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Cognitive Behavioral Therapy for Depression, Anxiety and Insomnia?




Cognitive Behavioral Therapy: History

Cognitive behavioral therapy was founded by the psychiatrist Aaron Beck M.D. in the 1960’s. As he was conducting research on psychoanalysis he noticed that an internal dialogue seemed to be taking place as patients thought through and discussed their problems. Beck is considered to be the founding father of cognitive behavioral therapy. Albert Ellis Ph.D. on the other hand, was a psychologist who was the original creator of the conventional cognitive therapies and some of the basic principles underlying cognitive behavioral therapy.

Albert Ellis Ph.D. and Rational Emotive Therapy

In the mid-1950’s, Albert Ellis Ph.D. began to recognize some very important principles associated with thinking and behaviors, which he then applied to his brand of psychotherapy referred to as rational emotive therapy. He discovered that people would develop strong beliefs which would affect their emotional reactions and functioning. He recognized that certain beliefs could be very irrational resulting in individuals becoming depressed, anxious or contributing to other self-destructive behaviors.

When he began to formulate his ideas in about 1955, the role of thinking or cognition had not been addressed in any significant way by the field of psychology. He developed the therapeutic modality of rational emotive therapy in reaction to the inadequate explanations and techniques of behaviorism and psychoanalysis. He concluded that the inadequacy of psychoanalysis and behaviorism resulted from a deficiency in conceptualizations of emotional disturbance and personality. He concluded that by ignoring the role of thinking or cognition in emotional disturbance, both therapeutic models failed to explain the development and maintenance of dysfunctional thinking patterns.




Aaron Beck M.D. and Cognitive Behavioral Therapy

Following upon the therapeutic model of Albert Ellis Ph.D. and his rational emotive therapy, Aaron Beck M.D. also began recognizing the importance of thinking or cognition in individual’s distress and dysfunction in their daily lives. He began to see that the connection between feelings, emotions and thoughts were crucial in understanding reactions and behaviors.

He also began to recognize that patients were not always aware of their emotions and thoughts and were very incapable of identifying how their thoughts affect their behaviors. He began to recognize that when an individual is upset for example, their thought process is generally negative, destructive and frequently impractical. It became very apparent to Dr. Beck that individual’s thoughts played a huge role in understanding and being able to overcome life’s challenges.

As he continued to develop his therapeutic model, Dr. Beck began to consider that these skewed thinking processes were actually the result of what he considered to be automatic, involuntary thoughts, and that people have a tendency to accept them as true without considering any other alternatives. His cognitive behavioral therapy model began to emphasize the transformation of automatic thoughts by questioning their validity and whether they were an actual reflection of reality. He began to recognize that as an individual considers the existence of and then reduces or alters their destructive, self-critical or catastrophic thoughts, their sense of despair, worry, or depression would gradually decrease, and they would begin to live a more positive and satisfying life.

Literally thousands of studies have confirmed the effectiveness and validity of cognitive behavioral therapy. Many studies have suggested that cognitive behavioral therapy is more effective than medication alone in treating such conditions as insomnia and depression. It now seems to be the treatment model of choice for most psychologists, psychiatrists and other mental health clinicians. Part of its beauty is that it seems to be a very common-sense approach to treatment and can be used for almost any maladjusted behavior, where thoughts and ideas play a crucial role in the development and maintenance of dysfunctional patterns of thought and behavior.

An Overview of Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a relatively short-term psychotherapy model. It is a practical, results oriented approach to coping with a multitude of dysfunctional disorders including anxiety, depression, posttraumatic stress disorder, panic attacks, obsessive-compulsive disorder, social phobia, bipolar disorder, substance abuse, schizophrenia, eating disorders and anger issues as well as many others. Its goal is to help people to change the way they think and feel about specific situations in life as well as to change their resulting reactions and behaviors.

The therapy involves altering an individual’s attitudes and behavioral patterns by focusing on their thoughts, underlying beliefs, attitudes, and visual imagery. Cognitive behavioral therapy combines cognitive and behavioral psychotherapies and places an emphasis on the meaning ascribed to experiences and thought processes that can often be traced back to earlier childhood experiences. The behavioral aspect of therapy focuses on the connection between the challenges and obstacles faced as well as the actions and thoughts related to them. Negative and unpleasant thoughts can often lead to emotional distress and various other psychological issues. CBT attempts to help people to gain a better awareness of their negative interpretations and the behavioral patterns which arise from their skewed thinking processes. This therapeutic model frequently helps to develop alternative ways of processing thoughts and assists in developing new, more functional thoughts and behavioral patterns to mitigate psychological trauma and distress.

Three Models of Cognitive Therapy

The book Cognitive Behavioral Therapy by George Muntau has identified three major approaches to cognitive behavioral therapy. They are rational emotive therapy, Beck’s cognitive therapy and stress inoculation therapy.

Rational Emotive Behavior Therapy

Like cognitive behavioral therapy, rational emotive therapy also attempts to remediate maladaptive thoughts and behavioral patterns. It utilizes the process of discussion and persuasion to alter relevant thinking processes.

Beck’s Cognitive Therapy

As previously mentioned, Dr. Beck’s cognitive behavioral model originally developed for treating depression, is now used for a multitude of psychological disorders such as eating disorders, anxiety disorders, insomnia and even has been used in such specialties as sports psychology. The focus is on making the connection between maladaptive thinking patterns, feelings, and the resultant reactions and behaviors. Patients are trained to recognize and utilize automatic thoughts to alter thinking patterns and remediate their emotional distress.

Stress Inoculation Therapy

Stress inoculation therapy utilizes self-guided training to assist the patient in developing and utilizing self-transformational statements and affirmations. It is almost a “pep-talk” approach to altering thoughts and the resulting behaviors.

Cognitive Behavioral Therapy: Conclusion

Cognitive behavioral therapy is currently the model used by the majority of clinicians in providing psychotherapy for a whole variety of mental health disorders including depression, anxiety, insomnia and eating disorders as well as many others. It focuses on a common-sense approach to recognizing and dealing with dysfunctional thoughts which underlie distressful feelings and dysfunctional behavioral patterns. Current studies have found cognitive behavioral therapy to be just as effective as medications alone and to have superiority over medications in reducing the rate of relapse of various psychological disorders. Frequently, cognitive behavioral therapy is used in addition to medications for the optimal remediation of psychological disorders.

By Paul Susic Ph.D. Licensed Psychologist




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Senior Care Psychological Consulting in St. Charles, Missouri





The Only Strictly Doctoral Psychology Practice in St. Louis, Missouri

Senior Care Psychological Consulting is the premier provider of doctoral level geropsychology services for the metropolitan St. Louis, Missouri area. Senior Care Psychological Consulting is a specialty geriatric psychology practice providing psychological assessment, mental health counseling services, psychological testing, neuropsychological evaluation and disability evaluation to the elderly and chronic mentally ill in an office-based practice in St. Charles, Missouri. We also provide in- home services as well as providing services in nursing homes and other long term care facilities throughout the metropolitan St. Louis, Missouri area.




Paul Susic Ph.D. Licensed Psychologist and Senior Care Psychological Consulting

Senior Care Psychological was founded by Paul Susic Ph.D Licensed Psychologist who has been providing mental health services to the senior community for well over two decades. Paul developed one of the first exclusively geriatric psychiatric Partial Hospital programs in the St. Louis area, which he managed for approximately five years as the Program Manager at the former Incarnate Word Hospital. He also created and developed a whole continuum of outpatient mental health services which he also managed at Incarnate Word Hospital. He later was promoted to Director of the Department of Psychiatry of Incarnate Word Hospital, which he left in December, 1999 to begin a full-time geropsychology practice.

Paul Susic and Senior Care Psychological Counseling have continued their commitment to providing high-quality psychological assessment and mental health counseling services to the senior community. Senior Care specializes in providing psychological counseling and assessment services, psychological testing and neuropsychological evaluation in- home, in nursing homes and long-term care facilities throughout the metropolitan St. Louis area and also in an office based practice in St. Charles, Missouri. All services are provided under the direction of Dr.Susic who is the Clinical Director. Mental health assessments, testing as well as assessments for cognitive (memory) functioning and need for long-term placement are also available at senior care.

Please feel free to call and ask for Paul Susic Ph.D. Licensed Psychologist, and he will be pleased to assist you in any way possible. He may be reached at his office at (636) 300-9922 for local calls, or or he may also be reached by e-mail at seniorcarepsych@yahoo.com

Senior Care Psychological Consulting 500 Huber Park Ct. Suite 205, Weldon Spring, MO 63304

Information and webpage by Paul Susic Ph.D. Licensed Psychologist




Senior Care Psychological Consulting:

St. Louis, Missouri Metropolitan Area Home Visits by Psychologists




Yes! Psychologists will make home visits in the St. Louis, Missouri metropolitan area.

Psychologist home visits in St. Louis, Missouri: Overview

Psychologist home visits in the St. Louis, Missouri metropolitan area are now available through Senior Care Psychological Consulting.We are proud and excited to announce home visits to include psychological assessment, counseling, psychological testing and neuropsychological evaluation services in patient’s homes throughout the metropolitan St. Louis, Missouri area.




These psychological services are provided by experienced and professional Licensed Psychologists to homebound seniors and individuals with chronic medical and mental illnesses. No longer does a lack of transportation or immobility have to preclude your loved ones from receiving the mental health services that they may really need. Services are provided under Medicare, Medicaid and various private insurers such as Blue Cross Blue Shield , AARP and United Healthcare.

Services are supervised and sometimes provided by Paul Susic Ph.D. Licensed Psychologist as well as various members of his professional senior psychological staff.

Get the assistance that you, your loved one or patient need for problem depression, anxiety, stress, anger issues, assessment for memory problems and various other mental health related issues now. We welcome referrals from individuals, senior and home health care agencies, as well as medical and mental health professionals, senior apartments and long term care facilities. Simply call (636) 300-9922. You may also reach us online by e-mailing seniorcarepsych@yahoo.com (Re: Referral Info.)

We welcome the opportunity to provide psychologist home visits in St. Louis, Missouri and would look forward to your call.





Senior Care Psychological Consulting:

Senior Care Psychological Consulting Counseling and Assessment, St. Louis Missouri




Senior Care Psychological Consulting Counseling and Assessment Services: St. Louis, Missouri

Who are we, how are we different?

Senior Care Psychological Consulting is a strictly geriatric psychology practice based in St. Charles County Missouri. All clinicians providing services are doctoral level psychologists who provide services to seniors and individuals with chronic medical and mental health concerns in nursing homes and long term care facilities throughout the St. Louis metropolitan area.




Senior Care’s Clinical Director (Paul Susic Ph.D. Licensed Psychologist) has been known for providing high quality geriatric psychology services to the senior community for well over 25 years. In developing Senior Care Psychological Consulting, he has developed an effective model based upon genuine care and concern for the patient and the utilization of the latest research-based models for providing care. After nearly a decade of providing and supervising the provision of care to the senior community at Incarnate Word Hospital in St. Louis, Missouri he has brought this same concern and level of effectiveness to the community. In addition to utilizing an office-based practice in St. Charles, Missouri, Senior Care provides counseling and assessment to nursing homes and other long term care facilities and will even make house calls when appropriate and clinicians are available.

How effective is Senior Care Psychological Consulting?

Senior Care provides only high quality doctoral level licensed psychologists and relies upon various research based outcomes measures in addition to our clinical observations and discussions with other healthcare providers and family members, to enhance our effectiveness. Our effectiveness studies for patients living at home and in nursing homes continue to demonstrate an average of approximately 30-60% improvement in depressive and anxious symptoms for patients already on psychotropic medications. Current research continues to demonstrate the effectiveness of psychotherapy without medication as well as the significant additive effect when patients are on medication, as well as that improvements in psychological symptoms reduce mortality, improve quality of life, and reduce the incidence of falls among the elderly.

How can we help you?

Our approach for a community based individual is to maximize their functioning and quality of life in an effective, measurable manner. Our focus is a little different in the nursing home environment in that we emphasize our assistance to both the resident and the nursing home. We provide a regular, consistent presence (usually weekly), and spend significant time with the patient to ensure maximum care. Also, we focus our efforts on assisting the nursing facility in providing and documenting significant psychosocial interventions to assist in meeting the requirements of OBRA. We provide free inservicing to staff, assist with families (including family therapy) when appropriate, and emphasize collaboration with the attending physicians and psychiatrists to ensure the maximum in functionality and quality of life to the resident.

Ultimately, what benefits does Senior Care Psychological provide?

Our emphasis is on improving quality of life, decreasing vacancy through hospitalization and mortality, reducing staff time with demanding residents, in servicing, assisting with state and federal requirements (primarily OBRA) and establishing mutually beneficial long-term referral relationships.





Senior Care Psychological Consulting: