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Catching Thoughts
As you know, an initial goal in therapy with an anxious client is to help your client restructure his thinking by first becoming more aware of their thought processes. I like to use the phrase learning to "catch one's thoughts," which is a necessary step in correcting distortions. Often, clients find that increasing self-awareness is sufficient to start correcting their thinking errors. As you know, self-awareness allows your client to distance himself from faulty thinking and develop a more objective perspective toward a situation. As your client begins to collect automatic thoughts, you gain a greater understanding of your client's vulnerability and of the specific frames of reference that control his or her perception of a feared situation.
Directing Patients
I find merely telling clients to become more aware of their thinking can be sufficient. This is similar to the suggestion that one consciously chooses to remember one's dreams. The client may be unaware of his thinking because he has considered it unimportant. The therapist, as you know, with the anxiety disordered client, needs to stress the effect thinking has on his or her life. Automatic thoughts can be presented as being similar to subliminal advertisements: by learning to detect them, the client can free himself from their effects.
Peer-Reviewed Journal Article References:
Ciharova, M., Furukawa, T. A., Efthimiou, O., Karyotaki, E., Miguel, C., Noma, H., Cipriani, A., Riper, H., & Cuijpers, P. (2021). Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: A network meta-analysis. Journal of Consulting and Clinical Psychology, 89(6), 563–574.
Heuvel, M. W. H., Bodden, D. H. M., Moerbeek, M., Smit, F., & Engels, R. C. M. E. (2019). Dismantling the relative effectiveness of core components of cognitive behavioural therapy in preventing depression in adolescents: Protocol of a cluster randomized microtrial. BMC Psychiatry, 19, Article 200.
Rosenberg, H. J., Jankowski, M. K., Fortuna, L. R., Rosenberg, S. D., & Mueser, K. T. (2011). A pilot study of a cognitive restructuring program for treating posttraumatic disorders in adolescents. Psychological Trauma: Theory, Research, Practice, and Policy, 3(1), 94–99.
Shikatani, B., Fredborg, B. K., Cassin, S. E., Kuo, J. R., & Antony, M. M. (2019). Acceptability and perceived helpfulness of single session mindfulness and cognitive restructuring strategies in individuals with social anxiety disorder: A pilot study. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 51(2), 83–89.
Shurick, A. A., Hamilton, J. R., Harris, L. T., Roy, A. K., Gross, J. J., & Phelps, E. A. (2012). Durable effects of cognitive restructuring on conditioned fear. Emotion, 12(6), 1393–1397.
Online Continuing Education QUESTION
5: What is one way of presenting automatic thought to your client? To
select and enter your answer go to .
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