Table Of ContentDELIBERATE PRACTICE IN
COGNITIVE BEHAVIORAL
THERAPY
Essentials of Deliberate Practice Series
Tony Rousmaniere and Alexandre Vaz, Series Editors
Deliberate Practice in Cognitive Behavioral Therapy
James F. Boswell and Michael J. Constantino
Deliberate Practice in Emotion-Focused Therapy
Rhonda N. Goldman, Alexandre Vaz, and Tony Rousmaniere
ESSENTIALS OF DELIBERATE PRACTICE SERIES
TONY ROUSMANIERE AND ALEXANDRE VAZ, SERIES EDITORS
DELIBERATE PRACTICE IN
COGNITIVE BEHAVIORAL
THERAPY
JAMES F. BOSWELL
MICHAEL J. CONSTANTINO
Copyright © 2022 by the American Psychological Association. All rights reserved. Except
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Psychological Association.
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Library of Congress Cataloging-in-Publication Data
Names: Boswell, James F., author. | Constantino, Michael J., 1971- author.
Title: Deliberate practice in cognitive behavioral therapy / by James F. Boswell and
Michael J. Constantino.
Description: Washington, DC : American Psychological Association, [2022] |
Series: Essentials of deliberate practice | Includes bibliographical references
and index.
Identifiers: LCCN 2021013084 (print) | LCCN 2021013085 (ebook) |
ISBN 9781433835551 (paperback) | ISBN 9781433835568 (ebook)
Subjects: LCSH: Cognitive therapy. | Behavior therapy. | BISAC: PSYCHOLOGY /
Education & Training | PSYCHOLOGY / Clinical Psychology
Classification: LCC RC489.C63 B68 2022 (print) | LCC RC489.C63 (ebook) |
DDC 616.89/1425—dc23
LC record available at https://lccn.loc.gov/2021013084
LC ebook record available at https://lccn.loc.gov/2021013085
https://doi.org/10.1037/0000256-000
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
We dedicate this book to our mentor, Louis G. Castonguay. Un mentor est quelqu’un qui
voit plus de talent et de capacité en vous, que vous ne voyez en vous-même, et qui aide
à les faire sortir de vous. [A mentor is someone who sees more talent and ability within
you, that you did not see in yourself, and helps bring it out of you.]
—James F. Boswell and Michael J. Constantino
Contents
Series Preface ix
Tony Rousmaniere and Alexandre Vaz
Acknowledgments xiii
Part I Overview and Instructions 1
CHAPTER 1. Introduction and Overview of Deliberate Practice
and Cognitive Behavioral Therapy 3
CHAPTER 2. I nstructions for the Cognitive Behavioral Therapy
Deliberate Practice Exercises 25
Part II Deliberate Practice Exercises for Cognitive
Behavioral Therapy Skills 31
Exercises for Beginner Cognitive Behavioral Therapy Skills
EXERCISE 1. Explaining the Treatment Rationale for Cognitive
Behavioral Therapy 33
EXERCISE 2. Establishing Goals 43
EXERCISE 3. Negotiating a Session Agenda 53
EXERCISE 4. Assigning and Reviewing Between-Session Activities 63
Exercises for Intermediate Cognitive Behavioral Therapy Skills
EXERCISE 5. Working With Cognitions 73
EXERCISE 6. Working With Behaviors 83
EXERCISE 7. Working With Emotions 93
Exercises for Advanced Cognitive Behavioral Therapy Skills
EXERCISE 8. Adherence Flexibility 103
EXERCISE 9. Responding to Therapeutic Alliance Ruptures 113
EXERCISE 10. Responding to Client Resistance 123
Comprehensive Exercises
EXERCISE 11. Annotated Cognitive Behavioral Therapy Practice Session
Transcripts 133
EXERCISE 12. Mock Cognitive Behavioral Therapy Sessions 147
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viii Contents
Part III Strategies for Enhancing the Deliberate Practice Exercises 155
CHAPTER 3. How to Get the Most Out of Deliberate Practice: Additional Guidance
for Trainers and Trainees 157
APPENDIX A. Difficulty Assessments and Adjustments 175
APPENDIX B. Deliberate Practice Diary Form 179
APPENDIX C. Sample Cognitive Behavioral Therapy Syllabus With Embedded
Deliberate Practice Exercises 183
References 191
Index 201
About the Authors 209
About the Series Editors 211
Series Preface
Tony Rousmaniere and Alexandre Vaz
We are pleased to introduce the Essentials of Deliberate Practice series of training books.
We are developing this book series to address a specific need that we see in many psy-
chology training programs. The issue can be illustrated by the training experiences of
Mary, a hypothetical second-year graduate school trainee. Mary has learned a lot about
mental health theory, research, and psychotherapy techniques. Mary is a dedicated
student; she has read dozens of textbooks, written excellent papers about psychotherapy,
and receives near-perfect scores on her course exams. However, when Mary sits with her
clients at her practicum site, she often has trouble performing the therapy skills that she
can write and talk about so clearly. Furthermore, Mary has noticed herself getting anxious
when her clients express strong reactions, such as getting very emotional, hopeless, or
skeptical about therapy. Sometimes this anxiety is strong enough to make Mary freeze at
key moments, limiting her ability to help those clients.
During her weekly individual and group supervision, Mary’s supervisor gives her
advice informed by empirically supported therapies and common factor methods. The
supervisor often supplements that advice by leading Mary through role-plays, recom-
mending additional reading, or providing examples from her own work with clients.
Mary, a dedicated supervisee who shares tapes of her sessions with her supervisor, is
open about her challenges, carefully writes down her supervisor’s advice, and reads
the suggested readings. However, when Mary sits back down with her clients, she often
finds that her new knowledge seems to have flown out of her head, and she is unable
to enact her supervisor’s advice. Mary finds this problem to be particularly acute with
the clients who are emotionally evocative.
Mary’s supervisor, who has received formal training in supervision, uses supervisory
best practices, including the use of video to review supervisees’ work. She would rate
Mary’s overall competence level as consistent with expectations for a trainee at Mary’s
developmental level. But even though Mary’s overall progress is positive, she experiences
some recurring problems in her work. This is true even though the supervisor is confident
that she and Mary have identified the changes that Mary should make in her work.
The problem with which Mary and her supervisor are wrestling—the disconnect
between her knowledge about psychotherapy and her ability to reliably perform
psychotherapy—is the focus of this book series. We started this series because most
therapists experience this disconnect, to one degree or another, whether they are
beginning trainees or highly experienced clinicians. In truth, we are all Mary.
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