Faculty Reads: Psychologist Adds Heart to Cognitive Behavioral Therapy Techniques

What we think affects how we feel, and how we feel affects how we behave, and how we behave then affects what we think about ourselves…

If one or all facets of this thoughts-feelings-behavior triangle become dysfunctional, though, life can fairly quickly turn chaotic. Luckily, therapeutic techniques such as cognitive behavioral therapy help restore our inner life to harmony and break the cycle of disorder.

The question is: Are these techniques doing enough?

Psychology Professor Dean McKay, Ph.D. recently published Working with Emotion in Cognitive-Behavioral Therapy: Techniques for Clinical Practice (November 2014), a book he co-edited with his former doctoral student Nathan Thoma, Ph.D., GSAS ’08, ’11, a clinical psychologist in New York City.

The book features writings from leading psychologists on the role of emotion in cognitive behavioral therapy (CBT), a psychotherapy that focuses on the relationships between thoughts, behaviors, and feelings. This short-term, goal-oriented, and empirically validated treatment aims to change a client’s problematic behaviors and thinking patterns, which thereby improve how the client feels. It has proven to be effective for a range of psychopathologies, including depression, anxiety, and post-traumatic stress disorder.

The problem, McKay says, is that the emotional aspect does not always get its due, which means that clients sometimes leave treatment with a reduction in symptoms, but without fully resolving the issue at hand.

“Clients often seek treatment due to a range of emotional struggles, ones that might linger after successful treatment for behavioral problems and [improving] patterns of thinking,” said McKay, who specializes in treating people with anxiety disorders. “While emotion has never been neglected in CBT, the emphasis on emotional processes has not been as high as it is for the other two domains.”

The book offers information about emotional processes and includes techniques that clinicians can use to better address emotion in therapy. Topics covered include the use of mindfulness therapy and the importance of exposing clients to difficult emotions so that they learn to face uncomfortable feelings rather than use maladaptive behaviors to escape them.

“CBT has long emphasized behaviors and thoughts (or cognitions) as centrally important in psychopathology,” McKay said. “But [we] developed the book in an effort to fill an important gap in the available sources for clinicians.”

— Joanna Mercuri