
Martina Mueller (ed.)
et al.
Published online:
01 January 2015
Published in print:
01 May 2010
Online ISBN:
9780191797576
Print ISBN:
9780199561308
Contents
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Introduction Introduction
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What factors affect the outcome of therapy? What factors affect the outcome of therapy?
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The therapy model The therapy model
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The therapist The therapist
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The patient The patient
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Therapist-patient interaction Therapist-patient interaction
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The golden rule: use the CBT model… The golden rule: use the CBT model…
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Use the formulation Use the formulation
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Use collaboration Use collaboration
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Use structure Use structure
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Use the empirical approach Use the empirical approach
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The role of CBT as a therapy model The role of CBT as a therapy model
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Characteristics and demands of CBT Characteristics and demands of CBT
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Assessing ‘suitability’ for CBT Assessing ‘suitability’ for CBT
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Difficulties in applying the model Difficulties in applying the model
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Difficulties in collaboration Difficulties in collaboration
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Difficulties in short-term therapy Difficulties in short-term therapy
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Difficulties in accessing thoughts or emotions Difficulties in accessing thoughts or emotions
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Difficulties with structure Difficulties with structure
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Difficulties in facing difficult situations Difficulties in facing difficult situations
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Difficulties with homework Difficulties with homework
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The nature of the problem The nature of the problem
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Therapists and their contexts Therapists and their contexts
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Therapist ‘adherence’ Therapist ‘adherence’
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Therapist beliefs and attitudes Therapist beliefs and attitudes
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I must not upset my patients I must not upset my patients
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The research evidence doesn’t apply to my practice The research evidence doesn’t apply to my practice
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It’s the therapist what gets the blame… It’s the therapist what gets the blame…
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I have to help everyone or I cannot help anyone I have to help everyone or I cannot help anyone
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Therapist contexts Therapist contexts
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Service constraints on treatment Service constraints on treatment
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Availability of supervision Availability of supervision
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Type of service Type of service
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Other demands from outside work Other demands from outside work
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Patients and their contexts Patients and their contexts
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Patient characteristics Patient characteristics
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Patients with highly avoidant coping style Patients with highly avoidant coping style
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Patients who find it difficult to disclose clear information Patients who find it difficult to disclose clear information
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Patients who find it hard to move from ‘head’ to ‘heart’ Patients who find it hard to move from ‘head’ to ‘heart’
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Patients whose problems are driven by fixed beliefs Patients whose problems are driven by fixed beliefs
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Patients who have poor memory Patients who have poor memory
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Patients who have very biased information processing Patients who have very biased information processing
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Patients who misuse alcohol, street drugs, or prescribed medication Patients who misuse alcohol, street drugs, or prescribed medication
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Patient contexts Patient contexts
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Psychosocial support and wider systemic factors Psychosocial support and wider systemic factors
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Inadequate social support Inadequate social support
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The support network is hostile to treatment The support network is hostile to treatment
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The support network has unrealistic expectations of treatment The support network has unrealistic expectations of treatment
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The support network inadvertently maintains aspects of the problem The support network inadvertently maintains aspects of the problem
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Real-life adversity Real-life adversity
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When life gets in the way of treatment When life gets in the way of treatment
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Therapist-patient interaction Therapist-patient interaction
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Too low matching Too low matching
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Too high matching Too high matching
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Conclusion Conclusion
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Further reading Further reading
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References References
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Cite
Westbrook, David, and others (eds), 'Common problems in therapy', in Martina Mueller, and others (eds), Oxford Guide to Surviving as a CBT Therapist, Oxford Guides to Cognitive Behavioural Therapy (Oxford , 2010; online edn, Oxford Academic, 1 Jan. 2015), https://doi.org/10.1093/med:psych/9780199561308.003.0001, accessed 5 May 2025.
Abstract
Chapter 1 explores common problems in therapy, the factors that can affect the outcome of therapy, the use of the cognitive behavioural therapy (CBT) model, the role of CBT as a therapy model, difficulties that can occur in applying the model, therapists , patients, and their contexts, and therapist-patient interaction.
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