Is there only one way to do things?

Is there only one way to do things?

Hello everyone,

At my Stanford Tuesday training group this week, one of our members asked a super-important question, “Does David believe there is only one correct way to do things?” By way of coincidence, Rhonda and I recently recorded a podcast on this very topic, and it will be published on Monday. This is the title: “Is Cognitive Therapy a Cure-All for Everything?” You might enjoy it, and you’ll get my thinking on several controversial topics.

If you’re not yet a podcast fan, you and some of your patients might like them. Here’s an email I got just this morning from someone in Kosovo.

Dr. David,

Greetings from Kosovo. Your book has been a wonderful journey on my self-help regarding my anxieties, worries, and stress – so thank you very much. After reading the book I found out about the podcast (very recently) and ever since I started watching all of the episodes one by one from the very first one. The story of Marilyn has hit me deeply and has made me realize how irrational I am being about my problems – although they feel very real to me. However, seeing how Marilyn coped with her severe anxieties, mine went away almost instantly. I’m sending all my love to You, Matt and Marilyn. I have recommended your book and podcast to all of my friends.

Gratefully, Dea

As you can see, Dea actually experienced significant improvement just from listening to the live work with Marilyn. You or your patients might also find that my podcasts o books might greatly accelerate learning and recovery.

You can find a list of all the podcasts and show notes on my website.  In addition, you will find a search function in the right-hand panel of every page. This makes my entire website searchable, which is super-convenient if you want to recommend certain kinds of podcasts to your patients, or if you are looking for self-help. For example, you can type in “Five Secrets of Effective Communication,” “Positive Distortions,” “Anxiety,” “Suicide Prevention,” or whatever you want, and some wonderful resources will pop right up!

david

 * * *

And if you need training, CE credits, or just four days of training and personal refueling, attend one of my upcoming intensives. The Calgary program is coming up in two days but if you move fast, you can still register!

High-Speed Treatment of Depression and Anxiety Disorders—

Attend one of the three Summer / Fall Intensives

With David D. Burns, MD!

Three Great Locations—

Calgary, July 15 to 18, 2019

South San Francisco, July 29 to August 1, 2019

Atlanta, Georgia,November 4 – 7, 2019

 Learn powerful new tools to boost your effectiveness in the treatment of depression and all of the anxiety disorders! Discover how TEAM-CBT can produce extremely rapid and lasting changes for your depressed and anxious clients—and for you.

This workshop will be experiential. You will have the chance to practice lots of innovative techniques in small groups and get immediate feedback so you can refine your skills. You’ll also have the chance to work on your own feelings of self-doubt so you can leave this workshop on a high, with renewed confidence and excitement about your clinical work.

This dynamic workshop offers:

  • State-of-the-art TEAM-CBT techniques for depression and all of the anxiety disorders.
  • Powerful new methods for the treatment of habits and addictions—your own and your clients’!
  • Innovative resistance-busting techniques to boost patient motivation and eliminate “yes-butting.” Learn to pinpoint and eliminate the eight most common forms of therapeutic resistance.
  • Live demonstrations and video clips from actual therapy sessions.
  • Powerful Relapse Prevention Training for lasting results.
  • Lots of fun and the chance to get some much-needed emotional refueling!

The annual intensives are almost always the best workshops of the year. If you can join us this year, they will be even better!

This workshop has been approved for Levels 1 through 3 TEAM-CBT Certification
and is s
uitable for novice as well as highly experienced therapists.
Of course, you’ll get tons of CE credits as well.

The two intensives will be similar, but there are some differences that may be important to you.

Special features at this year’s South SF intensive

  • Sunny Choi will be speaking on “TEAM with Compassion.” Sunny spoke last year and was amazing, so he is returning, as they say, “by popular demand.” He describes incredible, high-speed TEAM therapy to populations with severe problems and extremely limited resources, including immigrants who do not speak English.
  • Dr. Jill Levitt will be joining me as co-therapist for the live demonstration on the evening of day 1. In past years, these dramatic live demos have provided tremendous opportunities for learning. If you have never seen Jill, this will be a real treat for you!
  • I will be joined by many expert helpers from the Feeling Good Institute who will help provide feedback for you during the many practice sessions.
  • There will be two amazing evening sessions to add depth to your training. You’ll be totally exhausted, but chock-full of incredible new skills and insights that can change the direction of your career and transform your personal life as well.

Special features at this year’s Calgary, Canada intensive

  • The three optional evening hikes / meals together will be a highlight for many. While hiking, you will have chances for personal work with David, Q and A, difficult case consultation, and additional practice with the new techniques you are learning.
  • If you don’t want to hike, you can enjoy your evenings with friends or family and refuel for the next day.
  • There will be a live demo on the morning of day 2. In past years, these live therapy sessions have been inspirational and wonderfully informative. Last year’s live therapy demonstration in Whistler was jaw-dropping!
  • And, as you probably know, Jack Hirose always puts on an amazing event, designed to provide you with maximum comfort, delight, and learning!

In both workshops, David promises to catapult at least 65% of the participants into a state of joyous enlightenment. Would you like to finally free yourself from feelings of self-doubt and endless obsessions about whether you’re “good enough?” Check out the registration links now!

Feeling good feels wonderful! You owe it to yourself to feel good! Join me in

Calgary (in two days!)

or

South San Francisco (at the end of July)

or

Atlanta (in early November)

David Burns, MD

Here’s a photo of my esteemed colleague, Mike Christensen, at a recent Canadian workshop.

IMG_20180607_100631_1

 

The Cognitive Revolution! Wow!

The Cognitive Revolution! Wow!

Whether you’re a patient, therapist, or general citizen, you might enjoy my interview on The Cognitive Revolution on Stanford’s radio station KZSU,  published yesterday.

It was an incredibly fun and energetic interview. They plan to re-broadcast it to let more people know about the benefits of CBT, as well as the new TEAM-CBT.

Here is a link to the interview:  http://www.modernteknews.com. The radio station reported that they got a strong and positive response to the program, and I hope you like it, too!

 * * *

And if you need training, CE credits, or just four days of fantastic training and personal refueling, attend one of my summer intensives. The Calgary program is coming up REALLY SOON but if you move fast, you can still register!

High-Speed Treatment of Depression and Anxiety Disorders—

Attend one of the three Summer / Fall Intensives

With David D. Burns, MD!

Two Great Locations—

Calgary, July 15 to 18, 2019

South San Francisco, July 29 to August 1, 2019

Atlanta, Georgia,November 4 – 7, 2019

 Learn powerful new tools to boost your effectiveness in the treatment of depression and all of the anxiety disorders! Discover how TEAM-CBT can produce extremely rapid and lasting changes for your depressed and anxious clients—and for you.

This workshop will be experiential. You will have the chance to practice lots of innovative techniques in small groups and get immediate feedback so you can refine your skills. You’ll also have the chance to work on your own feelings of self-doubt so you can leave this workshop on a high, with renewed confidence and excitement about your clinical work.

This dynamic workshop offers:

  • State-of-the-art TEAM-CBT techniques for depression and all of the anxiety disorders.
  • Powerful new methods for the treatment of habits and addictions—your own and your clients’!
  • Innovative resistance-busting techniques to boost patient motivation and eliminate “yes-butting.” Learn to pinpoint and eliminate the eight most common forms of therapeutic resistance.
  • Live demonstrations and video clips from actual therapy sessions.
  • Powerful Relapse Prevention Training for lasting results.
  • Lots of fun and the chance to get some much-needed emotional refueling!

The annual intensives are almost always the best workshops of the year. If you can join us this year, they will be even better!

This workshop has been approved for Levels 1 through 3 TEAM-CBT Certification
and is s
uitable for novice as well as highly experienced therapists.
Of course, you’ll get tons of CE credits as well.

The two intensives will be similar, but there are some differences that may be important to you.

Special features at this year’s South SF intensive

  • Sunny Choi will be speaking on “TEAM with Compassion.” Sunny spoke last year and was amazing, so he is returning, as they say, “by popular demand.” He describes incredible, high-speed TEAM therapy to populations with severe problems and extremely limited resources, including immigrants who do not speak English.
  • Dr. Jill Levitt will be joining me as co-therapist for the live demonstration on the evening of day 1. In past years, these dramatic live demos have provided tremendous opportunities for learning. If you have never seen Jill, this will be a real treat for you!
  • I will be joined by many expert helpers from the Feeling Good Institute who will help provide feedback for you during the many practice sessions.
  • There will be two amazing evening sessions to add depth to your training. You’ll be totally exhausted, but chock-full of incredible new skills and insights that can change the direction of your career and transform your personal life as well.

Special features at this year’s Calgary, Canada intensive

  • The three optional evening hikes / meals together will be a highlight for many. While hiking, you will have chances for personal work with David, Q and A, difficult case consultation, and additional practice with the new techniques you are learning.
  • If you don’t want to hike, you can enjoy your evenings with friends or family and refuel for the next day.
  • There will be a live demo on the morning of day 2. In past years, these live therapy sessions have been inspirational and wonderfully informative. Last year’s live therapy demonstration in Whistler was jaw-dropping!
  • And, as you probably know, Jack Hirose always puts on an amazing event, designed to provide you with maximum comfort, delight, and learning!

In both workshops, David promises to catapult at least 65% of the participants into a state of joyous enlightenment. Would you like to finally free yourself from feelings of self-doubt and endless obsessions about whether you’re “good enough?” Check out the registration links now!

Feeling good feels wonderful! You owe it to yourself to feel good! Join me in

Calgary

or

South San Francisco!

David Burns, MD

Here’s a photo of my esteemed colleague, Mike Christensen, at a recent Canadian workshop.

IMG_20180607_100631_1

 

Register by June 17th and save $100!

Dear colleague,

If you have ever dreamed of bringing extremely rapid healing to your patients, this is a workshop you won’t want to miss. David Burns, MD, will present TEAM-CBT: a new, powerful treatment approach that can produce extremely rapid and lasting changes in severe depression and anxiety. Lectures and demonstrations by a master therapist followed by the opportunity to practice the techniques with your colleagues will leave you with a deeper, richer appreciation of the practice of psychotherapy as well as a variety of tools you’ll be able to apply right away to your work. In addition, you’ll have the opportunity to do your own personal work during the workshop so you can experience greater self-esteem and joy in your professional work and in your personal life.

High-Speed Treatment of Depression and Anxiety Disorders

A Four-Day TEAM-CBT Advanced Intensive

w/ David Burns, MD

32 hrs of CE credit available

Workshops in S. San Francisco and Atlanta!

Register with friends and save 20%!

<Register>

The evening sessions on days 1 and 3 will add another dimension to your workshop experience, and are nearly always the most highly rated workshop segments. You’ll be tired, but joyous, by the end of your intensive, and you’ll leave with a renewed session of joy and optimism!

 

 

“What will I learn at an intensive?”

Dear colleague,

A therapist emailed me to say he was very interested in the upcoming intensives, but wanted to know what he’d learn if he attended. Certainly, a great question, so I put together this list of some of the things I’ll be teaching at this year’s intensives. They’re organized around the T E A M of TEAM-CBT.

T = Testing

  • I’ll illustrate fast, accurate assessment tools that will show you how your patients really feel, and how they feel about you. You’ll also find out how effective you are at every session with every patient. This information may be shocking, but can transform your clinical work.

E = Advanced Empathy Training

  • Five Secrets of Effective Communication
  • Law of Opposites
  • How to transform therapeutic failure into success
  • The five most common empathy errors, and how to avoid them!

A = Assessment of Resistance: New, sophisticated tools that can quickly melt away therapeutic resistance and greatly boost patient motivation

  • Outcome Resistance tools
  • Straightforward Invitation
  • Paradoxical Invitation
  • Miracle Cure Question
  • Specificity
  • Magic Button
  • Positive Reframing
  • Pivot Question
  • Process Resistance tools
  • Dangling the Carrot
  • Gentle Ultimatum
  • Sitting with Open Hands
  • Fallback Position

M = Methods

  • Daily Mood Log
  • Recovery Circle
  • 50 Ways to Untwist Your thinking, including
  • Identify the Distortions
  • Examine the Evidence
  • Be Specific / Shades of Grey
  • The Experimental Technique
  • The Pleasure-Predicting Sheet
  • The Paradoxical Double Standard Technique
  • Externalization of Voices
  • The Acceptance Paradox
  • Cognitive, Classical, and Interpersonal Exposure Techniques, including
    • Gradual Exposure
    • Cognitive Flooding
    • Memory Rescripting
    • Response Prevention
    • Smile and Hello Practice
    • Self-Disclosure
    • Talk-Show Host
    • Shame Attacking Exercises
  • The Hidden Emotion Technique
  • And more

Getting at root causes: How to pinpoint and modify Self-Defeating Beliefs

  • The Individual Downward Arrow
  • The Interpersonal Downward Arrow (psychoanalysis at warp speed!)
  • The Semantic Method
  • The Feared Fantasy

How to overcome habits and addictions, including

  • The Habit / Addiction Log
  • The Paradoxical Cost-Benefit Analysis
  • The Triple Paradox
  • The Anti-Procrastination Sheet
  • The “I stubbornly refused” Technique
  • The Devil’s Advocate Technique

Plus

  • Relapse Prevention Training for lasting results
  • Video of high-speed TEAM-CBT trauma treatment

The goals of TEAM-CBT include rapid, complete and lasting recovery from depression and anxiety. Teaching tools will include lecture, videos, live demonstrations, live therapy, and lots of small group practice with immediate feedback so you can refine your therapy skills.

You’ll also have the chance to do your own personal work if you want, so you can leave the workshop fueled with a renewed sense of excitement about your life and clinical work. I’ve always felt that effective personal work is tremendously important, since the challenges and pressures on therapists can sometimes be intense. When you’ve experienced your own personal transformation, you’re no longer a technician–you’re now a healer!

Finally, all three intensive provide CE credits plus credit toward certification in TEAM-CBT. In fact, you’ll be eligible for Level 1 TEAM certification just for attending!

Thank you so much for your interest!

David Burns, MD

* * *

This year, you have three great intensives to choose from!

High-Speed Treatment of

Depression and Anxiety Disorders

A Four-Day TEAM-CBT Advanced Intensive

with David Burns, MD

July 15 – 18, 2019, Calgary, Canada

Sponsored by Jack Hirose & Assoc.

The Calgary intensive will be similar to the SF and Atlanta intensives described below, but there will be no evening sessions. Instead, Dr. Burns will lead optional, informal evening hikes for those who are interested, followed by dinner. On the hikes, you can do personal work, ask questions, practice techniques, or just schmooze with colleagues and have fun!

This intensive is just around the corner, so act fast if you want to attend!

* * *

High-Speed Treatment of

Depression and Anxiety Disorders

A Four-Day TEAM-CBT Advanced Intensive

with David Burns, MD

32 hrs of CE credit available

July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis

and

November 4 – 7, 2019
Atlanta, Georgia four-day intensive
Sponsored by Praxis

This will be my first east coast intensive in more than 25 years/

Register with friends and save 20%!

<Register>

The evening sessions on days 1 and 3 will add another dimension to your workshop experience, and are nearly always the most highly rated workshop segments. You’ll be tired, but joyous, by the end of your intensive, and you’ll leave with a renewed session of joy and optimism!

 

 

David’s Awesome Summer Intensives–Are You Planning to Come to One?

High-Speed Treatment of Depression and Anxiety Disorders—

Attend the Summer / Fall Intensives

With David D. Burns, MD!

Three Great Locations—

Calgary, July 15 to 18, 2019

South San Francisco, July 29 to August 1, 2019

Atlanta, November 4 to 7, 2019

What so great about the intensives?

  • Observe live demonstrations of TEAM-CBT with audience volunteers that are cool, powerful and inspirational.
  • Have FUN—lots of neat people to hang out with!
  • Earn TEAM certification credits as well as CE credits.
  • Learn tons of powerful new techniques to boost your effectiveness in the treatment of depression, anxiety disorders, and habits and addictions.
  • Practice in small groups, with immediate feedback to help you refine and master your new skills.
  • Learn to pinpoint the eight most common forms of therapeutic resistance.
  • Learn how to melt away therapeutic resistance for super-fast recoveries.
  • Overcome your own feelings of anxiety and self-doubt, and leave the workshop in a state of joyous enlightenment! You can’t beat that!
  • Lots of tears—and lots of laughter!
  • You’ll work your butt off—but come out with exciting new insights and directions for your clinical work.

Special features at this year’s South SF intensive

  • Sunny Choi will be speaking on “TEAM with Compassion.” Sunny spoke last year and was amazing, so he is returning, as they say, “by popular demand.”
  • Jill Levitt will be joining David as co-therapist for the live demonstration on the evening of day 1. In past years, these dramatic live demos have provided tremendous opportunities for learning.
  • Do your own “solo flight” on the evening of day 3. In previous years, this has been the highlight of the annual SF intensive.
  • I will be joined by many expert helpers from the Feeling Good Institute who will provide feedback and mentoring for you during the many practice sessions. Of course, I’ll be giving you personal feedback, too!

Special features at this year’s Calgary, Canada intensive

  • The three optional evening hikes / meals together will be a highlight for many. While hiking, you will have chances for personal work with David, Q and A, and additional practice with the many new techniques you are learning.
  • There will be a live demo on the morning of day 2.

The summer / fall intensives are almost always my best teaching of the year. If you attend, this year’s intensives will be even better!

The Calgary Intensive will be from July 15 to 18, 2019.
For more information / registration, click here!

The South SF Intensive will be from July 29 to August 1, 2019.
For more information / registration, click here!

The new Atlanta intensive will be from November 4 – 7, 2019,
and will be similar to the South SF Intensive.
This will be my first east coast intensive in 25 years!
For more information / registration, click here!

David Burns, MD

Unsolicited Testimonials from Participants at David’s Workshops

These are anonymous comments on workshop evaluation forms:

  • The live demonstration in the evening was freaking incredible!!!
  • The live demonstration was dynamite! . . . It was beautiful!!
  • The entire process was fantastic!
  • I liked all of it! I appreciated Dr. Burns willingness to be vulnerable with his own flaws and fears.

Here’s a photo of my esteemed colleague, Mike Christensen, at a recent Canadian workshop. We’ll be working together again this year in Calgary!

IMG_20180607_100631_1

Here’s a photo from some of my Sunday hikes in California with therapists from my free weekly training group at Stanford.

 

102: Helping the Suicidal Patient

102: Helping the Suicidal Patient

The Prediction and Prevention of Suicide

Dr. Maor Katz, the founder of the Feeling Good Institute in Mt. View, California, asked if we’d do a show on the Prediction and Prevention of Suicide, so his staff could learn about the unique approach I have developed. Dr. Fabrice Nye and I were delighted to devote today’s show to this topic.

Suicidal thoughts and urges are very common among depressed patients. The vast majority of depressed individuals have thoughts of suicide from time to time, and some struggle with serious suicidal urges. The experts tell us that 10% to 15% of chronically depressed individuals do eventually commit suicide, even if they are receiving treatment for depression. It is hard for me to believe that suicide is that common, but even if it is only 2% or 3%, that’s still very significant, especially if you have a large clinical practice and you treat lots of depressed individuals.

Suicide attempts are shocking and devastating for the patient, for the family, and for the therapist as well. The loss of a patient through suicide is the dark side of our profession. The loss of life is a horrible and unnecessary tragedy, since the feelings of hopelessness that trigger suicidal urges are always the result of cognitive distortions; the belief that you are hopeless and cannot improve is never valid. Yet, the depressed patient does not realize this, and sometimes turns to suicide as the only way out of his or her suffering.

Sadly, clinicians’ capacity to assess suicidal urges in patients they are treating is very poor. In fact, in a research study I did, experts estimated how suicidal patients were feeling at the end of a several hour diagnostic interview at the Stanford Hospital. The patients recorded how suicidal they were actually feeling at the exact same time. Surprisingly, the patients’ and experts’ assessments were not significantly correlated. In other words, the experts accuracy in detecting suicidal fantasies and urges was zero. that’s one reason so many patients in treatment do commit suicide–because the therapist simply did not realize the patient was feeling that way.

In this podcast, I describe how you can solve this problem with the use of the EASY Diagnostic System and a systematic suicide interview, if needed, at the initial evaluation, and the use of the Brief Mood Survey at all subsequent sessions, with no exceptions.

In this podcast, I focus on two things. First, how can the clinician identify and evaluate a new (or old) patient who is struggling with suicidal thoughts and fantasies and determine if the patient is at risk for a suicide attempt? Second, how can the therapist make the patient accountable and guarantee that the patient will not now, or ever, make a suicide attempt?

The “defensive psychotherapy” I recommend will sound unfamiliar and maybe even shocking to many therapists but can save lives and make your practice far more peaceful and rewarding. The approach to the suicidal patient involves Paradoxical Agenda Setting techniques, including the Gentle Ultimatum, Sitting with Open Hands, and Fallback Position.

I hope you enjoyed today’s podcast on a very serious topic!

David

 

Subscribe

 

101: Therapy Wars–REBT vs TEAM: Mirror, mirror, on the wall . . .

101: Therapy Wars–REBT vs TEAM: Mirror, mirror, on the wall . . .

A fan who wishes to remain anonymous (we’ll call him Jim) wrote a thoughtful question based on an internet video he’d just watched on The REBT Advocate’s YouTube channel, featuring Tommy Bateman and Dr. Michael Edelstein. One of their listeners had asked what they thought about the new TEAM-CBT developed by Dr. David Burns. They said they were not terribly familiar with TEAM, but looked it up on Wikipedia, and had three criticisms:

  1. The T = Testing is not important or desirable since you can just ask patients how they’re doing, and if they keep coming, it must mean you’re doing a good job. Testing, they think, is an artificial attempt to “dress up” the therapy and makes the treatment too clinical and impersonal!
  2. E = Empathy is not important, either, because patients pay good money to get help, and not to feel validated. Self-help books, they say, wouldn’t help if empathy was important.
  3. A = (Paradoxical) Agenda Setting is also unimportant. Resistance does not need to be addressed in treatment, since patients can go elsewhere if they aren’t getting the help they want.

This is what “Jim” concluded after listening to the REBT podcast:

“I don’t think they know as much about TEAM as they claimed. It made me angry that they were dismissing it so flippantly. Maybe you can invite yourself to talk on their podcast!

“I appreciate your approach to therapy a lot, even if I don’t always agree with you. I have watched every episode of your Feeling Good Podcasts and find the live therapy sessions especially intriguing!”

Sincerely, “Jim”

Thanks for the great question, Jim, and I appreciate your comments! Fabrice and I took a quick look at the video you saw on line and I strongly resonated with your assessment. Although there was value in all of their criticisms–there is ALWAYS truth in any criticism– I agree that they perhaps didn’t really grasp TEAM. And, like you, I found the comments flippant and disrespectful, kind of like a series of hurtful put-downs, rather than an attempt to grasp the potential value of something new or an invitation to meaningful and respectful dialogue.

I felt a bit angry, to be honest!

And I might add that in my interactions with Dr. Albert Ellis, the creator of REBT, I always found him to be incredibly respectful, warm, and supportive of my work. He was THE BEST, in my opinion! Toward the end of his career, he actually changed his mind about the importance of empathy, based on my research, and decided that empathy could, in fact, be helpful. I have many fond memories of times we talked and will always be grateful for his work and career; and also for his wonderfully wild, wacky and incredibly genuine and real personality!

Dr. Ellis was famous for his outrageous–and usually brutally honest and accurate–comments about other schools of therapy. And  I have to confess that sometimes I’ve also been guilty of dismissing competing schools of therapy in a flippant way, and I’ve gotten rightfully battered for that at times. People don’t like that type of adversarial dialogue for the most part. When I slip up and try to promote myself in a narcissistic way, it’s mostly thumbs down! But it sure can be tempting!

The perceived lack of empathy in some REBT therapists was actually one of Dr. Aaron Beck’s motivations for creating Cognitive Behavioral Therapy (CBT), which evolved about ten years after Dr. Ellis created REBT. CBT shares much in common with REBT, but with a greater emphasis on research to find out what really works, and empathy and the therapeutic alliance. CBT was also the first school of therapy to emphasize testing at every session to assess therapeutic progress, or the lack of progress.

The adversarial attitude of putting down the competition is at the heart of the “therapy wars,” with everyone claiming to have the “best” approach and dismissing other approaches. But if you look at all of the outcome studies of psychotherapy for depression or anxiety, for the most part, nothing comes out much better than treatment with placebos. So perhaps an attitude of humility, curiosity, and openness to new approaches would be more productive and appropriate.

The comments of Dr. Edelstein and Mr. Bateman were especially hard for me to hear, since I’ve always been a huge fan of Dr. Albert Ellis and I have so many respected friends and colleagues who are REBT therapists. I’ve always felt the contributions of Dr. Ellis to the field were legendary, and I’ve always supported and admired him.

My goal in TEAM has never been to create yet another competing school of therapy, but rather to create a systematic, data-driven approach to therapy based on process research on what works and what doesn’t work. I am convinced that therapists from any school of therapy who use T = Testing and work hard to improve their E = empathy skills will experience improved outcomes.

A = (Paradoxical) Agenda Setting is also important. Learning to melt away patient resistance and boost patient motivation can dramatically speed recovery, and is one of the most important components of TEAM! And I think that virtually all therapists, and especially REBT therapists, will have to admit that they have many patients who DO “yes-but” them and resist their efforts to help or persuade their patients to change.

But what does the research show? Is there any solid evidence for the various components of TEAM? At the end of these show notes, I have compiled a list of just a few of the published, peer-refereed studies that have led to the development of TEAM, and you can hear a summary of some of these studies on today’s podcast.

In a nutshell, here are a few of the highlights from research:

  • Session-by-session testing has been shown to improve therapeutic outcomes.
  • Research indicates that therapists’ perceptions of how their patients feel, and how their patients feel about them, are not accurate, and are frequently wildly inaccurate. This can have life and death implications, for example, in treating depressed patients with episodic suicidal impulses.
  • Therapeutic empathy has a direct causal impact on reducing depression. However, the magnitude of the effect is small. However, therapeutic empathy and trust can enhance, and even make possible, the therapeutic effects of other more powerful techniques.
  • Patient motivation is the only variable in the world literature that has been shown to have large causal effects on recovery from depression.

Finally, I’ll share an email I just received from another Feeling Good Podcast fan. It kind of cheered me up from the funk I was in after watching the REBT folks rip into TEAM!

Hi Dr. Burns,

I really enjoyed the recent Feeling Good Podcast on how you overcame many challenges to get your book published (podcast #99, the interview with Nicole Bell). I love the fact that you require measurement before and after every session as well as homework. Hope you and your great work will continue to take your field out of the Dark Ages. I suspect you won’t have much difficulty publishing your new book, Feeling Great!

Phil

David

T = Testing, E = Empathy, A = (Paradoxical) Agenda Setting–
What can we learn from research?

Research on Testing

Boswell, JF, Kraus, DR, Miller, SD & Lambert, MJ (2013). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy Research, DOI: 10.1080/10503307.2013.817696 (2013)

Hatcher, R. L., Barends, A., Hansell, J. & Gutfreund, M.J. (1995). Patients’ and therapists’ shared and unique views of the therapeutic alliance: An investigation using confirmatory factory analysis in a nested design. Journal of Consulting and Clinical Psychology, 63(4), 636 – 643.

Research on Therapeutic Empathy

Burns, D. D., & Nolen-Hoeksema, S. (1992). Therapeutic empathy and recovery from depression in cognitive – behavioral therapy: a structural equation model. Journal of Consulting and Clinical Psychology, 60(3): 441 – 449.

Burns, D. D., & Auerbach, A. (1996). Therapeutic Empathy in Cognitive – Behavioral Therapy: Does it Really Make a Difference? Chapter 7 in Frontiers of Cognitive Therapy (P. Salkovskis, ed. ) New York: Guilford Press, pp. 135 – 164.

Eisen, K. P., & Burns, D. D. (2007). Getting specific about “non-specific” factors: The role of therapeutic alliance in cognitive therapy. Psicologia Brasil (Psychology Brazil).

Krupnick, J. L. et al. (1993). The role of the therapeutic alliance in psychotherapy and psychotherapy outcome: Findings in the NIMH treatment of depression collaborative research program. Journal of Consulting and Clinical Psychology, 64(3), 636 – 643.

Orlinsky, D. E., Grawe, K., & Parks, B. K. (1995). Process and outcome in psychotherapy–Noch einmal. Chapter 8 in A. E. Bergin & S. L. Garfield (Eds.), Handbook of Psychotherapy and Behavioral Change (pp. 270 – 376). New York: John Wiley & Sons, Inc.

Persons, J., & Burns, D. D. (1985). Mechanisms of action of cognitive therapy: Relative contributions of technical and interpersonal intervention. Cognitive Therapy and Research, 9(5): 539 – 551.

Research on Therapeutic Resistance / Motivation

Burns, D. D., Adams, R., & Anastopolous, A. (1985). The role of self – help in the treatment of depression. Chapter 19 in Handbook for the Diagnosis, Treatment and Research of Depression, (Beckham, E. E. and Leber, W. R., eds. ), Homewood, II: Dorsey Press, pp. 634 – 669.

Burns, D. D., Shaw, B. F., & Crocker, W. (1987). Thinking styles and coping strategies of depressed women: An empirical investigation. Behavior Research and Therapy, 25(3): 223 – 225.

Burns, D. D., & Nolen-Hoeksema, S. (1991). Coping styles, homework compliance and the effectiveness of cognitive – behavioral therapy. Journal of Consulting and Clinical Psychology, 59(2): 305 – 311.

Burns, D. D., & Spangler, D. (2000). Does psychotherapy homework lead to changes in depression in cognitive behavioral therapy? Or does clinical improvement lead to homework compliance? Journal of Consulting and Clinical Psychology, 68(1): 46 – 59.

Burns, D. D., & Spangler, D. (2001). Can We Confirm Our Theories? Can We Measure Causal Effects? A Reply to Kazantzis et al. (2001). Journal of Consulting and Clinical Psychology, 69(6), 1084-1086.

Burns, D. D., & Auerbach, Arthur H. (1992). Do self – help assignments enhance recovery from depression? Psychiatric Annals, 22(9): 464 – 469.

Burns, D., Westra, H., Trockel, M., & Fisher, A. (2012) Motivation and Changes in Depression. Cognitive Therapy and Research DOI 10.1007/s10608-012-9458-3 Published online 22 April 2012

Burns, D. D. (March / April, 2017). When helping doesn’t help. Psychotherapy Networker, 41(2), 18 – 27, 60. https://www.psychotherapynetworker.org/blog/details/1160/when-helping-doesnt-help

Persons, J.B., Burns, D.D., & Perloff, J.M. (1988). Predictors of dropout and outcome in cognitive therapy for depression in a private practice setting. Cognitive Therapy and Research, 12, 557 – 575.

 

Subscribe

 

100: The New Micro-Neurosurgery–A Remarkable Interview with Dr. Mark Noble!

100: The New Micro-Neurosurgery–A Remarkable Interview with Dr. Mark Noble!

How Does TEAM-CBT Affect the Brain?

The famed neuroscientist, Dr. Mark Noble, from the University of Rochester, has developed a strong interest in TEAM-CBT and has visited our Tuesday group and Sunday hikes on three occasions this year. I (David) feel very fortunate to have his collaboration and interest!

IMG_2402

Mark and David at the Cupertino Plaza for a sumptuous dim sum feast at the Joy Luck Palace following a Sunday hike.

Mark is a Stanford-trained geneticist and molecular biologist who is considered one of founders of the field of stem cell research. He has been developing a model of how TEAM-CBT affects the brain, and graciously agreed to present his model at our Tuesday evening Stanford TEAM-CBT seminar last week. Although his model is not yet fully polished and refined, and involves considerable speculation, it is an exciting first step, kind of like the time when astronomers broke away from the Catholic church and started trying to make sense of the universe. In this instance it is the “inner universe” Dr. Noble, all of us, are trying to understand. His model will evolve and get more and more refined over time.

The participants in the seminar really liked his concept that we are doing micro-neurosurgery for depressed patients with TEAM-CBT! He is convinced that the rapid recovery we see with TEAM-CBT will probably never be equaled by medication, since the brain circuits that modulate happiness and unhappiness tend to use the same neurotransmitters. But with language, you can affect brain circuits far more selectively and effectively, almost like a micro-neuro-surgeon.

Dr. Noble describes brain function in terms of the SNEFF model. This stands for Structures, Networks, Emotions, Frames and Filters, and links these concepts to the prefrontal cortex, amygdala and sympathetic nervous system. Then he describes the four steps of TEAM (T = Testing, E = Empathy, A = (Paradoxical) Agenda Setting, and M = Methods), and links each step to the SNEFF model, making interesting speculations on how TEAM works and what makes it so effective.

Dr. Noble also discusses David’s “fractal” theory about psychotherapy and relates that to brain function as well as to the mathematics of complex structures. He describes how and why some people get stuck in the “homeostasis” of chronic, refractory depression and explains why TEAM-CBT is usually able to trigger sudden and dramatic changes in the brain, as well as in the way the depressed and anxious individual thinks, feels, and behaves. He also explains why conventional talk therapy is unlikely to be helpful for individuals struggling with depression and anxiety, and may, in some cases, make the depression worse.

This is because neurons that “fire together wire together.” In other words, if you go to therapy and complain or emote about your life and your problems over and over, without taking action to change, the circuits in your brain that support complaining and feeling depressed will just get more and more intensely wired together.

Dr. Noble also speculates on why Paradoxical Agenda Setting is such an important key in ultra-rapid-recovery and in the sudden transformation of brain function as well.

Years ago, when I was kid on vacation in Minnesota, I saw an article in a small newspaper published in a rural area. A local scientist had speculated that one day we would have guided missiles and satellites and drew a simple diagram for the newspaper of how they would work. At the time it seemed a bit like science fiction, and I wondered if an unknown scientist from a small rural Minnesota town could actually predict a major scientific development. But now we see that he was right.

Will we someday think about Dr. Noble in the same way? Listen to this exciting podcast, and you can decide for yourself!

You might be interested in some of the comments from individuals who attended the Stanford seminar and heard Dr. Noble’s talk:

  • Mark’s work was wonderful in helping me understand the map of TEAM onto the brain. We’re all micro-neurosurgeons!! Everyone has honorary MDs!
  • Loved the presentation!
  • Mark’s presentation was fascinating! I got really excited about all of the interesting research that could come out of it.
  • I absolutely appreciated Mark’s presentation on his research and how made the connections with TEAM. This was truly very interesting and helpful, and made me realize how fortunate I am to belong to this Tuesday group!
  • Interesting new perspectives brought in by our guest speaker
  • I highly enjoyed Mark’s visit and was captivated by the information! Thank you!
  • Loved learning how frames and filters interact to build experience.
  • AWESOME PRESENTATION! It was wonderful to hear Mark’s presentation. He did an outstanding job and I was extremely fascinated with the information he presented to us. He did a fantastic job in describing brain functioning in relation to TEAM CBT. Loved every minute of it!
  • I loved the concept of fractals in creating the concentrated surge of change into the next “valley” rang true.
  • I resonated with the importance of “storytelling” and the value of a client being heard and respected when the therapist uses the Five Secrets of Effective Communication, and how this induces a sense of the client being equal, and how that can quiet the agitated brain!

David

Subscribe

Attend my 2018 Summer Intensive in San Francisco!

This year, I am again offering my annual SF summer intensive in August at the South San Francisco Conference Center. This four-day intensive is almost always my most exciting and rewarding workshop of the year.

Here are the details:

David’s TEAM-CBT Summer Intensive

August 6 – 9, 2018, South San Francisco Conference Center, California

For more information, click here, or call IAHB.org at 800-258-8411

Here are just a few of the really cool things about this intensive:

  • You will have the chance to practice techniques in small groups after I demonstrate each technique with a live demonstration in the front of the room.
  • You will get immediate feedback and personal grooming from me and from many of my colleagues from my weekly TEAM-CBT training group at Stanford. They’ll be there to help you, and I’ll be there to help you, too!
  • There will be a live demonstration on the evening of day 1. The amazing Dr. Jill Levitt will be my co-therapist. Last year’s live demonstration, and in fact all of them in recent years, have been jaw-dropping and incredibly inspirational!
  • You’ll get a chance to practice TEAM-CBT in real time the evening of day 3. This will be an incredibly challenging but rewarding “solo flight.”
  • You will be able to do your own personal work on the last day of the workshop using the Externalization of Voices and Acceptance Paradox. In previous workshops, at least 60% of the participants indicated they experienced jubilant enlightenment during this exercise. Their fears and insecurities suddenly vanished!
  • You’ll learn how to do Relapse Prevention Training (RPT).
  • You’ll learn how to improve your empathy skills.
  • You’ll learn tons of powerful cognitive, behavioral, and motivational treatment techniques for depression and all of the anxiety disorders.
  • You will have the abundant opportunities to schmooze with colleagues, network, and have fun.
  • You will have two fabulous free luncheon banquets featuring talks by Sunny Choi, LCSW, who is using TEAM-CBT successfully with an underserved population in primary care with limited resources and language skills (“I must apologize for my success.”), and the wonderful Vandana Aspen, PhD, who will speak on “New Treatment Strategies for Eating Disorders.”)
  • And much more.

If you can only attend one of my workshops this year, the South San Francisco August intensive is the one to attend!

 

099: Nicole Bell’s Incredible Interview with Dr. David Burns

099: Nicole Bell’s Incredible Interview with Dr. David Burns

Behind His Brilliance: Critical Thinking

Lisa Nicole Bell is the host of the highly regarded podcast, Behind the Brilliance. In this lively interview, Nicole and David talk about

  • David’s path into the mental health field
  • the difficulties and rejections David faced getting his first book, Feeling Good, published
  • David’s advice to listeners interested in therapy
  • how he approaches perfectionism, depression, and anxiety with patients
  • the joys of a life free from the need to be special—
  • and much more!

Click here if you’d like to learn more about Nicole and hear more of her fantastic interviews! Lisa’s show delivers a smart and funny take on pursuing ambitions, designing a life, and living joyfully. Lisa’s most recent media work includes producing an Australian documentary on identity and gender politics within sports and a digital docu-series produced by Academy Award-winning actress Viola Davis.

092: Feeling Good Now

092: Feeling Good Now

David and Stephanie James, part 1

Hi everybody!

I recently did the first of three interviews with Stephanie James on her superb radio show and podcast, The Spark.  Here’s how Stephanie described the interview (with minor changes):

We have amazing power within us to change our thoughts, our feelings, our actions, and our lives.

This episode is an inspirational way to take control of your automatic negative thoughts today and transform them in order to create a more joyful present and a more fulling future.

Join us as we talk with the legendary Dr. David Burns about how we can break through the old thinking habits that bind us and begin to live a more happy, harmonious life where we can feel good now.

Stephanie is a superb therapist and dynamic radio personality from Colorado. It was an honor to be on her show. She is co-authoring a book on how to live a “spark-filled life.” It should be completed soon, so you’ll likely be hearing from Stephanie a lot next year!

Following the interview, Stephanie visited my Tuesday training group at Stanford and participated in one of our Feeling Good Podcasts with some students in the group. She suggested we might want to broadcast the Tuesday group live so that therapists from all over the world could join us. We are thinking about that, but will have to check with the powers that be to see if we could get permission to broadcast from Stanford, as well as our Tuesday group members who may have mixed feelings, due to the intensely personal nature of the training.

Let me know what you think about this idea!

My second interview with Stephanie was on the evolution of traditional Cognitive Behavioral Therapy (CBT) into the new TEAM-CBT. Fabrice and I will publish it for you shortly. My third interview with Stephanie will be on the interpersonal TEAM model—how to convert conflicted relationships into loving, rewarding ones.

* Copyright © 2018 by David D. Burns, MD

 

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

Attend a Summer Intensive!

This year, I am offering a July summer intensive in Whistler, Canada, and one in August at the South San Francisco Conference center. The intensives are almost always my most exciting and fun workshops of the year. Hope you can join us at one of these locations.

Here are some details:

Advanced Cognitive Behavioral Therapy: 

A Four-Day Intensive Training in TEAM-CBT

July 3 – 6, 2018 Whistler, BC, Canada

For more information, contact Jack Hirose & Associates Inc.
Phone: 604.924.0296, Toll-free: 1.800.456.5424

* * *

High Speed, Drug Free Treatment of Depression and Anxiety Disorders–

A Four-Day

Advanced TEAM-CBT Intensive

August 6 – 9, 2018, South San Francisco Conference Center, California

For more information, click here, or call IAHB.org at 800-258-8411

If you can only attend one of my workshops, consider attending one of these intensives!