Therapist Materials for Core Beliefs

The session in this chapter looks at the concept of core beliefs and how negative automatic thoughts are related to negative core beliefs. Negative core beliefs are the roots from which different types of related automatic thoughts grow. Core beliefs arise from repeated similar experiences and powerful single experiences. Clients learn to identify their personal core beliefs (such as I am worthless, I am unlovable, I will go crazy) by using the downward arrow technique. Although arriving at a core belief and saying it out loud is an emotionally evocative experience, it’s a necessary part of the client’s work. It is also an opportunity for the therapist to hear the client and empathize with the client’s experience. Over time, the client builds a repertoire of experiences that allow for new core beliefs to form, making their original core beliefs less valid.

Core Beliefs

During this session, clients learn about core beliefs, which are powerful beliefs that exist deep within our brains and influence how we think. They are at the root, or the core, of our automatic thoughts about ourselves, and they can be positive or negative. In this chapter, clients learn what core beliefs are and where they come from—specifically, they can come from repetitive early experiences, or from a single formative, highly emotional experience. They will also learn about the relationship between negative core beliefs and negative automatic thoughts—specifically, that negative core beliefs, though usually outside of awareness, influence or shape automatic thoughts. Clients are taught the downward arrow technique to identify their own negative core beliefs.

Fear of Thoughts, Images, and Trauma Memories

Like Chapter 5 (fear of emotions and bodily sensations), Chapter 7 discusses the treatment of internal threats including thoughts, images, and trauma memories. Imaginal exposure is particularly effective for the treatment of these fears. It has advantages over in vivo exposure because it can be used when in vivo exposure may not be appropriate or feasible (e.g., for combat traumas, contracting a disease, dying alone, harming someone). It can be used alone or in combination with in vivo exposure. When used in combination, it is generally delivered first in therapy (sequentially) or along with in vivo exposure (concurrently). Imaginal exposure therapy steps include identifying the core threat (downward arrow technique) or trauma memory, developing an imaginal exposure script/planning sheet, delivery of imaginal exposure for approximately 30-minutes (recording patient voice, first person, present tense), processing of the imaginal exposure (what was learned/meaning), and assigning home practice (listen to the recording daily). Imaginal exposure can be used as a transdiagnostic approach to reduce fear. In particular, the chapter discusses slight modifications in the cases of generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder.

Socratic Questions With Children: Recommendations and Cautionary Tales

This clinically focused article offers cognitive behavior therapists recommendations and cautionary tales for using the Socratic method when working with children. The importance of the therapeutic relationship in combination with developmental considerations is discussed. The use of Socratic method in various cognitive behavioral modules is illustrated by means of case examples. Dialogues provide examples of how the cognitive specificity hypothesis and downward arrow technique can be used to support young clients in eliciting negative automatic thoughts. The importance of pacing, the mixing of closed and open-ended questions, and behavioral experiments to aid cognitive restructuring are also highlighted through extracts from clinical conversations. Finally, the article emphasizes that the purpose of the Socratic method is to broaden thinking and to access new knowledge rather than just giving young clients new thoughts and problem solving strategies.

Changing Beliefs: Thinking Your Way Out of the Hoarding Box

Chapter 8 provides clients with strategies for changing beliefs about non-acquiring, sorting, and discarding. These include a review of problematic thinking styles, self-generated questions about possessions, advantages and disadvantages, the downward arrow method, and the use of thought records to track thinking and emotions. Other methods include defining need versus want, perfectionism and considering the value of time. Clients can select the methods that work best for them to try out as homework.