Cognitive Behavioral Therapy Program

The Cognitive Behavioral Therapy (CBT) Program, directed by Susan Sprich, PhD, brings together highly experienced psychologists and interns from throughout the Department of Psychiatry at Massachusetts General Hospital who specialize in the use of CBT for the treatment of psychiatric disorders and medical issues. Cognitive behavioral therapy (CBT) has been shown to be a highly effective form of treatment for a broad range of psychiatric disorders and health concerns. Mass General prides itself on its dedication to providing state-of-the-art treatment to patients in the CBT Program.

Conditions We Treat

The CBT Program provides clinical treatments and education for many psychiatric disorders and medical issues, including:

• ADHD
• Anxiety disorders
• Depression
• Insomnia
• Obsessive-compulsive disorder
• Pain
• Schizophrenia

Our Approach

About Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) consists of two components:

• Cognitive Strategies: The therapist and patient work together to identify how certain distorted patterns of thinking are related to the patient’s symptoms. The therapist then attempts to help the patient evaluate and modify his or her inaccurate or unhelpful thoughts and beliefs.
• Behavioral Interventions: Behavioral interventions are derived from learning theory and are used to alter a person’s maladaptive behaviors. Behavioral interventions help to lessen the associations between an individual’s concerns and his or her maladaptive responses to them.

Behavioral techniques include:

• Exposure: Patients learn to confront situations they usually avoid, such as a public bathroom for a patient who fears being contaminated or a dog for a patient who is afraid of dogs. This is generally a gradual process, moving from less anxiety-provoking situations to more challenging ones at a rate at which the patient feels comfortable. Following such exposures, a previously disturbing and unpleasant situation will likely become significantly more tolerable.
• Ritual Prevention: Patients learn to manage and decrease ritualistic behaviors, such as compulsive hand-washing or constantly comparing oneself to others. The overall goal of the ritual prevention exercise is to reduce anxiety or discomfort caused by certain scenarios or behaviors.
• Assertiveness Training: Patients learn to use various strategies for recognizing and acting upon their wants, needs and views while still being respectful and appropriate toward others. Assertiveness training typically involves role-plays in which participants practice clearer and more direct forms of communicating with others. Improving communication skills can often improve one’s relationships, career opportunities and basic interpersonal interactions.
• Activity Scheduling/Behavioral Activation: Patients learn to constructively build routines by incorporating enjoyable events and achievement-oriented activities into their weekly schedules. An increase in activity and success can have a positive impact on behavior and motivation.
• Problem-solving: Patients learn to identify, analyze and solve problems and evaluate the effectiveness of their solutions. If the results are not satisfactory, patients learn how to troubleshoot to create a better outcome.
• Motivational Strategies: Patients increase their commitment to CBT by learning strategies that can change and boost motivation.

What to Expect in CBT Treatment

CBT is very structured and goal-oriented and requires a joint effort between the therapist and patient. Development of this collaborative relationship is key. This means that both the patient and therapist must take an active role in understanding the patient’s issues, identifying the goals to be accomplished through treatment and working to reach these goals.

Your CBT therapist will begin by conducting a detailed assessment of problems and symptoms and then determine what you hope to gain in treatment. You will work together with your therapist to develop a personal, individualized treatment plan with those goals in mind. A specific agenda, with various techniques and concepts, is set for every session.

To obtain significant improvement with CBT, motivation is vital. CBT requires a great deal of commitment and effort from both parties. It is important for the patient to give feedback—both positive and negative—at each therapy session. This allows the therapist to alter the speed, style and content of future sessions to meet the specific needs of the individual patient.

Patients will also be given many “homework” assignments to complete outside of therapy sessions. These tasks are assigned to reinforce the skills learned during the sessions. While participating in CBT requires a great deal of work and energy, the outcomes can be extraordinary.

Professional Training

The CBT program also serves an educational purpose, with training provided through the Mass General/Harvard Medical School Internship in Clinical Psychology, postdoctoral training positions and post-graduate psychology training through Mass General’s Psychiatry Academy.

The Internship in Clinical Psychology is offered to matriculated doctoral students enrolled in clinical or counseling psychology programs. This program includes an elective in Cognitive Behavioral Therapy that provides interns with valuable experience in clinical settings per to the scientist-practitioner model

In this elective, interns receive intensive training designed to provide:

• The latest knowledge of clinical research methods and outcomes
• Understanding of the nature of the DSM-5 conditions and treatment interventions based on the current empirical literature
• Experience in formulating and implementing treatments based on functional analyses of maladaptive behaviors in patients with a wide range of severity, comorbidity and clinical presentations

Learn more about the CBT Elective

Learn more about the Internship