Dear Dr. Burns —

You seem to be a very involved, structured and positive therapist. It has been difficult to find a therapist that fits this description. I’ve seen a couple of “cognitive therapists” but it only ended up being traditional talk therapy. No one has been able to be consistent with the three-column technique or other strategies.

I am very knowledgeable about your strategies but I easily lose focus and get confused. I need guidance and consistency. What do you recommend therapy wise? How or where do I find a competent therapist?

Dear friend,

This is one of the most common questions I get at this site. Many people want to know how and where to find a good cognitive therapist, or a good therapist in general.

First, you can look on my website referral page. This will show you how to find cognitive therapists in various regions. This is a good place to start. You can also search for “cognitive therapy referral” on Google.

My colleagues and I in California have developed a new form of therapy, called T.E.A.M. Therapy, that can be surprisingly effective and fast-acting for many individuals who are struggling with depression and anxiety. T.E.A.M. addresses some of the limitations of cognitive therapy, especially in the areas of therapeutic resistance and motivation.

You can go to the website, FeelingGoodInstitute.com, to find therapists trained in the latest T.E.A.M. therapy techniques. We hope to be able to list more therapists trained in the new techniques in more locations in the United States, Canada and Europe over the next year or two. Unfortunately, at the moment most of our therapists are here in the San Francisco Bay Area. To overcome this problem, in the past some people have arranged to come here for several days of intensive, back-to-back sessions. The goal is to make a therapeutic breakthrough, and then follow up on that with a local therapist if needed after returning home. This option can be somewhat costly, and is not a good choice for everyone, but for some people it could be very helpful, or even life-changing.

What are your other options? You can call the local psychological, psychiatric or clinical social work associations in your region to ask for help. You can also call the corresponding departments at any local universities to ask. Finally, you will find several centers for cognitive therapy listed on my referral page. You can email or phone them and ask for help. They may know of someone in your region they can recommend.

My books can help you learn these methods as well, although they are not intended as a substitute for therapy with a mental health professional. There have been many published outcome studies on my book Feeling Good: The New Mood Therapy. Researchers have reported that two-thirds of the depressed people who were given the book improved or recovered within four weeks with no other treatment. That’s very exciting, but of course, the book is not a panacea, and many people will also need the help of a compassionate therapist.

Here’s a reference to one of their many research studies supporting the use of my books.

Smith, N. M., Floyd, M. R., Jamison, C., and Scogin, F. (1997). Three-year follow-up of bibliotherapy for depression. Journal of Consulting and Clinical Psychology, 65(2), 324-327.

Of course, you can view a list of all my books, with brief descriptions, on the Books page.

The Ten Days to Self-Esteem is a systematic, ten-step program for learning cognitive therapy individually or in groups. This book presents a brief and a somewhat simplified version of cognitive therapy. A group leader’s manual is also available as an eBook.

I wish I could do more. I have been frustrated by how hard it can be to find a therapist who adheres to these methods in the way they are intended to be administered.

Finally, if you are struggling with depression or anxiety, I would like to emphasize the importance of the written Daily Mood Log, which is a five-step process you do on paper, not in your head. When you write down your negative thoughts you can more easily attack them, one by one. You can learn about the Daily Mood Log in any of my books, such as The Feeling Good Handbook. And if you are struggling with a relationship problem, such as a conflict with a family member, friend, or colleague, I w3ould encourage you to try the written exercises, such as the  Relationship Journal, which are described in a step-by-step manner in my latest book, Feeling Good Together.

All the best,
David Burns, MD