Lesson - 05 CBT

Cognitive Behavioural Therapy
Lesson 5
Behavioural Techniques
Positive Statements
Positive Affirmations
Behavioural Experiments
Exposure
Activity Scheduling
Useful Physical Techniques
Relaxation
Controlled Breathing
Sleep Management
Exercise
Behavioural Techniques
Using cognitive behavioural techniques is a practical and very useful model for
helping bring change to the client‘s mindset and view situations in a
constructive way as opposed to their previous negative thought process.
It is a model frequently used within CBT with very positive results for clients
and research evidence has demonstrated that it is effective.
Often clients commonly think self critical thoughts or judge themselves (or
others) in extreme ways. It may well be then that the client would benefit from
the intervention of some behavioural techniques.
If a client has a tendency to engage in thought and behaviour practices known

as:
Mind Reading
This is where the client imagines that other people are thinking negative
thoughts about them even when there is little objective evidence to support that
and then they start acting out on that assumption.
Fortune Telling
This is where the client imagines negative things happening which are not
necessarily going to happen.
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In some cases the client‘s anxieties about them may increase the likelihood of
them happening as when, for example, they worry about their partner having an
affair. They allow this to influence their behaviour towards their partner in such
a way that their partner then feels attacked or controlled and seeks to break free.
All or Nothing Thinking

This is where the client sees everything in extreme terms when in fact there may
be some positive and some negative aspects or consequences to the situation.
A CBT practitioner trained in cognitive behavioural techniques will aim to help

the client to identify these thought patterns and find ways of substituting more
realistic and constructive ways of thinking.
One technique that can be used to counter negative thoughts is to make a note of
what is going through the client‘s mind and then create a positive statement.
As an example, a client might note the following thought and then create a
positive statement:
Negative Thought Positive Statement
I arrived 30 minutes late for work On this occasion I arrived 30

again. I am hopeless. I can never minutes late. Punctuality is not my
get to work on time. I will get the strong point but I am going to work
sack if this keeps happening. on it to try to improve, by practical
measures such as setting my alarm
clock 40 minutes earlier in the
morning and stop hitting the snooze
button. The rest of my work is good
and I have told my manager that I
am attending CBT sessions to
address my ongoing time
management issue.
In the example given, the positive statement does not seek to pretend that there
is no difficulty or that the client is perfect. Instead it tries to help the client put
things in perspective and come up with positive realistic actions to try to
improve their situation.

Negative self critical thoughts quite often contain words such as ―never‖ or
―should‖ which are either extreme or else moralistic in their self condemnation.
The use of positive statements is to moderate these elements in a realistic way to

help the client achieve a more balanced approach to themselves, to others and to
their life.
Affirmations
One technique that a therapist can use with the client if the client finds
themselves frequently being self critical is to draw up a list of ‗affirmations‘ – a
list of their positive qualities and experiences. They then read the list through
on a daily basis or at times when they are feeling low, to remind themselves of
the positive aspects that they frequently tend to forget.
If the client is unable to think of positive qualities immediately then the

therapist can suggest that the client ask trusted friends what they like about them
or consider what the client‘s positive qualities or achievements are and use these
as a starting point.
This technique can be helpful if the client is experiencing low self esteem or self
loathing behavioural traits.
Examples of Positive Affirmations are:
I am a good person.
I am a hard working person.
I am kind.
I am successful.
I am finding peace and happiness in all I do.
I am a loving and caring person.
My friends and family love and respect me.

I know that everyday I am improving.
I give 100% to everything I do.
I am an intelligent and logical person.
Behavioural Experiments
Within behavioural techniques used within CBT, one of the best known and
widely recognised techniques used are behavioural experiments.
Behavioural experiments are pre-planned experiential activities, based upon

experimentation or observation.
These experiments are undertaken by clients during or between CBT sessions.
Their design is taken directly from the formulation of the problem and their
main purpose is to obtain fresh relevant information regarding the presenting
issue.
They also test the actual validity of the client‘s beliefs about themselves, other
people and the world around them.
They are also used to build and test more adaptive or positive beliefs.
And finally, they contribute to the overall development and authentication of the
formulation.
Basically, behavioural experiments are designed very akin to a scientific

experiment to actually generate evidence that will help the therapist and client
to decide on what form of treatment is most appropriate for the particular
presenting issue.
By testing the client‘s predictions regarding certain situations or disempowering

cognitions or identifying specific elements of the formulation through action
and observation rather than just verbal discussion, the client and therapist have
much stronger facets of the problem to explore and deal with, which is vital in
CBT.

An example of a behavioural experiment within the CBT context would be:
A client who has an issue with lifts
The main goal of the session in the lift would be to help the client test out their
negative beliefs about what would happen once in a lift.
If the client has a fear of passing out in a lift or a panic attack, when the
experiment occurs, do they actually pass out or have an attack or does it just feel
like they might?
Throughout the experiment the client would be asked to observe how the
session impacts upon them physically, emotionally and behaviourally.
Normally, in this type of experiment, the client may well feel that they will lose
control within the process but frequently do not.
This works in two ways, firstly the client by not losing control or passing out
proves to themselves that whilst the thought was there, the resulting action did
not occur and that if they engage in the situation that causes then so much
anxiety again then the situation may not be as distressing as they had
anticipated.
Frequently, within the CBT process, continuous repeated experiments are

performed by the client, often with the therapist there with them giving support,
observing and monitoring the situation. As the frequency of the experiments
continue the less concerned the client becomes about the presenting issue or
situation.
Points to remember when planning a behavioural experiment are:
Both the therapist and client fully understand the purpose and reason for the
experiment and work together to plan it.
The therapist and client should be fully aware of what cognition they will be
testing and have a firm concept they will be testing.
e.g. If a client can only say that the situation will be awful and cannot define
exactly how it will be awful this makes the testing of the cognition almost
impossible as the term awful is completely subjective.

Instead, if a client says that they are afraid that people will laugh at them
openly, it is far easier to test as it can be seen as happening or not and thus
proved or disproved.
The client will need to be able to rate their belief of a cognition before it is
tested. e.g.: 0-100% - 0% = not at all to 100% = completely certain that it is
true.
Decide whether the experiment will be observational e.g.: using the lift scenario
– actually observing people going in and out of a lift for a period of time,
observing how it makes the client feel, if the people in the lift pass out or have
panic attacks and possibly researching lift based anxiety disorders.
Or if the experiment will be active e.g. going into the lift and experiencing the
experiment for themselves.
It is worth remembering, observational experiments are much less threatening

and daunting for a client to engage in so it is often far more successful to start
with the observational and gradually move up to the active participation
experiments.
Experiments need to be designed so the client does not feel like they have lost
and that there is always a positive outcome in some shape or form.
e.g. if the client engages in the active participation lift experiment but has a
minor panic attack then whilst this did occur, at least they did not pass out so
that one of their cognitions was proved as untrue.
That the therapist has a contingency plan to deal with the experiment should it
go badly wrong e.g.: in the active lift experiment if the client had a major panic
attack and passed out, would the therapist know how to contain and deal with
the situation, if there were complications, could the therapist summon extra
assistance or medical support?
The client needs to be fully engaged in the actual situation as opposed to just
going through the motions.
The client and therapist need to be continuously monitoring and observing the
client‘s physical sensations, emotions, thought processes and behaviours, whilst
undertaking the experiment, with one of them recording the process and
outcome of the experiment.

Exposure
If the client continually reacts with anxiety, fear or anger to particular events or
situations, these reactions can be cut down to size with exposure procedures.
This technique works particularly well with phobias.
Basically, this involves exposing the client to the situations and remaining in
them until the emotion diminishes, which takes only a few minutes providing
the client can resist escaping physically or mentally, and avoid catastrophic
thoughts about not being able to cope.
This is a challenging task which takes practice but can work extremely well.
It is often better and more successful to first rehearse the situation in the client‘s
imagination, this is known as ‗imaginal exposure‘ before tackling the situation
or issue directly which is known as ‗in vivo exposure‘.
Activity Scheduling
In depression and sometimes in anxiety conditions as well, it is very common to

avoid normal activities — either in an attempt to prevent emotional distress or
because the client lacks normal energy or motivation.
This is perfectly understandable, but its effect is to worsen and prolong the
depression and anxiety.
Activity Scheduling is a strategy for getting the client up and moving so that
they can experience more of the positive things in life that they have been
missing while they were trying to avoid the discomfort and anxiety and fear of
the situation or issue.
The therapist and client work together to develop lists of activities that are
usually either pleasurable in themselves or that give the client far greater control
of themselves and their environment.
Then, the therapist and client schedule times and places to carry them out in
increasing ―doses.‖

The underlying strategy to this form of behavioural technique is: ―Do better and
more now, feel better later.‖
Interestingly, recent research evidence suggests that behavioural activation by

itself may be able to do as much as extreme cognitive modification to change
depressive and anxious thought patterns.
Useful Physical Techniques
Physiological responsiveness is one of the 4 main interacting systems.

The other three being thoughts, moods and behaviour, that are the basis of CBT.
Physical symptoms caused by mood and behaviours can also create moods and
behaviours and they are cyclic and self-perpetuating.
Now, let us look at the physical symptoms can affect a client who has major
issues or problems causing them anxiety, stress and negativity.
Tiredness
Sleep problems
Lethargy
Dizziness
Palpitations
Stomach problems
Sweating
Headaches
Breathing Difficulties
Exhaustion

Bodily aches and pains
General physical discomfort
Within the CBT process or model the most important physical techniques are
relaxation, controlled breathing, sleep management and physical exercise.
Relaxation
Positive muscle relaxation actually involves tensing and relaxing in succession

16 different muscle groups within the body.
By teaching the client this form of coping strategy they are more empowered to
deal with a negative situation or presentation of their presenting issues
proactively, without having to wait to see their practitioner/therapist before they
can take active measures.
Firstly, ensure that the client and Practitioner are in a quiet, comfortable setting
that will not be disturbed.
Ask the client to take a few, deep, slow breaths before they commence.
Ask the client to tense each muscle group hard for about 10 seconds and then
slowly let go ( letting go too quickly from a muscle tension can cause cramp so
always remind the client of this).
Ask the client to allow the feeling of relaxation to continue for 15-25 seconds
dependent on what feels better for them and continue onto the next muscle
group requiring tension.
Ask the client to take notice of how each muscle group felt when completely
relaxed in direct contrast to how it felt when completely tensed before moving
onto the next muscle grouping.
The practitioner could also encourage the client to say ‗relax‘ to themselves in
their mind as they do so to give them an extra area of focus.
Now, let us look at the muscle areas to be worked during the exercise.

Firstly, ask the client to clench their fists and then hold for 10 seconds and then
slowly release.
Relax for 15-25 seconds.
Ask the client to tighten their bicep muscles by actively pulling their forearms
up and towards their shoulders and tightening both muscles to the point that the
bicep muscle can be seen visibly raised.
Hold for 10 seconds then slowly release.
Ask the client to tighten their tricep muscles, which are the muscles on the
underside of the upper arms, by extending their arms out straight and locking
their elbows.
Ask the client to tighten their forehead muscles by raising their eyebrows as
high as they can.
Ask the client to tighten their jaw by opening their mouth so widely that they
stretch the muscles around the jaw hinge area.
As they relax let their lips part and ask them to let their jaw hang completely
slack.
Ask the client to tighten the muscles around the eyes by clenching them tightly
shut.
As the client relaxes ask them to imagine and feel the sensation of relaxation
spreading throughout their face.
Ask the client to tighten the muscles in the back of their neck by gradually
pulling their head right back as if they were trying to touch their head to their
back. Encourage the client to focus only on tensing the muscles in the neck and
not back or shoulders.

At this point ask the client to take a few deep slow breaths and to feel the weight
of their head sinking back into the chair or couch or wherever they are doing the
exercises.
Then ask the client to tighten their shoulders by raising then right up as if they
were trying to touch their ears.
Ask the client to then tighten the muscles around their shoulder blades by
pushing their shoulder blades back as if they were trying to touch each other and
then ask them to be aware of the feeling of tension growing.
This step can be repeated if the client‘s upper back is still holding tension at this
point.
Ask the client to then tighten their stomach muscles by sucking their stomach
in.
Ask the client to be aware of the feeling of relaxation spreading throughout their
entire abdomen.
Then ask the client to tighten their lower back by arching it up (If the client
suffers any form of lower back pain or injury – this part of the exercise should
be ignored).
Then ask the client to then slowly tighten their buttocks by pulling them
together.
As the client relaxes ask them to imagine that their hips and pelvic area are
becoming loose and limp.
Ask the client to squeeze the muscles in their thighs – from the top of the thighs
down to the knees.

As the client is relaxing ask them to become aware of the sensation of their
thigh muscles relaxing completely and smoothing and lengthening out fully.
Then ask the client to tighten their lower legs and feet by pulling their feet
upwards and then curling their toes downwards.
Finally, ask the client to picture and feel a wave of complete relaxation slowly
spreading throughout their body, starting at their head and gradually sinking
through each of the muscle groups worked right down to their toes.
Repeat 2 more times until the client feels completely relaxed and at peace.
As part of the client‘s homework, they should be encouraged to practise these

exercises very regularly and in effect develop their own routine that they can
use for daily relaxation sessions but also to develop a smaller routine that they
can use whenever one of their presenting issues occurs or a crisis is triggered.
Controlled Breathing
The benefits of correct breathing are numerous and include oxygenating the
body and thus keeping it functioning and alive. Breathing carries oxygen to the
brain and the better the intake of oxygen the brain receives; the better it is able
to function. It keeps the heart rate and blood pressure down and is vital for
managing emotions and aiding relaxation.
Within CBT, learning to control the breathing is an important part of the entire
CBT process.
It also helps control the physical sensations that are apparent with high or
distressed emotion which is frequently part of a client‘s presenting issues.
Controlled breathing can empower the client to learn to feel calmer and more in
control of situations, no matter how they might affect them.
When learning controlled breathing, the client must first become aware of how
they actually breathe normally.
To do this, the practitioner/therapist will need to ask the client to lie on their
back, either in the clinic setting or at home, wherever is more appropriate, with
their knees slightly bent, in a completely relaxed position.

Then the client will need to place their right hand on their stomach, just where
their actual waistline is and then place their left hand on the centre of their chest
where the sternum is.
Then the client will need to breathe in and out but without changing their
normal breathing rhythm.
Ask the client to look for the hand that rises highest when they breathe in?
Is it the right hand – stomach?
Or
Is it the left hand – chest?
This exercise will tell the client and practitioner/therapist if the client is a deep
breather, which will show if the hand on the stomach lifts higher or a shallow
breather, which will show when the hand lifts higher on the chest.
Frequently, clients who undergo therapies especially CBT based models will
prove to be shallow breathers and this is because individuals who have an
excess of anxiety, worry or stress tend to be shallow breathers.
The client will also need to become aware of how their breathing is affected or
how it changes when they are in a stressful situation. Also how they feel in a
relaxed, non-threatening situation or environment.
Does the breathing become deeper or more shallow, faster or slower or is there
any irregular breathing, hyperventilation or anxiety hiccups or breathlessness or
stress asthma like symptoms?
The practitioner will need to ask the client to observe the differences and record
them in their workbook or CBT diary, whichever is more appropriate or in use.
When teaching a client controlled breathing, the practitioner will be evaluating

the client to see when their breathing process is actually calming the client down
as opposed to bringing them to the point of hyperventilation.
Ask the client to find a count and rhythm that feels completely comfortable to
them.
Then ask them to sit or stand, remember the controlled breathing is a coping
strategy that they will need to be able to use out and about in their every day
life. So if they can master the process standing up, it will be even better for
them.

Ask the client to place their hands on their stomach and chest, as they did
previously to check how they breathed.
Then ask them to breathe in slowly through their nose and count to 4.
Ensure that the client does this and that the hand on the stomach rises but that
the hand on the chest remains as still as possible.
Then ask the client to exhale slowly – counting to 4 again and ensure that the
client‘s hand on the stomach gradually sinks back down.
As the client is breathing in this controlled way ask them to clear their minds of
everything except the breathing.
This works in two ways. Firstly, by concentrating on the breathing in a crisis

situation they will be more likely to control negative emotions or cognitions
rising up out of control and flooding them and second because it serves as a
very good distraction to deal with general cognitions.
The client will need to record in their diary or workbook each time they
complete the exercise, how it felt and the thoughts around its effects. Also
whether and how they used it in a real life situation to counter a crisis or trigger
cognition.
This exercise needs to be practised several times a day until it becomes

completely natural for the client and that they can do it without thinking how it
is done. This is because if they are having a crisis, the last thing on their mind
will be breathing in a controlled focused manner.
Sleep Management
One of the most common problems when a client is in a low mood state and
their thought processes are negative is failing to get a good nights sleep or much
restorative rest.
Specific or free-floating worries and anxiety, stress and depression can all
trigger sleep problems. These problems trigger other symptoms which then
make it much harder to deal positively and pro-actively with the negative
thoughts, feelings and behaviours that originally triggered the sleep problems in
the first place.

The vicious circle of sleep depravation affects the client in many ways and this
plays out as:
CBT issues causing lack of sleep or rest = Tossing and Turning in bed =
Frustration at lack of sleep = Tiredness = Lethargy = Worrying about lack of
sleep = Physical affects = Emotional effects = Doing less because of exhaustion
= Life appears to be getting harder = Exacerbation of cognitions/CBT
presenting issues = Lack of sleep.
The client needs to be aware of the fundamentals of the sleep process in order to
be able and capable of working with the issue in an empowered fashion.
Generally, an average night‘s sleep can range from 3-11 hours.

The rule of thumb is that if the client wakes the next day feeling awake,
refreshed and physically and emotionally well, then they have achieved suitable
and adequate sleep.
On average, it takes between 20-30 minutes to fall asleep.
There are 4 stages of sleep in the normal sleep cycle.
Stage 1: Drowsy Sleep - This is the transitional period of time between, being
awake and falling asleep. This makes up 3-7% of the total night‘s sleep.
Stage 2: Light Sleep - This makes up for 40-50% of the night‘s sleep.
It includes all the important stages of sleep and this is where REM (Rapid Eye
Movement), also known as dreaming sleep if found. REM is the part of the
sleep cycle where information is processed, memories are fixed and set and the
nervous system is restored.
Stages 3 & 4: Deep Sleep - During these stages, the human brain activity and
metabolic rates slows down, while growth and other tissue building hormones
are secreted.
Deep sleep is the most restorative time for the human body but it actually only
makes up 20-25% of the night‘s sleep.
After 90-120 minutes of sleep comes the first REM period. This can start by
lasting 5 minutes, but as the night or sleep period progresses these periods
become longer and can eventually last up to 60 minutes.

The remaining part of the night or sleep period – up to 50% is made up of stage
2 and REM sleep which are interspersed by very short periods of when the
individual is briefly awake but totally unaware.
This is based upon an average normal sleep pattern but when sleep difficulties
happen, no matter the reason, the cycle becomes disjointed and becomes
chaotic.
Within CBT, sleep management is important as it can be almost impossible to

work with a client who is almost catatonic through sleep deprivation or so low
in mood that they are physically and emotionally unable to take a full part in
their recovery.
So, restoring an appropriate sleep pattern is vital for CBT to work fully and
successfully.
Below are some suggestions for a client experiencing sleep difficulties
Do not eat heavy meals near to bedtime - the energy required for the body to
digest the meal will keep the individual awake.
Take regular, moderate exercise such as walking or swimming, but remember to

leave a 3 hour gap before going to bed.
Make a ‗to-do-list‘ before going to bed this will relax the brain as it will not
need to keep that information current as it will all be down on paper.
Once the list is made, put it down, away from the bed room and forget about it
until the next day.
Relax before going to bed. Try a warm, not hot bath, use aromatherapy oils,
listen to music or practise gentle yoga or meditation.
Cut out tea and coffee during the evening.
The caffeine found in both is a stimulant that will wake up the metabolic rate
and stimulate the nervous system jolting the body and mind awake.
Try a warm milky drink or a herbal tea instead.
If the client cannot avoid irregular hours due to work or family commitments,
make the biological clock follow a set pattern by trying to have 4 hours sleep at
the same time every day.

Whilst the client may well be tempted to a have an alcoholic drink before
retiring as an aid to relaxation or to deal with feelings of anxiety, worry or
annoyance, advise against it.
Alcohol will cause sleep disturbances because the body, mainly the liver then
has detoxify the alcohol out of the body and this creates major sleep
disturbances.
And if the client cannot sleep, encourage them not to lie in bed worrying that
they cannot sleep or brooding on their cognitions. Advise them to get up and do
something relaxing until they do actually feel sleepy and only then return to
bed.
Physical Exercise
Within the CBT process, low mood, anxiety and upsetting cognitions are often
partially treated by physical exercise.
The reason that physical exercise is frequently used in CBT is because by doing
regular focused exercise, something that raises the heart rate for a period of 30
minutes, the human body is quite capable of producing its own natural anti-
depressant, serotonin.
Serotonin is known as the ‗feel-good‘ chemical which helps to maintain positive

stable moods which works well within the CBT model.
Clients are far more likely to engage in regular exercise if they understand why
they need to do it and the subsequent benefits.
The benefits of exercise are:
It keeps energy levels raised.
It oxygenates the body which keeps the blood and circulation healthy.
It reduces stress physically by refocusing the individual‘s energy into something

constructive for health and general well-being.
It slows down the breathing and focuses it.

It lowers the heart rate.
It decreases blood pressure.
It keeps the muscles in the body healthy and toned.
It helps with weight management, which then can help prevent diseases related
to obesity such as strokes, heart failure and diabetes.
It releases Serotonin which stabilises mood.
Any form of exercise will be useful for the client but they will need to find
some activity that they enjoy doing. If it becomes a tedious chore to them, they
will allow the concept of exercise to fall by the wayside.
Ideally, they should be looking at something that raises the heart rate for 30-45
minutes per session at least 3 times per week to maximum benefits.
Exercises that a client could use include:
Walking
Swimming
Cycling
Jogging
Cross country running
The Gym
Martial Arts
Dancing
Hiking
Riding

Whatever form of exercise the client chooses to engage in, they will need to
observe how it makes them feel physically, mentally and emotionally and then
record their observations in their CBT diary or workbook so that it can reviewed
on a regular basis by their therapist.
© Sue Etherden 2008

The right of Sue Etherden to be identified as the author of this work has
been asserted by her in accordance with the Copyright, Designs and
Patents Act 1988.

QUESTIONS ON LESSON FIVE
Q1. What occurs in stage 2 Sleep and why is it so important?
Q2. What are the physical symptoms that can affect a client who has
major issues or problems causing them anxiety, stress and
negativity?
Q3. What conditions can Activity Scheduling work well for?
Q4. What is your understanding of ‘Exposure’ within the CBT context

and what condition is it frequently used for?
Q5. What physical exercise would you advise a client to try?
Q6. What are behavioural experiments used for? Give an example of an

active experiment?
Q7. What chemical is released when exercising regularly and why is it

important within the CBT context?
Q8. What advice would you give a client who is experiencing sleep
difficulties?
Q9. Explain how a client could become aware of how they actually
breathe?
Q10. Design a relaxation exercise for a client?

Return your answers to either:
Dr.neetaparate9@gmail.com
Do not send any attachments; just type your answers into the body of
the email, some formatting required.
Please complete the subject box of every email exactly as

follows
(This has to be machine read and is Case Sensitive):
Your Name – CBT (tutored) – Lesson Number
Leave at least one blank line between each answer.
Don’t forget to keep a copy for your own records

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Cognitive Behavioural Therapy

If a client has a tendency to engage in thought and behaviour practices known

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

All or Nothing Thinking

A CBT practitioner trained in cognitive behavioural techniques will aim to help

Negative Thought Positive Statement

I arrived 30 minutes late for work On this occasion I arrived 30

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

The use of positive statements is to moderate these elements in a realistic way to

If the client is unable to think of positive qualities immediately then the

Examples of Positive Affirmations are:

I am a hard working person.

I am finding peace and happiness in all I do.

I am a loving and caring person.

My friends and family love and respect me.

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

I know that everyday I am improving.

I give 100% to everything I do.

I am an intelligent and logical person.

Behavioural experiments are pre-planned experiential activities, based upon

These experiments are undertaken by clients during or between CBT sessions.

Basically, behavioural experiments are designed very akin to a scientific

By testing the client‘s predictions regarding certain situations or disempowering

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

An example of a behavioural experiment within the CBT context would be:

A client who has an issue with lifts

Frequently, within the CBT process, continuous repeated experiments are

Points to remember when planning a behavioural experiment are:

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

It is worth remembering, observational experiments are much less threatening

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

This technique works particularly well with phobias.

In depression and sometimes in anxiety conditions as well, it is very common to

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

Interestingly, recent research evidence suggests that behavioural activation by

Useful Physical Techniques

Physiological responsiveness is one of the 4 main interacting systems.

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

Bodily aches and pains

General physical discomfort

Positive muscle relaxation actually involves tensing and relaxing in succession

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

As part of the client‘s homework, they should be encouraged to practise these

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

When teaching a client controlled breathing, the practitioner will be evaluating

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

This works in two ways. Firstly, by concentrating on the breathing in a crisis

This exercise needs to be practised several times a day until it becomes

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

Generally, an average night‘s sleep can range from 3-11 hours.

On average, it takes between 20-30 minutes to fall asleep.

There are 4 stages of sleep in the normal sleep cycle.

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

Within CBT, sleep management is important as it can be almost impossible to

Below are some suggestions for a client experiencing sleep difficulties

Take regular, moderate exercise such as walking or swimming, but remember to

NEETA TRAINING & CONSULTING SERVICES WWW.NEETATCS.COM

Serotonin is known as the ‗feel-good‘ chemical which helps to maintain positive

The benefits of exercise are:

It keeps energy levels raised.