Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work / Edition 1

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"In this volume, Judith S. Beck builds on her Cognitive Therapy: Basics and Beyond to help clinicians learn to recognize and solve problems ranging from common clinical missteps to complex treatment challenges." "Written in an accessible style, the book provides a clear framework and step-by-step suggestions for identifying and overcoming therapeutic obstacles. Beck emphasizes the need to base intervention on a systematic yet flexible conceptualization of the individual patient. She shows how revisiting the case conceptualization can illuminate why progress may be getting derailed at any given point, as well as how to get back on track. Strategies are presented for remediating difficulties in the fundamental elements of cognitive therapy: the therapeutic relationship, goal setting, structuring sessions, solving problems, cognitive and behavioral change, and homework. While the recommendations presented are applicable to a variety of difficult situations, particular attention is given to addressing the longstanding distorted beliefs and self-defeating coping strategies associated with personality disorders." This book will enhance the knowledge and skills of practitioners at all levels, as well as students in clinical and counseling psychology, psychiatry, social work, family therapy, and psychiatric nursing.
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Editorial Reviews

Doody's Review Service
Reviewer: Susan Richardson, MA, PsyD (Private Practice)
Description: This book, written by Judith Beck, daughter of the creator of cognitive behavior therapy, (CBT), Aaron Beck, considers situations where the basics of CBT aren't sufficient.
Purpose: The purpose is to assist clinicians in developing behavioral methodology for formulating and breaking through therapeutic impasses. The author seeks to provide clinicians with advanced methods in CBT for complex clinical scenarios when the basic techniques are not sufficient.
Audience: The book is written for psychotherapists, psychiatrists, psychologists and other mental health professionals interested in advancing their proficiency in the provision of cognitive behavioral psychotherapy. The author is from the royal family of cognitive behavioral therapy, and having been taught by Aaron Beck himself, she is quite an authoritative voice on the subject.
Features: Overall, the book covers quite a lot of material. First, it assists the clinician in conceptualizing the problems that keep clients from progress. The therapist/client relationship is examined for reactions from both parties that might be interfering with the treatment. Difficulties in goal setting, session structure, and between session compliance are also discussed. The book is visually appealing and contains many useful diagrams and charts. The font and format used for underscoring key concepts is attractive as well.
Assessment: Dr. Beck is clearly quite expert in the methodology and provides dozens of useful, realistic clinical examples and scenarios. The book is very helpful in breaking down the focal areas where clinicians can improve their techniques in assisting clients with complex or chronic problems. This is a useful addition to the library of materials available on cognitive behavioral therapy.
From the Publisher

"This is a highly practical guide for using cognitive therapy with patients who present challenging problems to clinicians with diverse levels of experience. An excellent hands-on text for graduate-level courses and for novice therapists, it can also fruitfully guide mature practitioners who wish to expand their realm of expertise. Enriched with numerous illuminating case materials, the book will enlighten even the most experienced mental health worker."--Theodore Millon, PhD, DSc, Institute for Advanced Studies in Personology and Psychopathology

"Clinicians have been reporting for some time now that they are seeing increasingly difficult cases in their consulting rooms. Axis I and Axis II comorbidities have become the rule rather than the exception. By systematically addressing these challenges in this clearly written and eminently readable volume, Judith Beck takes cognitive therapy to a new level. This book will be equally useful to students and to experienced therapists."--Glen O. Gabbard, MD, Department of Psychiatry, Baylor College of Medicine

"This excellent book focuses on the art of cognitive therapy. When therapy does not seem to be going well, most clinicians can think of another therapist who they think would fare better. This book teaches you how to become that therapist. Drawing on her vast experience with therapists and clients, Dr. Beck beautifully outlines how to identify and overcome many of the difficulties that can arise in cognitive therapy. As a consequence, therapists will be heartened and more patients will experience the benefits they hope for. Highly recommended reading for novice to highly experienced cognitive therapists."--David M. Clark, DPhil, Institute of Psychiatry, King's College, London, UK

Behavioural and Cognitive Psychotherapy

"Judith Beck's first book, Basics and Beyond, was a godsend to me in my first post when I had little access to CBT supervision....I was keen to read the sequel '...What to Do When the Basics Don't Work and I was not disappointed. The book is structured in a similar form to its predecessor, with chapters devoted to each of the essentials of cognitive therapy; formulation, the therapeutic relationship, structuring sessions, identifying cognitions etc....Points are illustrated with case examples and transcripts of sessions, which provide very useful models of exactly how to address tricky issues such as people who keep talking and become controlling whenever a therapist becomes directive....Given the proliferation of cognitive therapy courses, the relative lack of experienced supervisors, and the complexity of cases seen, more and more therapists are likely to feel the need for advice on what to do when the basics don't work. Fortunately, this timely arrival goes a long way to filling that gap."--Behavioural and Cognitive Psychotherapy
Research on Social Work Practice

"An essential educational opportunity for therapists working with varied and challenging adult client populations. It is an empirically supported guide for the helping professional to regain or maintain client-therapist working momentum and for invigorating the therapeutic frame....This book would be a great desk reference for the helping professional or an added reading opportunity for a graduate practice class. The case examples offer the reader pertinent comparatives for real-world dilemmas. Moreover, they clarify the information regarding exigent clients' coping styles, core beliefs, and interfering behaviors....The strength of this text lies in its expanded technical suggestions, born from an empirical model, and put forth by an experienced practitioner....This easy-to-read book is a pragmatic tool for any experienced helping professional or graduate student eager for assistance in working with challenging client populations."--Research on Social Work Practice
Cognitive Behavioral Therapy Book Reviews

"An outstanding teaching text which I recommend to all my trainees....The chapter on dysfunctional reactions to patients is particularly good, and to be recommended to all therapists....This book will be much appreciated by therapists working with patients with challenging problems, and is an excellent companion to Cognitive Therapy: Basics and Beyond."--Cognitive Behavioral Therapy Book Reviews
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Product Details

  • ISBN-13: 9781593851958
  • Publisher: Guilford Publications, Inc.
  • Publication date: 8/25/2005
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 324
  • Product dimensions: 6.42 (w) x 9.32 (h) x 1.06 (d)

Meet the Author

Judith S. Beck, PhD, is President of the Beck Institute for Cognitive Behavior Therapy ( and Clinical Associate Professor of Psychology in Psychiatry at the University of Pennsylvania School of Medicine. She has written nearly 100 articles and chapters as well as several books for professionals and consumers; has made hundreds of presentations, nationally and internationally, on topics related to CBT; and is the codeveloper of the Beck Youth Inventories and the Personality Belief Questionnaire. Dr. Beck is a founding fellow and past president of the Academy of Cognitive Therapy.

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Table of Contents

1. Identifying Problems in Treatment
2. Conceptualizing Patients Who Present Challenges
3. When a Personality Disorder Challenges Treatment
4. Developing and Using the Therapeutic Alliance
5. Therapeutic Relationship Problems: Case Examples
6. When Therapists Have Dysfunctional Reactions to Patients
7. Challenges in Setting Goals
8. Challenges in Structuring the Session
9. Challenges in Solving Problems and in Homework
10. Challenges in Identifying Cognitions
11. Challenges in Modifying Thoughts and Images
12. Challenges in Modifying Assumptions
13. Challenges in Modifying Core Beliefs
Appendix A: Resources, Training, and Supervision in Cognitive Therapy
Appendix B: Personality Belief Questionnaire
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