Deliberate Practice in Cognitive Behavioral Therapy

Deliberate practice exercises help students and trainees rehearse fundamental cognitive-behavioral therapy (CBT) skills to develop basic competence and hone their own personal therapeutic style.

Each book in the Essentials of Deliberate Practice series contain customized exercises consisting of role-playing scenarios in which two trainees act as a client and a therapist, switching back and forth under the guidance of a supervisor. The trainee playing the therapist improvises appropriate and authentic responses to a series of client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common problems and concerns encountered by CBT practitioners.
 
The first 10 exercises each focus on a single skill, such as establishing goals for treatment; assigning and reviewing between-session exercises; working with various client cognitions, behaviors, and emotions; and addressing relationship ruptures and client resistance. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate these essential skills into a single CBT session.

Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided. 


 

James F. Boswell, PhD, is an associate professor of clinical psychology at the University at Albany, State University of New York. He is also an associate of the Center for the Elimination of Minority Health Disparities. He received his PhD in clinical psychology from The Pennsylvania State University. Dr. Boswell has received the Early Career Award from the American Psychological Foundation/American Psychological Association (APA) Division 29, the Outstanding Early Career Achievement Award from the Society for Psychotherapy Research, the David Shakow Early Career Award for Distinguished Scientific Contributions to Clinical Psychology, the Dissertation and Marvin R. Goldfried New Researcher Awards from the Society for the Exploration of Psychotherapy Integration, and a Rising Star designation from the Association for Psychological Science. He is also a Fellow of the APA and serves as president of the North American Society for Psychotherapy Research. Dr. Boswell has published extensively in the areas of psychotherapy process and outcome, measurement-based care, and practice-oriented research. His work has been funded by the Patient Centered Outcomes Research Institute, National Institute of Mental Health, Robert Wood Johnson Foundation, and APA. He is also a member of the Advisory Committee to the APA Mental and Behavioral Health Data Registry. In addition, he served as a technical expert panelist on the government-sponsored white paper prepared for the U.S. Department of Health and Human Service and the Office of the Assistant Secretary for Planning and Evaluation on Strategies for Measuring the Quality of Psychotherapy. Dr. Boswell is on the editorial board of the Journal of Consulting and Clinical Psychology, Behaviour Research and Therapy, Behavior Therapy, Psychotherapy Research, Psychotherapy, and the Journal of Clinical Psychology.

Michael J. Constantino, PhD, received his BA in psychology from SUNY Buffalo, and his MS and PhD from The Pennsylvania State University. He completed a predoctoral clinical internship at SUNY Upstate Medical University and a postdoctoral fellowship at the Stanford University Medical Center. Dr. Constantino is now professor of psychological and brain sciences at the University of Massachusetts Amherst, where he directs the Psychotherapy Research Lab and serves as graduate program director. His professional and research interests center on patient, therapist, and dyadic factors in psychosocial treatments; pantheoretical principles of clinical change; and measurement-based care. He has published more than 150 articles and chapters in leading journals and books in the field, and he has received extramural grant and contract support for his research, including from the Patient-Centered Outcomes Research Institute, National Institute of Mental Health, Robert Wood Johnson Foundation, and APA. He is also coeditor of the book Principles of Change: How Psychotherapists Implement Research Findings in Practice (Oxford University Press) and the in-preparation Handbook of Psychotherapy, to be published by APA. Dr. Constantino has received several early- and mid-career research awards, including from the International Society for Psychotherapy Research, the Society for the Advancement of Psychotherapy (APA Division 29), and the Society for the Exploration of Psychotherapy Integration. Dr. Constantino is also an APA Fellow. Among other professional positions, he is associate editor for Psychotherapy and past-president of both APA Division 29 and the North American Society for Psychotherapy Research.

Series Preface
Tony Rousmaniere and Alexandre Vaz

Acknowledgments

Part I. Overview and Instructions

Chapter 1. Introduction and Overview of Deliberate Practice and Cognitive Behavioral Therapy

Chapter 2. Instructions for the Cognitive Behavioral Therapy Deliberate Practice Exercises

Part II. Deliberate Practice Exercises for Cognitive Behavioral Therapy Skills

Exercises for Beginner Cognitive Behavioral Therapy Skills
Exercise 1. Explaining the Treatment Rationale for Cognitive Behavioral Therapy
Exercise 2. Establishing Goals
Exercise 3. Negotiating a Session Agenda
Exercise 4. Assigning and Reviewing Between-Session Activities

Exercises for Intermediate Cognitive Behavioral Therapy Skills
Exercise 5. Working With Cognitions
Exercise 6. Working With Behaviors
Exercise 7. Working With Emotions

Exercises for Advanced Cognitive Behavioral Therapy Skills
Exercise 8. Adherence Flexibility
Exercise 9. Responding to Therapeutic Alliance Ruptures
Exercise 10. Responding to Client Resistance

Comprehensive Exercises
Exercise 11. Annotated Cognitive Behavioral Therapy Practice Session Transcripts
Exercise 12. Mock Cognitive Behavioral Therapy Sessions

Part III. Strategies for Enhancing the Deliberate Practice Exercises

Chapter 3. How to Get the Most Out of Deliberate Practice: Additional Guidance for Trainers and Trainees

Appendix A. Difficulty Assessments and Adjustments
Appendix B. Deliberate Practice Diary Form
Appendix C. Sample Cognitive Behavioral Therapy Syllabus With Embedded Deliberate Practice Exercises

References
Index
About the Authors
About the Series Editors