Let's Talk about CBT- Practice Matters

Rachel Handley for BABCP
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The podcast for therapists using Cognitive Behavioural Therapy to help shape and inform their practice.

  1. 31 MAR

    Exploring the value of low intensity CBT with Prof Paul Farrand

    In this episode of Let's Talk About CBT- Practice Matters, Rachel Handley is joined by Professor Paul Farrand to unpack the theory and practice of low intensity CBT. They explore what low intensity really means, challenging common misconceptions and clarifying its evidence base, including its focus on single-strand interventions and stepped care delivery. Paul discusses how low intensity approaches improve access, efficiency, and patient empowerment, while maintaining clinical rigour through strong practitioner competencies in engagement and risk assessment. The conversation also highlights adaptation for diverse populations, evolving delivery formats, and future directions, including digital innovation and applications in physical health settings. A great listen for anyone wanting to learn more about low intensity CBT or thinking about applying it in different contexts. Further resources: Find out more about Paul and his work here Paul's publications, including the systematic review he mentions can be found here Find out more about the Cognitive Behaviour Therapist Low Intensity special issue here The Sage book in which Paul's chapter on low intensity CBT is included is: Papworth, M., & Marrinan, T. (2019). Low intensity cognitive behaviour therapy : a practitioner's guide (2nd ed.). SAGE. More information about NHS Talking Therapies can be found here Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 3min

  2. 27 FEB

    Doing more that matters- Behavioural Activation for Depression in Children and Young People With Professor Shirley Reynolds

    In this episode of Let's Talk About CBT: Practice Matters, Rachel Handley speaks with Professor Shirley Reynolds about behavioural activation for depression in children and young people. Shirley reflects on what we know about depression in adolescence, the challenges of access to effective treatment, and why brief, values-based approaches may be particularly well suited to this developmental stage. Drawing on findings from large clinical trials, she explains how young people often attend fewer sessions than are offered, prompting important questions about engagement and the design of therapy. The conversation explores how behavioural activation helps young people identify what matters to them and gradually increase meaningful activity. Shirley outlines what a course of BA looks like in practice, from early psychoeducation and activity monitoring through to parent contracting and relapse prevention, and discusses the importance of supervision, system support and therapist wellbeing. Further resources: Find out more about Shirley and her work: https://www.drshirleyreynolds.com/about More information about the online training with Shirley and Laura Pass can be found here: https://www.cbtreach.org/pass-reynolds The IMPACT trial: Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., Senior, R., Target, M., Widmer, B., Wilkinson, P., & Fonagy, P. (2017). Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial. The Lancet Psychiatry, 4(2), 109–119. https://doi.org/10.1016/s2215-0366(16)30378-9   Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 9min

  3. 28 JAN

    Why simplicity does not mean superficiality: exploring Low-intensity Behavioural Activation for Depression with Prof David Ekers

    How do we make effective therapy for depression more widely available without losing quality or compassion? In this episode, Rachel Handley is joined by Professor David Ekers, a leading researcher and clinician specialising in behavioural activation (BA). David shares the story of how his clinical experience with long waiting lists led him to focus on scalable, evidence-based approaches to care. The conversation explores the development of behavioural activation, the evidence underpinning low intensity delivery, and key findings from major trials including the COBRA and BASIL studies. David explains why behavioural activation is a robust, practical intervention that can be delivered effectively by a range of practitioners, without losing therapeutic depth or compassion. David reflects on common myths about low intensity work, the importance of supervision and therapeutic relationships, and the challenges services face when balancing access, outcomes, and relapse prevention. Further resources: David's University of York webpage can be found here which details all his publications and research projects Papers and links to further information about the trials mentioned in this episode are listed below: COBRA: Finning, K., Richards, D. A., Moore, L., Ekers, D., McMillan, D., Farrand, P. A., O'Mahen, H. A., Watkins, E. R., Wright, K. A., Fletcher, E., Rhodes, S., Woodhouse, R., & Wray, F. (2017). Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation. BMJ Open, 7(4), e014161. https://doi.org/10.1136/bmjopen-2016-014161 Richards, D. A., Rhodes, S., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Barrett, B., Finning, K., Ganguli, P., Warren, F., Farrand, P., Gilbody, S., Kuyken, W., O'Mahen, H., Watkins, E., Wright, K., Reed, N., Fletcher, E., Hollon, S. D., & Moore, L. (2017). Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression. Health Technology Assessment, 21(46), 1–366. https://doi.org/10.3310/hta21460 Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C., Barrett, B., Farrand, P. A., Gilbody, S., Kuyken, W., O'Mahen, H., Watkins, E. R., Wright, K. A., Hollon, S. D., Reed, N., Rhodes, S., Fletcher, E., & Finning, K. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority Trial. The Lancet, 388(10047), 871–880. https://doi.org/10.1016/s0140-6736(16)31140-0 BASIL: Gilbody, S., Littlewood, E., McMillan, D., Atha, L., Bailey, D., Baird, K., Brady, S., Burke, L., Chew-Graham, C. A., Coventry, P., Crosland, S., Fairhurst, C., Henry, A., Hollingsworth, K., Newbronner, E., Ryde, E., Shearsmith, L., Wang, H.-I., Webster, J., & Woodhouse, R. (2024). Behavioural activation to mitigate the psychological impacts of COVID-19 restrictions on older people in England and Wales (BASIL+): a pragmatic randomised controlled trial. The Lancet Healthy Longevity, 5(2), e97–e107. https://doi.org/10.1016/s2666-7568(23)00238-6 Littlewood, E., McMillan, D., Graham, C. C., Bailey, D., Gascoyne, S., Sloane, C., Burke, L., Coventry, P., Crosland, S., Fairhurst, C., Henry, A., Hewitt, C., Baird, K., Ryde, E., Shearsmith, L., Traviss-Turner, G., Woodhouse, R., Webster, J., Meader, N., & Churchill, R. (2022). Can we mitigate the psychological impacts of social isolation using behavioural activation? Long-term results of the UK BASIL urgent public health COVID-19 pilot randomised controlled trial and living systematic review. Evidence-Based Mental Health. https://doi.org/10.1136/ebmental-2022-300530 More information and publications related to the study can be found www.BASILStudy.org CASPER: Gilbody, S., Lewis, H., Adamson, J., Atherton, K., Bailey, D., Birtwistle, J., Bosanquet, K., Clare, E., Delgadillo, J., Ekers, D., Foster, D., Gabe, R., Gascoyne, S., Haley, L., Hamilton, J., Hargate, R., Hewitt, C., Holmes, J., Keding, A., & Lilley-Kelly, A. (2017). Effect of Collaborative Care vs Usual Care on Depressive Symptoms in Older Adults With Subthreshold Depression. JAMA, 317(7), 728. https://doi.org/10.1001/jama.2017.0130 Lewis, H., Adamson, J., Atherton, K., Bailey, D., Birtwistle, J., Bosanquet, K., Clare, E., Delgadillo, J., Ekers, D., Foster, D., Gabe, R., Gascoyne, S., Haley, L., Hargate, R., Hewitt, C., Holmes, J., Keding, A., Lilley-Kelly, A., Maya, J., & McMillan, D. (2017). CollAborative care and active surveillance for Screen-Positive EldeRs with subthreshold depression (CASPER): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness. Health Technology Assessment, 21(8), 1–196. https://doi.org/10.3310/hta21080 ‌DiaDeM: More information and publications related to the programme can be found here Insika Yomama: Rochat, T. J., Dube, S., Herbst, K., Hoegfeldt, C. A., Redinger, S., Khoza, T., Bland, R. M., Richter, L., Linsell, L., Desmond, C., Yousafzai, A. K., Craske, M., Juszczak, E., Abas, M., Edwards, T., Ekers, D., & Stein, A. (2021). An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: study protocol for the Insika Yomama cluster randomised controlled trial. Trials, 22(1). https://doi.org/10.1186/s13063-021-05672-0 ‌MODS: More information and publications related to the study can be found www.MODSStudy.org Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 1min

  4. 29/12/2025

    Understanding Historical Context in CBT Practice with Dr Alasdair Churchard

    In this episode of Let's Talk About CBT- Practice Matters, Rachel is joined by Dr Alasdair Churchard, clinical psychologist, CBT therapist and NIHR pre doctoral fellow at the University of Oxford. Alasdair's work focuses on ethnic inequalities in psychological therapies, and together they explore why historical context matters in CBT practice. The discussion covers the importance of addressing ethnic inequalities in mental health services and explores practical considerations for therapists, including how to broach difficult historical topics, the balance of asking versus self-education, and the need to focus on histories of strength and self-empowerment alongside trauma. Further resources: Language used: Talking about race and ethnicity at work | The Law Society, Writing about ethnicity - GOV.UK RHO report: Ethnic Inequalities in Improving Access to Psychological Therapies (IAPT) MHA detentions: Detentions under the Mental Health Act - GOV.UK Ethnicity facts and figures Marmot report: Structural Racism, Ethnicity and Health Inequalities in London - IHE Bansal meta-ethnography: Bansal, N., Karlsen, S., Sashidharan, S. P., Cohen, R., Chew-Graham, C. A., & Malpass, A. (2022). Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Medicine, 19(12), e1004139. Some culturally-adapted CBT links: Williams, M. T. (2020). Managing microaggressions: Addressing everyday racism in therapeutic spaces. Oxford University Press. Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015). Cultural adaptation of CBT for serious mental illness: a guide for training and practice. John Wiley & Sons. Beck, A. (2016). Transcultural cognitive behaviour therapy for anxiety and depression: A practical guide. Routledge. Iwamasa, G. Y., & Hays, P. A. (2019). Culturally responsive cognitive behavior therapy: Practice and supervision (pp. xi-348). American Psychological Association. Lawton, L., Thwaites, R., & Warnock-Parkes, E. (2025). Using cognitive therapy for PTSD when racism was part of the traumatic event (s): case illustrations and practical considerations for therapists and supervisors. the Cognitive Behaviour Therapist, 18, e31. What is metacompetence?: Whittington, A., & Grey, N. (2014). Mastering metacompetence: The science and art of cognitive behavioural therapy. How to become a more effective CBT therapist: Mastering metacompetence in clinical practice, 1-16. Helen Kennerley on the working relationship: Kennerley, H. (2014). Developing and maintaining a working alliance in CBT. How to become a more effective CBT therapist: Mastering metacompetence in clinical practice, 31-43. Ian Andrew James on kitchen sink formulations: James, I. A. (2010). Cognitive behavioural therapy with older people: Interventions for those with and without dementia. Jessica Kingsley Publishers. Ken Laidlaw on formulation: Laidlaw, K. (2014). CBT for older people: An introduction. Source for Seamus Heaney quotes: Heaney, S. (2014). Crediting Poetry: The Nobel Lecture. Farrar, Straus and Giroux. DPR model: Churchard, A. (2022). How can psychotherapists improve their practice with service users from minoritised ethnicities? An application of the Declarative-Procedural-Reflective (DPR) model of clinical skill development. The Cognitive Behaviour Therapist, 15, e1. Thwaites, R., Churchard, A., Mofrad, L., Wood, D., & Brooks-Ucheaga, M. (2025). Considering the whole self: integrating identity (s), context and power into the declarative procedural reflective (DPR) model of CBT practitioner development. The Cognitive Behaviour Therapist, 18, e35. SP/SR for therapists from minoritised ethnicities: Chowdhury, S. S., Churchard, A., Lawton, L., Malik, Z., Thwaites, R., & Clements, H. (2025). A novel self-practice/self-reflection programme for CBT therapists from minoritised ethnic backgrounds: a multiple baselines single case experimental study. the Cognitive Behaviour Therapist, 18, e15. Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    59 min

  5. 27/11/2025

    The what, how and why of Behavioural Activation with Dr Christopher Martell

    In this episode of Practice Matters, host Rachel Handley speaks with Dr Christopher Martell, a leading expert in behavioural activation (BA) for depression. Christopher shares his journey from early training in CBT to becoming a key figure in the development of BA, describing how behavioural strategies can help people move toward a more meaningful life when depression keeps them stuck. Rachel puts common myths to him, including whether BA is too simplistic for complex cases or ignores thoughts and emotions, and he explains how BA works with both private and public behaviour to support change. They explore the importance of values, small steps, and compassionate coaching, as well as new research into biological mechanisms involved in recovery. Christopher also reflects on therapist challenges, resilience in clients, and why activation sometimes means slowing down. Further resources: Behavioural Activation for Depression: Second Edition: A Clinician's Guide A Darkness Visible- William Styron The Noonday Demon- Andrew Solomon Find out more about Christopher and his publications here: https://christophermartellphd.com/ Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 17min

  6. 27/10/2025

    "The engine of mindfulness is exploration" … discovering Mindfulness-Based Cognitive Therapy with Professor Zindel Segal

    In this episode, Rachel talks with Professor Zindel Segal, Distinguished Professor of Psychology in Mood Disorders all about Mindfulness-Based Cognitive Therapy. (MBCT). Zindel discusses the origins of MBCT, detailing how he and his colleagues transitioned from traditional cognitive therapy to integrating mindfulness as a core mechanism for preventing depression relapse. The conversation explores the fundamental concepts of mindfulness, the challenges therapists face when shifting from goal-oriented CBT to mindfulness inquiry, and the empirical evidence supporting MBCT's efficacy, particularly concerning the neurobiological findings about sense foraging and the role of sensation in recovery. Further resources: Mindfulness-Based Cognitive Therapy for Depression – Segal, Williams & Teasdale Better in Every Sense – Segal & Farb MBCT website Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 13min

  7. 30/09/2025

    Rumination and Depression with Professor Ed Watkins

    In this episode, Rachel Handley talks with Professor Ed Watkins, Professor of Psychology at the University of Exeter a world-leading expert in Rumination and its impact on mental health and wellbeing. Professor Watkins talks about Rumination-Focussed Cognitive Therapy, an evidence-based approach he has developed and trialled to target these specific processes in depression.   They discuss: What is rumination What might be the different between adaptive and maladaptive rumination How rumination can become a habit that can maintain low mood, anxiety and depression The development and application of Rumination-Focused CBT (RFCBT) to depression Practical techniques to shift clients from ruminative abstract, self-critical thinking into concrete, experiential, and compassionate approaches When RFCBT may be especially helpful, including with complex or chronic depression Resources & Further Learning: Find more information about Ed and his publications here Find out more about The Calming Minds Project here Stay Connected: Follow us on Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

    1hr 25min

  8. 19/08/2025

    Prof Judith Beck : Back to basics… or back to the future?

    In this episode of Practice Matters, Rachel is joined by Professor Judith Beck, President of the Beck Institute for Cognitive Behaviour Therapy and one of the most influential voices in the field. Judith discusses her personal and professional journey into CBT, the legacy of her father Aaron T. Beck, and the evolution of cognitive therapy from its traditional roots to recovery-oriented cognitive therapy (CT-R). Judith also shares insights on the importance of the therapeutic relationship, strategies for validating clients, managing hopelessness, and adapting CBT across cultures and how therapists can look after themselves, continue learning, and stay connected. Resources and links mentioned in this episode: Beck Institute for Cognitive Behavior Therapy Subscribe to the Beck Institute newsletter Cognitive Behavior Therapy: Basics and Beyond (3rd edition, 2021) by Judith S. Beck Beck Institute social media channels: Facebook: https://www.facebook.com/beckinstitute LinkedIn: https://www.linkedin.com/company/beck-institute-for-cognitive-behavior-therapy/ X: https://twitter.com/beckinstitute YouTube: https://www.youtube.com/user/BeckInstitute   Stay Connected: Follow us on Instagram: @BABCPpodcasts Send us your questions and suggestions: podcasts@babcp.com Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow Transcript: Rachel: Welcome to Let's Talk About CBT Practice Matters, the BABCP podcast for therapists using cognitive behavioral therapy with me, Rachel Handley. Each episode, we talk to an expert in CBT who will share insights that will help you understand and apply CBT better to help your patients. Today, I'm really delighted to be joined by Professor Judith Beck. Professor Beck is president of the Beck Institute for Cognitive Behavior Therapy and clinical professor of psychology and psychiatry at the University of Pennsylvania Perelman School of Medicine. She has published prolifically on CBT, including key texts that are to be found on the bookshelves of almost every CBT therapist with a desire to hone their craft. And they really do guide us through the basics and beyond. Judy, welcome to the podcast. Judith Beck: Thank you for having me. Rachel: I'm fortunate to have met you previously during a brief period of study at the Beck Institute many moons ago now. However, I imagine that I feel about spending time talking to you about CBT the same way normal people might feel about chatting to celebrities, given that of course your CBT royalty, your father being Aaron T. Beck, also widely regarded as the father of CBT and that you've worked so closely with him to develop the field. It might perhaps seem inevitable given that background that you would end up in this work, but you clearly could have chosen any number of career pathways. Can you tell us a little bit about your personal and professional journey to where you are now? Judith Beck: So I've always loved children. And when I was probably six or seven, I decided that I wanted to be a teacher. And so when I went to the University of Pennsylvania, I studied education to become a teacher, but I took a lot of psychology courses as well. And I taught kids with learning disabilities for a while and then decided that if I wanted to have a career or met my career as a teacher, I really had to go back and get a professional degree, a master's degree. And so I went back to school and got a master's in educational psychology. Then worked as a supervisor for a little while and decided that I should really probably get a PhD. And it was toward the beginning of my PhD program that I became more interested in psychology and in my father's work. And I really think that I must have been at least subliminally influenced by my dad when I was a teacher and when I was a supervisor. At the beginning when I started to consider going into this field, I had kind of a naive idea and it was an automatic thought. I thought, I just don't know if I'm cut out to be a psychologist because I've always been such an intuitive teacher. I didn't really need someone to teach me how to teach, especially when it came to teaching kids with learning disabilities. It was just quite natural for me to know how to take something that was complicated and break it down and speak to my young students in a way that they could understand. So I thought, how could I learn to be a psychologist? I'm not intuitive at all about how to do that. Rachel: So if it requires some learning, then it can't be for me. Judith Beck: That was my thought at the time. And fortunately it turned out to be wrong. And then I started to learn really in detail about my dad's work, and it all made so much good sense to me. And what's interesting is that I've really come full circle. For a while, especially at the beginning, I was primarily a CBT therapist. But then I really became a CBT teacher. And most of my activities now, or many of my activities at the Beck Institute have to do obviously with training and teaching other people to use CBT. Rachel: So you started by integrating psychology into your education and you've come full circle in now you're integrating education into your psychology. Judith Beck: That's right. You sometimes people draw interesting conclusions. More than a couple of people have said, well, you probably didn't go into psychology initially because that's what your father was doing. And I said, no, no, no, it wasn't a reaction to my father. It was just that I was always drawn to working with young children. And that's what I did as a teacher. Rachel: When talking about families, I've often spoken on this podcast previously about how as both a psychologist and a mother, I hope that my professional skills give me skills and insights as a parent that I might not otherwise have. But mostly it feels like I'm just more aware of the many, many ways in which I'm failing as a parent and setting my kids up with all kinds of dysfunctional assumptions about how the world works. I wonder how it was growing up in the Beck household. Was there lots of practice and reflection on CBT principles? Judith Beck: Well, I grew up in the late 1950s and 1960s and I didn't go to university until 1971. And it was really through the later 60s and into the 70s that my father was developing cognitive therapy. But my parents had a very traditional marriage. My father worked all of the time and my mother who actually went to, did something extraordinarily unusual. She went to law school when she had four kids under the age of 10. There were three women in her very large class. Women just didn't do that in those days. It was starting in probably 1961 or 62. Despite the fact that she was in school and then developing her own career, she really had probably 90 % of the care of the kids and the household and organization and so forth. We did have dinner every night, though, as a family. My father stopped work long enough to do that. But we didn't really talk about his work very much. There was one memory that I have that I've told a number of people about, that's when I was someplace around 10, 11, 12 years old. And my father said, Judy, I have a new idea I'd like to run by you. And then he described the cognitive model. That's not a situation that directly influences your reaction, but rather your interpretation of that situation, the thoughts that go through your mind. And so he told me that, and he gave me an example. And he said, what do you think? And what I said out loud to him was, well, yes, that makes sense. But in my own mind, my automatic thought was but that's so obvious. So I think I probably began thinking like a cognitive therapist fairly early on, although we really rarely discussed his work. I knew my both parents were unusual, my mother being in school and becoming a lawyer. And I knew my dad was unusual because he wrote books. And I didn't have any friends who's fathers or mothers wrote books. Rachel: To be fair, I think I've got teenage boys and most of what I say either seems extremely obvious to them or totally ridiculous. I mean, at the other extreme, but it's lovely to hear about your mother as well. Cause obviously we all know so much about your father's work, but obviously two very inspirational, hardworking parents who, you know, work with a love of learning and an interest in doing things in the world. So fantastic. Well, glad he got past you, Judy, because if you'd said it sounds like rubbish, maybe we never would have had CBT. So I'm glad you were one of the first audiences. Now, regular listeners to the podcast will by now be familiar with our podcast challenge. We love a good formulation here at Practice Matters in good CBT style, but because we're an audio podcast, it has to be done unlike almost everything we do in CBT without boxes or arrows or other visual aids. So here's your challenge. Can you give us a brief explanation of how the cognitive model explains psychological distress develops and is maintained without any of those aids. Judith Beck: Sure, so the first thing I want to say is that automatic thoughts do not cause depression. Depression is caused by so many different factors and it's important to take a biopsychosocial view of the development of depression. Automatic thoughts are probably an important precipitating factor among others that ultimately lead to the development of depression. I'm just gonna use depression as an example. But the automatic thoughts don't themselves cause depression. Okay, so the easiest way to talk about a formula

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The podcast for therapists using Cognitive Behavioural Therapy to help shape and inform their practice.

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