Practical CBT: Using transdiagnostic case formulations and therapies based on problem-maintaining circles

Gary Bakker




In 2008, clinical psychologist Gary Bakker introduced the problem-maintaining circle (PMC) model to the teaching and clinical application of cognitive behaviour therapy (CBT). PMC Theory allows the development of consistent CBT-based assessment, case formulation, and therapy selection resulting in effective practical interventions that are easily understandable, and complementary to the allied fields of medicine, psychiatry, and counselling. Since the first release of Practical CBT, his ground-breaking work has been in constant demand.

This new edition further develops the theoretical basis of the PMC model by describing a grand unified theory behind the simplified one presented to clients, and then extends the recommended assessment questions, taxonomy of PMCs, and homework activities beyond depression, anxiety, and anger problems, to the areas of health anxiety, eating disorders, relationship problems, chronic pain, obsessive–compulsive disorder, substance abuse/dependence, and sexual problems.

This is the ultimate ‘how-to’ manual for CBT therapists, drawing on 40 years of trial-and-error clinical practice in communicating the CBT approach to people, getting them to do their ‘homework’ effectively, and selecting and applying evidence-based CBT therapies. It includes 72 Homework sheets, including verbatim scripts to help ensure clients get the best out of their homework.

About the Author

Gary Bakker is a clinical psychologist with 40 years of experience working with children, adolescents, adults, couples, and families in clinics, hospitals, community centres, and for 30 years in private practice. He trained in CBT when it was newly emerging as the evidence-based therapy of choice, receiving the Fiona Allen Prize for academic excellence during his masters program. Gary has since given innumerable seminars and workshops on themes in CBT, all the while honing its presentation, clarity, and acceptability for his clients, resulting in the verbatim suggested scripts that comprise much of this book. He has bridged the gap between attention to the psychotherapy process and outcome research, and the demands of practical real-world therapy. The result is a whole new non-medicalising conception of clinical psychological problems, called PMC Theory.