What is CBT? And what is TEAM-CBT?
How we think about something determines how we feel about it. If you get a bad
grade on a test, or a bad review from your boss, do you become extremely
depressed and/or worried? Or are you able to accept it, learn from it, put it in
perspective, and move forward?
When some people get a bad grade, they begin to worry, “Oh, no. I’ll probably flunk
this course… and then I won’t be able to get a high enough grade point average to
get into the college of my choice, and then I won’t be able to get a good job, and
then… I’ll never be happy.” When we get worried, this is how we sometimes think.
These are called “negative thoughts,”” or “unhelpful thoughts.” And, when we are
thinking like this, we get even more worried. As I tell my patients, it’s like pouring
gasoline on a fire!
If we take the same circumstance and realize, “Hey, it’s true. I did not get as good a
grade as I had hoped. And, I did the best I could. And, yes, it might affect my grade
point average. But that doesn’t mean I won’t get into my first choice college. And,
even if I don’t, there are plenty of good colleges out there. And, I’ll bet that there are
many successful people who did not get into their first choice college.” You can see
that these are “positive thoughts, or “helpful thoughts.” Or, after explaining this to
one of my 9-year-old patients, she told me, “Gee, Dr. Lazarus…that’s like pouring
water on the fire!”
So you can see that it is not the circumstances in our lives that determine how we
feel, rather, it is how we think about them, and view them, and approach them.
When we are able to recognize the errors in our thinking, we can then learn to talk
back to them.
And, when we change the way we think, we change the way we feel. This, to me,
is the essence, of Cognitive Behavioral Therapy (CBT).
Dr. Burns is an internationally recognized pioneer in the field of cognitive
behavioral therapy, or CBT. Years ago, he wrote several self-help books, the best
known of which is Feeling Good: The New Mood Therapy. This book has sold over 5
million copies worldwide, and is published in almost every language you can
imagine. It has helped countless patients who have suffered with depression as well
as their families.
Dr. Burns is one of the two best teachers I have ever had. He is warm, funny,
inspiring, brilliant, supportive, and extremely generous. He very graciously allowed
me to incorporate his use of “The Magic Dial” into “Controlling Your Gut Feelings®.”
He has developed TEAM-CBT, which includes tools that can be applied for virtually
any type of therapy, including medical hypnosis, cognitive behavioral therapy (CBT), and every patient interaction.
The TEAM acronym stands for:
T – Testing
E – Empathy
A – Agenda Setting
M – Methods
This comprises having patients fill out a brief mood survey that identifies
how they are feeling at that moment. In addition, it includes a section on
positive feelings patients are having about themselves, as well as relationship
satisfaction with a person who is important in the patient’s life.
This is a very helpful process and allows patients to share what they’re
feeling and why.
This questionnaire is completed at the beginning and at the end of each
session. In addition, it allows for an evaluation of how the session was,
including whether or not they felt the therapist was empathic, how helpful
the session was, their commitment to doing homework, and what they liked
least and most about the session.
Before starting treatment with methods, I believe you have to meet patients
“where they are.” How often have you told someone, “I’m really worried
about the upcoming test” or “I’m really worried about what my boss will say
at my annual review tomorrow?”
And, how often have your friends, colleagues, or family members replied,
“Don’t worry.” Or, “You’ll do fine.” Or, “Just relax.” Or, my favorite: “CALM
DOWN!” And how often has that really helped you??? Virtually all of my
patients answer that question with, “NEVER!”
Until we acknowledge how patients are really feeling, we can’t connect with
them in a warm and supportive way.
Dr. Burns has also developed “The Five Secrets of Effective Communication.”
When we are able to use these, we can truly connect with not only our
patients, but also with literally everyone with whom we have contact: a
loved one, boss, employee, teacher, student…everyone.
Agenda setting helps us determine how motivated patients are to getting
better. It incorporates some very sophisticated methods that are similar to
I see a lot of patients with headaches or stomach aches and these allow them
to stay home from work or school, play video games, and watch television,
because those are the only things that can help get their minds off the
discomfort. If the patient and family don’t want to change, then it is not up to
me to try to change them. And, the harder we push people to change, in
general, the harder they will push back.
There are over 50 different CBT techniques to help patients talk back to their
negative, or unhelpful, thoughts. And, until we have gone through the T-E-A
of T-E-A-M, our methods will not be effective.
When one incorporates TEAM with CBT, it is, as Dr. Burns has said, “like CBT on
steroids!” It allows for unbelievably high-speed change in patients’ improvement.
Although each aspect of TEAM is important, I believe the most essential one is
empathy. Unless we’ve truly connected with our patients, we can’t really help them in any meaningful way.
And, this holds true for every one of our relationships, both personal and
Controlling Your Gut Feelings® incorporates the TEAM-CBT approach, including
“The Five Secrets of Effective Communication,” as much as can be done in an online,
video-streamed, non-interactive program.