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This groundbreaking book addresses what to do when a patient is not making progress. Provided is practical, step-by-step guidance on conceptualizing and solving frequently encountered problems, whether in developing and maintaining the therapeutic alliance or in accomplishing specific therapeutic tasks. While the framework presented is applicable to a range of challenging clinical situations, particular attention is given to modifying the longstanding distorted beliefs and dysfunctional behavioral strategies of people with personality disorders. Helpful appendices include a reproducible assessment tool, the Personality Belief Questionnaire.

See also Dr. Beck's Cognitive Behavior Therapy, Second Edition: Basics and Beyond, the leading text for students and practicing therapists who want to learn the fundamentals of CBT. "This is a highly practical guide for using cognitive therapy with patients who present challenging problems to clinicians with diverse levels of experience. An excellent hands-on text for graduate-level courses and for novice therapists, it can also fruitfully guide mature practitioners who wish to expand their realm of expertise. Enriched with numerous illuminating case materials, the book will enlighten even the most experienced mental health worker."--Theodore Millon, PhD, DSc, Institute for Advanced Studies in Personology and Psychopathology

"Clinicians have been reporting for some time now that they are seeing increasingly difficult cases in their consulting rooms. Axis I and Axis II comorbidities have become the rule rather than the exception. By systematically addressing these challenges in this clearly written and eminently readable volume, Judith Beck takes cognitive therapy to a new level. This book will be equally useful to students and to experienced therapists."--Glen O. Gabbard, MD, Department of Psychiatry, Baylor College of Medicine

"This excellent book focuses on the art of cognitive therapy. When therapy does not seem to be going well, most clinicians can think of another therapist who they think would fare better. This book teaches you how to become that therapist. Drawing on her vast experience with therapists and clients, Dr. Beck beautifully outlines how to identify and overcome many of the difficulties that can arise in cognitive therapy. As a consequence, therapists will be heartened and more patients will experience the benefits they hope for. Highly recommended reading for novice to highly experienced cognitive therapists."--David M. Clark, DPhil, Department of Experimental Psychology, University of Oxford, United Kingdom

Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work

Foreword, Aaron T. Beck

1. Identifying Problems in Treatment

2. Conceptualizing Patients Who Present Challenges

3. When a Personality Disorder Challenges Treatment

4. Developing and Using the Therapeutic Alliance

5. Therapeutic Relationship Problems: Case Examples

6. When Therapists Have Dysfunctional Reactions to Patients

7. Challenges in Setting Goals

8. Challenges in Structuring the Session

9. Challenges in Solving Problems and in Homework

10. Challenges in Identifying Cognitions

11. Challenges in Modifying Thoughts and Images

12. Challenges in Modifying Assumptions

13. Challenges in Modifying Core Beliefs

Appendix A: Resources, Training, and Supervision in Cognitive Therapy

Appendix B: Personality Belief Questionnaire