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HOW DO WE TEST THIS THOUGHT? Padesky matches the level of thought with effective CBT interventions.

In today's Clinical Tip, Christine A. Padesky, PhD describes three levels of thought identified in cognitive behavior therapy and the interventions ideally suited to test each. Automatic thoughts are usually tested by looking in the situation in which they occur for the evidence that supports and doesn’t support them. Depending on the frequency of these thoughts, help your clients look for evidence using Socratic Dialogue and/or the 7-Column Thought Record. Underlying assumptions are best tested with behavioral experiments to see if their “if… then…” predictions occur in real life experiments. When core beliefs are tested, use a continuum and core belief record to build new core beliefs rather than focusing on dismantling negative core beliefs. Padesky recommends therapists not test core beliefs in the first 4 - 6 months of therapy (see Hawley, et al., 2017). For more Clinical Tips, see our YouTube Clinical Tips playlist https://bit.ly/3hn6LrF [see Timestamps at end of this section] ************* REFERENCES ************* • Hawley, L. L., Padesky, C. A., Hollon, S. D., Mancuso, E., Laposa, J. M., Brozina, K., et al. (2017). Cognitive behavioral therapy for depression using Mind Over Mood: CBT skill use and differential symptom alleviation, Behavior Therapy, 48(1), 29–44. • Greenberger, D., & Padesky, C.A. (2016). Mind Over Mood: Change How You Feel by Changing the Way You Think, 2nd Ed. Available at a discount from Guilford Press: https://bit.ly/3b7UXpZ • Padesky, C.A. with Greenberger, D. (2020). The Clinician's Guide to CBT Using Mind Over Mood, 2nd Ed. Available at a discount from Guilford Press: https://bit.ly/2L5tR86 ************* RESOURCES (please note, we use bit.ly links when the web address is lengthy): ************* 1) FREE Socratic Dialogue Rating Scale and Manual Available free online from padesky.com website's Clinical Corner - Clinical Tools section. [download available from] https://www.padesky.com [direct link to clinical tools] https://bit.ly/2zgbY3H 2) 7-Column Thought Record Details for effective use of 7-Column Thought Record found in Mind Over Mood, 2nd Edition (2016) Chapters 6 through 9. And for therapists in The Clinician's Guide to CBT Using Mind Over Mood (2020) in Chapters 4 and 5. [download available from] https://www.MindOverMood.com [direct link to worksheets] https://bit.ly/32BHx4S 3) Behavioral Experiments Worksheet (MOM2) To learn more about how to design and debrief behavioral experiments, see The Clinician's Guide to CBT Using Mind Over Mood. Chapter 7 covers how to setup and design and debrief behavioral experiments to maximize client learning and Chapter 11 shows how to use with anxiety disorders. [download available from] https://www.MindOverMood.com [direct link to worksheets] https://bit.ly/32BHx4S 4) Continuum and Core Belief Records For a rationale and guidance for using Continuum and Core Belief Records, see Chapter 8 of The Clinician's Guide to CBT Using Mind Over Mood (2020). 5) Get 60 client Worksheets from “Mind Over Mood, 2nd Edition” (2016). Available at a discount from Guilford Press: https://bit.ly/3b7UXpZ 6) Follow Padesky on   / padesky   TIME STAMPS FOR THE VIDEO 00:00 Clinical Tips Intro 00:20 How Do We Test This Thought? 00:25 Three Types of Thoughts we test in CBT 00:36 Automatic Thoughts explained 00:53 Best intervention to test Automatic Thoughts - LOOK FOR EVIDENCE in SITUATION 01:01 Situation specific Automatic Thoughts - use Socratic Dialogue 01:27 For recurring Automatic Thoughts - use 7-Column Thought Record 01:54 7-Column Thought Record tests out hot thoughts & images that drive moods & behaviors 02:03 If most of evidence supports the hot thought, make an Action Plan to solve a problem 02:10 If some evidence does not support a hot thought, create an Alternative/Balanced Thought 02:39 Benefits of using the 7-Column Thought Record over time 03:22 Underlying Assumptions explained - important for anxiety disorders 04:18 Best way to test Underlying Assumptions - Behavioral Experiments 05:32 Core Beliefs explained 05:58 Best way to test Core Beliefs - use a continuum 06:19 Use a positive continuum along with a core belief record to construct new Core Beliefs 06:58 Levels of thought are all connected. 07:24 Which level of thought should we test? 07:36 For depression, begin identifying negative automatic thoughts & use 7- Column Thought Record 08:05 For anxiety, begin by identifying KEY underlying assumptions & test with behavioral experiments 08:16 Emerging research suggests not a good idea to focus on core beliefs in first 4-6 months 08:37 Three levels of thought. Different interventions ideally suited to test each of them. 08:44 Summary of levels of thought with ideally suited interventions 09:04 Good therapy requires continuous improvement 09:20 Just a hammer? 09:31 Chart showing levels of thought with corresponding interventions MUSIC Happy Ukulele from Motion Array