Written by Michelle Craske
Reviewed by Molly Wilder
Michelle Craske provides a straight forward look into the past, present and future of Cognitive Behavioral Therapy. Within the first few pages, she begins by giving a succinct and general overview of the theory behind CBT and its importance in successfully treating patients. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. This therapy can be a helpful tool in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. It can be an effective tool to help anyone learn how to better manage stressful life situations. Craske does not miss a chance to define or explain a concept. This makes it much easier to follow without a dictionary or DSM 5 in hand. Although some concepts may take a bit longer to wrap your head around, the use of examples makes the content a bit easier to swallow. In only about 200 pages the reader is placed in the role of the therapist, soon able to recognize these negative patterns and behaviors. This book is geared towards a narrow audience, ranging from those with a basic understanding of theory in the field of psychology to seasoned practitioners interested in understanding this approach.
It is important to keep in mind that although several variations on the original theory have developed over the decades, all types of cognitive—behavioral therapy are unified by their foundation, reliance on the theory and science of behavior and cognition, and problem-focused goals. Craske defines theory as “the compass that allows psychotherapists to navigate the vast territory of clinical practice” (viii). She explains the hallmark features of CBT as “a short-term, problem-focused cognitive behavioral intervention using strategies” (pg. 3) that are derived from these theories over time. In the next chapter Craske wrote a 12-page condensed version of the origins and future direction of CBT. She looks at multiple ways clinicians may draw from their inclinations when creating a treatment plan. She delves into several theoretical approaches including Beck and Ellis (Irrational Beliefs) among others. She explores each of these theories, their use, history and relation to CBT. For visual learners, the book also provides figures to map out a few of these more complicated models.
In the next few chapters, Craske goes into the therapy process and the application of these models. She describes how “without a guiding theory we might treat the symptom without understanding the role of the individual” (viii). She emphasizes the importance of the individual within society and the ways in which well-meaning practices may harm or inhibit progress. In CBT, the therapist and the client work together to identify unhelpful patterns of thinking and behavior. Carefully constructed exercises are used to help clients evaluate and change their thoughts and behaviors. Some aspects of treatment focus more on thoughts and some aspects focus more on behaviors. If a client has difficulty identifying and challenging negative thoughts, the therapist may focus on addressing behaviors such as avoidance, withdrawal or poor social skills. On the other hand, if such behaviors are not as noticeable, the therapist may focus on challenging unrealistic thinking. CBT uses various techniques such as goal setting and identifying thoughts and behaviors as they occur. Craske emphasizes that CBT should not be applied as a ‘cookie-cutter’ approach. The therapist must carefully assess the client’s motivations and how to best approach them individually.
In combination with the DVD that is paired with this edition of the book, individuals can watch the theory be applied to practice with real live sessions. Sometimes descriptions are not enough to fully comprehend these concepts and techniques. These short videos can be incredibly useful for those who want a better understanding of these theories when applied to real life.
From its theoretical origins to its current potential, Craske defines the key concepts and techniques of Cognitive Behavioral Therapy and creates a solid outline for those interested in using this therapeutic treatment. She adds a summary at the end for those readers who may not feel ready to dive so deep into the theories behind it all, although the theories do help to better understand the practice. This book is the perfect tool for graduate students studying theories of therapy and counseling as well as practitioners interested in CBT.
Michelle Craske is currently a professor in the Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, UCLA, and director of the UCLA Anxiety Disorders Behavioral Research program. She received her PhD from the University of British Columbia in 1985. She has published extensively in the area of fear and anxiety disorders. She has written academic books on the topics of the etiology and treatment of anxiety disorders, gender differences in anxiety, and translation from the basic science of fear learning to the understanding and treating of phobias, in addition to several self-help books and therapist guides.
Molly Wilder is currently a junior at New York University Steinhardt studying applied psychology with a focus on occupational therapy.