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CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit



CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit

Nigel Sage, Michelle Sowden, Elizabeth Chorlton, Andrea Edeleanu

ISBN: 978-1-118-68760-4 May 2013 392 Pages

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There is a growing awareness of the need to address the psychological distress associated with physical ill health; however, current resources are limited and difficult to access. The best way to tackle the issue is by enhancing the skills of those professionals who have routine contact with them. CBT provides the evidence-based skills that most readily meet these requirements in a time and cost efficient manner. Based on materials prepared for a Cancer Network sponsored training programme and modified to address the needs of a larger client population of people experiencing psychological distress due to physical ill-health, this innovative workbook offers a basic introduction and guide to enable healthcare professionals to build an understanding of the relevance and application of CBT methods in everyday clinical practice.

Related Resources

About the Authors.



Part I: The Workbook: The Cognitive Behavioural Approach.

Chapter 1: What is the Cognitive Behavioural Approach?

Chapter 2: The Relevance of a Cognitive Behavioural Approach for People with a Life-changing Illness.

Chapter 3: Does Cognitive Behaviour Therapy Work? The Evidence Base.

Chapter 4: Communication Skills in Health Care.

Chapter 5: Cognitive Behavioural Communication Style.

Chapter 6: Guided Discovery: Using the Socratic Method.

Chapter 7: Assessment.

Chapter 8: Formulation.

Chapter 9: Deciding on a Course of Action: Part 1.

Chapter 10: Goal Setting and the Step-by-Step Process.

Chapter 11: The Practicalities of Setting Goals.

Chapter 12: Bringing About Change.

Chapter 13: Methods of Behaviour Change.

Chapter 14: Methods of Cognitive Change.

Chapter 15: Challenging Unhelpful Thoughts.

Chapter 16: Managing Emotions and Unpleasant Physical Sensations.

Chapter 17: Decision on a Course of Action: Part 2.

Chapter 18: Applying a Cognitive Behavioural Approach to Clinical Practice.

Part II: The Issues: Some Psychological Problems.

How to Use This Part of the Book.

Glossary of Everyday Terms.

Adjustment Difficulties.

Altered Body Image.





Fear of the Future.



Intrusive/Distressing Thoughts.

Lack of Motivation.

Loss of Pleasure or Ability to Enjoy Things.

Low Mood.

Low Self-Esteem.

Negative Outlook.


Panic Attacks.

Special Note: Safety Behaviours.

Physical Tension.

Poor Concentration.

Problem Solving Difficulties.


Sleep Difficulties.



Part III: The Toolkit: CBT Methods in Practice.

Section 1: Techniques.

Activity Monitoring.

Assertiveness Skills.

Assessing Psychological Distress.

Attention Strategies.

Basic Counselling Skills.

Behavioural Change Methods: A Summary.

Behavioural Experiments.

Behavioural Rehearsal.

Believable Alternative Thoughts.

Breathing Control.

Challenging Unhelpful Thoughts.

Cognitive Change Methods: A Summary.

Denial: Strategies for Encouraging Acceptance.

Denial: Strategies for Engaging the Patient.

Denial: Strategies for Reducing Distressing Thoughts.

Denial: Suggestions for Questions to Ask.

Effective Communication Skills.

Emotional Expression.

Expressive Writing.

Graded Activities.

Listening Skills.

Mental Distraction.



Problem Solving.


Purposeful Planning.

Relaxation Exercises.

Respectfulness Skills.

Socratic Questioning.

Stimulus Control.

Weighing the Pros and Cons.

Section 2: Information Sheets.

Antidotes to Bad Days.

The Assertiveness Model.

Assertiveness Rights.

Assertiveness Techniques.

Bad Old Habits: Avoiding Relapsing Into Them.

Change: Bringing It About.

Change: The Desire for It.

Change: The Transition Curve.

Coping with Setbacks 1: Physical Health Setbacks.

Coping with Setbacks 2: Mental Attitude Setbacks.

Denial: Advantages and Disadvantages.

Experiential Learning Cycle.

Goal Setting and the Step-by-Step Approach.

Goal Setting: Examples.

Goal Setting Questions.

Mental Traps: Examining the Evidence.

Mental Traps: Examples of How to Get Out of Them.

Mindfulness Attitudes.

Mindfulness Exercises.


Pacing Examples.

The Reactions of Other People.

Reflective Practice Diary Guidance.

Relaxation: Mental Exercise.

Relaxation: Muscle Exercise.

Relaxed Breathing Exercise.

The Serenity Prayer.

Sharing and Mixing with Other People.

SMART Guidelines.

Socratic Questioning: Examples.

Stress: The Effect it Has.

The Stress Response..

A Vicious Cycle Model of Anxious Avoidance.

A Vicious Cycle Model of Anxious Preoccupation.

A Vicious Cycle Model of Hopelessness-Helplessness.

Section 3: Record Forms.

Event-Emotion-Thought Analysis Form.

Example of Event-Emotion-Thought Analysis Form.

Believable Alternatives.

Thought Record.

Pacing Record Form.

Denial: Assessing its Costs and Benefits.

Denial: Example of Pros and Cons Assessment.

Action Plan for Denial.

Goal Planning: Step-By-Step Action Plan.

Your Ideas for Goals.

Reflective Practice Diary.



?It is very thorough, with clear explanations of the approach, uses, and techniques to assist patients or families in changing behavior so that they may better manage their illnesses and meet their life goals..? (Doody?s , August 2009)