Working with Emotion in Cognitive-Behavioral Therapy

Techniques for Clinical Practice

Edited by Nathan C. Thoma and Dean McKay

Hardcovere-bookprint + e-book
October 20, 2014
ISBN 9781462517749
Price: $58.00
416 Pages
Size: 6" x 9"
October 31, 2014
ePub and PDF ?
Price: $58.00
416 Pages
print + e-book
Hardcover + e-Book (ePub and PDF) ?
Price: $116.00 $63.80
416 Pages

Working actively with emotion has been empirically shown to be of central importance in psychotherapy, yet has been underemphasized in much of the writing on cognitive-behavioral therapy (CBT). This state-of-the-art volume brings together leading authorities to describe ways to work with emotion to enrich therapy and achieve more robust outcomes that go beyond symptom reduction. Highlighting experiential techniques that are grounded in evidence, the book demonstrates clinical applications with vivid case material. Coverage includes mindfulness- and acceptance-based strategies, compassion-focused techniques, new variations on exposure-based interventions, the use of imagery to rework underlying schemas, and methods for addressing emotional aspects of the therapeutic relationship.

“This book covers a broad range of topics that encompass both traditional and non-traditional approaches to cognitive behavioral therapy. This includes useful discussion on compassion, mindfulness, image rescripting, and relational techniques. The book is uniquely placed in the CBT literature in its focus on emotion as the central theme in the therapeutic process. It is well structured, taking the reader on a journey through a wide variety of emotions followed by techniques that are relevant to particular diagnoses. This includes significant contributions from leading clinicians discussing their respective areas of expertise….Each chapter skillfully educates the reader on techniques whilst presenting a solid research base which has informed the therapeutic process. This book will be of relevance and interest to clinicians and CBT practitioners of all levels of experience.”

The Psychologist

“This outstanding volume brings together the latest theory, research, and clinical strategies underlying experiential approaches to working with emotion in therapy. The contributors are the leading clinical scientists in the areas of emotion acceptance and compassion, emotion during exposure therapy, imagery rescripting, innovative ways of managing emotion in therapy sessions, and relational techniques. The chapters are brimming with useful dialogue and examples of how to apply these techniques. This is a 'must read' for practicing clinicians of all levels.”

—Michelle Craske, PhD, Professor and Vice Chair of Psychology and Director, Anxiety Disorders Research Center, University of California, Los Angeles

“Unlike many books that offer a limited perspective on what constitutes evidence-based practice, this volume is unique in that it is not restricted to a single theoretical orientation. Although it is basically a cognitive-behavioral book, the editors have included data-based chapters from distinguished contributors from varying orientations—making it a truly ‘evidence-based’ contribution to the literature. The important organizing theme that cuts across orientations is the significant role of emotion in the therapy change process. As such, this book represents an important, cutting-age perspective.”

—Marvin R. Goldfried, PhD, Distinguished Professor of Psychology, Stony Brook University

“Psychotherapy is becoming less tied to specific traditional schools, and psychotherapists of different persuasions are moving beyond emphasizing one single mode of functioning. Thoma and McKay have brought together an esteemed group of researchers and clinicians working to refine our interventions by examining techniques, modes of behavior, and models not generally highlighted in CBT. This book will be seen as an important step toward the creation of what will be called 'cognitive affective behavior therapy.' With its emphasis on affect and experience, it will be of interest to practitioners and advanced graduate students thirsty for a more complex view of human suffering and its solution.”

—Jacques P. Barber, PhD, ABPP, Dean and Professor, The Derner Institute of Advanced Psychological Studies, Adelphi University

“Thoma and McKay have gathered serious scientific minds to explore how to broaden and deepen clinical work with emotional experience. Techniques aimed at developing mindfulness, compassion, and the therapeutic alliance are discussed both in the form of new approaches and also in combination with ‘tried and true’ CBT methods. It is the nature of scientific efforts to go through periods of stability followed by periods of dramatic change. This book comes at a time of great change, making it an asset to clinicians who are interested in the growth and development of CBT.”

—Kelly G. Wilson, PhD, codeveloper of acceptance and commitment therapy; Department of Psychology, University of Mississippi

Table of Contents

Introduction, Nathan C. Thoma & Dean McKay

I. Acceptance as Engagement: Noticing, Allowing, and Being with Emotion

1. Mindfulness: It’s Not What You Think, Christopher Germer & Christian S. Chan

2. Understanding and Taking Advantage of Experiential Work in Acceptance and Commitment Therapy, Jennifer C. Plumb Vilardaga, Matthieu Villatte, & Steven C. Hayes

3. Compassion-Focused Therapy: An Introduction to Experiential Interventions for Cultivating Compassion, Dennis Tirch & Paul Gilbert

II. Exposure: Evoking and Staying with Difficult Emotions

4. Exposure in Experiential Context: Imaginal and In Vivo Approaches, Dean McKay & Rachel Ojserkis

5. Behavioral Experiments: Using Experiences to Test Beliefs, Susan Daflos, Rachel Lunt, & Maureen Whittal

6. Application of Exposure and Emotional Processing Theory to Depression: Exposure-Based Cognitive Therapy, Adele M. Hayes, C. Beth Ready, & Charlotte Yasinski

7. Creating Change through Focusing on Affect: Affect Phobia Therapy, Kristin A. R. Osborn, Pål G. Ulvenes, Bruce E. Wampold, & Leigh McCullough

III. Using Imagery to Connect with Emotions and Transform Maladaptive Schemas and Beliefs

8. Imagery Rescripting for Personality Disorders: Healing Early Maladaptive Schemas, Arnoud Arntz

9. Imagery Rescripting for Posttraumatic Stress Disorder, Arnoud Arntz

10. Experiential Exercises and Imagery Rescripting in Social Anxiety Disorder: New Perspectives on Changing Beliefs, Jennifer Wild & David M. Clark

IV. Emotion-Focused Approaches: Capturing and Enhancing In-Session Emotion as a Step toward Change

11. Integrating Emotion-Focused Therapy into Cognitive Behavioral Therapy, Nathan C. Thoma & Leslie S. Greenberg

12. Working with Modes in Schema Therapy, Eshkol Rafaeli, Offer Maurer, & Nathan C. Thoma

13. Emotional Schema Therapy, Robert L. Leahy

14. Emotion Regulation Therapy: An Experiential Approach to Chronic Anxiety and Recurring Depression, Mia Skytte O’Toole, Douglas S. Mennin, & David M. Fresco

V. Working with Interpersonal Process: Using Clients’ and Therapists’ Emotional Reactions to Each Other as Vehicles for Change

15. Relational Techniques in a Cognitive-Behavioral Therapy Context: “It's Bigger Than the Both of Us”, Jeremy D. Safran & Jessica Kraus

16. Adding an Interpersonal–Experiential Focus to Cognitive-Behavioral Therapy for Generalized Anxiety Disorder, Thane M. Erickson, Michelle G. Newman, & Adam McGuire

17. Functional Analytic Psychotherapy: Using Awareness, Courage, Love, and Behaviorism to Promote Change, Mavis Tsai, Andrew P. Fleming, Rick A. Cruz, Julia E. Hitch, & Robert J. Kohlenberg

Conclusion. Experiential Methods, Cognitive-Behavioral Therapy, and Next Steps in Emotional Engagement in Treatments, Dean McKay & Nathan C. Thoma

About the Editors

Nathan C. Thoma, PhD, is Clinical Instructor of Psychology at Weill Cornell Medical College. He is a Diplomate of the Academy of Cognitive and Behavioral Therapies and serves as Member-at-Large and Membership Chair for the New York City Cognitive Behavioral Therapy Association. His clinical interests center on integrating experiential, interpersonal, and relational approaches into CBT, and he has undergone advanced training in emotion-focused therapy and schema therapy. Dr. Thoma has published on a variety of topics related to psychotherapy research, including an article in the American Journal of Psychiatry that was named by the editors as one of the seven most important articles of the year.

Dean McKay, PhD, ABPP, is Professor of Psychology at Fordham University, where he is a faculty member in the Doctoral Training Program in Clinical Psychology. He serves on the board of directors of the CBT specialty area of the American Board of Professional Psychology and is 2013-2014 President of the Association for Behavioral and Cognitive Therapies. He also serves on the Scientific Advisory Board of the International Obsessive-Compulsive Disorder Foundation and the Scientific Council of the Anxiety and Depression Association of America. Dr. McKay has published more than 195 articles, book chapters, and books, and is founder and codirector of a group private practice in White Plains, New York.


Arnold Arntz, PhD, Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands

Christian S. Chan, PhD, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong

David M. Clark, PhD, Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom

Rick A. Cruz, MA, Department of Psychology, Utah State University, Logan, Utah

Susan Daflos, MA, Vancouver CBT Centre, Vancouver, British Columbia, Canada

Thane M. Erickson, PhD, Department of Psychology, Seattle Pacific University, Seattle, Washington

Andrew P. Fleming, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

David M. Fresco, PhD, Department of Psychology, Kent State University, Kent, Ohio

Christopher K. Germer, PhD, Division of Psychology, Harvard Medical School, Boston, Massachusetts

Paul Gilbert, PhD, Mental Health Research Unit, University of Derby, Derby, Derbyshire, United Kingdom

Leslie S. Greenberg, PhD, Department of Psychology, York University, Toronto, Ontario, Canada

Adele M. Hayes, PhD, Department of Psychology, University of Delaware, Newark, Delaware

Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada

Julia E. Hitch, PhD, private practice, Seattle, Washington

Robert J. Kohlenberg, PhD, ABPP, Department of Psychology, University of Washington, Seattle, Washington

Jessica Kraus, MA, Clinical Psychology Program, New School for Social Research, New York, New York

Robert L. Leahy, PhD, American Institute for Cognitive Therapy, New York, New York

Rachel Lunt, PhD, Vancouver CBT Centre, Vancouver, British Columbia, Canada

Offer Maurer, PhD, The Center for Academic Studies, Or-Yehuda, Israel; Israeli Institute of Schema Therapy, Tel-Aviv, Israel

Leigh McCullough, PhD (deceased), Harvard Medical School, Boston, Massachusetts

Adam McGuire, MS, Department of Psychology, Seattle Pacific University, Seattle, Washington

Dean McKay, PhD, ABPP, Department of Psychology, Fordham University, Bronx, New York

Douglas S. Mennin, PhD, Department of Psychology, Hunter College, New York, New York

Michelle G. Newman, PhD, Department of Psychology, Pennsylvania State University, University Park, Pennsylvania

Rachel Ojserkis, MA, Department of Psychology, Fordham University, Bronx, New York

Kristin A. R. Osborn, MA, Department of Psychiatry, Harvard Medical School, Concord, Massachusetts

Mia Skytte O’Toole, MSc, PhD fellow, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark

Eshkol Rafaeli, PhD, Department of Psychology, Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel; Israeli Institute of Schema Therapy, Tel-Aviv, Israel

C. Beth Ready, PhD, Department of Psychology, University of Delaware, Newark, Delaware

Jeremy D. Safran, PhD, Clinical Psychology Program, New School for Social Research, New York, New York

Dennis Tirch, PhD, American Institute for Cognitive Therapy, New York, New York

Nathan C. Thoma, PhD, Department of Psychiatry, Weill Cornell Medical College, New York, New York

Mavis Tsai, PhD, Department of Psychology, University of Washington, Seattle, Washington

Pål G. Ulvenes, PhD, Research Institute, Modum Bad Psychiatric Center, Vikersund, Norway

Jennifer C. Plumb Vilardaga, PhD, VA Puget Sound HealthCare System, Seattle, Washington

Mattthieu Villatte, PhD, Evidence-Based Practice Institute, Seattle, Washington

Bruce E. Wampold, PhD, ABPP, Department of Counseling Psychology, University of Wisconsin, Madison, Wisconsin; Research Institute, Modum Bad Psychiatric Center, Vikersund, Norway

Maureen Whittal, PhD, Vancouver CBT Centre, Vancouver, British Columbia, Canada

Jennifer Wild, DClinPsy, Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom

Carly Yasinski, MA, Department of Psychology, University of Delaware, Newark,Delaware


Clinical psychologists, psychiatrists, clinical social workers, mental health counselors, and psychiatric nurses.

Course Use

May serve as a supplemental text in graduate-level courses.