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Chapter 9 - Adaptations of the Original Model of Cognitive Behavioural Therapy

from Part III - Application and Adaptations for Mental Health Presentations

Published online by Cambridge University Press:  18 November 2025

Jessica Davies ,
Paul Salkovskis  and
Kenneth Laidlaw
Foreword by
Judith S. Beck
Jessica Davies
Affiliation:
University of Exeter
Paul Salkovskis
Affiliation:
Oxford Health NHS Foundation Trust & University of Oxford
Kenneth Laidlaw
Affiliation:
University of Exeter
Judith S. Beck
Affiliation:
Beck Institute for Cognitive Behavior Therapy & University of Pennsylvania
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Summary

The chapter will help you to be able to describe the evolution of disorder specific CBT protocols, explain the value of using a disorder specific protocol over a generic CBT approach, consider the relative efficacy of CBT in different populations, and so choose whether CBT is appropriate for your patient, and if so, which adaptation of CBT would be most helpful

Keywords

CBTevidenceNICE guidelinesCOREAPABABCP

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Chapter
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Cambridge Guide to Cognitive Behavioural Therapy (CBT) , pp. 85 - 92
Publisher: Cambridge University Press
Print publication year: 2025

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References

Further Reading

Hofmann, SG, Asnaani, A, Vonk, IJ, Sawyer, AT, Fang, A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cogn Ther Res. 2012;36:427–440.CrossRefGoogle ScholarPubMed
Roth, AD, Pilling, S. A competence framework for the supervision of psychological therapies. www.ucl.ac.uk/clinical-psychology/CORE/supervision_framework.htm.Google Scholar

References

Beck, AT. Thinking and depression: II. Theory and therapy. Arch Gen Psychiatry. 1964;10(6):561–571.CrossRefGoogle ScholarPubMed
Mowrer, OH. On the dual nature of learning: A re-interpretation of ‘conditioning’ and ‘problem-solving’. Harv Educ Rev. 1947;17:102–148.Google Scholar
Wolpe, J. Psychotherapy by Reciprocal Inhibition. Stanford: Stanford University Press; 1958.Google Scholar
Michelson, L, Mavissakalian, M, Marchione, K. Cognitive and behavioral treatments of agoraphobia: Clinical, behavioral, and psychophysiological outcomes. J Consult Clin Psychol. 1985;53(6):913–925.CrossRefGoogle ScholarPubMed
Butler, G, Cullington, A, Munby, M, Amies, P, Gelder, M. Exposure and anxiety management in the treatment of social phobia. J Consult Clin Psychol. 1984;52(4):642–650.CrossRefGoogle ScholarPubMed
Butler, G. Exposure as a treatment for social phobia: Some instructive difficulties. Behav Res Ther. 1985;23(6):651–657.CrossRefGoogle ScholarPubMed
Clark, DM. A cognitive approach to panic. Behav Res Ther. 1986;24(4):461–470.CrossRefGoogle ScholarPubMed
Salkovskis, PM. The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behav Cogn Psychother. 1991;19(1):6–19.CrossRefGoogle Scholar
Salkovskis, PM. Phenomenology, assessment and the cognitive model of panic. In: Rachman S, Maser JD (Eds.) Panic: Psychological Perspectives [Internet]. Hillsdale, NJ: L. Erlbaum Associates; 1988. https://books.google.co.uk/books?id=LhFsAAAAMAAJ.Google Scholar
Clark, DM, Wells, A. A cognitive model of social phobia. In: Heimberg, RG, Liebowitz, MR, Hope, DA, Schneier, FR (Eds.) Social Phobia: Diagnosis, Assessment, and Treatment [Internet]. New York: Guilford Publications; 1995. p. 69–93. https://books.google.co.uk/books?id=rXrekuSy2bsC.Google Scholar
Salkovskis, PM. Cognitive approaches to health anxiety and obsessional problems: Some unique features and how this affects treatment. In: World Congress of Behavioural and Cognitive Therapies, Copenhagen, Denmark. 1995.Google Scholar
Ehlers, A, Clark, DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000;38(4):319–345.CrossRefGoogle ScholarPubMed
Clark, DM, Salkovskis, PM, Hackmann, A, Middleton, H, Anastasiades, P, Gelder, M. A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. Br J Psychiatry. 1994;164(6):759–769.CrossRefGoogle ScholarPubMed
Salkovskis, PM, Hackmann, A, Wells, A, Gelder, MG, Clark, DM. Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: A pilot study. Behav Res Ther. 2007;45(5):877–885.CrossRefGoogle ScholarPubMed
Fairburn, CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press; 2008.Google ScholarPubMed
Vlaeyen, JW, Linton, SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain. 2000;85(3):317–332.CrossRefGoogle ScholarPubMed
Barlow, DH, Farchione, TJ, Fairholme, CP, Ellard, KK, Boisseau, CL, Allen, LB, et al. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. New York: Oxford University Press; 2011.Google Scholar
Hayes, SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther. 2004;35(4):639–665.CrossRefGoogle Scholar
Fennell, MJV. Low self-esteem: A cognitive perspective. Behav Cogn Psychother. 1997;25(1):1–26.CrossRefGoogle Scholar
Egan, SJ, Wade, TD, Shafran, R, Antony, MM. Cognitive-Behavioral Treatment of Perfectionism [Internet]. New York: Guilford Publications; 2016. https://books.google.co.uk/books?id=jpmCCwAAQBAJ.Google ScholarPubMed
Butler, AC, Chapman, JE, Forman, EM, Beck, AT. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clin Psychol Rev. 2006;26(1):17–31.CrossRefGoogle ScholarPubMed
Hofmann, SG, Asnaani, A, Vonk, IJ, Sawyer, AT, Fang, A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cogn Ther Res. 2012;36:427–440.CrossRefGoogle ScholarPubMed
Henwood, KS, Chou, S, Browne, KD. A systematic review and meta-analysis on the effectiveness of CBT informed anger management. Aggress Violent Behav. 2015;25:280–292.CrossRefGoogle Scholar
Fernandez, E, Malvaso, C, Day, A, Guharajan, D. 21st century cognitive behavioural therapy for anger: A systematic review of research design, methodology and outcome. Behav Cogn Psychother. 2018;46(4):385–404.CrossRefGoogle Scholar
Öst, LG, Havnen, A, Hansen, B, Kvale, G. Cognitive behavioral treatments of obsessive–compulsive disorder: A systematic review and meta-analysis of studies published 1993–2014. Clin Psychol Rev. 2015;40:156–169.CrossRefGoogle ScholarPubMed
Chiang, KJ, Tsai, JC, Liu, D, Lin, CH, Chiu, HL, Chou, KR. Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A metaanalysis of randomized controlled trials. PLoS ONE. 2017;12(5).CrossRefGoogle Scholar
Khoo, EL, Small, R, Cheng, W, Hatchard, T, Glynn, B, Rice, DB, et al. Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis. BMJ Ment Health. 2019;22(1):26–35.Google ScholarPubMed
Bhattacharya, S, Goicoechea, C, Heshmati, S, Carpenter, JK, Hofmann, SG. Efficacy of cognitive behavioral therapy for anxiety-related disorders: A meta-analysis of recent literature. Curr Psychiatry Rep. 2023;25(1):19–30.CrossRefGoogle ScholarPubMed
Bandelow, B, Reitt, M, Röver, C, Michaelis, S, Görlich, Y, Wedekind, D. Efficacy of treatments for anxiety disorders: A meta-analysis. Int Clin Psychopharmacol. 2015;30(4):183–192.CrossRefGoogle ScholarPubMed
Cuijpers, P, Gentili, C, Banos, RM, Garcia-Campayo, J, Botella, C, Cristea, IA. Relative effects of cognitive and behavioral therapies on generalized anxiety disorder, social anxiety disorder and panic disorder: A meta-analysis. J Anxiety Disord. 2016;43:79–89.CrossRefGoogle ScholarPubMed
Cuijpers, P, Miguel, C, Harrer, M, Plessen, CY, Ciharova, M, Ebert, D, et al. Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry. 2023;22(1):105–115.CrossRefGoogle Scholar
Fukumori, M, Kikuchi, T, Zhou, Y, Hattori, S, Kudo, T. Network meta-analysis of the effectiveness of psychotherapies with or without medication for treating adult depression. Acta Neuropsychiatr. 2024;36(6):423–437.CrossRefGoogle ScholarPubMed
Scott, AJ, Bisby, MA, Heriseanu, AI, Salameh, Y, Karin, E, Fogliati, R, et al. Cognitive behavioral therapies for depression and anxiety in people with chronic disease: A systematic review and meta-analysis. Clin Psychol Rev. 2023;106:102353.CrossRefGoogle ScholarPubMed
Linardon, J, Wade, TD, de la Piedad Garcia, X, Brennan, L. The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. J Consult Clin Psychol. 2017;85(11):1080–1094.CrossRefGoogle ScholarPubMed
Trauer, JM, Qian, MY, Doyle, JS, Rajaratnam, SMW, Cunnington, D. Cognitive behavioral therapy for chronic insomnia. Ann Intern Med. 2015;163(3):191–204.CrossRefGoogle ScholarPubMed
Benz, F, Knoop, T, Ballesio, A, Bacaro, V, Johann, AF, Rücker, G, et al. The efficacy of cognitive and behavior therapies for insomnia on daytime symptoms: A systematic review and network meta-analysis. Clin Psychol Rev. 2020;80:101873.CrossRefGoogle ScholarPubMed
Cheung, JMY, Jarrin, DC, Ballot, O, Bharwani, AA, Morin, CM. A systematic review of cognitive behavioral therapy for insomnia implemented in primary care and community settings. Sleep Med Rev. 2019;44:23–36.CrossRefGoogle ScholarPubMed
Li, X, Laplante, DP, Paquin, V, Lafortune, S, Elgbeili, G, King, S. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev. 2022;92:102129.CrossRefGoogle Scholar
Crotty, K, Viswanathan, M, Kennedy, S, Edlund, MJ, Ali, R, Siddiqui, M, et al. Psychotherapies for the treatment of borderline personality disorder: A systematic review. J Consult Clin Psychol. 2024;92(5):275–295.CrossRefGoogle ScholarPubMed
Bighelli, I, Huhn, M, Schneider-Thoma, J, Krause, M, Reitmeir, C, Wallis, S, et al. Response rates in patients with schizophrenia and positive symptoms receiving cognitive behavioural therapy: A systematic review and single-group meta-analysis. BMC Psychiatry. 2018;18(1):380.CrossRefGoogle ScholarPubMed
Jauhar, S, McKenna, PJ, Radua, J, Fung, E, Salvador, R, Laws, KR. Cognitive–behavioural therapy for the symptoms of schizophrenia: Systematic review and meta-analysis with examination of potential bias. Br J Psychiatry. 2014;204(1):20–29.CrossRefGoogle ScholarPubMed
Magill, M, Ray, L, Kiluk, B, Hoadley, A, Bernstein, M, Tonigan, JS, et al. A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition. J Consult Clin Psychol. 2019;87(12):1093–1105.CrossRefGoogle ScholarPubMed
Fordham, B, Sugavanam, T, Edwards, K, Stallard, P, Howard, R, Nair, R das, et al. The evidence for cognitive behavioural therapy in any condition, population or context: A meta-review of systematic reviews and panoramic meta-analysis. Psychol Med. 2021;51(1):21–29.CrossRefGoogle ScholarPubMed
World Health Organization. Guidelines for the Management of Conditions that Are Specifically Related to Stress [Internet]. World Health Organization; 2013. https://apps.who.int/iris/handle/10665/85119.Google Scholar
World Health Organization. Regional Office for Europe. Mental Health Promotion and Mental Health Care in Refugees and Migrants: Policy Brief [Internet]. World Health Organization. Regional Office for Europe; 2018. Report No.: WHO/EURO:2018–3138–42896–59848. https://apps.who.int/iris/handle/10665/345918.Google Scholar
American Psychological Association. Impact: APA and APA Services, Inc. strategic plan. 2019;1:2020.Google Scholar
Roth, A, Pilling, S. The CBT Competencies Framework for Depression and Anxiety Disorders. Lond UK Cent Outcome Res Eval. 2007.Google Scholar
Hool, N, Bennett, R, Corrie, S, Cox, A, Curran, J, French, S, et al. BABCP Core Curriculum [Internet]. Bury: British Association for Behavioural & Cognitive Psychotherapies; 2021. https://babcp.com/Core-Curriculum.Google Scholar

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