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.

Shame and Guilt

Shame and guilt

Learning Objectives

After reading this chapter you should:

  • be aware of how shame and guilt impact on therapist, client and therapy;
  • have an understanding of the skills needed to negotiate barriers to disclosure and therapeutic progress due to shame and guilt experiences;
  • have knowledge of management interventions.


Therapists can never predict entirely what underlies the client's presenting problem. This chapter describes the various ways shame and guilt can create obstacles in therapy and explores management strategies.

Clients present in different ways to therapy. Some are reticent and struggle to disclose the details of their problem; others may be hostile and defensive. Shame-based experiences from past events can present in a covert way. The experience of shame can evoke strong feelings, which can impact on therapeutic ...

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