985-Knowing What Does and Doesn't Work in CBT: Lessons for Counselors

Counselor Toolbox Podcast with DocSnipes

### Video Summary

**Title:** A Guide to Cognitive Behavioral Therapy for Counselors: What Works, What Doesn’t, and Why

**Presenter:** Dr. Dawn-Elise Snipes

**Link:** [Watch the video](https://youtu.be/tlR6T5jTCkM?si=Jjn2Wicv0EqvXJ-V)

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#### Introduction

- Explanation of Cognitive Behavioral Therapy (CBT)

- Importance of CBT and its impact on thoughts, feelings, and behaviors

- Overview of the session's structure: what CBT is, what works, what doesn’t, and why

#### Understanding CBT

- CBT focuses on the interaction between thoughts, feelings, and behaviors

- Cognitive schemas: mental shortcuts based on past experiences

- Importance of checking and updating schemas as they may not always be accurate

#### Effects of Stress on the Brain

- Persistent stress impacts brain structure and function

- Weakens the vagus nerve, which affects the body's relaxation response

- Causes changes in the nervous system, impacting sleep and circadian rhythms

#### What Doesn’t Work in CBT

- Jumping into cognitive processing without establishing rapport, safety, and empowerment

- Aggressive confrontation of beliefs and behaviors

- Failing to address all three points of the CBT triangle: thoughts, feelings, and behaviors

- Telling instead of exploring, using mechanistic approaches, and not individualizing therapy

- Forcing new beliefs or schemas that the client doesn’t believe

#### What Works in CBT

- Educating clients about the connection between feelings, thoughts, and behaviors

- Validating clients' experiences and feelings

- Helping clients develop emotional intelligence and distress tolerance

- Addressing behaviors that create vulnerabilities

- Using a personalized approach to explore and alter unhelpful schemas and beliefs

- Maintaining motivation and reinforcing new thoughts and behaviors between sessions

#### Application of CBT in Various Disorders

- **ADHD**: Developing organizational skills, addressing negative self-referential beliefs, and improving communication

- **Mood Disorders**: Identifying behaviors that create vulnerabilities, developing distress tolerance, and empowering clients to address problematic thoughts and behaviors

- **Addiction**: Developing mindfulness, reducing vulnerabilities, exploring cognitive distortions, and addressing distress tolerance

- **Personality Disorders**: Understanding the underlying thoughts and beliefs, addressing behaviors, and enhancing coping mechanisms

- **Schizophrenia**: Joining clients in their reality, reducing stress, and developing safety plans

- **Trauma**: Normalizing thoughts and behaviors, developing distress tolerance, and exploring schemas related to trauma

#### ABCDEs of CBT

- **A**wareness: Recognize thoughts, feelings, and behaviors and their communication

- **B**ehaviors: Reduce vulnerabilities and increase safety and empowerment

- **C**ognitions and Schema: Explore and restructure based on current and past contexts

- **D**istress Tolerance: Develop skills to manage distress

- **E**xplore: Explore experiences, beliefs, and coping mechanisms with curiosity

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### Time Codes for Major Points

01:30 Introduction to CBT and its importance

08:15 Effects of stress on the brain and vagus nerve

15:45 Common mistakes in CBT practice

25:30 Effective strategies in CBT

35:00 Application of CBT in ADHD and mood disorders

45:15 Use of CBT in addiction, personality disorders, and schizophrenia

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