Teaching CBT without fear

Cognitive behavior therapy (CBT) is a well-established, empirically validated psychological treatment for depression, anxiety, and other disorders, but its assumptions, principles, and methods have recently been described as harmful and oppressive to clients in racial, ethnic, sexual, and other marginalized populations. The claim is that CBT's emphasis on altering these clients' thinking in more rational and helpful directions imposes the values of Western white culture while failing to address the discriminatory social, cultural and structural realities that serve to create and perpetuate the problems they experience. If students taking introductory, clinical, and abnormal psychology, not to mention those in graduate psychotherapy practica, are aware of and sensitive to these criticisms, they may not react well when their professors present CBT in uniformly positive terms, including by highlighting empirical research demonstrating its superiority over other therapeutic approaches for treating a wide range of clients and disorders. This article offers suggestions for teaching this content in ways that minimize unpleasant classroom consequences by establishing contracts with students that invite them to express their concerns about the alleged harmfulness of CBT while legitimizing the instructor's right to challenge them to think critically about the claims underlying it.