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Descriptions of CBT Demonstrations on MP4 Video

CBT Clinical Demonstrations featuring Christine A. Padesky, PhD.

Professionally recorded video clinical presentations designed to assist mental health professionals and graduate students in mental health fields. Learn and apply the theory and methods of Cognitive Behavior Therapy.

We provide detailed descriptions and time codes useful for teachers, professors, researchers, therapists. Also these details can be helpful when seeking administrative approval for purchase.

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Action-Based Learning (sku: dACTION) – “JENNIFER”

In-Session Action-Based Learning with Behavioral Experiments – Full Color MP4 video. (length: 87 minutes)

Filmed at a conference, this live, spontaneous, and unedited clinical demonstration features Christine A. Padesky, PhD conducting a therapy session with “Jennifer” (role played by therapist Jennifer O’Connor, PhD). Jennifer reports extreme difficulty saying no to people and finds she accommodates other people’s needs instead of her own.

In their previous session, Dr Padesky and Jennifer had decided that her behavioral experiment would be to say no to a friend’s request to do things for her. This session begins with Jennifer revealing she did not do the behavioral experiment she had planned to do between sessions.

Padesky demonstrates

• Debriefing a behavioral experiment
• How to setup and conduct behavioral experiments within a session. Padesky suggests this is often more therapeutic because there is the opportunity to immediately debrief the experience with the client.
• How to use Socratic dialogue and processes of guided discovery to maximize client learning from experiments done in session.

Jennifer’s issues

• Difficulty setting boundaries and saying no to people
• Feels her needs are less important to other people than their own needs are
• Lots of worries about people rejecting her if she doesn’t fulfill all their needs
• Generally tries to please people and do what they want
• Ends up feeling quite resentful of other people always putting demands on her
• Feels other people don’t understand her pain and her feelings and don’t accommodate and meet her needs in the same way that she tries to meet other people’s needs

DISCUSSANT COMMENTS: by William Miller, creator and founder of Motivational Interviewing.

BRIEF QUESTION & ANSWER SEGMENT
The last 20 minutes consists of audience questions and insightful answers from Dr. Padesky and role play participant Jennifer that flush out sophisticated elements and nuances of the demonstration.

PRODUCT REVIEW: “I am a Beck Institute CBT certified clinician. What I love most about Dr. Padesky’s seminars is her desire to bring difficult points to clients in a simple way. In the Seminar: In-Session Action-Based Learning with Behavioral Experiments (vACTION) I liked my desire to do behavioral experiments in the session. This causes my personal interest and benefit to clients. The day after watching the seminar, I even randomly turn on the option to use Behavioral Experiments in sessions with my clients. This is an improved experience.
I recommend to all!”

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Thought Record (sku: dVATR) – “SHARON”

Testing Automatic Thoughts With Thought Records – Full color MP4 video
(length: 70 minutes –  Includes close-up shots of client and therapist notes)

Viewers comment on the helpfulness of this video to demonstrate the pacing and timing of a therapy session when using a thought record. It is especially helpful to see how empathic and conversational the therapy session can be even while teaching skills in a structured way.

A word about copyright and the 7-Column Thought Record

MP4 video TIME CODES (70 minutes)

• 00:00 – Introduction and explanation
• 01:40 – Beliefs & Interventions
• 14:33 – Situations, Mood, Thoughts
• 22:22 – “Hot” Thoughts
• 30:57 – Supporting Evidence
• 41:52 – Non‐supporting Evidence
• 50:44 – Search for Hidden Evidence
• 1:02:24 – Alternative / Balanced Thoughts
• 1:09:36 – Summary & Feedback, End Credits

VATR PRODUCT REVIEW Excellent Demonstration (submitted by a Clinical Psychologist ) “I am an advanced CBT therapist and trainer. This video is an excellent demonstration of how a therapist can elicit automatic thoughts and teach cognitive restructuring skills for a depressed patient using the format in the book Mind Over Mood. Dr. Padesky is very directive while at the same time she highlights many general therapeutic skills such as empathy, patience, two way communication, collaboration, and affirmation of patient qualities. She also explains some key concepts related to cognitive therapy such as automatic thoughts, underlying assumptions, and core beliefs; and provides insightful commentary about responding to challenges related to working with depressed patients. I highly recommend this video for any therapist learning cognitive restructuring.”

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New Core Beliefs (sku: dVBEL) – “LINDA”

Constructing New Core Beliefs – Full color MP4 video (length: 61 minutes)

The primary methods used to strengthen new core beliefs are demonstrated including use of a continuum and assignment of a core belief log.

In narrative comments before and after the demonstration, Dr. Padesky highlights the importance of the therapeutic alliance and the benefits of using written “shoulder-to-shoulder” methods instead of “eyeball-to-eyeball” dialogues when constructing new core beliefs. Since it is difficult for clients to imagine new core beliefs, this client’s skepticism and cognitive “blanks” are quite typical.

This video illustrates how to engage a client and evoke curiosity regarding the possibility of new core beliefs even when the client is doubtful that this approach will help.

MP4 video TIME CODES (61 minutes)

• 00:00 – Intro and Core Beliefs
• 06:38 – Review of the treatment protocol
• 07:54 – Meet “Linda” and Session Overview
• 11:06 – Identify Core Beliefs
• 17:10 – Continuum Ratings
• 22:34 – Using Continuum Criteria and Develop Strategies
• 37:29 – Client doubtful
• 49:14 – Core Belief Log Rationale
• 50:19 – Navigate Roadblocks
• 52:54 – Ask for Client Reaction
• 55:00 – Feedback & Summary
• 56:48 – Discussion with audience

VBEL PRODUCT REVIEW

Submitted by Frank M. Dattilio, PhD, ABPP, (Department of Psychiatry, Harvard Medical School and University of Pennsylvania School of Medicine)

“Outstanding Educational Training Resources: These are outstanding educational training resources that will be helpful to students and practitioners of all levels. I have found them to be a great resource in my clinical work and will also use them in my didactic lectures with students. I highly recommend them.”

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Case Conceptualization (sku: dVCON) – “SARAH”

Collaborative Case Conceptualization – Full Color MP4 video (length: 59 minutes)

Also includes identification of new beliefs and rules to support behavior change.

Our therapist viewers comment how much they can identify with this client’s issue of taking on too much work. They appreciate seeing how much can be accomplished in a single session.

Includes use of a split screen. Allows the viewer to see the therapist-client interaction up close.

MP4 video TIME CODES (59 minutes)

• 00:00 – Permissions & Use Advisement
• 00:54 – Presenting Issues
• 11:33 – Cultural Context
• 20:33 – Beliefs, Rules & Strategies
• 27:39 – Summary, Benefits & Costs
• 31:41 – Goals
• 37:12 – Written Conceptualization
• 41:38 – Conceptualization & Goals
• 51:09 – New Rules to Reach Goals
• 54:50 – Summary & Feedback
• 58:12 – End Credits

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Panic Disorder (sku: dVPAN) – “MARY”

Cognitive Therapy for Panic Disorder – Full Color MP4 video (length: 51 minutes)

• Have you read about the success of cognitive therapy with panic disorder but are not quite sure what happens in a session?
• Do some of your panic clients tell you that they know they are not in danger during a panic attack – but only intellectually and only when it is over?
• Do you then struggle with helping them learn that this is true even when they are having a panic attack?
• Are you hesitant to induce panic symptoms during a session, not knowing how you will feel or what the client might say or do?
• Learn why it is impossible for a client to faint when they are having a true panic attack.

Observe how the therapist uses guided discovery to help the client understand the cognitive model of panic. See how the therapist induces sensations and uses a series of specific questions to guide discovery of a believable explanation for the client’s panic-related sensations.

Distinguish the important diagnostic rule outs for panic disorder as well as the critical factors to consider before doing an in-session induction of panic sensations.

Specific questions, summaries and procedures are clearly modeled that demonstrate the cognitive therapy protocol for panic disorder.

Christine Padesky demonstrates key stages:

• Therapist & client collaboratively identify elements of the client’s recent panic attack including sensations, thoughts and images, and catastrophic misinterpretations
• Client data is used to develop the cognitive model
• The therapist induces sensations which closely mimic a panic attack
• Therapist and client debrief the induction to help the client discover believable alternative explanations for the panic-related sensations

Viewers find this video extremely helpful in understanding how the induction of sensations paired with guided discovery helps the client develop meaningful alternative explanations for their panic sensations. Also, they comment on how quickly Dr. Padesky is able to form a positive therapeutic alliance through the use of humor and collaboration.

Includes close-up shots of therapist notes. Split screen work allows the viewer to see the therapist-client interaction up close.

MP4 video TIME CODES (51 minutes)

• 00:00 – Permissions & Use Advisement
• 00:54 – CBT Panic Disorder
• 04:29 – Sensations & Thoughts
• 17:06 – Panic Model
• 23:28 – Induction Experiment
• 28:14 – Debrief Experiment
• 36:47 – Two Hypotheses
• 41:00 – Treatment Plan
• 48:15 – Homework Assignments
• 49:49 – End Credits

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Building Resilience with Strengths-Based CBT (sku: dVRES) – “SUKI”

Building Resilience with Strengths-Based CBT – Full Color MP4 video (length: 63 minutes)

Important phases of the interview are highlighted with chapter titles. Each chapter title is paired with an audio voice over narration in which Padesky describes the therapy processes and strategies that viewers can look for in the next segment.

Padesky’s narrative guidance helps make this video an excellent teaching tool for therapists who want to learn to foster client resilience.

Dr. Padesky begins the interview by asking about Suki’s difficulties and positive interests. Positive interests that are not directly linked to difficulties are prime areas where it is possible to observe client strengths and resilience in action. Suki is struggling with grief and wants to learn to be more resilient. She reports a variety of positive areas in her life (e.g, her affectionate relationship with her dogs, a daily blog she has been keeping for several years). She chooses to talk about her blog activities for this interview.

4-Step Model to Build Resilience

Step 1: SEARCH for Strengths
Padesky uses Socratic dialogue to help Suki uncover a variety of strengths that she relies on to maintain her blog.

Step 2: CONSTRUCT a Personal Model of Resilience (PMR) 
Her identified strengths become integral to the PMR that Suki constructs.

Step 3: APPLY the PMR to a Problem Area 
With Padesky’s guidance, Suki develops a behavioral experiment to investigate the impact her PMR might have on her grief process.

Step 4: PRACTICE Resilience
In the final chapters of the interview, viewers can observe how Padesky keeps Suki’s focus on remaining resilient in the face of grief, rather than trying to alleviate her grief. Viewers can observe how important it is to stay alert to client statements that suggest they want to eliminate the problem rather than practice staying resilient in the face of the problem.

Key Elements
While this interview focuses on our 4-step model to build resilience, we also demonstrates many of the key elements of Strengths-Based CBT (SB-CBT). Viewers can see how a SB-CBT therapist maintains a focus on strengths, collaborates with the client to construct new beliefs and possibilities, relies on the client’s everyday experiences to construct models, and employs signature nonverbal methods of the approach such as smiling, silence and facial expressiveness.

REFERENCE
Padesky, C. A. & Mooney, K.A. (2012). Strengths-based Cognitive-Behavioural Therapy: A four-step model to build resilience. Clinical Psychology & Psychotherapy, 19 (4), 283-90. (reprint available from www.padesky.com/clinical-corner/publications)

MP4 video TIME CODES (63 minutes)

• 00:00 – Intro
• 00:50 – Identify Problems & Positive Interests
• 06:06 – Choosing a Positive Interest for Strengths Search
• 10:47 – Identify Obstacles
• 15:19 – STEP 1: SEARCH for Strengths
• 29:20 – STEP 2: CONSTRUCT a Personal Model of Resilience (PMR)
• 35:57 – Set a Goal to be Resilient
• 44:11 – STEP 3: APPLY PMR to a Problem
• 48:06 – STEP 4: PRACTICE Resilience

VRES PRODUCT REVIEWS

Licensed psychotherapist (CBT) (Freddy S): This video shows in an educational way how to work with patients where they can not offer as many sessions. I work in a health center and meet my patients between six to eight times. An important part of treatment is to improve the patient’s own strengths and skills that they use to feel better, so the patient will become their “own therapist.” This video shows you how can to do this. I am a licensed psychotherapist (CBT) in Sweden, Stockholm, who have worked for over ten years. I am also an expert in CBT for schizophrenia and also in this area, this is useful.

Building Resilience…By Fiona M: This is a very useful resource that I will apply clinically and show to my CBT post graduate students

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Social Anxiety (sku: dVSA) – “POOH”

Cognitive Behavior Therapy for Social Anxiety – Full Color MP4 video (length: 54 minutes)

“Assertive Defense of the Self”

A young woman (Pooh) describes how she avoids certain social events and activities because she fears criticism from others. In the opening minutes of this DVD program, Pooh identifies her anxious thoughts and gives a brief history of her fears.

Via role play practice that Padesky debriefs using Socratic dialogue, Pooh begins to build her “Assertive Defense of the Self” repertoire and skills. Over the course of this single session Pooh gains confidence that she can cope with criticism.

Padesky emphasizes coping with criticism rather than testing out the belief that people are critical. This is because successful CBT protocols help people directly face their fears. If fear of criticism is central to social anxiety then it makes sense that learning to face and cope with criticism should be central to treatment.

Once Pooh gains confidence she can defend herself against criticism, she works with Padesky to devise a behavioral experiment to test her skills in the real world. She devises a challenging experiment that she hopes will elicit criticism from others. This experiment is based on the “Assertive Defense” philosophy that people with social anxiety should court criticism until their fears subside. Viewers will hear how Pooh and Padesky develop the experiment and how Pooh learns to view herself as “lucky” if she received criticism.

Make sure you watch until the very end. The end credits of the program include a photo of Pooh carrying out her behavioral experiment that she emailed to Dr. Padesky several weeks after this session was filmed.

PDF HANDOUT FOR SKU: vsa
A few weeks after the interview session, Pooh and Dr. Padesky exchanged several emails in which she reported on her behavioral experiment. This program includes a pdf document of Pooh’s Behavioral Experiement: Practicing Assertive Defense of the Self.

Our MP3 audio workshop on Social Anxiety includes more follow-up information on these experiments! (SKU sanx). Available from Digital Padesky – audio section.

MP4 video TIME CODES (54 minutes)

• 00:00 – Permissions & Use Advisement
• 00:54 – Fear of Criticism
• 08:15 – Relevant History
• 13:00 – Treatment Rationale
• 17:07 – Assertive Defense Setup
• 23:30 – Practice Assertive Defense
• 28:36 – Debrief Experiments
• 37:07 – Seek Criticism
• 44:00 – Practice “Gentle” Defense
• 46:50 – Summary & Assignment
• 53:19 – End Credits (make sure you watch until the end)

VSA PRODUCT REVIEW

I Love “Assertive Defense of the Self” (submitted by Ellen Tobey Klass, PhD).

“I’m so glad you asked for my review. When I finished this segment (only one so far), I was so happy with what I’d viewed and learned, I wanted to tell people and couldn’t figure the venue. I’m an experienced CBT-er and have taken workshops and consulted with Dr. Padesky.

Things I loved: Seeing a seamless, interactive, and validating approach to in-session behavior rehearsal — as opposed to the didacticism one often sees (and lapses into). Very notable also, Dr. Padesky’s skillfully eliciting the client’s naturally-occurring positive viewpoints/self-statements — great for the client being able to use these and also great in the context of much negativity. I also loved how Dr. Padesky worked with the “client” – respectful, positive. At times, I could see Dr. Padesky pausing when the client said something not “CBT-correct”, such as perhaps a negative self-statement used as reinforcement. In the pause, I thought I saw Dr. Padesky figuring out how to respond to move the comment back to assertive defense of the self without conveying the client had done it wrong. And Dr. P did come up with things that did this. Plus, warmth and humor.

I’m using what I learned with a client who has a very difficult problem. We’ve been able to move much closer to in vivo practice, identify key issues, and find ways through some of them.

I’m so happy that I went to the source (this video), rather than keeping on relying on what others had told me about assertive defense of the self as a treatment strategy.“

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Socratic Dialogue (sku: dVSOQ) – “SHARON, JEAN & CARL”

Guided Discovery Using Socratic Dialogue – Full Color MP4 video (length 45 minutes)

Padesky demonstrates the four stages of Socratic dialogue with three clients, each experiencing a different mood. Her use of the Socratic process helps them uncover cognitions characteristic of each mood state and re-evaluate key automatic thoughts.

Four Stages of Socratic Dialogue
Stage 1: informational questions
Stage 2: empathic listening
Stage 3: summaries
Stage 4: analytic / synthesizing question

Viewers comment that learning these four stages helps to demystify Socratic questioning.

Padesky demonstrates this process with three different clients and moods:

1. Depressed client: “Sharon”
2. Anxious client: “Jean”
3. Angry client: “Carl”

MP4 video TIME CODESs (45 minutes)

• 00:00 – Intro to Socratic Dialogue
• 02:40 – Four Stages
• 04:18 – DEPRESSED client: “Sharon”
• 17:07 – Collaborative Empiricism
• 17:54 – ANXIOUS client: “Jean”
• 31:40 – Advantages Guided Discovery
• 34:41 – ANGRY client: “Carl”
• 43:58 – Summary

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NEW Underlying Assumptions & Behavioral Experiments (sku: dVUAE) – “BOB”

Constructing NEW Underlying Assumptions & Behavioral Experiments – Full Color MP4 video (length: 55 minutes)

Dr. Padesky begins with a brief description of automatic thoughts, underlying assumptions, and core beliefs. She explains why recurrent problems are often best solved at the underlying assumption level.

Bob is a therapist struggling with ongoing procrastination regarding completion of case formulations at his clinic.

The session begins with a review of the underlying assumptions, identified prior to this interview, that maintain Bob’s procrastination. Together, she and Bob specify his goals for change and identify NEW underlying assumptions that would support these changes. Next, in collaboration with the therapist, Bob devises behavioral experiments to evaluate the utility of these NEW underlying assumptions. He makes specific predictions and identifies potential problems that need to be managed during his experiments. Dr. Padesky and Bob dialogue about the relative benefits of testing OLD and/or NEW beliefs.

For follow-up summaries of Bob’s behavioral experiments, visit our Clinical Corner

MP4 video TIME CODES (55 minutes)

• 00:00 – Permissions & Use Advisement
• 00:54 – Underlying Assumptions
• 06:09 – Bob’s Conceptualization
• 10:14 – Goals & NEW Beliefs
• 18:11 – Strengths Perspective
• 27:04 – NEW Underlying Assumptions
• 32:54 – Behavioral Experiments
• 36:00 – Bob’s Predictions
• 46:01 – Feedback & Summary
• 53:40 – End Credits

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