What are the basic steps in a cognitive-behavioral approach to a presenting problem?

• A. Identify maladaptive thoughts/behaviors, examine distortions, develop alternative beliefs, teach skills, assign homework, monitor progress.
• B. Focus on dream analysis.
• C. Emphasize insight into childhood trauma.
• D. Use only medication management.

Answer: (A)

Cognitive-behavioral work is a structured, present-focused process that targets how thoughts, feelings, and behaviors fuel the presenting problem. The steps align with actively identifying the maladaptive thoughts and behaviors driving the issue, examining the distortions in those thoughts, and then developing and testing more adaptive beliefs. From there, you teach practical skills to cope and solve problems, assign homework to practice between sessions, and monitor progress to see what helps and adjust accordingly. This sequence—identify maladaptive thoughts/behaviors, challenge distortions, replace with alternative beliefs, teach skills, assign homework, and track progress—embodies how CBT works in practice. The other approaches cited don’t reflect this structured, here-and-now, skill-building process; dream analysis is more aligned with psychodynamic exploration, focusing on past experiences and unconscious material, childhood trauma insight emphasizes past experiences rather than current cognitive-behavioral patterns, and medication management centers on pharmacological treatment rather than psychotherapy.