Overcoming Obstacles in CBT comes to the rescue of anyone struggling with the challenges of practicing CBT, whether you are a trainee working under supervision or a qualified practitioner. It examines key obstacles, issues and difficulties encountered over the course of the therapy, illustrated with extensive case examples. Learning objectives, practice exercises and further reading lists help you engage with and relate the issues to your own practice.

Working with Physical Symptoms

Working with physical symptoms

Learning Objectives

After reading this chapter, the reader should:

  • recognise physical symptoms as obstacles to therapy;
  • be able to formulate a CBT-based bio-psychosocial understanding of physical symptoms as obstacles to progress in therapy;
  • understand a hypothesis-based approach to the targeting of obstacles associated with physical symptoms.


Physical symptoms, with or without a medical explanation, can distress clients and those around them. It can be difficult for clinicians to distinguish the ‘real’ from the ‘imagined’ and the symptoms themselves can become an obstacle in therapy. The case of Pat illustrates a client presenting with physical symptoms.

The Case of Pat – ‘It's My body Not My Brain!’

Pat has been referred by her GP, suffering with pain in her limbs. She complains of swollen legs, ...

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