association for behavioral and ISSN 0278-8403 cognitive therapies ABCT s VOLUME 42, NO. 2 • FEBRUARY 2019 the Behavior Therapist

PRESIDENT’SMESSAGE Contents A of Purpose President’s Message and Perspective Bruce F. Chorpita A Wisdom of Purpose and Perspective • 33 Bruce F. Chorpita, UCLA

At ABCT Mary Jane Eimer NEXTMONTH is the deadline for submissions to ABCT’s From Your Executive Director • 35 2019 in Atlanta. It is a time when one might Professional Issues ask, Does it really matter if my Interviewed by David DiLillo submission fits the theme? A Primer for First-Time Book Authors: Q & A With And what even is the theme anyway? Well, this year the Dr. Keith Dobson • 36 theme is essentially “wisdom.” That may seem overly grand or perhaps too abstract, but one thing is certain: It is a contrived dilemma. Everyone preparing a submission must either Donald Robertson and R. Trent Codd, III abide by the convention theme or admit their Stoic as a Cognitive-Behavioral Therapy• 42 contribution is unwise. ABCT can’t lose! Of course, that is not the real reason for this year’s theme. It is in fact a reference to a con- Training ceptualization of wisdom common in the infor- Matthew W. Southward and Benjamin J. Pfeifer mation science literature, in which the term has Do as I Say and as I Do: Reflections on Three Methods of a specific, reserved meaning. Rowley (2007), for Evidence-Based Clinical Supervision of Graduate-Level example, summarizes in her comprehensive Trainees • 50 review the between , , and wisdom, such that information is data in an interpretable or meaningful metric; Lighter Side knowledge is generally thought of as informa- Jonathan Hoffman and Dean McKay tion embedded in the individual that is useful for decision-making or that predisposes action; From Our Mailbag: Why Do Some Clinical Programs Teach Both and finally, wisdom is the ability to prioritize, CBT and Psychodynamic Models? Schrödinger’s Rat • 54 integrate, or extrapolate among multiple sources of knowledge that sometimes do not even agree. Plus We recently gave a simple illustration of this hierarchy phases of evidence in the “wedding z Fellows at ABCT: Update • 34 problem” (Chorpita & Daleiden, in press) as z Annual Convention: Preparing to Submit an Abstract • 56 follows: Evidence that it is 85°F is information, given that we can all agree on what that means Annual Convention: Call for Papers • 57 z and imagine how it feels on a summer day. It z Call for Award Nominations • 58 z Call for Submissions: Graduate Student Research Grant • back page [continued on p. 35]

February • 2019 33 the Behavior Therapist Published by the Association for Behavioral and Cognitive Therapies Fellows at ABCT: Update 305 Seventh Avenue - 16th Floor New York, NY 10001 | www.abct.org Linda Carter Sobell, Chair, Fellows Committee (212) 647-1890 | Fax: (212) 647-1865

Most professional organizations serving and related health and Editor: Kate Wolitzky-Taylor professions have a “Fellow” membership category. In 2014 Editorial Assistant: Bita Mesri ABCT introduced its Fellow membership category. The first Fellows Committee, chaired by Dr. David DiLillio, invested considerable time develop- Associate Editors ing the criteria, application, and review process. In so doing, the committee RaeAnn Anderson looked to several other organizations (e.g., APA, APS) for guidance. Katherine Baucom Although APA was a place to start, it has 54 divisions, each with their Sarah Kate Bearman own criteria and process. In contrast, ABCT is a unified organization with a Shannon Blakey diverse membership that encompasses a wide range of professional activities, Angela Cathey engagement in the field, and commitment of time and service to the organi- Trent Codd zation. David DiLillo Lisa Elwood Because ABCT’s Fellow status is still in its infancy, we have received feedback and suggestions from some members. Based on this feedback, the Committee Clark Goldstein has decided to review the original criteria and their fit with our current and David Hansen evolving membership. Katharina Kircanski Richard LeBeau Over the coming months the Committee be having several conference Angela Moreland calls and an all-day meeting on the day before the 2019 Annual Convention. Stephanie Mullins-Sweatt Because of this review, the Committee, with the support of the Board, has decided not to accept Fellows applications in 2019. Amy Murell Alyssa Ward In the interim, if you have questions or suggestions please email them to Dr. Tony Wells Linda Sobell ([email protected]), the Committee Chair. Stephen Whiteside Monnica Williams INSTRUCTIONS Ñçê AUTHORS ABCT President: Bruce Chorpita Executive Director: Mary Jane Eimer The Association for Behavioral and Cog- Submissions must be accompanied by a Director of Communications: David Teisler nitive Therapies publishes the Behavior Copyright Transfer Form (which can be Therapist as a service to its membership. downloaded on our website: http://www. Director of Outreach & Partnerships: Eight issues are published annually. The abct.org/Journals/?m=mJournal&fa=TB Tammy Schuler purpose is to provide a vehicle for the T): submissions will not be reviewed with- Convention Manager: Stephen Crane rapid dissemination of news, recent out a copyright transfer form. Prior to Managing Editor: Stephanie Schwartz advances, and innovative applications in publication authors will be asked to behavior therapy. submit a final electronic version of their Copyright © 2019 by the Association for Behavioral and Cognitive Therapies. All rights reserved. No part of this Feature articles that are approxi- manuscript. Authors submitting materi- publication may be reproduced or transmitted in any mately 16 double-spaced manuscript als to tBT do so with the understanding form, or by any means, electronic or mechanical, includ- that the copyright of the published mate- ing photocopy, recording, or any information storage pages may be submitted. and retrieval system, without permission in writing from rials shall be assigned exclusively to Brief articles, approximately 6 to 12 the copyright owner. ABCT. Electronic submissions are pre- Subscription information: tBT is published in 8 issues double-spaced manuscript pages, are ferred and should be directed to the per year. It is provided free to ABCT members. preferred. Nonmember subscriptions are available at $40.00 per editor, Kate Wolitzky-Taylor, Ph.D., at year (+$32.00 airmail postage outside North America). Feature articles and brief articles [email protected]. Please Change of address: 6 to 8 weeks are required for address should be accompanied by a 75- to changes. Send both old and new addresses to the ABCT include the phrase tBT submission and office. 100-word abstract. the author’s last name (e.g., tBT Submis- ABCT is committed to a policy of equal opportunity Letters to the Editor may be used to sion - Smith et al.) in the subject line of in all of its activities, including employment. ABCT does not discriminate on the basis of race, color, creed, reli- respond to articles published in the your e-mail. Include the corresponding gion, national or ethnic origin, sex, sexual orientation, Behavior Therapist or to voice a profes- author’s e-mail address on the cover page gender identity or expression, age, disability, or veteran status. sional opinion. Letters should be lim- of the manuscript attachment. Please also All items published in the Behavior Therapist, includ- ited to approximately 3 double-spaced include, as an attachment, the completed ing advertisements, are for the information of our read- manuscript pages. copyright transfer document. ers, and publication does not imply endorsement by the Association.

34 from your executive director becomes knowledge if the context for that We come looking for wisdom, but we our excellent leadership team, which of information is one’s getting dressed for the might only get information or knowledge. course depends on the generosity of the day, because now one faces decisions about This year, we ask that authors consider many members who volunteer to be on the shorts versus pants or short sleeves versus including a statement of how the submis- Program Committee. Everyone is working long. One requires wisdom, however, when sion content connects to the larger purpose hard to prepare for the many submissions to there are multiple sources of knowledge to of ABCT: to help improve the health and come, and we aspire to an that is more prioritize and reconcile. For instance, if one well- of all people. Such statements than the sum of the parts and may just give is to attend a wedding that day, then per- could take many forms. How does any us a glimpse at wisdom this November. haps temperature is a less important con- single research finding fit together with sideration, whereas local traditions, terms other moving parts in an ever-growing evi- References of the invitation, or who else is on the guest dence base? How does existing knowledge Chorpita, B. F., & Daleiden, E. L. (2018). list play a more significant role. If one has apply in new contexts or with new popula- Coordinated strategic action: Aspiring to knowledge that she is the bride, perhaps the tions? How does a discovery translate wisdom in mental health service systems. priorities change even more so. Essentially, across different audiences, workforces, : Science and Practice, then, wisdom is about reconciling all the nosologies, industries, settings, or delivery 25, e12264. doi: 10.1111/cpsp.12264. things that we know and being capable of platforms? Such questions are outlined in Rowley, J. (2007). The wisdom hierarchy: an integrative judgment for a given pur- more detail in the 2019 Call for Papers Representations of the DIKW hierarchy. Journal of Information Science, 33, 163– pose and context. (http://www.abct.org/Conventions/?fa=Ca 180. doi: 10.1177/0165551506070706 And that brings us back to the conven- ll_For_Papers). tion theme. What is a convention but a The program this year is led by Program ... pageant of knowledge (or in some cases, Chair Alyssa Ward, Associate Program merely information)? We can encounter Chair Shannon-Wiltsey-Stirman, and Assis- The author has no conflicts of interest or groundbreaking or fascinating discoveries, tant Program Chair Cameo Stanick, under funding to disclose pertaining to this article. some that even predispose immediate the experienced guidance of Coordinator of Correspondence to Bruce F. Chorpita, action or decisions, but we do not always Convention and Education Issues Katharina Ph.D., Franz Hall 3227, Department of Psy- come away with the perspective of how it Kircanski. Convention Manager Stephen chology, University of California, Los Ange- all fits together to serve a larger purpose. Crane in ABCT’s Central Office rounds out les, CA 90095; [email protected]

ATABCT of the year. Coordinators, committee chairs, and editors are asked to address the strategic plan in their updates to the Board. From Your Executive Director To see the current strategic plan, visit: http://www.abct.org/docs/About/ Mary Jane Eimer, Executive Director Strategic_Planning_Dashboard.pdf 3. Back to the November meeting: During that meeting, we capture priorities that THEABCTBOARD of bers of leadership and all 9 staff members. need to be addressed and mapped onto the Directors meets once a He also conducted a survey of the entire strategic plan and we also maintain a list- month 11 months of the membership. The focus has been holistic: ing of Action Items (think Nike’s slogan, year and November is how our database system, web, list serv, "Just Do It!”). The Board reviews and votes our only face-to-face and directories serve our needs now and on priorities and action items at their meeting. Coordinators what is needed in the future. How do our December teleconference. and new officers partici- systems interact with our vendors and their Here are a few examples of priorities pate in the meeting. I software, such as the convention abstract regarding the 8 strategic initiatives: usually have an “ah ha” moment. This submission and management process, con- year’s is that we do a good job letting the vention registration, voting software for • Dissemination and Implementation: leadership know what is going on, but not our annual election, etc. Expect to hear Develop a consensus statement that is necessarily the membership. I will attempt more about this over the coming year. approved by the Board and made public on to change that over the coming year by our website. writing a column each issue. Here are a few 2. Once every 3 years, the Board of Direc- highlights that the Board has either autho- tors and coordinators meet for a 2 ½ day • Membership and Community Value: rized or consented: strategic planning retreat. We conduct an Address understanding and acceptance of environmental scan, review our current other career paths and/or disciplines with 1. ABCT has engaged the services of an IT plan, map out our SWOT, refine the plan our current leadership and membership. consultant to help us address current needs to match current needs. We currently have • Innovation and Advancement of Sci- and build a road map addressing those and 8 strategic initiatives that all levels of gover- ence: Pay attention to the issues our clini- future needs. We hired Denman Wall of nance are addressing with their staff cian members deal with and ensure our Dolici Interactive. He has completed the liaisons. The Board addresses or researchers are supporting them through discovery stage, talking with various mem- edits to the strategic plan during the course training opportunities, such as webinars,

February • 2019 35 d i l i l l o workshops, and journal articles. Special • Globalization: Continue to work with planner and other web-based Cadmium attention should be focused on hot topics and support the World Confederation of resources. (i.e., transdiagnostic treatments; technol- Cognitive and Behavioral Therapies. Ü Survey convention attendees for their ogy, including apps to enhance care, etc.). • Technology: Leadership, membership, interest in child care in Atlanta. • Building the Future of ABCT Through and staff all to be involved in the Fundraising: Develop a long-term on what should be included in the develop- As you can see, ABCT is a member-driven, fundraising campaign that is in line with ment of the new website, AMS (database), strategically oriented organization. One of our mission and supported by the mem- list serve, and other technologies used by my goals in 2019 is to remind members bership. ABCT to benefit all constituents. that ABCT offers valuable benefits and ser- vices 365 days and not just the 4 days of the • Outreach: Support members to enable Annual Convention. We can always use them to reach out to and respond to their 4. Several Action Items include: your help and active involvement. If inter- clients and colleagues rather than to Staff to finalize contract for 2021 Annual ested in serving, please contact me at respond to every current event. Responses Ü Convention in New Orleans—done! [email protected] with your interests or must reflect the scientific, educational, and where you think you would like to serve. training aspects of CBT. Ü Staff to research location options for the 2025 July World Congress by the April • Partnerships and Coalitions: Our ... involvement with current partnerships and 2019 deadline by the World Confedera- coalitions is in line with the ABCT mission tion of Cognitive and Behavioral Thera- Address correspondence to Mary Jane and will be reviewed for additional oppor- pies, taking into consideration the location Eimer, CAE, Executive Director, Association tunities when appropriate but at least for that year's November Annual Conven- for Behavioral and Cognitive Therapies, 305 Seventh Ave., 16th floor, New York, NY annually at a minimum. Current partner- tion. 10001; [email protected] ships and coalitions include Consortium of Ü Transition to new of no program Social Science Associations; Mental Health book: Continue to post PDF online, Liaison; and Coalition for Advancement develop a more interactive and robust app, and Application of Psychological Science. and improve functionality of the itinerary

PROFESSIONALISSUES fectly fine to approach multiple competi- tors at a time. Book publishers, and espe- cially the larger companies, have acquisi- A Primer for First-Time Book Authors: tion editors whose job it is to solicit book proposals, and to bring the better proposals Q & A With Dr. Keith Dobson for their company to the contract stage. Bear in mind that even if one publisher is Interviewed by David DiLillo, University of Nebraska not interested, another may be, so don’t give up too quickly if you get some negative responses. If you do approach multiple MANYPSYCHOLOGISTSANDOTHER CBT Cognitive-Behavioral Therapy, and The potential publishers, I suggest you be professionals consider authoring or editing Therapeutic Relationship in Cognitive- candid with them, and let them know that a book at some point in their career. The Behavioral Therapy. Below are his you are in discussions with different pub- appeal of doing so is obvious; we all responses to common questions asked by lishers. Some publishers will object, and I remember seminal books that shaped our potential first-time authors. personally think it is objectionable to try to research and practice as purveyors of cog- pit publishers against each other, but they nitive and behavioral therapies. However, I have a possible book idea. What it is important to think carefully before also recognize that you want the best out- should I look for in a publisher? How come for your book, its place in the market, deciding to contribute to this pantheon of should I approach potential publishers? great publications. No matter the rewards, and its sales. writing a book is a mammoth undertaking My best advice is this: When your first Once you know which publisher you that requires commitment and sacrifice. In get a book idea, imagine that it already want to approach, prepare a book proposal, this article, Dr. Keith Dobson shares his exists in the marketplace. Where would and get it to the acquisitions editor. A great wisdom on the topic. Dr. Dobson is a Pro- you go to find such a book? Would it be an way to do this is at a conference. Major fessor of Clinical Psychology in the Depart- academic or university press? A commer- publishers send these editors, and they fill ment of Psychology at the University of cial press? Would it be hard- or softcover? their conference schedules meeting Calgary. He published his first book in Once you can imagine where the book is authors and hearing book ideas. If you 1988 and has since co-authored or co- “best located” and where you would look cannot get to a conference, identify the edited 15 books, including Risk Factors for for it, then approach that (or those) pub- acquisitions person and email them. If you , The Prevention of and lisher(s) with the book proposal. If there is can, arrange a phone call to discuss your Depression, The Evidence-Based Practice of more than one potential publisher, it is per- idea and gauge their interest. If it seems like

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February • 2019 37 d i l i l l o a possible match then send them the formal better than others? Conversely, if there is Also, bear in mind that a commercial pub- proposal described below. no real competition, why not? Is your idea lisher is motivated to sell your book, and so ahead of its time? Provocative? Unusual? they will bring their marketing and sales What is typically required The publisher will want to know that they force to work on the book’s behalf. There in a book proposal? can make a profit on your idea, so if the are real time and work considerations in book is too esoteric they will likely be less marketing and sales, so think carefully if A book proposal or prospectus typically interested. this is work you want to do. has several sections, including a brief (one The other major consideration about page maximum) description of the book self-publishing is financial. If you self-pub- idea and the need for this book. If you What makes a strong book proposal? lish then you have to pay the production cannot “sell the idea” in a single page you All of the above points help to make a costs before any books are sold, as well as have likely not got a winning proposal. strong and compelling proposal or prospectus. You will need to write a per- all of the indirect costs associated with After the rationale for the book, the poten- obtaining an International Standard Book tial publisher will want to see the draft book suasive case for the book, and you should try to be as succinct as you can. In my opin- Number (ISBN), a unique code assigned to outline, and the approximate length of the each registered book. You also have to book. Bear in mind that every published , a proposal of about 8 to 10 pages should suffice to cover all of the above undertake all of the work associated with page is a “cost” to the publisher and will book distribution, such as managing increase the price to a purchaser, so pub- topics, and if you cannot frame your idea in a short space, the publisher may become inventory, marketing, labeling, mailing, lishers want books to be as efficient as pos- bad checks or credit cards, and managing sible, while covering the topic. This said, less convinced of the project. Ultimately, this is a “mating ritual”—you are trying to returns. You need to know how many some books (e.g., The Complete and Com- books you must sell before you make any prehensive Handbook of ***) need to be find a publisher who is interested in you and your work, and you are trying to find a profit, and be honest with yourself about longer to cover their content areas, so the the market potential. book proposal should be as long as you publisher who will honor and promote your efforts. Bear in mind that a given pub- think is warranted. My proposal was rejected. What next? In addition to the above materials, the lishing house will likely have several books publisher will want to know why this book in negotiation or production at a given Usually, if you have an initial expression is needed now. Has there been a recent time. Sometimes a publisher may be look- of interest and the publisher has accepted a development in the field? Are you the par- ing for new ideas and books, whereas other formal prospectus, they will send this ticular author who has something to say times they may already have quite a few prospectus to other authors who can advise about the area, and have not published this works in their cycle and be less interested them about the need for the book, the pro- idea before? Has it been a few years since a in new acquisitions. posed content, and you as an author. These similar book was published and it is timely may well be your colleagues, so make sure for a new edition or version of the book? Do I need an agent? the proposal is well done. They will take this information and put it in the context of The publisher will also have an eye I do not believe an agent is often the marketplace and their ability to sell the towards sales. They will want to know needed, unless you are proposing what book. A good book idea may not be right about you as the author(s). Why should might be a very large volume trade book, for a specific publisher. A good publisher they publish your work? If you are an where there may even be video or sub- will be honest with you about the feedback established author they may know you and sidiary rights to consider. My own thought they received about your proposal and believe you have a market appeal, but espe- is that first-time authors should talk to their level of interest. Take the feedback to cially as a newer author, you may need to trusted and more senior colleagues, ideally heart and consider if the idea needs to be convince the publisher that you can do this ones who have published books them- adjusted. The publisher may request or work, and that the result will be mar- selves, to get their opinion about their demand changes to the idea before they ketable. Indeed, if you are quite junior it intended book. Is it a book idea that has a will accept it, so consider your options. Do may not be the best idea to try to publish a lot of market potential? If so, consider an you negotiate, or take it to another pub- book. Instead, your time might be better agent, but if not, then you can approach a lisher? If this is your first rejection, you may spent writing shorter articles or pieces, to book publisher directly and begin the wish to take it elsewhere, but if this is your establish your credentials and become process of discussion. If it evolves into a project that becomes larger than you had third or fourth rejection, you may wish to better known. Publishers are often pretty negotiate. honest about this type of assessment, so be first envisioned, you can always approach open to their opinions. They may ask to see an agent later, and before you have signed a Once my proposal is accepted, how do I some of your work, or to see your CV. In contract. Once you sign a contract, of stay on track to complete the project by some cases, they may even want to see a course, it is very difficult to later add an draft chapter so that they can see a sample agent. I have never used an agent. the deadline? How much daily/weekly of your writing. writing time should I allot for timely The publisher will want to understand Should I consider self-publishing? completion? the competition. If there are other similar Self-publishing makes sense to me only If your proposal is accepted, the pub- books in the field, you will need to explain if you have a very niche market to sell to, lisher will insist on a production schedule. why there is a need for your specific and if you have some way to access this This agreement will include the date by volume. Do you bring a new angle to the market (e.g., a website or listserv on which which you will supply the first draft of the field? Is yours more practical and useful your target audience will find your book). book to the publisher. Once you have this than others? Does yours cover the research Most authors do not have these advantages. agreement, you need to put the time

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February • 2019 39 d i l i l l o needed to do the writing into your sched- copy editor reads the entire book line by copies of the final work to the authors (usu- ule. Will you try to complete the book part- line, and just as happens with a journal arti- ally about 5 copies), and to contributors to time over the longer term, or will you try to cle, they will catch typos, grammatical edited books (usually one copy per contrib- dedicate a focused time period to get it errors, confusing wording, reference omis- utor). You should ensure that these copies done more quickly? Will your book require sions or errors, any other issues that will are part of the contract, and you can ask for a fair bit of library work to get references affect the quality of the book. After the these numbers to be adjusted. organized, or is it more of a straightforward copy editor sends their edits to you, there is It is very uncommon that academic writing project? Are you using a lot of other usually a very short time line in which to books make much money, so don’t plan people’s work (e.g., figures; tables; quotes) respond, as the publisher will by now have your retirement based on a book you have so that you need to plan to get copyright put the book into a production and mar- in mind! Trade books (e.g., those intended permission to use their material? Are you keting schedule. for the public at large) can be profitable, writing the book, or is it edited (paradoxi- Another important part of the produc- but even in this market there are few real cally, the production of edited books, in tion cycle, especially for more academic “winners.” To my mind, the best incentives good measure, is out of the editor’s control, works, is indexing. Some books will pro- to write or edit a given book is that you see and can only be as fast as the slowest con- vide an index of keywords and concepts, it as a contribution to the field, that you tributor)? Is it a sole author work, or do you some will index authors and some will have made a real effort to produce the book have collaborators? Again, a co-authored index both. Publishers may invite you to do (i.e., you have “left something of yourself” book can only be completed as fast as the the indices, or they will offer to do the work in the book), and that you are proud of the slowest contributor. and subtract the cost against your royalties. effort and result. If you can write a book Whatever the plan for the book, the best My suggestion is that unless you have with these ideals in mind, then any finan- idea is to be extremely honest with yourself “extra” time, let them do it. They have the cial emolument is a true bonus. about your life, your existing time commit- , and your time would likely be ments, and your ability to carve out the better spent writing the next book prospec- How much marketing of my book large amount of time needed to complete a tus, since by then you will be an almost should my publisher be doing? book. I suggest making both a best-case published author. Anything I can do to help market? and a worst-case estimate of the time the Every publisher has certain scripted book might take and then settle somewhere How do royalties work and can they be marketing that they will undertake. This between on a realistic estimate. Then, add negotiated with the publisher? Will I work will likely involve some combination 50% to that estimate (seriously). Whether make much money? of electronic marketing (e.g., listservs that it comes in the form of smaller time blocks Royalties are usually computed as a per- they pay to send notices to; association or a few larger writing periods, put that centage of net profits. Net profits are the newsletters), paper marketing (e.g., time on your calendar. Then, protect that money that the book makes after all brochures, flyers), and conference market- time—you will need it! expenses are accounted for. The publisher ing. Paper marketing is less will compute all of the editing time the common as it is relatively expensive, and e- What kind of assistance can I expect book has required, the indexing costs, the marketing is becoming commensurately from my publisher (and editor) at marketing costs, the production costs, the more common. Marketing tends to follow different stages of the process? distribution costs, the storage costs, and certain cycles. For example, more academic Once a book contract is signed, the other costs, and then estimate the potential works or books that can be potentially sold book is passed from the acquisitions editor sales to generate a per-book cost that will to universities and colleges tend to be mar- to the production editor (in smaller com- hopefully generate a profit. That profit is keted in time for the academic year. Trade panies this may be the same person). This returned in part to the publishing company books can be marketed anytime, but late person will want to hear from you regularly and in part to the author. Typical royalties summer to early fall is a common time to and may contact you when you are nearing are in the range of 13% to 15% of net prof- release new books, as summer "fun" read- a production deadline, or if you are late. its, but you can negotiate these rates if the ing makes way for more serious works. They cannot help you to write the book, publisher thinks the book is especially mar- Sometimes books that are released late in a but they can provide the “encouragement” ketable, if you are a “hot author” or if the calendar year will be dated to the next, to to move along more quickly, which you can book goes into extra printing (e.g., you increase their marketability. share with co-authors or contributors to an might accept a royalty of 13% for sales of up There is not too much you can do to edited book. to 2,000 copies, and request 15% after- help market your book. If you happen to be Once you have a complete draft and you wards). someone who provides workshops or send it to the publisher, the production It is sometimes possible to request training, you can contact the publisher and team gets active. They will likely send the advances against sales. This circumstance ask that they sell your book at the venue book out to review again and get the opin- is more possible if you are a known author, where you are doing training. Even if they ion of some experts in the field. They may or if the publisher is confident about strong will not do so directly (it is often expensive come back and ask you to clarify, adjust, or sales numbers. In some cases, and espe- for them to try to do sales for a single move some unclear sections, or even cially for edited books, you might negotiate event), they might send you some copies rewrite parts of the book if they are truly a flat fee with each contributor to the based on an agreement that you will do the problematic. They will usually expect a volume, which the publisher will pay as an sales and return the funds and unsold fairly quick turnaround on such requests. advance to the authors and then charge books. Bigger publishers that attend con- Once they are happy with the content, they back to you against the royalties. It is typi- ferences such as ABCT will often look at will assign a copy editor to the book. The cal that publishers will provide some free the program and bring some of the books

40 the Behavior Therapist f i r s t time book authors q & a from their presenting authors. If you know - ... , you are going to be at a specific conference, you can let the publisher know (give them Drs. DiLillo and Dobson do not have any fair lead time), and they may be able to conflicts of interest or funding to disclose make books available for sales there, either pertaining to this article. Apps directly or through a third-party book sales Correspondence to Keith Dobson, Ph.D., company. If you belong to an association The University of Calgary, 2500 University or a listserv that permits marketing (many Dr. N.W., Calgary, AB, T2N 1N4, ; do not!), you can take advantage of that [email protected] ABCT is delighted to announce a new part- fact. nership with PsyberGuide, a nonprofit website reviewing smartphone applica- Any final advice? tions and other digital mental health tools. This partnership was established with the The last advice I would offer is to make aim of disseminating reviews of digital efforts to establish a long-term relationship mental health tools to a broad audience of with your publisher. If your book has met researchers, psychologists, psychiatrists expectations, and you have fulfilled your and other mental-health practitioners. contract well, you will have more latitude App reviews from both PsyberGuide and to propose the next book idea. Stay in Cognitive and Behavioral Practice will be touch with your acquisitions editor. Meet integrated on both sites to expand the them at the next conference. They are often reach of information on available apps. quite sociable people, they often develop a ABCT will be developing a dedicated app genuine interest in the field, and if they review page which will host a sample of rel- work in the field for a while they often have evant PsyberGuide reviews. PsyberGuide very good ideas that you can solicit. There will also link to C&BP reviews on their site, is almost always a good idea for the next where relevant. For full listings, visit: book in a conversation with an acquisitions editor! http://www.abct.org/Resources/ ?m=mResources&fa=ABCT_APPS

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February • 2019 41 SCIENCE their writings. However, as far back as his youth, before training as a psychotherapist, Ellis had “read the later Stoics, , Stoic Philosophy as a Cognitive-Behavioral Seneca, and ” (Still & Dryden, 2012, pp. xii–xiii). Indeed, Ellis Therapy refers to the Stoics, particularly Epictetus, throughout his writings. Even when he Donald Robertson, Donald Robertson Training, doesn’t mention the Stoics by name, though, Ellis often describes concepts and learn.donaldrobertson.name techniques that seem to demonstrate their influence. R. Trent Codd, III, Cognitive-Behavioral Therapy Center of Western In Ellis’ first major publication on North Carolina, P.A. REBT, he explained the central premise of this emerging cognitive approach to psy- chotherapy: Emotional disturbances, and SOCRATESCONSIDEREDPHILOSOPHY to chotherapy,” although written in the first associated symptoms, are not due to exter- be, among other things, a form of talking century A.D. nal events, as people tend to assume, but therapy, a sort of medicine for the mind. Dubois placed more emphasis than sub- mainly to our irrational beliefs about such Within a few generations of his death, this sequent psychotherapists on the funda- events. However, he also admitted that it idea of philosophy as psychotherapy had mental distinction Stoics make between was far from being a new idea: become commonplace among the various what is up to us and what is not. We schools of . How- should, the Stoics believed, learn to assume This principle, which I have inducted from ever, it was the Stoics who placed most more responsibility for our own voluntary many psychotherapeutic sessions with emphasis on this therapeutic dimension of actions while also becoming more tolerant scores of patients during the last several philosophy. For example, the Roman Stoic and accepting of things that merely happen years, was originally discovered and stated teacher Epictetus wrote, “It is more neces- to us. Or as Epictetus put it: by the ancient Stoic philosophers, espe- sary for the soul to be cured than the body, cially (the founder of the for it is better to die than to live badly” What, then, is to be done? To make the school), , of Rhodes (Fragments, 32), and he stated bluntly, “the best of what is in our power, and take the (who introduced into Rome), philosopher’s school is a doctor’s clinic” rest as it naturally happens. (Discourses, [sic.], Seneca, Epictetus, and (Discourses, 3.23.30). Today, though, most 1.1.17) Marcus Aurelius. The of Stoicism people are unaware of the extent to which were perhaps best set forth by Epictetus, ancient Greeks and Romans conceived of This central teaching of Stoicism found who in the first century A.D. wrote in the philosophy as a type of psychological ther- perhaps its best-known expression in the Enchiridion: “Men are disturbed not by apy. Serenity Prayer, written by Reinhold things, but by the views which they take of Stoicism survived for 500 years but its Niebuhr in the 1930s, but made popular by them.” (Ellis, 1962, p. 54)1 therapeutic concepts and practices were Alcoholics Anonymous: “, give me the largely neglected until the start of the 20th serenity to accept the things I cannot Indeed, Ellis taught this famous quote century when a rational approach to psy- change; the to change the things I from Epictetus to many of his clients chotherapy began emerging, which held can; and the wisdom to know the differ- during the initial socialization phase of that many emotional and psychosomatic ence.” However, by the middle of the 20th treatment. Following Ellis, this saying problems were caused by negative self-talk century Stoicism and rational psychother- became extremely well known to subse- or autosuggestions, which could be apy, based on relatively down-to-earth quent generations of cognitive-behavioral amenable to rational disputation. Its lead- philosophical principles, were temporarily therapists. Although, for some reason, sur- ing proponent, the Swiss psychiatrist Paul eclipsed in popularity by a more idiosyn- prisingly few of them chose to explore the Dubois, employed cratic theory that was to be very short-lived writings of Epictetus or other Stoics any with his patients and taught them the basic by comparison: Freudian . further. principles of a Stoic . Indeed, psychotherapists began to Mainly through Ellis’ writings, Stoicism Indeed, he declared: rediscover Stoicism from the 1950s onward continued to influence Aaron T. Beck, the through the writings of and founder of , and his col- If we eliminate from ancient writings a few what would become known as Rational leagues. Beck opened his first book on cog- allusions that gave them local colour, we Emotive Behavior Therapy (REBT). nitive therapy by describing how his new shall find the ideas of , Epictetus, Despite the similarity of his approach to style of therapy was founded upon the Seneca, and Marcus Aurelius absolutely that of early rational psychotherapists such emerging consensus among researchers modern and applicable to our times. as Dubois, Ellis was initially unaware of that cognitions play a central role in deter- (Dubois, 1909, pp. 108–109)

Dubois also noticed that, paradoxically, 1Cicero was an Academic philosopher, not a Stoic, although he was sympathetic to Stoicism the Stoic words of advice he read in the let- and wrote extensively about it, making him one of our main sources for information on the ters of the philosopher Seneca “seem to be philosophy. Beck et al., under the influence of Ellis, reproduce this error in their own drawn from a modern treatise on psy- account.

42 the Behavior Therapist stoic philosophy mining our . Then, like Ellis, he nitive theory of . Moreover, if the Roman emperor Marcus Aurelius. Since added: causes of emotional disturbance are mainly then, an increasing number of self-help cognitive, this implies the possibility of a books influenced by Stoicism have Nevertheless, the philosophical underpin- cognitive cure. They realized, therefore, appeared, such as Robertson’s CBT-influ- nings go back thousands of years, certainly that this shared premise had led Stoics and enced Stoicism and the Art of to the time of the Stoics, who considered cognitive therapists to the same conclu- (2013) and Ryan Holiday’s The Obstacle is man’s conceptions (or misconceptions) of sion: “Control of most intense feelings may the Way (2014). Likewise, a growing events rather than the events themselves as be achieved by changing one’s ideas.” number of blog articles and podcasts on the the key to his emotional upsets. (Beck, Ellis was only exaggerating slightly Internet testify to public interest in Sto- 1976, p. 3) when he later claimed: “I am happy to say icism as an approach to self-help and self- that in the 1950’s I managed to bring improvement. However, Stoic ideas were Nearly two decades after Ellis had first Epictetus out of near-obscurity and make ridiculed by Freud’s followers and they brought it up, Beck et al. (1979) restated him famous all over again” (Ellis & would never have resurfaced to this extent this claim that the doctrines of Stoicism MacLaren, 2005, p. 10). Indeed, in recent if CBT had not effectively replaced the psy- constitute the “philosophical origins” of decades, partly as a consequence of CBT’s chodynamic tradition, paving the way for cognitive therapy in their groundbreaking growing popularity, Stoicism has contin- Stoic philosophy to be taken seriously once treatment manual for clinical depression: ued to undergo a wider resurgence in pop- again. ularity. In the 1980s, Vice Admiral James Ironically, though, just as Stoicism was The philosophical origins of cognitive Stockdale helped popularize Stoic philoso- reaching a wider audience, through self- therapy can be traced back to the Stoic phy in the U.S. military. Stockdale docu- help literature and the Internet, the field of philosophers, particularly Zeno of Citium mented his reliance on the Stoicism of CBT was changing once again with the (fourth century B.C.), Chrysippus, Cicero Epictetus as a means of coping with torture emergence of the third wave. Third-wave [sic.], Seneca, Epictetus, and Marcus Aure- and incarceration during the Vietnam War therapy introduced greater emphasis on lius. (Beck, Rush, Shaw, & Emery, 1979, p. in Thoughts of a Philosophical Fighter Pilot themes like mindfulness, acceptance, and 8). (1995). The Tom Wolfe novel about the valued living, often turning to Buddhist lit- Stoicism of Epictetus, A Man in Full (1998) erature and practices for inspiration. Inter- Like Ellis, they quote the famous pas- reignited popular interest in Stoicism as estingly, these themes were already empha- from Epictetus above, which they did director Ridley Scott’s movie Gladiator sized in the Stoic “philosophical origins” of hailed as a forerunner of the modern cog- (2000), which featured Richard Harris as cognitive therapy. Ellis, and subsequently

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February • 2019 43 r o b e r t s o n c o d d Beck, had largely overlooked those aspects of Citium, who had been& shipwrecked near to its direct influence on Ellis and others, of Stoicism. So the next generation of ther- . Inspired by the example of Stoicism also indirectly influenced modern apists remained largely unaware of the Socrates, Zeno became a philosopher. He CBT through the writings of these and extent to which mindfulness and accep- trained for 10 years in the Cynic tradition other important Western thinkers. For tance were already practices native to and studied at the and instance, as well as citing the Stoics directly, ancient Stoicism. Practitioners and the , started by another of Beck illustrated the cognitive theory of researchers began to lose interest in West- Socrates’ followers, before founding his emotion by quoting Spinoza: “I saw that all ern philosophy as they turned to Buddhism own school of philosophy combining these the things I feared, and which feared me and Eastern thought instead. and other influences. He was succeeded as had nothing good or bad in them save inso- Many Western clients, and therapists, head (scholarch) of the school by far as the mind was affected by them” find Stoicism more congruent with their of Assos, and then by Chrysippus of Soli, (quoted in Beck, 1976, p. 156). Through the existing cultural concepts and values. one of the most highly regarded intellectu- writings of these early modern authors, When they learn about the Stoics, they als of the ancient world. Between them, Stoic ideas had spread throughout Western often report a sense of déjà vu as they “join these three men formulated the original culture and literature once again, although the dots” and realize how it connects doctrines of Stoicism. often not recognized as such. countless philosophical themes already Moreover, the Athenian school had an familiar to them. From Aesop’s Fables to unbroken succession of teachers lasting What Did the Stoics Believe? Hamlet’s “There’s nothing good or bad but over 200 years, until Panaetius of Rhodes, Ancient schools of philosophy were thinking makes it so” (also quoted by Ellis), who died at the end of the second century typically distinguished from one another in to the Roman poet Horace’s carpe diem B.C. By that time the philosophy had terms of their definition of the goal of life. (made famous by Robin Williams in Dead already gained popularity among the The Stoics rejected the popular notion that Poets’ Society), or the memento mori tradi- Romans, whose traditional values it com- the goal of life was (hedone, hence tion in the arts (e.g., Damien Hirst’s shark plemented, and it continued as an impor- “”), and the more philosophical in formaldehyde), Stoic concepts permeate tant, albeit more fragmented, tradition Epicurean version that equated pleasure Western culture and literature to this day. right down to the time of the last famous with freedom from and other unpleas- It’s as though we’re living among the Stoic, the Roman emperor Marcus Aure- ant feelings (). The Stoics also rubble of a once magnificent temple, with- lius, who died in 180 A.D. In other words, rejected the Platonic and Aristotelian view out realizing. Then someone shows us a Stoicism survived as a living tradition, in that the goal was comprised of a combina- sketch of what it used to look like and sud- ancient and Rome, for over 5 cen- tion of and external that lie denly the landscape is transformed before turies. partially outside of our control, such as our eyes as we begin to understand how all However, at a rough estimate, less than health, wealth, and reputation. Instead, the the pieces were long ago organized into a one percent of the ancient Stoic writings Stoics insisted on the hard line that the whole system of and survive today. We have about a book’s supreme goal of life is synonymous with psychotherapy. worth of fragments from early Greek Stoics arete, which is conventionally translated Unfortunately, the popularity of Sto- but no complete texts of theirs. Most of our “virtue,” although most scholars feel that icism, the Greek philosophy, among thera- knowledge comes from commentators and “excellence” (of character) is a better trans- pists has also been hampered because of the from three famous Roman Stoics of the lation. Put crudely, the Stoics believed that tendency to confuse it with (lower-case) Imperial period: , the most important thing in life is to culti- stoicism, the “stiff upper-lip” personality Epictetus, and Marcus Aurelius. vate the sort of character traits we would trait or coping style. The word “stoicism” is Stoicism was eventually assimilated into justifiably admire others for possessing. To often taken to mean crudely suppressing but it also left an impression those who objected that it’s not within feelings of distress—something potentially on early . The Stoics are even everyone’s power to be as wise as Socrates, quite unhealthy. However, Stoic philoso- featured in the New Testament, where St. Epictetus responded that it is nevertheless phy teaches a far more nuanced approach Paul addresses an audience of Stoic and within our power to desire to be wise. to emotional self-regulation, which is more Epicurean philosophers at the Areopagus The Stoics popularized the fourfold consistent with the aims of modern psy- in Athens, quoting a line from the Stoic model of virtue first mentioned by Socrates chotherapy. This article addresses this and poet to them. Stoicism and Chris- in the of : Wisdom, , other misconceptions about Stoicism and tianity shared similar ethical values in , and Fortitude. This Stoic makes the case that it can contribute in many respects, so modern followers of Sto- classification of virtue is still very popular important ways to the contemporary field icism often describe Stoicism as providing today and, for example, was incorporated of cognitive-behavioral therapy. We begin them with a secular alternative to Chris- into Peterson and Seligman’s (2004) classi- by introducing readers to the Stoics, tianity, based upon philosophical reason- fication of character strengths, employed in describing their beliefs and interventions, ing rather than religious faith. the field of Positive Psychology. The Stoics and elucidating parallels between Stoicism Following the Renaissance there was a intended these to be broad conventional and contemporary cognitive-behavioral revival of interest in the Stoics, known as headings, which include dozens of other therapy. Finally, resources for further study . The influence of ancient Sto- positive character traits. Following are offered. icism can particularly be seen therefore in the writings of early modern philosophers Socrates, they claimed that all of these other consist in forms of moral wisdom Who Were the Stoics? such as and Anthony Ashley-Cooper (Earl of Shaftesbury), and applied to different areas of life. Justice can The Stoic school was founded in 301 to some extent also in those of Descartes, be thought of as social virtue in general or B.C. by a Phoenician merchant called Zeno Spinoza, Kant, and Montaigne. In addition what it means to deal wisely with others,

44 the Behavior Therapist stoic philosophy both individually and collectively. Temper- living in accord with his philosophical to the body—the body itself is an indiffer- ance and courage are the virtues of self- principles and core values (the virtues). ent—but external to our volition or sphere control: wisdom applied to our desires and The Stoic Handbook of Epictetus pro- of control. A common misconception is respectively. So the goal of Stoicism vides a concise summary of practical guid- that Stoics place no value whatsoever on can also be understood as a form of moral ance about achieving this goal, based on the “external” or “indifferent” things. How- or practical wisdom, which is synonymous Stoic moral and psychological doctrines. It ever, one of the central doctrines of Sto- with living wisely and rationally. They also opens with the famous sentence: “Some icism holds that wisdom consists precisely equate this with sanity or mental health. things are up to us and other things are in our ability to distinguish between indif- The central doctrine of Stoicism was not.” Epictetus meant that the foundation ferent things rationally according to their therefore sometimes expressed as “virtue is of Stoic practice was the effort to maintain relative value. Nevertheless, this inferior the only true good,” by which they mean a clear distinction between what is volun- sort of “value” (axia), used in practical that wisdom and excellence of character tary and what is not, i.e., between our own decision-making, is completely incom- actions and what merely happens to us. mensurate with the value of arete, as the are to be valued for their own sake rather Modern Stoics call this the “dichotomy of supreme goal of life. The wise man prefers than as a means to some other end. Virtue control.” As we’ve seen, this Stoic doctrine health to sickness, wealth to poverty, is its own reward, in other words. For was stressed by Dubois and other early having friends to having enemies, within modern therapists, an important implica- rational psychotherapists but not by Ellis or certain limits set by reason. However, he is tion of Stoic psychology is their insistence subsequent cognitive-behavioral thera- not overly attached to anything outside his on a in which doing what is pists, although it is still well-known, having direct control because he always remem- under our direct control to the best of our found popular expression in the Serenity bers that his fortunes may shift and that ability, or living wisely, is valued more Prayer. such things are changeable and transient. highly than pleasure or the avoidance of Stoics class everything else as “indiffer- Put crudely, for Stoics externals are not unpleasant feelings, things not entirely ent” (), meaning neutral or worth getting highly upset about, although, under our control. Even the hypothetical unimportant with regard to the supreme as we’ll see, it’s nevertheless still considered ideal of the perfect Stoic wise man (the goal of life—Epictetus tends to sum this up natural to experience some emotions “Sage”) feels pain and the first flush of emo- by speaking of things such as “health, toward them. tions such as anxiety. However, he views wealth, and reputation” as indifferent. There’s much confusion about Sto- these involuntary experiences as ultimately These things are also called “externals,” by icism’s view of emotion due partly to prob- “indifferent” with regard to the goal of which Stoics mean not that they’re external lems of translation and also to the tendency

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February • 2019 20 East 49th St., Second Floor, New York, NY 10017 45 r o b e r t s o n c o d d to conflate Stoicism, the ancient philoso- sions such as and & anger in general. Method typically entailed strategies such as phy, with stoicism, the modern concept of Seneca highlights their involuntary nature verbalizing assumptions, identifying an unemotional or tough-minded coping by comparing these emotional reactions to exceptions to general definitions, distin- style. The ancient Stoics repeatedly insisted the eye-blink reflex. The Stoics emphasized guishing between appearances and reality, that their ideal was not to be emotionless, that even a perfectly wise Stoic philosopher highlighting double standards, and, of like a man made of iron or stone. One of will experience these sorts of involuntary course, drawing attention to contradic- the easiest ways to dispel these misunder- emotional reactions in a stressful situation. tions. standings is to highlight the distinction However, because such primitive emo- 2. The Dichotomy of Control, the founda- Stoic psychology made between good, bad, tional reactions are involuntary, they’re tion of Epictetus’ Handbook, which and indifferent emotions.2 neither good nor bad according to Stoic requires maintaining a clear distinction Bad emotions are described as being but indifferent. Epictetus therefore between what is up to us and what is not, unhealthy, excessive, and irrational. Cru- said that they’re to be accepted as natural, i.e., taking more responsibility for our own cially, they’re under our direct control, at and an inevitable part of life. We’re not to actions while accepting what merely hap- least potentially. It’s perhaps easiest to be afraid of them or consider them to be pens to us. compare these to perseverative cognitive bad or harmful in themselves but rather to processes like worrying or ruminating or to accept them with indifference. They resem- 3. Separating Judgments From Events, voluntary (strategic) cognitions involving ble the emotional reactions of nonhuman which Shaftesbury called the “sovereign strong positive or negative value judg- animals, which naturally abate over time. principle” of Stoicism, and Ellis introduced ments, of an unhealthy and irrational However, we’re to be careful not to be to the CBT field through the saying “It’s nature. Chrysippus, who was a long-dis- “swept along” by them by, for example, not things that upset us but our judgements tance runner, compared the difference indulging in worry or rumination and about them”—comparable to the process between reason and the passions to the dif- thereby amplifying or perpetuating them called “cognitive distancing” in Beck’s ference between a man walking slowly, beyond their natural bounds. approach. who can easily stop, and a man running so fast that he would struggle to stop or avoid What Did the Stoics Do? 4. Stoic Mindfulness, or prosoche (atten- an obstacle, although in principle his tion), through which Stoics maintain con- movements are still under voluntary con- Ancient Stoicism had a more extensive tinual attention to their own voluntary trol. The (unhealthy) passions are irra- and sophisticated armamentarium of ther- thoughts and actions and particularly the tional and excessive and, although origi- apeutic strategies than any other school of distinction between these and external nating in voluntary judgments, they easily philosophy. Most of these are well-known events or automatic thoughts, as in the two sweep us along with them. The Stoic wise to modern students of Stoicism, thanks preceding techniques. man is compared to someone walking largely to the scholarly work of a French 5. Stoic Acceptance and Indifference, or barefoot: cautiously and slowly, with self- historian of philosophy called Pierre (not apathy but freedom from awareness. Hadot, who carefully identified a variety of irrational passions), i.e., external events are Good emotions (eupatheiai) are there- “spiritual exercises” in ancient philosophy, viewed dispassionately without attaching fore healthy, moderate, and rational, and particularly Stoicism. Robertson’s (2010) strong values or emotions to them. also under our voluntary control. They The Philosophy of Cognitive-Behavioural supervene upon a rational worldview. Therapy provides a detailed overview of 6. Contrasting Consequences, through Stoics classify all healthy emotions under these techniques, which draws extensive which Stoics imagine beforehand steps three headings: rational joy, a healthy aver- parallels between them and psychological required in and likely consequences of dif- sion to doing wrong, and goodwill toward strategies employed in modern cognitive- ferent courses of action, typically the con- oneself and others.3 The goal of ancient behavioral therapy. The following list is not trast between actions guided by unhealthy Stoic therapy wasn’t the suppression of exhaustive but includes some of the and those in accord with wisdom unhealthy emotions but their transforma- techniques of most interest to cognitive- and virtue—comparable to functional tion into healthy emotions by modification behavioral therapists: assessment or cost-benefit analysis in CBT. of the underlying beliefs from irrational to rational ones. 1. Socratic Questioning, which was used 7. Postponement of Responses, through “Indifferent” emotion is how we might by Socrates to undermine irrational which Stoics would wait until strong emo- describe what the Stoics call the “proto- assumptions about virtue by exposing con- tions such as anger or unhealthy desires passions” (propatheiai), or initial involun- tradictions in the other person’s thinking, had naturally abated before deciding what tary stirrings of full-blown passions. The a process compared to the cross-examina- action to take in response to them—com- Stoics give examples such as being startled, tion (elenchus) of a witness in a trial, parable to time-out in anger management. blushing, turning pale, sweating, stammer- although we’re told it was done tactfully 8. Contemplation of the Sage, considering ing, and the initial reactions preceding pas- and with compassion. The Socratic the virtues of real or imaginary role models or how they would behave in specific situa- tions—comparable to modelling tech- niques in CBT. 2 The Stoics used the term “” to refer to what we would call emotions but also to desires. 9. Contemplation of Death, which takes a 3 The English word “compassion” sits awkwardly with Stoics because it implies “sharing a variety of forms but was considered to be of passion,” an unhealthy emotion, but Stoics refer to something similar as the virtue of kind- fundamental importance to the Stoics, who ness. sought to adopt a more philosophical atti-

46 the Behavior Therapist stoic philosophy tude toward the existential problem of their 16. Empathic Understanding, trying to tions and employing Socratic question- own mortality. understand the perspective, values, and ing, in a way that could be compared to assumptions of others in a rational and bal- group therapy or a self-help workshop. 10. The View From Above, which also anced manner rather than jumping to As we’ve seen, Epictetus himself com- takes various forms but typically involves hasty conclusions about them because the pared the philosopher's school to a picturing events from high overhead or in Stoics were influenced by the famous doctor’s clinic, albeit one for treating cosmological terms in order to place them Socratic that “no man does evil the mind or soul. within a broader context in terms both of willingly” (or knowingly)—Epictetus, for space and time, something the Stoics and example, taught his students to tell them- • The of Marcus Aurelius are other philosophers found valuable as a way selves, “It seemed right to him” when a private record of his own contempla- of moderating strong desires and emo- offended by someone’s actions in order to tive practices, like a Stoic self-help or tions. moderate anger and cultivate a more - therapy journal. sophical attitude toward the perceived 11. Contemplating Transience, this theme • The letters of Seneca show him offering wrongdoing of others. is encapsulated in the “View from Above” advice and support to others. Many are but the Stoics generally encouraged them- 17. Contemplating , which addressed to a novice Stoic (Lucilius). selves to contemplate the temporary nature Dubois had originally assimilated into Here Seneca is acting in a manner com- of all things, including their own lives and rational psychotherapy, the Stoics fre- parable to an individual therapist or the lives of others, as a way of regulating quently remind themselves to depersonal- perhaps a life coach. strong emotions. ize upsetting events and view them as an inevitable part of life. For example, there About six of Seneca’s letters fall under the 12. Contemplation of the Here and Now, are people who behave honestly and dis- heading of a genre known as consolatio or a theme particularly emphasized through- honestly in the world, dishonest people do philosophical consolation literature. These out The Meditations of Marcus Aurelius, dishonest things, therefore the wise man is are typically letters addressed to individu- which involves grounding attention in the not surprised when he sometimes encoun- als who are struggling following bereave- present moment, partly because this con- ters these things in life. ment or some other misfortune. They pro- stitutes our locus of control. vide a particularly clear example of the way in which Stoic philosophy was adminis- 13. Objective Representation, or phanta- Some of these general strategies are over- tered as a form of psychotherapeutic sia kataleptike, the description or mental lapping and not entirely conceptually dis- advice. Moreover, Epictetus described a representation of events in objective terms tinct. "The View From Above," for exam- Stoic called Paconius Agrippinus having without strong value judgments or emotive ple, inevitably entails the contemplation of written similar consolation letters to him- —similar to decatastrophizing in the finitude and transience of material self, in which he describes the potential CBT. things, and even one’s own mortality. Most of these general strategies are also opportunities or positives to be found in 14. Premeditation of Adversity, praemed- employed in the form of various specific seemingly catastrophic situations such as itatio malorum, another famous Stoic exer- techniques—that is, the Stoics often illness or exile. This might be compared to cise, which involves regularly imagining employ a shorthand version of contrasting the practice of writing “decatastrophizing (visualizing) a variety of feared situations consequences by reminding themselves of scripts,” advocated by Beck in the treat- as if they’re already befalling you, such as maxims such as that fear of pain does us ment of certain forms of anxiety (Clark & exile, poverty, sickness, dying, etc., in order more harm than the pain itself (also, anger Beck, 2011). to mentally rehearse a more philosophical often does us more harm than the thing However, there’s also some indication attitude toward them (apatheia) through we’re angry about). Indeed, there are a very that novice Stoics had individual tutors the use of some of the strategies mentioned wide range of cognitive (both imaginal and who administered Stoic therapy in person. above. This clearly resembles various imag- verbal) and behavioral therapy techniques For example, Marcus Aurelius mentions inal exposure strategies used in CBT but found in the Stoic literature, which go that his Stoic tutor per- perhaps a better analogy would be the beyond this list. Many of these are found in suaded him to undergo therapeia to covert rehearsal of cognitive and behav- other philosophical traditions, especially improve his character, perhaps to deal in ioral coping strategies in approaches such during the Hellenistic period, and in the particular with feelings of anger that he as Stress Inoculation Training (SIT). writings of poets such as Horace and Ovid, mentions. The early Greek Stoics actually who were influenced by philosophy. It’s the wrote several books on psychological ther- 15. Memorization of Sayings, of which Stoics themselves, though, who place most apy, which are sadly lost, such as the Ther- there are many examples in the Stoic texts, emphasis on these techniques. apeutics of Chrysippus, the third head of the which Stoics would learn until they were We might also ask where and with Stoic school. However, we do have a sur- “ready to hand” in challenging situations— whom the Stoics used these techniques. viving book called On the Diagnosis and comparable to the use of coping statements Conveniently, the three major surviving Cure of the Soul’s Passions, by Galen, in CBT. For example, Marcus Aurelius sources of Stoic literature provide some Marcus Aurelius’ court physician. Galen summed up his philosophy concisely in six good examples: wasn’t a Stoic, he was something of an Greek words translated as “the universe is eclectic. However, he’d studied Stoicism change; life is opinion”—meaning that • The Discourses of Epictetus are tran- and this book appears to be influenced by material things are changeable and tran- scripts of his discussions with groups of earlier Stoic writings on psychotherapy. sient, and that our value judgments shape students at his philosophical school, Galen notes that we tend to have a blind the quality of our life. where he can be seen answering ques- spot for our own errors and so he recom-

February • 2019 47 r o b e r t s o n c o d d mends obtaining the help of a wiser and 7. Ellis’ notion that & there are rational in this respect, who [sic., Epictetus’ words more experienced mentor who can ques- and healthy emotions, which we should were actually transcribed and edited by a tion us about our character and actions, aspire to cultivate instead of our irrational student called ] wrote—some nine- perhaps the role that Rusticus played for ones, clearly resembles the Stoic notion of teen centuries ago—that “the chief con- Marcus Aurelius. “healthy passions” (eupatheiai). cern of a wise and good man is his own 8. REBT’s concept of replacing abso- reason.” (Ellis, 1962, p. 109) REBT and Stoicism lutistic demands with flexible “desires” or Some of these parallels between REBT The extent of REBT’s indebtedness to “preferences” resembles the Stoic concept and Stoicism are probably due to the direct ancient Stoicism, both in terms of theory of the “reserve clause,” which attributes influence of Stoic writings read by Ellis on and practice, has been the focus of two “selective value” to external events, for the his thinking, some are perhaps more indi- recent books (Robertson, 2010; Still & purpose of making plans, while accepting rect, and some are probably due to Ellis and Dryden, 2012). As REBT is the form of psy- that they may not turn out as we would the Stoics arriving at similar conclusions chotherapy most closely related to Sto- like—the Stoics likewise distinguish on the basis of their shared premise that it’s icism, it’s worth highlighting some of the between light “preferences,” which adapt to not things that upset us but our beliefs similarities between them: setbacks, and rigid desires that are irra- tional, excessive, and of a demanding about them. Stoicism also influenced Beck and his 1. As we’ve seen, REBT practitioners nature. colleagues, as we’ve seen, although in this often orient clients to their role in therapy 9. REBT’s opposition to “awfulizing,” or case the influence appears to be mainly by teaching them the quotation from judging events to be absolutely cata- indirect through their exposure to Ellis’ Epictetus above (“Men are disturbed not by strophic, resembles the to writings on REBT. However, the distinc- things . . .”); this was a frequently cited judging external events to be uncondition- tion Beck makes between strategic (volun- strategy in ancient Stoicism, which ally “bad” or “evil” in an irrational and involved gaining cognitive distance by excessive manner. tary) and automatic thought processes in reminding ourselves that our distressing his revised cognitive model of anxiety hap- 10. The “shame-attacking” exposure pens to parallel a distinction the Stoics also emotions are due primarily to our own exercises, which Ellis called a “trademark” beliefs. made. They distinguished between judg- REBT technique, clearly resemble the ments or opinions that are up to us (dog- 2. Both REBT and Stoicism therefore Cynic and Stoic practice of shamelessness mata) and automatic thoughts or impres- (anaideia), which we’re even told included agree that our emotions are primarily sions that are not (). As noted walking through the streets of the potter’s determined by our beliefs or thinking (cog- earlier, the former we should learn how to district in Athens dragging a bottle by a nition) and that beliefs and emotions may change, as they’re potentially under our rope, as though walking a dog on a leash, be two aspects of a single process rather control, whereas the latter we should learn much like the “banana on a string” exercise than, as Plato believed, two fundamentally to accept with a relatively neutral or indif- used in REBT. separate psychological processes. ferent attitude. 3. REBT trains clients to closely moni- 11. The main imagery-technique tor the relationship between their thoughts, employed in REBT, called “Rational Emo- Third-Wave CBT actions, and feelings, when becoming tive Imagery” (REI), clearly resembles the upset, which is similar to the Stoic empha- Stoic practice of praemeditatio malorum; In some ways third-wave CBT actually sis on continual attention (prosoche) to both involve repeatedly picturing future has even more in common with Stoicism one’s faculty of judgment. setbacks or loss, as if happening now, in than the earlier approaches of Ellis and Beck did. However, there’s basically no 4. REBT’s main technique is the rational order to reduce anxiety and build psycho- logical resilience to potentially stressful longer any explicit reference to Stoicism so or “Socratic” disputation of irrational the connection has now been lost, ironi- demands, sometimes referred to as the events. cally, just as Stoicism is going through a client’s underlying “philosophy” of life; this resurgence. Third-wave behavior thera- is comparable to the philosophical disputa- Indeed, overall, Ellis described REBT as a pists turned predominantly to Buddhism tion of our fundamental value-judgments “philosophical” approach to therapy, and as an inspiration for introducing mindful- in Stoicism. its fundamental goal as “rational living,” which we might compare to the Stoic goal ness to CBT, though similar ideas were 5. REBT’s central claim, that irrational of living “in accord with reason,” or pru- already there in Stoicism—parallels could and absolutistic demands (rigid “must” dently and wisely ( Laertius, Lives, have been found in both Eastern and West- statements) lie at the root of emotional dis- 7.86). By “inducing the patient to internal- ern philosophy. Indeed, these were the turbance, resembles the Stoic emphasis on ize a rational philosophy of life,” in other main aspects of Stoicism overlooked by the centrality of irrational value-judgments words, REBT aims to directly uproot and Ellis, Beck, and other early cognitive thera- concerning what is unconditionally “good” counteract the core irrational beliefs devel- pists. Third-wave practitioners today could or “bad” in life. oped from childhood (Ellis, 1962, p. 65). still look deeper into Stoicism and find an 6. REBT encourages a threefold attitude ancient Western mindfulness-based psy- of tolerance, and acceptance of imperfec- By direct statement and implication, then, chotherapy from which both they and their tions, toward oneself, other people, and the modern thinkers are tending to recognize clients may wish to draw inspiration. world, comparable to the threefold empha- the fact that and reason can, and in a The focus on values clarification and sis on accepting our own body, other sense must, play a most important role in living in accord with our core values found people, and external events as “indifferent” overcoming human neurosis. Eventually, in approaches such as Acceptance and in Stoicism. they may be able to catch up with Epictetus Commitment Therapy (ACT) and Behav-

48 the Behavior Therapist stoic philosophy ioral Activation (BA) has obvious parallels describe this process as the “separation” of Although Stoicism was used as a ther- with ancient Stoicism (Hayes, Strosahl, & our thoughts and beliefs from their objects apy, overall it has a more preventative ori- Wilson, 2011). The Stoics made a funda- as opposed to allowing them to blend or entation than CBT and in that respect it mental distinction between the type of merge together—a strategy we might com- may especially hold promise as a form of intrinsic value that belongs to our own pare to “cognitive distancing” in Beck’s training in emotional resilience. CBT is a character and voluntary actions, which cognitive therapy or “cognitive defusion” therapy; Stoicism is a philosophy of life. they called virtue (arete), and the sort of in ACT. For example, Epictetus taught his That does introduce limitations because extrinsic value that belongs to external Stoic students that when a distressing some clients may disagree with the core events, including the outcomes of our thought pops into their mind they should concepts and values of Stoicism. Thera- actions, which they called selective “value” speak to it (apostrophize), saying, “You are pists, of course, shouldn’t indoctrinate (axia). As we’ve seen, the Stoic notion of just an impression and not at all the thing their clients into any particular or virtue can also be compared to the concept you claim to be.” Similar techniques, philosophy of life. That said, Stoic philoso- of values and “character strengths” in Pos- involving talking to thoughts as if to phy’s meta-ethic is not so far removed from itive Psychology (Peterson & Seligman, another person, are employed in ACT to some of the concepts relating to values 2004). aid defusion. taught in approaches such as ACT. More- The Stoics believed that we should More detailed comparisons with third- over, teaching clients about Stoicism is accept that external outcomes are not wave approaches could be made. However, arguably no more problematic in this entirely under our control and shift our greater dialogue between Stoics and third- regard than teaching them about Bud- focus more on the intrinsic value of our wave therapists is surely justified by the dhism. Indeed, there are clearly already own character traits, such as exercising many individuals who find Stoicism Stoic conceptions of value and mindful- greater kindness, friendship, and wisdom appealing as a philosophy, and broadly ness, and their emphasis on neutral accep- in life. They also construe this in terms of agree with its ethical values. tance of unpleasant feelings or events filling our various roles in life more The very fact that Stoicism is bigger and beyond our direct control. Over the past admirably, insofar as this is within our deeper than CBT in its aim to provide a few decades a growing number of people sphere of control, such as being a good philosophy of life perhaps gives us reason have been drawn to Stoicism as a form of parent or teacher. The practice of question- to believe that its benefits may be more last- ing and clarifying our values is integral to self-help as well as a philosophy of life ing than those of existing CBT-based the ancient and Stoic phi- capable of providing them with a sense of resilience training programs. People who losophy, as is the effort to live more consis- direction and purpose. People often report study Stoicism embrace it as part of their tently in accord with them, from moment that they were attracted to Stoicism pre- life rather than viewing it merely as a set of to moment, throughout each day. The cisely because they see it as providing a coping techniques, which they might later Stoics believed that this led to a greater “Western alternative to Buddhism.” It just forget if they don’t repeat their initial train- sense of fulfilment in life, and personal happens that neither Ellis nor Beck pre- ing. Stoicism offers people a permanent flourishing, whereas overattachment to sented it that way, so later generations of alternative to their existing worldview, one external events and the outcome of our cognitive therapists looked elsewhere for aligned with CBT in many regards, which actions tended to lead to desires and emo- inspiration when it came to mindfulness might provide a framework for changes tions of an excessive or irrational nature, practices, and Stoicism was unjustly that could endure long after initial expo- which damage our mental health. neglected. sure to them through books and courses. With regard to mindfulness, the Stoics Our hope, therefore, is that in the future placed considerable emphasis on the prac- Stoicism’s Benefits to CBT research may be conducted on the poten- tice of focusing attention on the present tial applications of combined Stoicism and Stoicism has things in common both moment. They called this simply prosoche CBT-based training courses as a form of with second- and third-wave approaches to (“attention”), although modern Stoics tend long-term emotional resilience-building. CBT. Perhaps it can even help to unite to describe it as “Stoic mindfulness.” practitioners of those approaches by Whereas mindfulness practices derived Resources for Further Study from Buddhism sometimes entail greater expanding their common ground. : attention to the body or breathing, Stoic Moreover, some clients, and therapists, https://modernstoicism.com/ mindfulness is focused specifically on the find Stoicism more congruent than Bud- Donald Robertson: activity of our executive function or “ruling dhism with their own cultural concepts and https://learn.donaldrobertson.name/ faculty” (hegemonikon). For the Stoics, values. The classical nature of Stoic litera- Robertson, D. J. (in press). Teach yourself attention should be focused on the seat of ture is also an important asset. For exam- ple, Seneca was one of the finest writers of stoicism and the art of happiness. our sphere of control: our voluntary cogni- London: Hodder. tive activity in the present moment. The antiquity. Many people therefore find these ancient texts more meaningful, engaging, Robertson, D.J. (in press). How to think basic principle applied in Stoic mindful- like a Roman Emperor: The Stoic philoso- and memorable than modern self-help or ness is then to distinguish clearly between phy of Marcus Aurelius. New York: St. our voluntary cognition (, “voli- therapeutic literature. People have quotes Martin’s Press. tion” or “moral choice”) and automatic from Marcus Aurelius tattooed on their Robertson, D. J. (2010). The philosophy of thoughts and impressions (phantasiai), bodies—nobody has an Albert Ellis tattoo. cognitive-behavioural therapy: Stoic phi- taking more ownership for the former and Some of the surviving Stoic writings are losophy as rational and cognitive psy- adopting an attitude of greater detachment very beautiful and contain teachings people chotherapy. London: Karnac. and indifference toward the latter. The can identify with at a very profound level, Robertson, D. J. (2012). Build your Stoics, as we mentioned above, also as a whole philosophy of life. resilience. London: Hodder.

February • 2019 49 s o u t h w a r d p f e i f e r References Ellis, A., & MacLaren, &C., (2005). Rational Still, A., & Dryden, W (2012). The histori- emotive behavior therapy: A therapist's cal and philosophical context of rational Beck, A. T. (1976). Cognitive therapy and guide (2nd ed.). Atascadero, CA: psychotherapy: The legacy of Epictetus. the emotional disorders. New York: Inter- Impact. London: Karnac. national University Press. Epictetus. (1995). The Discourses, The Stockdale, J. B. (1995). Thoughts of a philo- Beck, A. T., Emery, G., & Greenberg, R. Handbook, Fragments. London: Every- sophical fighter pilot (Vol. 431). Stand- (2005). Anxiety disorders and phobias: A man. ford, CA: Hoover Institution Press. cognitive perspective (20th Anniversary Hayes, S. C., Strosahl, K. D., & Wilson, K. Wolfe, T. (1998). A man in full: A novel. Edition). Cambridge, MA: Basic Books. G. (2011). Acceptance and commitment New York: Dial Press. Beck, A. T., Rush, A. J., Shaw, B. F. & therapy: The process and practice of Emery, G. (1979). Cognitive therapy of mindful change (2nd ed.). New York: ... depression. New York: Guilford Press. Guilford. Clark, D. A., & Beck, A. T. (2011). Cogni- Holiday, R. (2014). The obstacle is the way: Dr. Robertson is volunteer member of the tive therapy of anxiety disorders: Science The timeless art of turning trials into tri- committee of Modern Stoicism Ltd., which and practice. New York: Guilford Press. umph. New York: Penguin. is a nonprofit organization that carries out Diogenes, L., & Hicks, R. D. (1959). Lives Peterson, C., & Seligman, M. E. P. (2004). research on Stoicism. He also writes books of eminent philosophers (English transla- Character strengths and virtues: A hand- and runs courses on Stoicism and CBT. The tion, R.D. Hicks). Cambridge: Harvard book and classification. Washington, DC: authors do not have any other conflicts of American Psychological Association. University Press. interest or funding to disclose. Robertson, D. J. (2010). The philosophy of Dubois, P. (1909). Self-control and how to cognitive-behavioural therapy (CBT): Correspondence to Donald Robertson, . New York: Funk and Wagnalls. secure it Stoic philosophy as rational and cognitive [email protected] Dubois, P., & Gallatin, L. (1908). The influ- psychotherapy. London: Karnac. ([email protected]) or R. Trent ence of the mind on the body. New York: Robertson, D. (2013). Stoicism and the art Codd, III, Cognitive-Behavioral Therapy Funk and Wagnalls. of happiness: Teach yourself ancient tips Center of WNC, P.A., 1085 Tunnel Road, Ellis, A. (1962). Reason and emotion in for modern challenges. New York: 7A, Asheville, NC 28805; rtcodd@ psychotherapy. Secaucus, NJ: Citadel. McGraw-Hill. behaviortherapist.com

TRAINING used to scaffold our training: deliberate practice, feedback on client progress, and embodying the spirit of the treatment. Do as I Say and as I Do: Reflections on Three These methods are grounded in the research and theory of , relatively Methods of Evidence-Based Clinical Supervision straightforward to apply in graduate prac- tica, and flexible enough to adapt to diverse of Graduate-Level Trainees trainee backgrounds and abilities.

Matthew W. Southward, The Ohio State University and Duke Deliberate Practice University Medical Center Deliberate practice, defined as “individ- ualized training activities especially Benjamin J. Pfeifer, The Ohio State University and Veterans Affairs designed . . . to improve specific aspects of Ann Arbor Healthcare System an individual’s performance through repe- tition and successive refinement” (Ericsson & Lehman, 1996), is an important mecha- THECLINICALTRAINING many therapists unavailable in a surprisingly large number nism for increasing expertise in psy- receive during graduate school ranks of programs (Falender & Shafranske, 2014; chotherapy (Goodyear, Wampold, Tracey, among the most intensive periods of direct Lyon, Heppler, Leavitt, & Fisher, 2008), & Lichtenberg, 2017). Therapists who feedback in their careers. The supervision leaving many supervisors to rely on their engage in more frequent deliberate practice provided during these years is a major own experiences of supervision during to improve their therapeutic skills have shown better client outcomes (Chow et al., influence on trainees’ development from clinical training (Crook-Lyon, Presnell, 2015). It may be difficult to imagine how novices to (eventual) experts. We believe Silva, Suyama, & Stickney, 2011). focused, deliberate practice could apply to the efforts of supervisors in this pivotal Despite these limitations, our clinical psychotherapy, which is complex, dyna- developmental stage often receive too little supervisors successfully implemented mic, and allows for substantial latitude in attention. Supervisors may not know developmentally appropriate supervision focus and prioritization, even in manual- which training methods will be most effec- methods based on available research evi- ized treatments. In cognitive therapy (CT; tive for trainees with diverse clinical back- dence and established theoretical frame- Beck, Rush, Shaw, & Emery, 1979), for grounds and varying levels of prior knowl- works. Here we describe and demonstrate, instance, trainees can implement a variety edge and ability. This is in part because in order of increasing developmental of interventions at any given moment: cog- training in supervision remains limited or demands, three methods our supervisors nitive restructuring, reflective listening,

50 the Behavior Therapist e v i d e n c e based graduate level supervision Socratic questioning, and homework - - review, to name just a few. For students in graduate training, this can be an over- whelming set of options! Deliberate prac- tice is a way to provide more focus on essential therapy skills. Our supervisor used deliberate practice methods to teach cognitive restructuring during training preceding our practicum in CT for depression. He divided a white board into three columns to represent a simplified thought record: (1) a description of the situation, (2) hypothetical negatively biased automatic thoughts, and (3) alterna- tive responses to those thoughts. Our supervisor generated content for the first two columns, and challenged us to think of plausible and helpful alternative responses for the third column.

SUPERVISOR (S)1: Say your client, who just lost their job, goes to the checkout counter to pay for groceries and their credit card is denied. Their automatic thoughts are, “I Figure 1. Example spaghetti plot of Patient Health Questionnaire-9 (PHQ-9; Kroenke, failed my family,” “I’m so incompetent,” Spitzer, & Williams, 2001) scores used to gather feedback on client progress in supervision. and “Everyone at the store thinks I’m a loser.” What alternative responses might you and your client generate? repeatedly, we developed a mental edge; similarly, supervisors will never be TRAINEE (T): How about, “I couldn’t pro- roadmap of common themes in depressive mind-readers, and supervision time is lim- vide for my family this time,” in response thoughts (e.g., all-or-nothing thinking, dis- ited. One strategy our supervisor used to to the automatic thought, “I failed my counting the positive) and the types of address these limitations was to examine family”? alternative responses that were most clients’ session-to-session progress in a 2 S: That’s a start. Anything more? promising for them. This pattern reflects spaghetti plot. By regularly examining this the development of novices, who tend to graphical depiction of clients’ prespecified T: “I’m resourceful—I’ve always found a memorize lists and rules, into experts, who treatment targets during supervision way to provide for my family before. organize knowledge around a few core (Figure 1), we could determine quickly and Maybe I can buy some of these groceries components to guide their thinking collaboratively which trajectories indicated now and see if there are other community (Persky & Robinson, 2017). As a result, we progress, stability, or deterioration (Swift et resources for food when I get home.” could swiftly anticipate which core beliefs al., 2015)—information that facilitated S: Great! Let’s write that down. Okay, we’ve each negative thought might indicate and effective use of limited supervision time. A still got, “Everyone at the store thinks I’m a guide treatment to address those beliefs. substantial body of research suggests that loser” — what can we do with that one? Thus, a foundation was laid to integrate tracking and receiving feedback on client other core components of the model into progress may reduce the percentage of After we addressed each of the auto- our training in a natural, iterative manner. clients who ultimately deteriorate by 15% matic thoughts on the board, our supervi- and improve the percentage of clients who sor erased the original content and started Feedback on Client Progress ultimately recover by 30% (Lambert, 2017). a new example. We viewed these exercises By examining client progress in an easy-to- as a form of “lightning round” cognitive Soliciting and synthesizing feedback read graph, supervisors can ensure that restructuring, which required quick replies from one’s supervisor is an essential com- even clients who might be overlooked by to a diverse array of negative thoughts. As ponent of supervision. One limitation of trainees will be brought to their attention. training progressed, we felt increasingly the supervisor-trainee relationship is, as In Figure 1, we would likely identify clients able to generate multiple possible alterna- our supervisor put it, “In order to ask for 2, 3, and 5 as high-priority cases. These tive responses to negative automatic help, first you have to realize you need it.” three clients’ depression scores are either thoughts. By using deliberate practice to Trainees do not always perceive when they elevated and stable (i.e., clients 3 and 5) or generate alternative responses quickly and make errors or exhibit gaps in their knowl- rising (i.e., client 2). Of course, effective supervision includes feedback on not only trainees’ struggles, but trainees’ strengths and 1All vignettes are combinations of clinical conversations and do not reflect any specific progress as well. Our supervisor also used client, trainee, or supervisor comment. these spaghetti plots to discuss and rein- 2The R code to generate such plots can be found here: https://osf.io/k762d force what we did in sessions that preceded

February • 2019 51 improvements in depression scores (e.g., change. Underlyings o u t h w a r these d & pspecific f e i f e r methods when it happens, is a way of dialectically Sessions 10–12 for client 1). Linking in-ses- and techniques are evidence-based princi- honoring the in both parts. sion behaviors to graphical trends in ples about how the therapy is hypothesized clients’ symptoms strengthened our under- to work. These principles are grounded in By modeling a dialectical approach, our standing of the effects of our interventions. research on psychopathology and human supervisor did multiple beneficial things at behavior, with each component of an inter- once. First, she addressed an issue we SUPERVISOR (S): So what happened in Ses- vention intended to address various aspects raised about a challenging case. Second, she sions 10–12 with client 1? of the theoretical model. However, as modeled and explicitly labeled how a DBT TRAINEE (T): My client seemed to be more trainees, it can be challenging to grasp how technique (i.e., ) could address active in coming up with alternative all the pieces fit together when we are so that issue in a way we could imitate in ses- responses. They sounded more hopeful, focused on learning the basics. sions. Third, by embodying the spirit of and they reported connecting with the One way our dialectical behavior ther- DBT with dialectical strategies, she tacitly alternative responses at an emotional and apy (DBT; Linehan, 1993) supervisor fos- encouraged us to keep the core model in cognitive level. tered a deeper understanding of the treat- mind when considering how to respond to ment model was to embody the spirit of challenges in implementing DBT. Finally, S: That all sounds good. Was that different the dialectical approach validated our from prior sessions? core DBT principles in supervision. She was especially skillful in embodying the experience that the issue was a frustrating T: I guess so! I don’t think we did much spirit of dialectics. In DBT, adopting a problem with no initially obvious solution. differently, but maybe that was the point. dialectical approach means embracing and Our supervisor openly acknowledged the Because my client was willing to practice synthesizing the truth present in two oppo- apparent contradictions within the situa- cognitive restructuring over and over again tion that contributed to us feeling stuck. As site and seemingly contradictory ideas with different aspects of the same strongly a result, we experienced the value of (e.g., acceptance of painful emotions vs. held , they could truly believe in the acknowledging those feelings, which desire for change). Our supervisor fre- alternative responses. Before this session, allowed us to explore thorny issues non- quently noted and embraced examples of they completed all their homework but it judgmentally instead of grasping for an dialectics that emerged in supervision: hadn’t clicked yet. immediate solution. Experiencing the ben- efits of this approach firsthand during TRAINEE (T): I’m feeling stuck with a client. Reviewing graphical data of client supervision helped us envision more symptom trajectories allowed our supervi- One of our targets has been her tendency to clearly how that process could be therapeu- sor to help us connect our in-session show up late to events in her everyday life. tic for our clients during sessions. behaviors to clients’ symptom changes We’ve tracked her lateness for weeks, and By engaging us in dialectics in supervi- empirically and consider both which inter- we keep rehashing how important timeli- sion, our supervisor relied on observational ventions to implement and when to do so. ness is to her goals. It just feels like noth- learning principles (Bandura & Jeffery, This approach can be adapted to any treat- ing’s working—she’s even started showing 1973) to guide our clinical development. ment involving a target for change that can up late to our sessions! She says it’s a big We learned to model our in-session be regularly assessed. It can also be used to problem, and I’m feeling really frustrated, thought processes and behaviors off these call attention to other factors contributing because I don’t know how to help. demonstrations to the point that we could to change in the client’s life, such as envi- SUPERVISOR (S): I can hear the frustration in almost hear our supervisor’s voice coach- ronmental stressors or major life events. your voice. This sounds like a tough situa- ing us during sessions. Although we cannot Reviewing visual representations of clients’ tion. say for sure whether this learning resulted progress bolstered our confidence in the T: I just feel like we’re never going to make in better outcomes for our clients, some treatment and our growing abilities. This any progress if she can’t even show up to research suggests that such downstream has functioned as an antidote to periods in session on time! benefits may be possible. For example, training when it felt like only mistakes and clients of therapists who engage in rela- shortcomings were highlighted in supervi- S: So, to take a dialectical approach: on one tively more intensive mindfulness practice sion or when we experienced “imposter hand, you’re feeling frustrated because you may have better overall outcomes (Grep- syndrome.” Finally, plotting this data keep addressing this one target and aren’t mair et al., 2007; cf. Swift, Callahan, Dunn, helped us recognize that not all clients seeing change. And, on the other hand, Brecht, & Ivanovic, 2017), raising the pos- progress in a clear, linear fashion—in fact, you’re saying you can’t make any progress sibility that clients benefit from therapists’ almost no one does! However, thoughtfully until she stops being late. That really leaves modeling of a mindful stance in treatment. reflecting on the principles that led to even you two in a stuck place, where you can’t Similarly, trainees may benefit from super- small gains after certain sessions may ben- work on anything until she is able to do the visors’ effective modeling of treatment efit trainees and clients alike—even, or hardest thing. techniques and principles. As available evi- especially, in very challenging situations. T: I see what you mean. dence is quite limited, we look forward to more direct tests of the role of supervisory S: What would happen if we accepted both Embodying the Spirit modeling in future studies. things—that her being late is a big chal- of the Treatment lenge that you’re both still working on, and Conclusion Expertise in providing evidence-based that there may be other things to focus on, treatment involves a thorough apprecia- too? Perhaps spending less time on being Taken together and in the order tion of how the treatment’s methods and late during each session, while continuing described here, each of the preceding strategies cohere in a theoretical model of to acknowledge the lateness as a problem examples demonstrates how supervisors

52 the Behavior Therapist may scaffold graduate clinical training toe v i d e n c337-345. e - based https://doi.org/10.1037/ graduate - level supervision Linehan, M. M. (1993). Cognitive-behav- meet the developmental needs of trainees pst0000015 ioral treatment of borderline personality using theory-informed and evidence-based Crook-Lyon, R. E., Presnell, J., Silva, L., disorder. New York, NY: Guilford Press. training methods. Supervisors may incor- Suyama, M., & Stickney, J. (2011). Emer- Lyon, R. C., Heppler, A., Leavitt, L., & porate deliberate practice of fundamental gent supervisors: Comparing counseling Fisher, L. (2008). Supervisory training therapeutic skills in training sessions start- center and non-counseling center experiences and overall supervisory ing before trainees see their first clients. interns’ supervisory training experiences. development in predoctoral interns. The This ensures that trainees grasp the funda- Journal of College Counseling, 14, 34-49. Clinical Supervisor, 27, 268-284. https://doi.org/10.1002/j.2161- mentals of the treatment, upon which they https://doi.org/10.1080/07325220802490 1882.2011.tb00062.x can build during the practicum year. When 877 Ericsson, K. A., & Lehman, A. C. (1996). trainees begin seeing clients, supervisors Persky, A. M., & Robinson, J. D. (2017). Expert and exceptional performance: and trainees may use graphical printouts of Moving from novice to expertise and its Evidence of maximal adaptation to task implications for instruction. American client progress toward agreed-upon goals constraints. Annual Review of Psychology, Journal of Pharmaceutical Education, 81, to identify collaboratively which clients 47, 273-305. https://doi.org/10.1146/ 6065. https://doi.org/10.5688% need the most attention and discuss which annurev.psych.47.1.273 2Fajpe6065 strategies are most effective for whom. Falender, C. A., & Shafranske, E. P. (2014). Finally, as trainees become more comfort- Clinical supervision: The state of the art. Swift, J. K., Callahan, J. L., Dunn, R., able with these aspects of supervision, Journal of Clinical Psychology, 70, 1030- Brecht, K., & Ivanovic, M. (2017). A ran- supervisors may more strongly emphasize 1041. https://doi.org/10.1002/jclp.22124 domized-controlled crossover trial of mindfulness for student psychothera- and embody the spirit of the treatment. Goodyear, R. K., Wampold, B. E., Tracey, pists. Training and Education in Profes- This expert-level approach can help T. J. G., & Lichtenberg, J. W. (2017). Psy- trainees navigate unexpected therapeutic chotherapy expertise should mean supe- sional Psychology, 11, 235-242. https://doi.org/10.1037/tep0000154 moments by following the principles their rior outcomes and demonstrable supervisors model. Thus, each aspect dis- improvement over time. The Counseling Swift, J. K., Callahan, J. L., Rousmaniere, cussed here coheres in a developmental Psychologist, 45, 54-65. https://doi.org/ T. G., Whipple, J. L., Dexter, K., & model of clinical training in which super- 10.1177/0011000016652691 Wrape, E. R. (2015). Using client out- come monitoring as a tool for supervi- visors respond dynamically to the needs Grepmair, L., Mitterlehner, F., Loew, T., sion. Psychotherapy, 52, 180-184. and strengths of their trainees during grad- Bachler, E., Rother, W., & Nickel, M. https://doi.org/10.1037/a0037659 uate school. (2007). Promoting mindfulness in psy- chotherapists in training influences the treatment results of their patients: A ran- ... References domized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76, Bandura, A., & Jeffery, R. W. (1973). Role The authors disclose no current conflicts of of symbolic coding and rehearsal 332-338. https://doi.org/10.1159/ interest. Within the past three years, the processes in observational learning. Jour- 000107560 nal of Personality and Social Psychology, Kroenke, K., Spitzer, R. L., & Williams, J. authors have been partially supported by 26, 122-130. B. W. (2001). The PHQ-9: Validity of a The Ohio State University Center for Clini- Beck A. T., Rush, A. J., Shaw, B. F., & brief depression severity measure. Jour- cal and Translational Science under Grant Emery, G. (1979). Cognitive therapy of nal of General Internal Medicine, 16, 606- #TL1TR001069 (to M.W.S.). The funding depression. New York, NY: Guilford 613. https://doi.org/10.1046%2Fj.1525- source had no involvement in the conduct or Press. 1497.2001.016009606.x preparation of the research. Chow, D. L., Miller, S. D., Seidel, J. A., Lambert, M. J. (2017). Maximizing psy- Correspondence to Matthew W. South- Kane, R. T., Thornton, J. A., & Andrews, chotherapy outcome beyond evidence- W. P. (2015). The role of deliberate prac- based medicine. Psychotherapy and Psy- ward, 181 Psychology Building, 1835 Neil tice in the development of highly effec- chosomatics, 86, 80-89. https://doi.org/ Avenue, Columbus, OH 43210; tive psychotherapists. Psychotherapy, 52, 10.1159/000455170 [email protected]

ABCT PIOneerS SerIeS

David Barlow www.abct.org ABCT > FOr MeMBerS > CBT PIOneerS David Burns Andrew Christensen Phil Kendall ABCT’s growing CBT Pioneers series: Explore Judith Beck Interviews with CBT’s influential thinkers, Esther Deblinger researchers, and practitioners— Steven C. Hayes Alan Kazdin Art Nezu & Christine Maguth Nezu

February • 2019 53 LIGHTERSIDE cannot be taught as equals, any more than astrology and astrophysics, neurology and phrenology—but yet this fact seems to be From Our Mailbag: lost on some of our clinical programs. Why any of our clinical programs are Why Do Some Clinical Programs Teach educating students in such a patently con- fusing, downright intellectually indefensi- Both CBT and Psychodynamic Models? ble way is indeed a puzzlement. The usual rationalizations such as “it’s important to expose students to different perspectives” Schrödinger’s Rat just shouldn’t pass the science smell test anymore. Seriously, it’s not like our pro- grams are teaching literature or art, but Jonathan Hoffman, Neurobehavioral Institute rather how to psychologically assess and treat real-life, people. (Just imag- Dean McKay, Fordham University ine if medical training included placing the four humors of the ancient Greeks on equal ASHABITUALCONTRIBUTORS—some completely contradictory theoretical and footing with modern endocrinology.) might derisively call us offenders—to tBT’s practice frameworks? Exposing our clinical students to CBT and Psychodynamic models simultane- “Lighter Side” column, we long ago became Sincerely, ously places them in a state of cognitive dis- desensitized to fielding endless questions —Anonymous, Ph.D., ABPP sonance, which they will likely resolve by from our devoted readers. Although we’ve (Behavioral & Cognitive Psychology) eschewing one or the other of CBT or Psy- done our level best to answer each and Licensed Psychologist chodynamics completely, adopting the every one of you, it has exacted a tremen- P.S. I loved your “K. Ong” articles, I don’t position of their favored professor, or rec- dous toll on our professional and personal care what anyone else says.2 lives, which we only recently became aware onciling them in a way that might forever of after being ambushed by an intervention skew the way they think about and treat psychological disorders. We have observed arranged by our colleagues and families. Dear Dr. Anonymous, that the websites of some clinicians say they We now realize that spending day and First, thank you for your kind words will craft a CBT or Psychodynamic treat- night responding to our legion of fans regarding our “K. Ong” pieces. If you liked ment plan according to the presentation of leaves little room for research or clinical that, check out our early work on the CBT the client. This sounds more like a great work, not to mention upholding the dress Action Team.3 But on a more serious note, 1 idea for a revival of the theater of the code and hygiene standards for clinical unless your surname is actually “Anony- absurd4 than a credible clinical approach. scientists and scientist-practitioners. We mous,” we are very sorry that this question How can clinical programs that teach also have belatedly come to the conclusion is presently so politically incorrect that you both CBT and Psychodynamic models that the fairest policy going forward feel compelled to hide your identity. By remain accredited? Frankly, it beats us. We regarding our bottomless mailbag is to virtue of the powers conferred by “Lighter asked some of our colleagues, but they were respond to one question from a randomly Side” authorship, we apologize on behalf of just as stumped. Leaving no stone selected fan whenever the mood to do so our revered but obviously befuddled pro- unturned, and holding our noses all the strikes, beginning with the following: fession. way, we even took the unprecedented step Thank you for posing such a great ques- of reaching out across disciplines. Dear Drs. Hoffman and McKay, tion to the “Lighter Side,” where it can do Well, Dr. Anonymous, that was a waste How can some clinical programs teach the most good. We totally see your point, of time. Our counterparts in philosophy both Cognitive-Behavior Therapy and Dr. Anonymous. It should go without asked increasingly inscrutable questions Psychodynamic models in the same cur- saying that CBT and Psychodynamic ori- about the curricula of our field’s clinical ricula, given that they each promulgate entations cannot both be true and therefore programs, referencing the word “problem- atic” so many times that it lost any sense of meaning. The lawyers we consulted pushed hard for a class action lawsuit against said 1We’ve been to the conferences. The minimum hygiene requirements appear to be shower- programs. And the few biologically ori- ing at least every third day, and only picking slightly wrinkled clothing from the hamper to ented psychiatrists we were able to get a wear to presentations. response from could barely restrain schadenfreude, many quickly switching the 2 A two-parter about a gargantuan, immortal ape’s foray into becoming a clinician, which was featured in the Behavior Therapist’s Lighter Side in September and December 2017. topic to why we should refer all of our clients to their new TMS (Transcranial 3 A four-part series that appeared in the Behavior Therapist in 2014. We had some pull with Magnetic Stimulation) or ketamine cen- the editor back then. ters. 4 A term referring to plays that use conventional dramatic forms, but undermine them with Suddenly, it dawned on us that we had nonsensical dialog and futile attempts to make sense in a senseless world. not taken our cross-disciplinary efforts far enough. We needed to talk to the reclusive

54 the Behavior Therapist s c h r d i n g e r s r a t founder of Psycho-physics,5 B. F. however, this superpositionö ’ collapses into Schrödinger responded, “Don’t know Schrödinger. This intellectual giant was a singular reality.” who that is but I have an O. Hobart Feyn- renowned for not only thinking out of the “And, there it is …” said Schrödinger. man on my staff. That also is not a coinci- box, but for refusing to use a box altogether Perplexed, we inquired, “There what dence.” or even patronize a big box store on princi- is?” With this final remark, Schrödinger ple. The only problem was that the great Schrödinger replied, “I thought it was illuminated the important issue raised in man refused to meet with anyone these obvious. Not only are the students in a the- your question, albeit “coincidentally.” days. We were left with no choice but to oretical superposition, but so are the pro- Clinical programs should not be theaters of play the surefire “Lighter Side” author card. gram director, the faculty, and the accredi- the absurd. And without their students’ Schrödinger immediately made an tation body. Even when some students informed , no less. Until this problem is rectified, our exception and agreed to see us. When we leave the bunker, uh, the clinical program advice to any student in a theoretical shared the question posed by you with Dr. that has instructed them in both CBT and “superposition” is: Be a “rat” no matter Schrödinger, we discovered that he had a Psychodynamic models, the way they will what anyone is teaching you. And if you are special interest in the curricula of clinical practice remains in an indeterminate state. suffering with post-traumatic superposi- programs that provided education in both In this state, all theoretical models, no tion trauma, seek therapy immediately. We CBT and Psychodynamic models. What a matter how antithetical, appear valid. think you know what kind of therapy we coincidence, we said. He said, “A simple Thus, the model that will inform their clin- recommend. Psycho-physics thought experiment will ical work henceforth could be based in sci- Keep those questions coming, Dr. elucidate why CBT and Psychodynamic ence or from the much deeper well of dis- Anonymous! (Although in all candor we models are taught with equal fervor in cerning meaning in coincidences.” must say that the odds against one of yours some of your clinical programs. I call it We said to Schrödinger, “it sounds like ever being selected again under our new 'Schrödinger’s Rat,'6 and my interest in this you are also implying that our students policy are, shall we say, rather daunting.) subject cannot possibly be a coincidence.” who do not resolve this superposition suc- He continued, “Rat is shorthand for cessfully might potentially suffer from . . . ‘rational.’ Let’s say I place an otherwise post-traumatic superposition trauma. rational student in a bunker with poison Weird, this can be abbreviated as PTSD.” The authors have no conflicts of interest or gas…Sorry, meant to say that we place an To which B.F. retorted, “Don’t you two funding to disclose. otherwise rational student in a clinical pro- jokers get it? There are no coincidences!” Correspondence to Jonathan Hoffman, gram that provides instruction in both Schrödinger was not done. He informed Ph.D., Neurobehavioral Institute, 2233 CBT and Psychodynamic models.” (We us that we needed to bone up on Jungian Commerce Pkwy #3, Weston, FL 33326; overheard him muttering under his breath, models of intervention. “After all,” he said, [email protected] “Really, who can tell the difference between “what is the so-called uncon- poison gas and a clinical program scious if not just a poetic way to describe anyway?”) superpositions?” He went on, “Then I shut the door to He then said, “If you think you under- the bunker. But until I open it and discover stand clinical programs, you don’t under- what model they have chosen the student is stand clinical programs.” in a superposition in which both CBT and We said, “Isn’t that more or less what Psychodynamic frameworks make sense to the physicist Richard Feynman famously them. In the instant of my , stated regarding quantum mechanics?”

5 Psycho-physics integrates classical psychological theoretical models with quantum mechanics, e.g. examining the applicability of classical and operant conditioning to the behavior of subatomic particles. It is often confused with Fechner’s psychophysics (sans hyphen) of the late 19th Century, which examined the relationship between stimulus and sensation. 6 When we asked, B.F. said that any resemblance of his thought experiment to Irwin Schrödinger’s famous 1935 one, Schrödinger’s Cat, was coincidence, since it couldn’t possibly be plagiarism. 7 We will be proposing this new diagnosis for the next edition of the International Classification of Diseases (ICD). The folks over at the DSM would likely be disinclined to consider it because this would be the one condition for which they could not possibly fathom a biological basis. 8 Just for fun, Google the famous 1946 photograph of Irwin Schrodinger conversing with Carl Jung. 9 Orval Hobart Mowrer was the President of the American Psychological Association in 1954. He was well known for behavioral research as well as for creating Integrity Therapy, a concept which has had a lasting influence upon drug and alcohol rehabilitation. 10 According to Carl Jung, coincidences that have meaning despite the absence of any apparent causal relationship, what he termed synchronicity, “is an ever-present reality for those who have eyes to see.” This point of view is utterly inimical to science.

February • 2019 55 Call for Papers ABCT’s 53rd Annual Convention November 21–24, 2019 • Atlanta, GA

The ABCT Convention is designed for scientists, practitioners, students, and schol- Preparing ars who come from a broad range of disciplines. The central goal is to provide edu- cational experiences related to behavioral and cognitive therapies that meet the to needs of attendees across experience levels, interest areas, and behavioral and Submit cognitive theoretical orientations. Some presentations offer the chance to learn what is new and exciting in behavioral and cognitive assessment and treatment. an Abstract Other presentations address the clinical-scientific issues of how we develop empir- ical support for our work. The convention also provides opportunities for profes- sional networking. The ABCT Convention consists of General Sessions, Targeted and Special Programming, and Ticketed Events. ABCT uses the Cadmium Scorecard system for the submission of general ses- sion events. The step-by-step instructions are easily accessed from the Abstract Submission Portal, and the ABCT home page. Attendees are limited to speaking (e.g., presenter, panelist, discussant) during no more than FOUR events. As you prepare your submission, please keep in mind: • Presentation type: For descriptions of the various presentation types, please visit http://www.abct.org/Conventions/?fa=Understanding_The_ABCT_Convention • Number of presenters/papers: For Symposia please have a minimum of four presenters, including one or two chairs, only one discussant, and 3 to 5 papers. The total number of speakers may not exceed 6. Symposia are either 60 or 90 min- utes in length. The chair may present a paper, but the discussant may not. For an in-depth explanation of Symposia are presentations of data, usually investigating the efficacy, effective- ness, dissemination or implementation of treatment protocols. For Panel ABCT’s convention program, Discussions and Clinical Round tables, please have one moderator and between including the differences among three to five panelists. ticketed, general, and special • Title: Be succinct. programming, visit us at: • Authors/Presenters: Be sure to indicate the appropriate order. Please ask all www.abct.org authors whether they prefer their middle initial used or not. Please ask all authors > Conventions & CE their degree, ABCT category (if they are ABCT members), and their email address. > Understanding the ABCT Convention (Possibilities for “ABCT category” are current member; lapsed member or non- member; postbaccalaureate; student member; student nonmember; new profes- sional; emeritus.) • Institutions: The system requires that you enter institutions before entering authors. This allows you to enter an affiliation one time for multiple authors. DO NOT LIST DEPARTMENTS. In the following step you will be asked to attach affilia- Thinking about submitting an tions with appropriate authors. abstract for the ABCT 53rd • Key Words: Please read carefully through the pull-down menu of defined key- Annual Convention in Atlanta? words and use one of the keywords on the list. Keywords help ABCT have adequate The submission portal will be opened programming representation across all topic areas. from February 14–March 16. Look for • Objectives: For Symposia, Panel Discussions, and Clinical Round Tables, write more information in the coming three statements of no more than 125 characters each, describing the objectives weeks to assist you with submitting of the event. Sample statements are: “Described a variety of dissemination strate- abstracts for the ABCT 53rd Annual gies pertaining to the treatment of insomnia”; “Presented data on novel direction Convention. The deadline for sub- in the dissemination of mindfulness-based clinical interventions.” missions will be 3:00 a.m. (EST), Overall: Ask a colleague to proof your abstract for inconsistencies or typos. Saturday, March 16, 2019. We look forward to seeing you in Atlanta, GA! QUESTIONS? FAQs are at http://www.abct.org/Conventions/ > Abstract Submission FAQs

56 the Behavior Therapist CALL for PAPERS | Program Chair: Alyssa Ward

With ABCT now in its sixth decade, it is more important than ever to reflect on how well we are achieving our core mission of enhancing health and well-being. What can we do general together to extend the reach and social impact of our vast accumulation of scientific knowl- edge? How can we produce healthy, therapeutic behavior on a grand scale? The purpose of sessions this call is to engage us in ongoing reflection, commitment, and the effortful habit of evalu- ating our accomplishments in terms of this high-level goal of reducing mental health burden and improving lives; in other words, to measure our work against our mission. eme: We encourage submissions that investigate novel ways to extend the reach of our current therapeutic processes and products, and especially the scientific knowledge behind them. WISDOM OF Thematic examples include: PURPOSE AND ● Reaching and partnering with new and diverse populations (e.g., global mental health, PERSPECTIVE: underutilized behavioral health audiences, underserved communities, intersecting interests among two or more Special Interest Groups); EXTENDING THE ● Leveraging or developing new workforces or stakeholders (e.g., paraprofessional health SOCIAL IMPACT workers, instructional models for professional training and development, supervision mod- OF COGNITIVE els for training and/or distributing expertise in health systems, scientific/mental health lit- BEHAVIORAL eracy of the general population); SCIENCE ● Improving knowledge delivery and the efficiency to guide behavioral health decisions (e.g., innovative protocol designs; decision support or feedback systems to inform treat- ment or implementation; models to better connect theory or emergent scientific findings to impending therapeutic action, personalized treatments, translation across problem or practice , such as DSM and RDoC; use of research evidence); ● Interacting with industry (e.g., the role of emerging technology; the relationship between science and entrepreneurship, between human helpers and machines; models for Portal opens scaling our most effective solutions); February 14, 2019 ● Striving to solve problems that are meaningful to stakeholders (e.g., clients, therapists, mental health system administrators); dissecting our failures or the unintended conse- quences of our prior successes; developing extensible resources today that anticipate the world of tomorrow. Deadline for submissions: Submissions may be in the form of Symposia, Clinical Round Tables, Panel Discussions, and Posters. Submissions that are judged to be especially thematic will be recognized in the March 16, 2019 online program for the 2019 Convention. (3:00 A.M. EST)

Submission deadline: March 16, 2019 | 3:00 A.M. EST

February • 2019 57 ‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹ 2019 Call for Award Nominations to be presented at the 53rd Annual Convention in Atlanta, GA

The ABCT Awards and Recognition Committee, chaired by Cassidy Gutner, Ph.D., of Boston University School of Medicine, is pleased to announce the 2019 awards program. Nominations are requested in all categories listed below. Given the number of submissions received for these awards, the committee is unable to consider additional letters of support or supplemental materials beyond those specified in the instructions below. Please note that award nominations may not be submitted by cur- rent members of the ABCT Board of Directors.

Career/Lifetime Achievement Eligible candidates for this award should be members of ABCT in good standing who have made significant contributions over a number of years to cognitive and/or behavior therapy. Recent recipients of this award include Thomas H. Ollendick, Lauren B. Alloy, Lyn Abramson, David M. Clark, Marsha Linehan, Dianne L. Chambless, Linda Carter Sobell, and Mark B. Sobell. Applications should include a nomination form (available at www.abct.org/awards), three letters of support, and the nominee’s curriculum vitae. Please e-mail the nomination materials as one pdf document to [email protected]. Include “Career/Lifetime Achievement” in the subject line. Nomination deadline: March 1, 2019

Outstanding Training Program This award will be given to a training program that has made a significant contribution to training behavior therapists and/or promoting behavior therapy. Training programs can include graduate (doctoral or master's), predoctoral internship, postdoctoral programs, institutes, or continuing education initiatives. Recent recipients of this award include the Doctoral Program in Clinical Psychology at SUNY Albany, Massachusetts General Hospital/Harvard Medical School Predoctoral Internship in Clinical Psychology, the University of Nebraska-Lincoln Clinical Psychology Training Program, the Charleston Consortium Psychology Internship Training Program, and the Clinical Science Ph.D. Program at Virginia Polytechnic Institute & State University. Please complete the on-line nomination form at www.abct.org/awards. Then e-mail the completed form and associated materials as one pdf document to [email protected]. Include “Outstanding Training Program” in your subject heading. Nomination deadline: March 1, 2019

Distinguished Friend to Behavior Therapy Eligible candidates for this award should NOT be members of ABCT, but are individuals who have promoted the mission of cognitive and/or behavioral work outside of our organization. Applications should include a letter of nomination, three letters of support, and a curriculum vitae of the nominee. Recent recipients of this award include Mark S. Bauer, Vikram Patel, Benedict Carey, Patrick J. Kennedy, and Joel Sherrill. Applications should include a nomination form (available at www.abct.org/awards), three letters of support, and the nominee’s curriculum vitae. Please e-mail the nomination mate- rials as one pdf document to [email protected]. Include “Distinguished Friend to BT” in the subject line. Nomination deadline: March 1, 2019

Outstanding Clinician Awarded to members of ABCT in good standing who have provided significant contributions to clinical work in cognitive and/or behavioral modalities. Past recipients of this award include Albert Ellis, Marsha Linehan, Marvin Goldfried, Frank Datillio, Jacqueline Persons, Judith Beck, and Anne Marie Albano. Please complete the nomination form found online at www.abct.org. Then e-mail the completed form and associated materials as one pdf document to [email protected]. Include “Outstanding Clinician” in the subject line. Nomination deadline: March 1, 2019

58 the Behavior Therapist Anne Marie Albano Early Career Award for Excellence in the Integration of Science and Practice Dr. Anne Marie Albano is recognized as an outstanding clinician, scientist, and teacher dedicated to ABCT’s mission. She is known for her contagious enthusiasm for the advancement of cognitive and behavioral science and practice. The purpose of this award is to recognize early career professionals who share Dr. Albano’s core commitments. This award includes a cash prize of $1,000 to support travel to the ABCT Annual Convention and to sponsor participation in a clinical treatment work- shop. Eligibility requirements are as follows: (1) Candidates must be active members of ABCT, (2) New/Early Career Professionals within the first 5 years of receiving his or her doctoral degree (PhD, PsyD, EdD). Preference will be given to applicants with a demonstrated interest in and commitment to child and adolescent mental health care. Applicants should submit: nominating cover letter, CV, personal statement up to three pages (statements exceeding 3 pages will not be reviewed), and 2 to 3 supporting letters. Application materials should be emailed as one pdf document to [email protected]. Include candidate's last name and “Albano Award” in the subject line. Nomination deadline: March 1, 2019

Student Dissertation Awards • Virginia A. Roswell Student Dissertation Award ($1,000) • Leonard Krasner Student Dissertation Award ($1,000) • John R. Z. Abela Student Dissertation Award ($500) Each award will be given to one student based on his/her doctoral dissertation proposal. Accompanying this honor will be a monetary award (see above) to be used in support of research (e.g., to pay participants, to purchase testing equipment) and/or to facilitate travel to the ABCT convention. Eligibility requirements for these awards are as follows: 1) Candidates must be student members of ABCT, 2) Topic area of dissertation research must be of direct relevance to cognitive-behavioral therapy, broadly defined, 3) The dissertation must have been successfully proposed, and 4) The dissertation must not have been defended prior to November 2018. Proposals with preliminary results included are preferred. To be considered for the Abela Award, research should be relevant to the development, maintenance, and/or treatment of depression in children and/or adolescents (i.e., under age 18). Self-nominations are accepted or a student's dissertation mentor may complete the nomination. The nomination must include a letter of recommendation from the dissertation advisor. Please complete the nomination form found online at www.abct.org/awards/. Then e-mail the nomination materials (including letter of recom- mendation) as one pdf document to [email protected]. Include candidate’s last name and “Student Dissertation Award” in the subject line. Nomination deadline: March 1, 2019

President’s New Researcher Award ABCT's 2018-19 President, Bruce Chorpita Ph.D., invites submissions for the 41st Annual President's New Researcher Award. The winner will receive a certificate and a cash prize of $500. The award will be based upon an early program of research that reflects factors such as: consistency with the mission of ABCT; independent work published in high-impact jour- nals; and promise of developing theoretical or practical applications that represent clear advances to the field. Requirements: must have had terminal degree (Ph.D., M.D., etc) for at least 1 year but no longer than 6 years; must submit an article for which they are the first author; 2 letters of recommendation must be included; self-nominations are accepted; the author's CV, letters of support, and paper must be submitted in electronic form. E-mail the nomination materials (includ- ing letter of recommendation) as one pdf document to [email protected]. Include candidate's last name and "President's New Researcher" in the subject line. Nomination deadline: March 1, 2019

Nominations for the following award are solicited from members of the ABCT governance:

Outstanding Service to ABCT Please complete the nomination form found online at www.abct.org/awards/. Then e-mail the completed form and associat- ed materials as one pdf document to [email protected]. Include “Outstanding Service” in the subject line. Nomination deadline: March 1, 2019

February • 2019 59 the Behavior Therapist PRSRT STD Association for Behavioral and Cognitive Therapies U.S. POSTAGE 305 Seventh Avenue, 16th floor PAID New York, NY 10001-6008 Hanover, PA 212-647-1890 | www.abct.org Permit No. 4 ADDRESSSERVICEREQUESTED

call for submissions The ABCT Research Facilitation Committee is sponsoring a grant of up to $1000 to support graduate student research. Eligible candidates are gradu- ate student members of ABCT seeking funding for a currently unfunded (including internal sources of funding) thesis or dissertation research pro- ject that has been approved by either the faculty advisor or the student's Graduate full committee. The grant will be awarded based on a combination of merit Student and need. For full information on what to submit, please go to: Research http://www.abct.org/Resources/?m=mResources&fa= GraduateStudentGrant

Grant To submit: Please e-mail the required documents to Shannon Sauer-Zavala, Ph.D., at [email protected]. Include "Graduate Student Research Grant" in your subject heading. s Applications are due March 1, 2019