Clinical Psychology

learning is an active, not a passive, process. That is,
a host of personal characteristics and cognitive
processes influence behavior, sometimes indepen-
dently of stimuli, situations, or reinforcers. There-
fore, attempts were made to better investigate these

“new”influences on behavior, and treatments that

focused on these mediating, cognitive, and personal

factors were developed. In this section, we describe

a number of different cognitive-behavioral treat-

ment approaches.

work with clinical populations both in the context of

research and treatment settings was both personally

rewarding and necessary from a professional develop-

ment standpoint.

Any additional hints for applying to graduate school in

clinical psychology?

Both on paper and in person, present yourself as gen-

uinely as possible. Because applicants are selected on

the basis of overall match (i.e., for a certain research

advisor, for the particular year, for that particular pro-

gram, etc.), you won’t be doing anyone any favors by

trying to conform to some notion of a prototypically

ideal applicant.

What do you see as the advantages of a CBT approach

to working with adolescents?

Although my graduate training has been far more

influenced by CBT than any other orientation, I’ve had

the privilege of receiving supervision to work with

adolescent clients using complementary frameworks,

including those that are psychodynamically informed.

As a firm believer in“meeting the client where he/she

is,”I’ve made continuous efforts to receive broad,

integrationist training to better honor client prefer-

ences and expectations.

That said, to the best of my ability, my starting

point in therapy must be in accord with the evidence

base for a given problem. More often than not, the

evidence base for child and adolescent psychological

problems points to CBT. I have to admit that I’m cer-

tainly biased because I find that I’m usually relieved

that it does, particularly when working with adoles-

cents. Given that many adolescents lack agency (e.g.,

“My parentsmademe come!”) and are highly skeptical

of/anxious about the therapeutic process, I often find

that a CBT approach is uniquely suited to address and

alleviate these concerns. For example, by providing

early, authoritative psychoeducation about an adoles-

cent’s particular problem and the empirically based

likelihood of improvement with treatment, the essen-

tial question“Can you help? is often answered in the

affirmative. This goes a long way to reducing anxiety

and fostering trust and alliance. At the same time,

CBT’s emphasis on transparency of process (e.g.,

agenda setting, rationale provided for principle-based

techniques, etc.) not only arms the therapist and

adolescent client with a roadmap for treatment but

paves the way for ongoing, reciprocal collaboration

between adolescent and his/her therapist. At its core,

CBT assume that both the therapist and client are

experts—the therapist with respect to the treatment

and the adolescent with respect to his/her life chal-

lenges and strengths. I can’t imagine a better way to

approach an adolescent client than from a perspective

that assumes equal standing.

John Guerry

John Guerry

PSYCHOTHERAPY: BEHAVIORAL AND COGNITIVE-BEHAVIORAL PERSPECTIVES 415