The main skill in the work of a cognitive-behavioral psychologist, in addition to skillful cognitive debate, is the competent preparation of a conceptualization of a client case. In this article I will show, using an accessible example, what and how a psychologist should do in order to collect this conceptualization. So below are the stages of forming a conceptualization: 1. Description of the situation/situations (the word “trigger” would be more appropriate).2. Identification and structuring of emotions (for example, “I feel 70% angry”) 3. Identification of behavioral and physiological reactions (I wanted to hit, my muscles tensed) 4. Identification of automatic thoughts 5. Identification of intermediate beliefs (attitudes, rules, assumptions) 6. Identification of deep-seated beliefs and possible activating events 7. Identification of coping strategies (determination of behavioral reactions) In CBT, we focus only on situations that have happened to the client recently and are “fresh” to identify thoughts. For example, the client says that he suffers from rescuer syndrome, talks for a long time about. about how this interferes with him, but our goal is to gently redirect him from conclusions about himself to specific situations: “Remember the situation when you realized that you had this syndrome?” Next, we write down the situation. A friend complained about life, I started looking for solutions her problems. As a result, she continued to whine. The second stage of emotion: “What emotions did this situation evoke in you?” Let’s say it was anger at 60. The third stage: “What was in the body?” - Your arms tensed, the blood rushed to your face. "What did you do?" “I wrote to her that she was annoying me and didn’t want to solve her problems!” The fourth stage is one of the most important, in which the psychologist voices the main question of all cognitive behavioral therapy: “What were you thinking at that moment?” I thought about that that she is a whiner, and does nothing but complain to me about her life. She constantly wants to be saved, but I fall for it, she doesn’t want to do anything, but demands that others solve problems for her! At this stage it is also desirable. find cognitive distortions and help the client reformulate thoughts so that he sees these distortions for himself. For example: She is a whiner (labeling), always complains to me about life (generalization), constantly wants to be saved (mind reading). to this, and she should not whine (shoulds). She does not want to do anything, but demands that problems be solved for her (mind reading, hasty conclusions). In general, already at this stage in the first sessions, the psychologist can begin to work on it. automatic thoughts, which involves ridding these thoughts of cognitive distortions. But now our goal is to draw up a conceptualization. We go to the fifth stage. We identify intermediate beliefs using the falling arrow technique, usually these are two main questions: “What can this lead to?” and “What does this say about you/other people/the world?” Suppose we have already identified these beliefs. They may sound like this. If someone whines, then I must help. If I don’t help, then I am a soulless bad person. If someone whines, then he is weak and needs help. I must save the weak. If I save weak, then I am strong. A person should not ask for help. When a person whines, he demonstrates his weakness. And being weak is unacceptable. If I am weak, then it is dangerous and something can happen to me. To be weak is to be vulnerable. If I help, and a person resists my help (I help in vain), then this is work in vain, and this is unfair. If this is unfair, then I am a victim. Of course, at the initial stage of his practice, not every psychologist will be able to “squeeze” all intermediate beliefs out of 4 thoughts, but with skill it comes. All of the above beliefs are maladaptive, or dysfunctional, and require further challenging and formulating new beliefs that will be rational, without retreating into “positive” thinking. But again, this is work. Let's return to the plan. The sixth stage will be difficult to implement in one situation, because the client’s deepest beliefs are mostly!