The Principles of Recovery and Values in CBT A Case Example with Aaron T. Beck, MD. – excellent article about CBT

Full article here by Dr Beck @

Summary – without claim to the copyright of the work by the Beck Institute – shared in the spirit of effective psychological practice

  • client in visibly upset
  • Dr Beck conducts a mood check
  • Dr Beck reframes the client’s experience/therapy towards times the client felt good
  • Dr. Beck reinforces the positive feelings, praising her, and asking whether this showed she was able to do difficult tasks.
  • As the session progresses, Mary moves into an adaptive mode of functioning, with clear thinking and communication.

When Dr. Beck conversationally inquires, “What would be good about having a job?” she lists income, a better house and education for her son.  He helps her realize that other good aspects would be a feeling of success and greater confidence. Dr. Beck summarizes her experience in common parlance: “I think you’ve lost your confidence,” a beautiful, humanistic description of her difficulties, which gives her hope that she can improve her life.

  • the therapist shows empathy and concern
  • the therapist and client brainstorm ways to build confidence/esteem
  • Dr. Beck asks, “Can we make this our destination?” This demonstrates to her that he has hope and wants to be a partner in her recovery. It also normalizes Mary’s experiences, and indicates that these aspirations will require some time and effort.
  • Dr. Beck asks Mary to expand on her aspirations and guides her in creating visual images of herself and her son in a new house and at her son’s graduation from college. It is apparent that these images are boosting her sense of hope.

Mary expresses a wish: “If only someone would believe in me.” Dr. Beck points out: “It’s important to believe in yourself.” Mary found this inspiring and she liked the idea that she would play a role in her own destiny. Mary and Dr. Beck agree on focusing on the future and improving her confidence (for example, by recording her daily successes, no matter how small).


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