked for help with this pain? How helpful was this help on a scale of 0-100% (Previous Treatment)

Is there anything you stand to gain or have already gained as a result of this accident/pain/injury?  (Secondary gain)

(Pain Imagery)
What does your pain look like when you imagine it at its…


Imagine what brings you pain relief. What does it look like?

(Miracle Imagery)

Imagine yourself pain free.

What do you look like?

How do you feel?

What are you doing?

Who are you with?

How has your life changed?

On a scale of 0-100%, how motivated are you to do everything you can to get relief from your pain?  (Motivation)

How much have you improved since starting therapy (0-100%)? (Improvement)

What else do you think I should know at this time?  (Additional Info)

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Oct 24 2008

Use of Cognitive Restructuring for the self-evaluation of alcohol problems

If you are reading my blog or know me, you realize I like to use the cognitive restructuring exercise a lot. It is a great tool to help clients evaluate their own thoughts, beliefs, feelings and behavior.

It works great in evaluating alcohol problems. Here is how it works…

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Aug 06 2008

Free Cognitive Restructuring Worksheet

This is a worksheet for you to use to practice your ability to challenge and reframe your own thoughts and beliefs.

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Aug 04 2008

Cognitive restructuring (CR): The ABCDE way to change automatic negative, self-defeating beliefs into more affirming messages

Cognitive restructuring is a therapy exercise which can help you evaluate negative and perhaps irrational beliefs and turn them into more positive, life affirming messages.

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Aug 04 2008

Cognitive therapy: The Beck Institute Blog

If you are reading my blog, you know I’m writing about Cognitive Therapy.

In the spirit of offering you links to websites that offer great information, click here for the Beck Institute Blog.

You will find a wealth of information related to Cognitive Therapy, including commentary from Aaron Beck, one of the co-founders of the Cognitive Therapy.

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