Articles by James Pretzer

James Pretzer, Ph.D. is the Director of the Cleveland Center for Cognitive Therapy and is Assistant Clinical Professor of Psychology in the Department of Psychiatry at the Case Western Reserve University School of Medicine. He received his Ph.D. in Clinical Psychology from Michigan State University and completed a post-doctoral fellowship at the Center for Cognitive Therapy at the University of Pennsylvania where he worked closely with Aaron T. Beck, M.D., David Burns, M.D., and other leading cognitive therapists. Jim and his wife, Barbara Fleming, Ph.D., have been actively involved in applying Cognitive Therapy in areas such as the treatment of personality disorders and marital problems. They have also been providing advanced training in Cognitive Therapy for mental health professionals for over thirty years (see Jim is a co-author, with Art Freeman, Barbara Fleming, and Karen Simon, of Clinical Applications of Cognitive Therapy (second edition, 2004) and he is a co-author, with Aaron T. Beck and colleagues, of Cognitive Therapy of Personality Disorders (second edition, 2004). He has also authored and co-authored a number of papers and book chapters on a range of topics in Cognitive Therapy. Jim has presented his work at conventions of the Association for the Advancement of Behavior Therapy, the World Congress of Behavior Therapy, and the American Psychological Association, as well as in workshops locally, regionally, and internationally. His work has been translated and published in a number of languages including German, Japanese, and Swedish.

How Can a Busy Therapist Improve Their Skills in CBT?

Sunday, June 26th, 2016

I sometimes get questions from therapists who realize that their grad school training didn’t really equip them to use CBT under real-world conditions. With the personal and professional demands we all face it isn’t simple, but there are a number of good options for improving CBT skills once you’re in practice. . The first options […]


CBT in the Real World

Tuesday, April 5th, 2016

In the past few months I’ve seen several comments about how CBT is “constrained” by treatment protocols. Apparently, some practitioners have the impression that CBT is “cookbook” approach where the therapist takes a manualized treatment protocol and imposes it on the client without tailoring it to the client’s needs. They seem to think that if […]


Let Me Sleep On It: CBT for Insomnia

Monday, February 29th, 2016

The February, 2016 edition of Consumer Reports recommends CBT as an alternative to medication for chronic insomnia (see for some of what they say about insomnia). CBT for insomnia (CBT-I) combines “standard” CBT with cognitive and behavioral interventions specifically focused on insomnia. There is a substantial body of research supporting the effectiveness of CBT-I […]


Is the Effectiveness of CBT Fading?

Friday, August 21st, 2015

A recent meta-analysis published under the provocative title “The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis” (Johnsen & Friborg, 2015) has provoked considerable discussion (and some gloating on the Internet by those who are opposed to CBT). The authors computed the effect-sizes found in 70 studies of Cognitive Behavioral […]


Schemas, Assumptions, and Beliefs, Oh My!

Wednesday, February 5th, 2014

The term “schema” has been popular in cognitive-behavioral circles in recent years with theorists discussing the role of schemas in a range of disorders, researchers studying schemas, and clinicians proposing a range of interventions for modifying problematic schemas. The terms “schema”, “core belief”, “irrational belief”, “underlying assumption”, “dysfunctional belief”, etc. have sometimes been used interchangeably […]


Interesting Study of Psychoanalytic Psychotherapy vs CBT in the Treatment of Bulimia

Friday, December 6th, 2013

An interesting study has been published recently that compares psychoanalytic psychotherapy and cognitive-behavioral therapy in the treatment of bulimia (abstract of the study). I thought it worth noting here.


Cultural Differences and Cognitive Therapy

Wednesday, July 10th, 2013

The question of how cultural differences impact the practice of CBT has been highlighted by a special series on cultural considerations in using acceptance and mindfulness-based treatments in Cognitive and Behavioral Practice (February, 2013) and a special series on cultural competence in the Behavior Therapist (June, 2013). Back in the old days, many Americans were […]


The Therapeutic Relationship in CBT

Thursday, May 16th, 2013

In a recent online discussion, a colleague wrote “Perhaps psychodynamic therapists have relied too heavily on the relationship at the expense of client skill-building, while the opposite tends to be true for CBT therapists.”  This is a common criticism of CBT, but is there reason to believe that CBT therapists emphasize client skill-building at the […]


The Academy of Cognitive Therapy opens new membership levels

Tuesday, March 8th, 2011

Of all the professional associations to which I belong, the Academy of Cognitive Therapy ( is one of the best. I especially value the high levels of CBT discussions and information on the Academy’s ListServ. Until recently, the only way to join the Academy (and be able to read the ListServ) was to become a […]


Using Homework in CBT

Thursday, January 27th, 2011

The October, 2010 edition of Advances in Cognitive Therapy (the newsletter of the Academy of Cognitive Therapy and the International Association of Cognitive Psychotherapy) is a special issue on homework in CT. Here are a few highlights: Homework assignments are a core feature of Beck’r CBT but some studies have found weak correlations between homework […]