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By D Sudak

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White if he was willing to do an activity schedule as an experiment and increase his pleasurable activities in the next week to see if he would feel better. He agreed to try this. His mood improved, and therapy continued. Treatment begins with establishing the relationship and educating the patient. In the first several sessions after assessment, the therapist presents a conceptual model to the patient about how he or she understands the patient's problems. This serves several purposes: it begins to educate the patient about the cognitive model; it starts the process of translating practical problems into psychological ones; and it strengthens the therapeutic alliance by helping the patient feel less alone and more understood by a genuinely concerned person who has a new view of how these problems came to be.

Reprinted with permission from Cognitive Therapy: Basics and Beyond . New York: The Guilford Press. 1995. 48 The therapist teaches the patient to fill out the dysfunctional thought record, generally during at least two sessions. The skill required to identify and change automatic thoughts is difficult for many patients, and therapists must be patient and deliberate in teaching each part of the process. The first task involves teaching the patient the cognitive model, generally by using an example from the patient's life in the last week.

GREEN brought in several thought records that described situations where she was called on to complete a task and became extremely anxious. In each situation she had the thought that she would fail to complete the task in an adequate way. ― The therapist and Ms. Green agreed that a rule that governed her behavior was that if she were to do something that did not meet her standards it would mean to her that other people would see that she was a failure, and she would see herself as a failure as well.

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