Cognitive Conceptualization: Don’t get stuck in therapy again

With the Cognitive Conceptualization Diagram, you can develop a road map for your clients that shows them where their problems came from and sets them on a path to success.

It’s difficult to do good therapy without having an accurate case conceptualization. Jeff Riggenbach, PhD, LPC, says, “It’s like getting lost hiking on a mountain trail with no map. You don’t know where you’ve come from, and you don’t know where you’re going.”

But with the Cognitive Conceptualization Diagram, you can develop a road map for your clients that shows them where their problems came from to set them on a path to success.

Download the worksheet below, and watch this short video to learn how to use this tool effectively with your clients.


Download the Worksheet: Cognitive Conceptualization Diagram


Jeff Riggenbach, Ph.D., LPC, is one of the most sought after trainers in North America in the area of CBT and personality disorders. Over the past 15 years he has developed and overseen CBT based Mood Disorder, Anxiety Disorder, Borderline Personality Disorder treatment programs at two different psychiatric hospitals serving over 3,000 clients at multiple levels of care. Dr. Riggenbach trained at the Beck Institute of Cognitive Therapy and Research in Philadelphia, is a Diplomat of the Academy of Cognitive Therapy, and has presented in all 50 United States, Mexico, and Canada on topics related to CBT, DBT and Personality Dysfunction.


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Joaquin’s Deadly Fury: How to help others while not hurting yourself

The same CBT techniques that you may suggest to your clients can be equally beneficial to you in preventing compassion fatigue. If thoughts identified in a distressing situation involve a “what if” or “worst case scenario” thinking pattern, a technique from the book Overcoming Compassion Fatigue can help. Bonus: Free worksheet “De-Catastrophizing When Thinking the Worst.”

We’ve all seen horrific images in the aftermath of an angry hurricane Joaquin. Seeing massive flooding, loss of life, and a container ship presumably lost at sea with 33 crew members on board can leave us emotionally ragged even if we’re safe and dry in our own homes.

Worse than the devastating impact on property is the human toll of the storm. In his wake, Joaquin leaves grieving families and sorely traumatized people.

How can we better support the survivors of such overwhelming experiences? Whether our clients have been through a natural disaster or trauma of another form we have the obligation to provide the best treatment possible to help them recover.

When working with traumatized people we’re all at risk of developing compassion fatigue. Also known as vicarious traumatization or secondary traumatic stress, the symptoms can be disabling and overwhelming. Most professional ethical codes include a mandate around provider self-care.

The same cognitive-behavioral therapy techniques that you may suggest to your clients can be equally beneficial to you in preventing compassion fatigue. If thoughts identified in a distressing situation involve some “what if” or “worst case scenario” thinking pattern, the following technique from the book Overcoming Compassion Fatigue can help.

The steps involved include:

  • Identifying what future negative outcomes are being predicted.
  • Consider how likely it is that each of these will actually occur (de-catastrophizing).
  • Consider the worst outcome and what the consequences would be (de-awfulizing).
  • Asking, “How awful would it actually be if that did happen?”
  • Identifying what coping strategies could be used to deal with it.

Download and print the worksheet: De-Catastrophizing When Thinking the Worst to help explore the probabilities and consequences of negative predictions.

If you’re struggling with compassion fatigue in the wake of a catastrophe, utilizing CBT resources will help you treat traumatized people with a solid evidence base while you protect yourself from the risks of helping people weather the storms that come.


This blog was contributed by PESI speaker Martha Teater, MA, LMFT, LCAS, LPC. She is a co-lead of the Red Cross national headquarters disaster mental health support program and provides support for international deployers as well. These interventions are designed to prevent development of vicarious traumatization among those who help people who’ve gone through natural disasters or other traumas. A prolific writer, she has published over 175 articles in newspapers and magazines, and is the coauthor of Overcoming Compassion Fatigue: A Practical Resilience Workbook.


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