Cognitive-Behavioral Theory and Intervention
What to know
CBT is grounded in the cognitive model: situations are filtered through appraisals, which drive emotion and behavior. Candidates should master the cognitive triad, automatic thoughts, intermediate beliefs (rules and assumptions), and core beliefs, plus behavioral principles (operant and respondent conditioning, exposure, behavioral activation, reinforcement). Know the structure of a session (mood check, agenda, bridge, review of homework, work on the agenda, summary, new homework) and specific protocols: exposure and response prevention for OCD, prolonged exposure and cognitive processing therapy for PTSD, behavioral activation for depression, and panic protocol with interoceptive exposure.
Traps
Questions often mislabel a technique: thought stopping is not exposure; distraction is not the same as habituation-based exposure. Watch for items that ask what to do first-usually agenda-setting or assessment, not interpretation. Another trap is assuming CBT ignores emotion or the therapeutic alliance; the alliance is a precondition, not an alternative.
Rule of thumb
Match the intervention to the maintaining mechanism: avoidance maintains anxiety (use exposure), inactivity maintains depression (use activation), and safety behaviors maintain panic (drop them, don't add them).
Worked example
A client with panic avoids elevators and carries water "just in case." The target is not reassurance but interoceptive and in-vivo exposure with elimination of safety behaviors, graded by a fear hierarchy and tracked with a SUDS rating.