1: A CBT Toolbox: Toward Wise Living
Learn why cognitive behavioral therapy (CBT) is such a powerful and effective therapy to help you move toward Wise Mind—that state where your emotions and cognition are working together, each from its own strength, to support you in your best possible life. You’ll meet Amanda, David, and Miriam and watch their initial CBT sessions.
2: Laying a Foundation: Assessments and Goals
A full self-assessment is a foundational CBT skill, giving you a good sense of your strengths and areas for improvement. And as you move forward in your therapy, self-assessment will show you whether or not you’ve been progressing toward your goals. Learn how to access the NIH’s free PROMIS system to collect the data you’ll need for your self-assessment and case formulation.
3: Behavioral Activation: Potent Mood Boosters
While you already know your emotions can affect your behaviors, the reverse is also true. For example, have you ever noticed that you seem to be in a better mood after exercise or watching a funny movie? Explore the umbrella concept of behavioral activation and learn the important ABCs of behavior—antecedents, behavior, and consequences—to make them work for you.
4: Advanced Behavioral Techniques
Learn about the numerous techniques for somatic quieting, including some that Dr. Satterfield has begun to use for himself. Watch as he suggests various behavioral activations for both Amanda and David. Although their issues and needs are very different, you’ll see that behavioral activation is an important CBT tool for both.
5: Capturing Thoughts and Making Connections
As you investigate your two distinct systems of cognition, you will immediately recognize the roles they have both played in your life. Explore how your personal habits of mind and habits of selective attention have affected your own behavior and emotions. Watch as Dr. Satterfield works with Miriam and David on important cognitive exercises.
6: Cognitive Restructuring and Thought Records
The CBT thought record is the workhorse of the therapy, the tool that will lead to cognitive restructuring. Learn how to create your own thought record, identifying your triggers, emotions, and automatic thoughts. Watching David as he works through the first part of his own thought record will help you develop your own and better understand the power of the tool.
7: Worry, Rumination, and Sticky Thoughts
Have you ever found yourself worrying so much that you wished you could just turn your brain off? You’re not alone—it’s normal to worry from time to time. But when worrying becomes unproductive and continual, CBT tools can help you regain control. Learn several techniques—from distracting yourself to scheduling official worry time—that can help you redirect your thoughts and avoid rumination.
8: Digging Deeper: Rules and Core Beliefs
To benefit from CBT, it’s not enough to look only at your automatic thoughts. Use a new worksheet to identify your deepest beliefs and schemas, as well as your signature strengths. Functioning as an advanced thought record, your detailed core beliefs worksheet will help you understand what drives your automatic thoughts about yourself.
9: Toolbox in Action: Stress and Assertiveness
In this lecture, you will continue exploring blended techniques, using both cognitive and behavioral strategies to practice assertiveness and stress management. The basics are already in your toolbox, but you’ll learn to create the new tools of cognitive rehearsal, microaffirmations, and savoring by combining the basic skills in new ways.
10: Understanding and Managing Emotions
You have experienced emotions every day of your life, and they influence everything you think and do. And yet, they are not always easy to identify and understand, and certainly not easy to control. Discover how to identify your primary emotions, their triggers, associated cognitions, and linked behaviors. Watch David as he learns about the modal model of emotions and emotion regulation skills.
11: Key Steps to Solving Problems
Learn about problem-solving therapy and how it can help manage the negative effects of stressful events. As you develop the skills to identify the stressors that trigger your sadness and anger, you’ll be able to better manage negative emotions. You will become more confident about your ability to cope with difficult problems—and even more accepting of problems that might not have a solution at all.
12: Grief, Sadness, and Depression
Grief and loss unite us all; if you haven’t experienced a loss yet, you will before long. Learn about the relationships between sadness, grief, and depression, and how CBT can help at all points along the depressive continuum. Watch Miriam as she begins to cope with the grief of having recently lost her mother. How can you determine whether or not she’s clinically depressed?
13: Panic Attacks and Anxiety
Anxiety, one of the most common negative emotions, is something we’ve all experienced at one time or another. Look closely at the differences between anxiety, anxiety disorder, and panic attacks. Explore the treatment of exposure therapy and its success rates—the one aspect of CBT you should seek professional help to implement.
14: Addiction and Pain Medications
Learn how CBT can play a significant role in the treatment of substance abuse disorders—particularly when combined with medication assisted treatment—by addressing the underlying social disconnection that can lead to drug use. Watch Scott work with the issues of an opioid addiction that began with a legitimate need for pain relief from a physical problem.
15: Embracing Imperfection
The costs of being a perfectionist are high: anger, irritability, impatience, stress, rigidity—the gut-churning desperation to avoid failure and disapproval. Determine which CBT cognitive and behavioral techniques can be helpful in treatment, and watch Amanda as she addresses her own perfectionism. Discover the powerful Dutch concept of niksen and consider how it might fit into your own life.
16: Beating Procrastination
Explore the cognitions, behaviors, and emotions that come into play with procrastination. Learn to use your CBT thought record, core beliefs worksheet, and problem-solving therapy to identify ways in which you can reframe the task at hand. Watch how Amanda addresses her procrastination by employing the “four squares” technique developed by US President Dwight Eisenhower.
17: Soothing Rejection, Promoting Connection
We are wired to be overly sensitive to rejection, and while that might have been adaptive in our evolutionary past, it is not helpful now. Watch how Stephen responds to perceived rejection. Learn about the nature of rejection itself and which CBT skills can help Stephen, Amanda, and others address those habits of mind that can work against us.
18: Early Childhood Trauma and Neglect
Learn about the ACEs study—Adverse Childhood Experiences—and why it has been so impactful in the medical and mental-health communities. You can identify your own ACEs number and associated risks. But more importantly, explore the many ways in which CBT can help you rewrite your own story and lower that risk as you watch Miriam address her own past trauma.
19: Managing Chronic Disease
Using the tools in your CBT toolbox, explore how chronic disease can affect self-image and a sense of hope, and how it also challenges notions held about mortality and vulnerability. While CBT cannot cure the physical illness, it can be used to ameliorate many of the habits of mind that affect daily life. Watch Miriam as she addresses the impacts of several chronic illnesses.
20: Coping with Chronic Pain
Learn which CBT tools can be used to manage the psychological suffering that usually accompanies chronic pain, something that affects 15 to 20% of Americans each year. While CBT is not meant as a substitute for other types of pain intervention, it can add to the treatment protocol as it targets emotion regulation and improved social and occupational functioning.
21: How to End Insomnia and Finally Sleep
Lack of sleep is one of the most common medical complaints seen in primary care clinics today. Explore the impressive efficacy of CBT-I (“I” for insomnia) and watch Christian as he addresses his seven-year battle with insomnia using CBT-I techniques. Learn about sleep hygiene, sleep efficiency, how to keep a sleep log, and how you might apply these aspects of CBT-I to your own life.
22: CBT for the Beginning of the End of Life
How can we use CBT to improve the quality of the last years of life, when death becomes either imminent or certain within the next few years? Explore the many CBT tools that can be used to work with end-of-life issues. Watch David as he addresses these issues with a very specific configuration of CBT tools in a 12-session format.
23: Expanding CBT with Technology
Technology can be a boon for CBT, expanding its accessibility to those who aren’t able to work with a therapist in person and those who prefer technological assistance to the standby pen and paper. Explore the exciting possibilities of expanding CBT accessibility through chatbots, mobile apps, websites, video games, virtual reality, and the even newer technologies on the horizon.
24: Reclaiming and Rewriting Our Stories
What stories do you tell about yourself? Your loved ones? Explore how CBT and the search for cognitive balance can inform and reshape our stories in constructive ways. Explore the practice of writing your own character sketch and the “library exercise” in which you curate your own library of stories. What would you like to change now that you have the CBT tools to do just that?
Doing a comprehensive course on mind-body medicine has been a lifelong dream. We can all manage our health and alter our environments. Next up: cognitive therapy tools that can improve health and wellness. Onward and upward!
About Jason M. Satterfield
Professor Jason M. Satterfield is Professor of Clinical Medicine, Director of Social and Behavioral Sciences, and Director of Behavioral Medicine in the Division of General Internal Medicine at the University of California, San Francisco (UCSF). He earned his B.S. in Brain Sciences from the Massachusetts Institute of Technology and his Ph.D. in Clinical Psychology from the University of Pennsylvania. He currently directs the UCSF Behavioral Medicine Unit, which integrates mental and behavioral health services into adult primary care. Professor Satterfield’s book, A Cognitive-Behavioral Approach to the Beginning of the End of Life: Minding the Body, was recognized as a Self-Help Book of Merit by the Association for Behavioral and Cognitive Therapies. He served on the Behavioral and Social Science Subcommittee that revised the Medical College Admission Test-work that was recently featured in the New England Journal of Medicine and The New York Times. Professor Satterfield is also part of a core interdisciplinary team that is writing a medical textbook based on the biopsychosocial model. He has been nominated for multiple teaching awards at UCSF, and he is often competitively selected to teach at national conferences for a wide variety of health professionals, including physicians, nurses, social workers, and psychologists.