Brief Health Focused CBT
Transforming suffering to strengths
CBT – Simple Overview
CBT is a time limited, collaborative, here and now
focused treatment aimed at helping patients
through developing more accurate healthy
thoughts, increased coping skills, behavioral
activation and emotional regulation skills.
• The CBT relationship is based on collaborative empiricism… The Patient
and the Therapist collaborate to discover facts and truth grounded in
• Good CBT Requires: Warmth, Empathy, Consideration, Exploration and
Curiosity, Ability to Give Feedback and Solid Doubt or ‘show me the facts
• The CBT therapist brings expertise in therapy and skills but expects the
patient to be experts in themselves and bring that expertise into the
Three Key Parts of Health Focused CBT
• Functional Assessment: Looks at the real life way that mental and
physical health challenges arise. Not simple that some one is depressed…
but what is that depression in this person’s life.
• Skills Training: Is active and focused on helping enhance the ability to
change thoughts, improve emotions and take effective actions.
• Changing Thoughts: Negative thoughts are a core part of how CBT
conceptualizes mental suffering. Clinicians help patients gain skills to
challenge their thoughts, recognize distorted thinking, find more
accurate and helpful thoughts and cope cognitively.
The Core Levers of Change…
What Creates Change?
In CBT the core of human suffering is
developed by any one of the core
components. These are thoughts,
feelings and behaviors.
If a patient changes how they act it
will change their thoughts and if they
change their thoughts they can change
how they act.
Principles of CBT
• CBT is… Time Limited
• CBT is… Biopsychosocial
• CBT is… Focused on Present
• CBT is… Person Centered
• CBT uses the… Collaborative Set
• CBT uses… Regular Homework
• CBT takes… Active Stance
• CBT therapists help… Challenge/Change Thoughts
• Challenging Thoughts: Many times inaccurate thoughts go unchallenged.
They can be like a ‘Trojan Horse’ we believe them because they are
inside our mind. Examining thoughts can lead to changing thoughts.
• Accepting Thoughts: We can simply accept thoughts as they are. Not
fixing them but not in the words of ACT ‘fusing’ with them.
• Thought Stopping: We can use various skills to stop thoughts. The most
simple of these is to simply using our inner voice to say ‘stop’ to an
• Distraction: Focusing on something other then a thought can allow the
thoughts to stop and reduce their impact.
• Thought Replacement: We can replace a negative unhelpful thought with
a more true and more helpful thought.
Core Cognitions are the central thoughts that a person
believes and guide thinking, actions and feelings. These
tend to be deeply held beliefs that were formed in
difficult moments and never examined.
The way we work with core cognitions is to identify them,
develop evidence to counter them and come up with more
accurate core beliefs. Core cognitions lead
to automatic thoughts.
CBT Session Overview
• The first 1/3 or 20 min: Is focused on assessing where a patient
is, their concerns about tx and reviewing homework.
• The second 1/3 20 min: Is focused on introducing session topic and
relating topic to patient’s life and symptoms.
• The third 1/3 20 min: Is focused on exploring patients
understanding and reaction to interventions, developing home
work and reviewing and addressing risk and challenges they may
face in HW or in the week.