Topic Professional & Subtopic Learn how to make every day more powerful and peaceful using the tools of Personal Development Thinking Skills cognitive behavioral therapy. C Cognitive Behavioral “Pure intellectual stimulation that can be popped into o g n the [audio or video player] anytime.” it i —Harvard Magazine ve Therapy for Daily Life B e “Passionate, erudite, living legend lecturers. Academia’s h a best lecturers are being captured on tape.” vio Course Guidebook —The Los Angeles Times ra l T h “A serious force in American education.” er Professor Jason M. Satterfield —The Wall Street Journal ap University of California, San Francisco y f o r D a i ly L i f e Jason M. Satterfield is a Professor of Clinical Medicine at the University of California, San Francisco. He completed his PhD in Clinical Psychology at the University of Pennsylvania, where he worked with Dr. Martin Seligman. Professor Satterfield’s book A Cognitive-Behavioral Approach to the Beginning of the End of Life and the accompanying patient workbook, Minding the Body, were recognized as Self-Help Books of Merit by the Association for Behavioral and Cognitive Therapies. Among his other Great Courses is Cognitive Behavioral Therapy: Techniques for Retraining Your Brain. THE GREAT COURSES® Corporate Headquarters 4840 Westfields Boulevard, Suite 500 Chantilly, VA 20151-2299 USA G Phone: 1-800-832-2412 u www.thegreatcourses.com id e b Cover Image: © kieferpix/Getty Images. o o Course No. 9661 © 2020 The Teaching Company. PB9661A k 4840 Westfields Boulevard | Suite 500 | Chantilly, Virginia | 20151‑2299 [phone] 1.800.832.2412 | [fax] 703.378.3819 | [web] www.thegreatcourses.com LEADERSHIP PAUL SUIJK President & CEO BRUCE G. WILLIS Chief Financial Officer  JOSEPH PECKL SVP, Marketing JASON SMIGEL VP, Product Development CALE PRITCHETT VP, Marketing MARK LEONARD VP, Technology Services DEBRA STORMS VP, General Counsel KEVIN MANZEL Sr. Director, Content Development ANDREAS BURGSTALLER Sr. Director, Brand Marketing & Innovation KEVIN BARNHILL Director of Creative GAIL GLEESON Director, Business Operations & Planning PRODUCTION TEAM TOM KRZYWICKI Producer SUSAN DYER Content Developer SCOTT MILLER Associate Producer JAMES NIDEL Graphic Artists BRIAN SCHUMACHER OWEN YOUNG Managing Editor BEN BACHARACH-WHITE Sr. Editor KATY MERRY HANNAH Editor CHARLES GRAHAM Assistant Editor CHRIS HOOTH Audio Engineer GEORGE BOLDEN Camera Operator MATTHEW CALLAHAN Production Assistants VALERIE WELCH ROBERTO DE MORAES Director ROBERTO DE MORAES Field Crew (Library/Vignette Shoots) ANDREW GRAY JONATHAN D. LEVEN ED SALTZMAN PUBLICATIONS TEAM FARHAD HOSSAIN Publications Manager BLAKELY SWAIN Sr. Copywriter RHOCHELLE MUNSAYAC Graphic Designer JESSICA MULLINS Proofreader ERIKA ROBERTS Publications Assistant WILLIAM DOMANSKI Transcript Editor COPYRIGHT © THE TEACHING COMPANY, 2020 Printed in the United States of America This book is in copyright. All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise), without the prior written permission of The Teaching Company. JASON M. SATTERFIELD, PHD Professor of Clinical Medicine University of California, San Francisco J ason M. Satterfield is a Professor of Clinical Medicine and the Academy Endowed Chair for Innovation in Teaching at the University of California, San Francisco (UCSF). He also serves as the director of the UCSF School of Medicine’s Health & Society Block as well as its Health and the Individual Block. Professor Satterfield received his BS in Brain Sciences from the Massachusetts Institute of Technology with a special minor in Psychology from Harvard University. He completed his PhD in Clinical Psychology at the University of Pennsylvania (Penn), where he worked with Dr. Martin Seligman. Professor Satterfield was trained as a cognitive behavioral therapist at Penn’s Center for Cognitive Therapy under the supervision of Drs. Aaron T. Beck, Judith Beck, Robert DeRubeis, and others. His clinical work has included adaptations of cognitive behavioral therapy for underserved, medically ill populations and psychological interventions for patients with serious chronic illness. He is the past director of the UCSF Behavioral Medicine Unit, which integrates mental and behavioral health services into adult primary care. Professor Satterfield’s book A Cognitive-Behavioral Approach to the Beginning of the End of Life and the accompanying patient workbook, Minding the Body, were recognized as Self‑Help Books of Merit by the Association for Behavioral and Cognitive Therapies. He is also an associate editor of the best‑selling i PROFESSOR BIOGRAPHY textbook Behavioral Medicine: A Guide for Clinical Practice, now in its 5th edition. Professor Satterfield’s special clinical publications include treatment models for cognitive behavioral therapy, treatment adaptations to improve cultural competence, and a transdisciplinary model to promote evidence‑ based behavioral practices in medicine, including interventions for smoking, weight management, drug abuse, and chronic disease management. He is a coauthor of a national report detailing the role of behavioral science in medicine, and he served on the Behavioral and Social Science Subcommittee that revised the Medical College Admission Test—work that was featured in the New England Journal of Medicine and The New York Times.  At UCSF, Professor Satterfield has been nominated for multiple teaching awards, including the Robert H. Crede Award for Excellence in Teaching and the Henry J. Kaiser Award for Excellence in Teaching. He is the past chair of the Academy of Medical Educators’ Scholarship Committee and received the academy’s Cooke Award for the Scholarship of Teaching and Learning. Professor Satterfield grew up in Middle Tennessee and was the first in his family to attend college. After living in Boston and Philadelphia for school, he moved in 1994 to San Francisco. He is an avid traveler and enjoys a large circle of friends and family. Professor Satterfield’s other Great Courses include Cognitive Behavioral Therapy: Techniques for Retraining Your Brain; Mind-Body Medicine: The New Science of Optimal Health; and Boosting Your Emotional Intelligence. ii TABLE OF CONTENTS INTRODUCTION Professor Biography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Course Scope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 GUIDES 1 A CBT Toolbox: Toward Wise Living . . . . . . . . . . . . . . . .3 2 Laying a Foundation: Assessments and Goals. . . . . . . . . 11 3 Behavioral Activation: Potent Mood Boosters. . . . . . . . . . 18 4 Advanced Behavioral Techniques . . . . . . . . . . . . . . . . 27 5 Capturing Thoughts and Making Connections . . . . . . . . .34 6 Cognitive Restructuring and Thought Records. . . . . . . . .42 7 Worry, Rumination, and Sticky Thoughts . . . . . . . . . . . . 49 8 Digging Deeper: Rules and Core Beliefs. . . . . . . . . . . . . 57 9 Toolbox in Action: Stress and Assertiveness. . . . . . . . . . 65 10 Understanding and Managing Emotions. . . . . . . . . . . . . 74 11 Key Steps to Solving Problems. . . . . . . . . . . . . . . . . . 81 12 Grief, Sadness, and Depression . . . . . . . . . . . . . . . . .86 13 Panic Attacks and Anxiety. . . . . . . . . . . . . . . . . . . . . 95 14 Addiction and Pain Medications . . . . . . . . . . . . . . . . 103 iii TABLE OF CONTENTS 15 Embracing Imperfection. . . . . . . . . . . . . . . . . . . . . 112 16 Beating Procrastination . . . . . . . . . . . . . . . . . . . . . 121 17 Soothing Rejection, Promoting Connection. . . . . . . . . . 128 18 Early Childhood Trauma and Neglect . . . . . . . . . . . . . 135 19 Managing Chronic Disease . . . . . . . . . . . . . . . . . . . 144 20 Coping with Chronic Pain . . . . . . . . . . . . . . . . . . . . 153 21 How to End Insomnia and Finally Sleep. . . . . . . . . . . . 160 22 CBT for the Beginning of the End of Life. . . . . . . . . . . . 168 23 Expanding CBT with Technology . . . . . . . . . . . . . . . . 177 24 Reclaiming and Rewriting Our Stories. . . . . . . . . . . . . 184 SUPPLEMENTARY MATERIAL Multiple-Choice Quiz. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 iv DISCLAIMER This series of lectures is intended to increase your understanding of the emotional and social lives of children and/or adults and is for educational purposes only. It is not a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment of mental health conditions. These lectures are not designed for use as medical references to diagnose, treat, or prevent medical or mental health illnesses or trauma, and neither The Teaching Company nor the lecturer is responsible for your use of this educational material or its consequences. Furthermore, participating in this course does not create a doctor‑patient or therapist‑client relationship. The information contained in these lectures is not intended to dictate what constitutes reasonable, appropriate, or best care for any given mental health issue and does not take into account the unique circumstances that define the health issues of the viewer. If you have questions about the diagnosis, treatment, or prevention of a medical condition or mental illness, you should consult your personal physician or other mental health professional. The opinions and positions provided in these lectures reflect the opinions and positions of the relevant lecturer and do not necessarily reflect the opinions or positions of The Teaching Company or its affiliates. The Teaching Company expressly DISCLAIMS LIABILITY for any DIRECT, INDIRECT, INCIDENTAL, SPECIAL, OR CONSEQUENTIAL DAMAGES OR LOST PROFITS that result directly or indirectly from the use of these lectures. In states that do not allow some or all of the above limitations of liability, liability shall be limited to the greatest extent allowed by law. v vi Cognitive Behavioral Therapy for Daily Life C ognitive behavioral therapy (CBT) is a well‑tested collection of practical tools for managing emotions, improving social relationships, maximizing work productivity, and even modifying health‑related behaviors through self‑awareness, critical analysis, and taking steps toward gradual, goal‑oriented change. CBT provides a clear and compelling model that illuminates the relationships between thoughts, emotions, and behaviors and uses those connections to gather and tailor practical tools to stimulate change. Built on a solid foundation of cognitive and behavioral research, CBT is not just about treating mental illness. CBT is an approach almost anyone can use to promote greater mental health, manage emotions, and improve functioning in nearly any domain. In this course, you’ll learn about CBT by constructing your own CBT toolbox filled with strategies best suited to your goals. You’ll learn about each tool through active exercises and by sitting in on therapy sessions where clients are learning and practicing the tools to address the problems they face. Those problems include worry, anxiety, sadness, grief, procrastination, perfectionism, rejection sensitivity, and a host of medical issues, including insomnia, pain, addiction, and chronic disease management. Although this is the second Great Course on CBT, it is designed to stand alone and to complement the first CBT course: Cognitive Behavioral Therapy: Techniques for Retraining Your Brain. The focus in this new course is on building your toolbox and learning how to use it. The first CBT course includes many tools but also spends more time covering the conceptual basis for CBT, research that supports CBT, and the ways CBT is used to treat specific mental illnesses. Taken together, these two CBT courses will provide a complete and practical introduction to what has become the most popular form of therapy and self‑improvement. You get the science as well as the practical tools you can apply to daily life. This course begins where therapy begins: with a broad overview and some goal setting. First, the main goal for the course will be set: an understanding of the CBT toolbox, including foundational knowledge and skills like self‑ 1 COURSE SCOPE monitoring, goal setting, and distinguishing between cognitions, emotions, and behaviors. You’ll learn about the two compartments of the toolbox, in which you’ll organize both cognitive and behavioral tools—all of which address emotion regulation and/or improvements in functioning in the social, occupational, and physical/medical domains. You’ll be introduced to the three primary clinical cases that will be followed throughout the course, and you’ll begin your own workbook to capture your goals and the milestones you’ll set to achieve them. From there, the course will present a variety of common concerns that your CBT tools can help you address. Unlike the first CBT course, nearly all of these appear in daily life and do not fall in the realm of mental illness—a distinction that the course will help you make throughout. These common concerns include how to worry less, how to let go of outdated beliefs about yourself, how to use a structured approach to solve complex social problems, how to accept imperfection, how to stop procrastinating, and how to better ease the sting of social rejection. The course will also address the challenges of living with a chronic illness or chronic medical symptom like pain or insomnia. You’ll learn what tools fit and when and how to use them. Drawing on adult learning theory, toolbox recaps are nested throughout the course to help you solidify your knowledge and internalize your new skill set. In perhaps a first for The Great Courses, the approach used in this new CBT course is based on feedback from customers who worked through the first, highly rated CBT course. Customers suggested that this second CBT course focus more deeply on skills and provide more opportunity to review and consolidate skills. They even shared some of their own CBT adaptations— making this a sort of open‑source CBT. Their tips and tricks will be shared as you dig deeper to create a solid, scientifically sound toolbox worthy of everyday use. Roll up your sleeves, open your toolbox, and prepare to learn. All of the worksheets from the therapist guide and patient workbook Minding the Body can be downloaded for free here: https://www.oxfordclinicalpsych.com/view/10.1093/med:psy ch/9780195341645.001.0001/med-9780195341645-appendix-1. 2