Workshop Participant Spotlight – Katherin Torres

At this week’s CBT for Substance Use Disorders workshop, we had the pleasure of welcoming Katherin Torres back to Beck Institute.

DSC_0046editShe and her colleagues from Pathways in San Diego recently attended the CBT for Schizophrenia workshop in April, and now she returned solo to learn more about using CBT with her substance abusing clients.

A pre-licensed MFT intern at Pathways in San Diego, Katherin is a first episode of psychosis specialist, working in the Kickstart program which provides confidential assessment and early assistance for young people between the ages of 10 and 25 who are at risk for mental illness in San Diego County.

First episode of psychosis clients often have comorbidity, and this workshop taught Katherin new ways to treat substance use disorders, address issues with open communication, and provide support to her high-risk clients.

Katherin has a long time affection for CBT, “It’s my therapeutic style: collaborative.”

At the workshop, she enjoyed watching the videos of  the instructor, Dr. Cory Newman, in therapy sessions and completing roleplays with fellow participants to put new skills into practice.

This workshop will help her to structure her sessions, remember to set goals, and better understand her clients with substance use disorders. She is most excited to bring  what she has learned back to the staff in the Kickstart program.


Workshop Participant Spotlight: Kanan Kanakia

This week’s workshop, CBT for Children and Adolescents, included Kanan Kanakia, who traveled from Mumbai, India to attend the workshop. She has experience as a psychotherapist, special educator, counselor, and hyKanakiapnotherapist which allows her to choose the best treatment path for her clients.

After learning about CBT, she wanted to get the actual feel of how to apply CBT and researched Beck Institute workshops, deciding “which better institute than here.”

“This workshop was exactly what I was looking for with the know-how and the application in real life and real circumstances.”DSC_0281

When asked about Dr. Torrey Creed, the workshop instructor, Kanan replied, “Oh, she’s amazing!” She presented real case examples of the topics she was instructing, which made the complex topics easy to grasp.

Kanan also had the opportunity to role play a tough client with Dr. Aaron Beck via Skype.



Conflicting Research on Dieting

Deborah Beck Busis_2014-2015By Deborah Beck Busis, LCSW

Director, Beck Diet Programs


A recent article published in the New York Times, “After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight,” details how most of the contestants on the television show, “The Biggest Loser,” regained much, if not all of the weight they had lost while on the show. The article also describes how the contestants’ metabolisms slowed down as they lost weight and did not return to their original level once they regained their weight. The level of the hormone leptin, which influences hunger, also did not return to the original level, and in fact, reached only about half of what it had been before they started to diet.

The article certainly is discouraging. It also emphasized that the dieters, who lost weight through extreme calorie restriction and high levels of exercise, had to eat substantially fewer calories (up to 500 calories less) than other people who hadn’t dieted, to maintain their weight loss. We don’t believe the situation is hopeless, however. There is a significant amount of research that shows that while there is a change in metabolism as people lose weight, the amount varies. These studies generally show that the metabolic penalty is between 20-200 calories and that this penalty decreases modestly in the year following weight loss. On the other hand, a meta-analysis that was published in 2012 found no change in the metabolic rates of dieters.

In our program, most people have been able to lose weight and keep it off—when they’re willing to have periodic booster sessions to keep their cognitive and behavioral skills sharp. There are several key components of our weight loss program that are drastically different from what the contestants on the “The Biggest Loser” do. First and foremost, our clients do not lose as much weight and they do not lose it quickly; usually, the rate is half a pound to two pounds per week.

Along with slower weight loss, our clients also follow diet and exercise plans that fit in with their lives. In terms of exercise, none of our clients devote the nine hours per week that the “Biggest Loser” participants were advised to do once they returned home. Although the article didn’t describe the specific diets participants followed while they were being filmed, it is likely that the diets were quite restrictive, both in terms of number of calories and the types of permitted foods. This, too, is quite contrary to our program. From the start, we work with our clients to incorporate all their favorite foods into their diets in reasonable ways. We work hard to ensure that our clients only make changes in their eating that they can sustain in the long term.

When helping our clients make changes in eating and exercise, the two words that we constantly use are reasonable and maintainable. We have found that when dieters lose weight eating or exercising in a way they can’t maintain, they invariably gain the weight back when they revert to old behaviors.  Most of our clients don’t lose as much as they’d like because to do so would require unmaintainable eating and/or exercise plans. But they do get to a place where they feel strong and in control of their eating; their health is better; they have gained most of the advantages of being at a lower weight; they experience far fewer cravings; and they feel confident that they can keep doing what they’re doing. They not only know what to do but also can competently solve problems and address dysfunctional thoughts and beliefs that interfere with maintaining the needed changes in behavior.

As far as we can tell, “The Biggest Loser” is the antithesis of our program. Although we haven’t had our clients track their metabolisms before and after weight loss, we assume that taking a much more measured approach is part of what enables our clients to lose weight and keep it off.  While doing it this way is less compelling in the moment, because the pounds fail to drop off at lightning speed, it seems to pay off in the long term, as dieters lose weight by putting behaviors into place, supported by changes in cognition, that they can ultimately maintain.


Are you a professional who works with dieters?

Learn more about our upcoming workshop: CBT for Weight Loss and Maintenance. 

Treating Substance Misuse Disorders with CBT


Cory Newman, PhD

If you plan to treat patients suffering from substance misuse disorders, I have good news and bad news. First, the bad news. When people habitually misuse a psychoactive chemical – whether it is alcohol, marijuana, benzodiazepines, stimulants, opioids, hallucinogens, or any other – they typically receive significant, immediate positive reinforcement (e.g., a sense of “high”) as well as powerful, immediate negative reinforcement (e.g., relief from negative emotions and/or withdrawal symptoms). Even when people are motivated to change, these experiences are formidable opponents to healthier, more stable, more meaningful sources of gratification, such as the pride one feels in having the ability to say “no” to urges, the satisfaction of having spent a productive day, and the trust of caring others, including therapists. Thus, effective treatment is at once an uphill climb.

Now, here is the good news. In order for people to overcome a substance misuse disorder, they need psychological tools, and cognitive therapy provides this very well. In a nutshell, this includes skills in self-awareness (e.g., of the onset of cravings and urges), self-instruction, planning, problem-solving, well-practiced behavioral strategies to reduce risk and to increase enjoyable sober activities, and methods of responding effectively to dysfunctional beliefs (about drugs, oneself, and one’s “relationship” to drugs). A chief text for the cognitive therapy of substance abuse (Beck, Wright, Newman, & Liese, 1993) describes seven main areas of potential psychological vulnerability, each of which represents a factor that contributes to the patient’s risk of alcohol and other substance misuse, and each of which suggests a potential area for therapeutic intervention. These include:

  1. High-risk situations, both external (e.g., people, places, and things) and internal (e.g., problematic mood states).
  2. Dysfunctional beliefs about drugs, oneself, and about one’s “relationship” with drugs.
  3. Automatic thoughts that increase arousal and the intention to drink and/or use.
  4. Physiological cravings and urges to use alcohol and other drugs.
  5. “Permission-giving beliefs” that patients hold to “justify” their drug use.
  6. Rituals and general behavioral strategies linked to the using of substances.
  7. Adverse psychological reactions to a lapse or relapse that lead to a vicious cycle.

An overarching benefit that cognitive therapy brings to the treatment of substance use disorders is its emphasis on long-term maintenance. As misusers of alcohol and other drugs are often subject to relapse episodes, therapists need to teach patients a new set of attitudes and skills on which to rely for the long run. These attitudes and skills not only improve patients’ sense of self-efficacy, they also lead to a reduction in life stressors that might otherwise increase the risk of relapse. A short (non-exhaustive) list of some of the attitudes and skills that patients learn in cognitive therapy includes:

  • Learning how to delay and distract in response to cravings, by engaging in constructive activities, writing (e.g., journaling), communicating with supportive others, going to meetings, and other positive means by which to ride out the wave of craving until it subsides.
  • Identifying dysfunctional ways of thinking (e.g., “permission-giving beliefs”) and getting into the habit of thinking and writing effective responses. For example, a patient learns to spot the thought, “I haven’t used in 90 days, so I deserve a little ‘holiday’ from my sobriety,” and to replace it with a thought such as, “What I really deserve is to keep my sobriety streak alive, to support my recovery one day at a time, including today, and to stop trying to fool myself with drug-seeking thoughts.”
  • Developing and practicing a repertoire of appropriately assertive comments with which to politely turn down offers of a drink (or other substance) from someone (e.g., “Thanks, but I’ll just have a ginger ale, doctor’s orders!”).
  • Learning how to solve problems directly and effectively, rather than trying to drown out a problem by getting impaired, which only serves to worsen the problem.
  • Becoming conversant in the “pros and cons” of using alcohol and other drugs, versus the pros and cons of being sober, and being able to address distortions in thinking along the way.
  • Practicing the behaviors and attitudes of self-respect, including counteracting beliefs that otherwise undermine oneself and lead to helplessness and hopelessness (e.g., “I’m a bad person anyway, so I might as well mess up my life by using.”).
  • Utilizing healthy social support, such as 12-step fellowship (12SF) meetings, friends and family who support sobriety, and staying away from those who would undermine therapeutic goals.
  • Making lifestyle changes that support sobriety and self-efficacy, including having a healthy daily routine, refraining from cursing and raging, engaging in meaningful hobbies, and doing things that promote spirituality and serenity (e.g., yoga).

To provide accurate empathy to patients, and to ascertain the optimal combination of validation for the status quo versus action toward change, it is important for therapists to assess the patient’s “stage of change.” Some patients are quite committed to giving up their addictive behaviors, and thus are at a high level of readiness for change. Others are more ambivalent, and may waver in their willingness to take part in treatment. Similarly, patients who are uncertain about giving up drinking and drugging may present for treatment with the goal of “cutting back” on alcohol and other drugs. Such patients may disagree that they will need to eliminate their use of psychoactive chemicals, and may decide to leave therapy if the therapist insists that the goal must be abstinence. Of course, there are some patients who are remanded for treatment who otherwise would not seek treatment on their own. They may deny that they have a problem with alcohol and other drugs, and not truly engage in the therapy process at all. The therapist’s understanding of the patient’s stage of change will be vital in helping them know just how directive to be, without going too far for a particular patient to tolerate at a given time in treatment. This sort of sensitivity may allow therapists to get the maximum out of treatment with patients who are most motivated, while retaining less motivated patients in treatment until such time as they begin to feel more a sense of ambition in dealing with their problem.

Cognitive therapy can be used in conjunction with supplemental treatments. For example, cognitive therapy can be woven into a comprehensive program in which patients (for example) take suboxone, and also attend 12SF meetings. Similar to advancements in the treatment of bipolar disorder and schizophrenia, where promise has been shown in combining cognitive therapy with pharmacotherapy, the study of best practices for alcohol and substance use disorders will probably involve more instances of coordinated care. For example, the strength of medication-based treatments that diminish the patients’ subjective desire for their drug(s) of choice can be paired with the strengths of cognitive therapy in modifying faulty beliefs and maximizing skill-building.

Empirical evidence indicates that cognitive therapy has the potential to be an efficacious treatment for alcohol and other substance use disorders, especially with adult patients who present with comorbid mood disorders, and with adolescents. However, improvements in the treatment approach still can be made, most notably via alliance-enhancement strategies that may improve retention in treatment, and more routine incorporation of the “stages of change” model.


Learn more about upcoming workshops on CBT for Substance Use Disorders.


Recommended Readings

Anton, R. F., Moak, D. H., Latham, P. K., Waid, R., Malcolm, R. J., Dias, J. K., & Roberts, J. S. (2001). Posttreatment results of combining naltrexone with cognitive- behavioral therapy for the treatment of alcoholism. Journal of Clinical Psychopharmacology, 21(1), 72-77.

Baker, A., Boggs, T. G., & Lewin, T. J. (2001). Randomized controlled trial of brief cognitive-behavioral interventions among regular users of amphetamine. Addiction, 96(9), 1279-1287.

Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive therapy of substance abuse. New York: Guilford Press.

Deas, D., & Thomas, S. E. (2001). An overview of controlled studies of adolescent substance abuse treatment. American Journal on Addictions, 10(2), 178-189.

Maude-Griffin, P. M., Hohenstein, J. M., Humfleet, G. L., Reilly, P. M., Tusel, D .J., & Hall, S. M. (1998). Superior efficacy of cognitive-behavioral therapy for urban crack cocaine abusers: Main and matching effects. Journal of Consulting and Clinical Psychology, 66(5), 832-837.

Newman, C. F. (2008). Substance abuse. In M. A. Whisman (Ed.), Adapting cognitive therapy for depression (pp. 233-254). New York: Guilford Press.

Nishith, P., Mueser, K. T., Srsic, C. S., & Beck, A. T. (1997). Differential response to cognitive therapy in parolees with primary and secondary substance use disorders. The Journal of Nervous and Mental Disease, 185(12), 763-766.

Ouimette, P. C., Finney, J. W., & Moos, R. H. (1997). Twelve-Step and cognitive-behavioral treatment for substance abuse: A comparison of treatment effectiveness. Journal of Consulting and Clinical Psychology, 65, 230-240.

Prochaska, J. O., & Norcross, J. C. (2002). Stages of change. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 303-313). New York: Oxford University Press.

Waldron, H.B., & Kaminer, Y. (2004). On the learning curve: The emerging evidence supporting cognitive-behavioral therapies for adolescent substance abuse. Addiction99, 93-105.


A Buckley

Amy Buckley – Workshop Participant Spotlight

Traveling from Burlington, Vermont, Amy is a clinical social worker in a private practice where she treats anxiety and depression in college students and young professionals. A BuckleyThe transition into college and navigating the independence and responsibility of adulthood can be daunting, and she uses CBT and mindfulness to improve the lives of her clients.

She attended our recent CBT for Anxiety: Core 2 workshop in Philadelphia and learned practical strategies for treating clients with anxiety. All the knowledge from this workshop hasn’t sunken in yet, so she is looking forward to “go home and study” the enormous amount of information Dr. Amy Wenzel presented during the workshop. Learning about the worry script and using exposures are the main take-aways for Amy. Her favorite part? Meeting with Dr. Judith Beck and having the opportunity to Skype with Dr. Aaron Beck were her favorite parts of the experience.

Reducing Clinician Stress When Treating Traumatized, Suicidal Clients

Marjan G. Holloway, Ph.D., Beck Institute Faculty



Marjan G. Holloway, Ph.D.

As an educator, I have noticed that two subgroups of clients are highly likely to activate anxiety and other types of emotional distress (e.g., professional burnout) among clinicians.  The first subgroup consists of traumatized clients and the second subgroup consists of suicidal clients.  When working with clients who are traumatized and suicidal, the potential for therapy-interfering emotions such as excessive worry and therapy-interfering behaviors such as avoidance on the part of the clinician notably increases.  These problematic emotional and behavioral reactions often stem from a series of maladaptive clinician cognitions, as described below.

  1. All-or-None Thinking (Example: “After months of therapy, nothing has changed.”)
  2. Catastrophic Thinking (Example: “If I ask too many questions about the traumatic event, the client will deteriorate, fall apart, and may even become suicidal.”)
  3. Labeling (Example: “This client is resistant to change – wants to remain a victim.”)
  4. Personalizing (Example: “As an incompetent therapist, it’s my fault that the client remains symptomatic.” )

We have all been there.  I recall my excitement after having received a new client referral in the early years of my practice.  This excitement quickly transformed to anxiety, indecisiveness, and self-doubt as I learned about this particular client’s history of multiple lifetime traumas and suicidal behaviors.  I was terrified to accept the case as a newly licensed psychologist and I frankly questioned my ability to work effectively with the client (even after years of solid clinical training).  Not surprisingly, I avoided taking the case.  To address my sense of responsibility and guilt, I started to call other community clinicians and colleagues in private practice to find a good referral source.  Very quickly, I discovered that other clinicians, regardless of their seasonality, were similarly not available to accept a “complex” trauma case who was also considered at high risk for suicide.  As I listened to the justifications provided by these clinicians, I had an opportunity to examine my own beliefs about the client.  I realized that these beliefs – along with my negative emotions – were dictating my decision to avoid.

During an upcoming 2016 Beck Institute Workshop on CBT for PTSD, I plan to review two evidence-based CBT interventions for trauma: Prolonged Exposure (PE; Foa, Hembree, & Rothbaum, 2007) and Cognitive Processing Therapy (CPT; Resick & Schnicke, 1996).  While each intervention has a different theoretical underpinning and technical approach, both emphasize the following:

  • The importance of having the client understand (i.e., “digest”) the traumatic event
  • The importance of having the client understand that the memory of the traumatic event, by itself, is not dangerous and therefore, not to be avoided

By repeated exposure to the memories associated with the traumatic event and/or repeated examination of the impact of the traumatic event, the traumatized client can gain a sense of control and mastery over the traumatic memories.

To date, there is no scientific evidence to suggest that asking about trauma-related and/or suicide-related content exacerbates psychiatric symptoms.  CBT clinicians can learn to effectively manage their own anxiety and emotional distress, while working with this highly vulnerable client population, by engaging in the following recommended activities:

  • Gaining continuing education in evidenced-based CBT for PTSD
  • Being mindful of their own therapist maladaptive emotions, cognitions, and/or behaviors
  • Seeking peer consultation and/or supervision, as needed
  • Listening carefully to the trauma/suicide narratives of their clients in order to construct meaningful cognitive behavioral conceptualizations for treatment planning
  • Paying close attention to self-care and early signs of professional burnout

Working with traumatized clients is certainly not easy.  However, we as CBT clinicians have the responsibility to intervene, rather than to avoid.  Prolonged Exposure and Cognitive Processing Therapy are two CBT-oriented treatment packages that are evidence-based.  Gaining familiarity and future competency in delivering these interventions will certainly prove to be beneficial to your clients and to you.


Recommended Resources

Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences – Therapist guide. New York, NY: Oxford University Press.

Ghahramanlou-Holloway, M., Neely, L., & Tucker, J. (2014). A cognitive-behavioral strategy for preventing suicide. Current Psychiatry, 13(8), 18-25.

Resick, P. A., & Schnicke, M. K. (1996). Cognitive processing therapy for rape victims. Newbury Park, Sage Publications.


Mobile Apps to Consider

PE Coach


Provider Resilience

CBT for Perinatal Distress

Amy Wenzel ProfileAmy Wenzel, Ph.D., ABPP

Beck Institute Faculty

Perinatal distress is defined as depression or anxiety experienced by women who are pregnant or who are in the first postpartum year (Wenzel, 2015). Those of you who have attended the Core 2 CBT for Anxiety Workshop at Beck Institute know that I do not include this issue as a part of the curriculum; nevertheless, questions pertaining to work with perinatal women are frequently asked once workshop participants know my background, and lively discussion usually ensues. Thus, we thought it would be of interest to address this topic in this e-newsletter.


On many occasions, I have encountered negative attitudes toward CBT in the community of mental health professionals (the vast majority of whom identify with other theoretical orientations) who treat perinatal women. Examples of these attitudes include:

  • Attention to the therapeutic relationship is paramount, and cognitive behavioral therapists place little, if any, significance on it.
  • Session structure is too rigid and cold for a perinatal woman in substantial distress, who needs to be provided with a “holding environment” (a Donald Winnicott construct) that provides nurturance, reassurance, and a sense of safety.
  • There is no way that a new mom who is frazzled and sleep-deprived can do homework in between sessions.


When I encounter these myths in conversations with colleagues, I treat them as assumptions that should be tested prospectively, rather than factual information that must be followed without critical evaluation in one’s clinical work. When I open up dialogue with these colleagues, they are pleased to learn about the central importance that cognitive behavioral therapists place on the therapeutic relationship and the high-quality research that has been published on the topic in the past decade. They are also surprised to learn that CBT with perinatal women (or with any clients, for that matter) should not be practiced in a mechanistic way, according to a checklist, but instead should proceed in a flexible, collaborative manner that is driven by the individualized case conceptualization and the client’s preferences. In contrast to the experience of some of my non-CBT colleagues, many perinatal women have expressed gratitude for CBT’s session structure and tangible exercises, remarking that it is precisely because they are frazzled and sleep-deprived that they respond well to CBT’s organized approach. Moreover, newer technology such as Mobile phone apps allow perinatal women much flexibility in completing homework; for example, many of my clients have completed the equivalent of a thought record or an activity log while nursing their infants to sleep.


Interestingly, unlike the literature on CBT for a host of adult mental health problems, there is mixed evidence for CBT’s efficacy with perinatal women (with postpartum depression being the perinatal mental health problem that has received the vast majority of the attention). Authors of meta-analyses on this subject generally conclude that there is strong evidence for the efficacy of interpersonal psychotherapy (IPT) and weak to moderate evidence for the efficacy of CBT for this population. However, in my recent comprehensive review of psychotherapy for perinatal mental health problems (Wenzel, 2016), I concluded that a true “Beckian” approach to CBT—one in which the case conceptualization lies at the heart of the treatment and informs intervention in a flexible, individualized, and collaborative manner—has not yet been evaluated with perinatal women. The majority of the “CBT” treatment packages evaluated to date are heavily focused on psychoeducation and specific techniques (e.g., relaxation) delivered at prescribed times throughout the course of treatment. Although these packages are thoughtfully designed and often theoretically driven, in many instances they did not fare better than usual care in outcome analyses. Thus, I recently published a manual that describes a case conceptualization-driven approach to CBT with perinatal women (Wenzel, 2015), and I look forward to empirical research that evaluates this approach to treating perinatal distress. I will also call your attention to an excellent article written by Arch, Dimidjian, and Chessick (2012) that refutes myths about the dangers of exposure therapy with pregnant women and provides guidelines for conducting exposures with this population in a safe but effective manner.


Arch, J. J., Dimidjian, S., & Chessick, C. (2012). Are exposure-based cognitive behavioral therapies safe during pregnancy? Archives of Women’s Mental Health, 15, 445–457.

Wenzel, A. (2015; with K. Kleiman). Cognitive behavioral therapy for perinatal distress. New York, NY: Routledge.

Wenzel, A. (2016). Psychotherapy for psychopathology during pregnancy and the postpartum period. In A. Wenzel (Ed.), Oxford handbook of perinatal psychology (pp. 341-365). New York, NY: Oxford University Press.

Cathryn Prendergast – Workshop Participant Spotlight

Traveling all the way from Perth, Australia, Cathryn is a psychologist at the Hollywood Clinic, a private hospital, where she provides individual and group treatment to inpatients and outpatients for a variety of diagnoses including addiction, borderline-personality disorder, and eating disorders. Cathryn initially learned the foundation of CBT from her masters program at Curtin University and always wanted to travel to Beck Institute as, “the base of CBT globally.” DSC_0002

The most valuable part of the workshop for Cathryn was not a specific skill, but the entire experience. “At times, the workshop felt more like specialized supervision for my practice. I’m taking a lot home with me.” Cathryn also mentioned that, while the instructors are wildly experienced, they are still human and provide examples that apply to a variety of professions.

Unlike most workshop participants, Cathryn decided to stay in downtown Philadelphia to get the full experience, and used the convenient SEPTA bus to travel to the Crowne Plaza each day for the workshop. This allowed her to explore the Reading Terminal Market, and plan to visit Independence Hall and the Liberty Bell on Thursday.

“This workshop exceeded my expectations very much. I hope I can come back!”

Grant Porteous, LMSW and Kevin DeBruyn, LMSW – Workshop Participant Spotlights

TKevin and Grant November, 2015raveling from Traverse City, Michigan, Kevin and Grant attended the 2-day CBT for Weight Loss and Maintenance workshop taught by Deborah Beck Busis, LMSW.

Kevin DeBruyn, LMSW, is the founder and owner of Adaptive Counseling and Case Management, which helps chronically ill patients manage their health care and achieve a healthy lifestyle. Grant works as a clinician at Adaptive Counseling and Case Management.

Many chronically ill patients have issues with weight loss and maintenance, which made this workshop a perfect fit. Both use evidence-based treatments in their practice and were interested in training in CBT. Synthesizing CBT with health care made this workshop a unique fit and had the benefit of being, as Grant stated, ” straight from the horses mouth.”

Their best take aways?

Grant: The framework and process demonstrations through roleplays and case examples

Kevin: “I learned many new ways to structure what I’m already doing” to engage the client and move through treatment

Workshop Participant Spotlight – Pablo Alonso

As a therapist in Madrid, Pablo knew he wanted to improve his skills and, after reading many of both Drs. Beck’s books, he decided to come to Philadelphia for our Core 2: CBT for Anxiety course. “Part of being a great therapist is constantly working to improve your skills, and the best way is to go directly to the source.”

DSC_0138Pablo works in a clinic at the University of Madrid where he is a therapist, researcher, and supervisor of final-year students. He also works at the Deyre Medical Clinic, where he provides therapy to trauma patients. His clients are mainly adults and adolescents with depression, anxiety, and substance use disorders.

“When I grow up as a therapist I want to be just like Amy,” referring to Dr. Wenzel, who instructed the 3 day course on CBT for Anxiety. Roleplays were his favorite part of the workshop, because that’s when he got to see Dr. Wenzel “in action.”

On having the opportunity to meet Dr. Aaron Beck, “I have seen so many videos on YouTube, it was like I met him a long time ago.” 

His favorite lesson from the workshop was that “CBT is eclectic, it’s not a rigid therapy where you have to do A, B, then C. It’s fluid.”

No trip to Philadelphia is complete without a history tour and a cheese steak, which Pablo enjoyed and said,”I’m going to have to repeat that!”