Judith S. Beck, PhD, Beck Institute President
Hope is the belief that you know how to reach your goals and that you have the motivation and ability to do so. Hope is such an important part of emotional well-being and contributes to your sense of resilience—the idea that no matter what challenges you encounter, you’ll be able to handle them and bounce back. When you have hope, you feel empowered to create a life that’s worth living.
Unfortunately, many clients who seek treatment for depression, anxiety, and other concerns have lost hope. Some clients have strong negative beliefs about the future. And other clients don’t believe anything they do—including going to therapy—will lead to positive change. At the same time, research shows that hope improves outcomes for a range of mental health challenges. One of my most important jobs as a therapist is instilling hope in my clients.
How CBT Builds Hope in Therapy
Cognitive Behavior Therapy (CBT) helps clients feel more hopeful in a number of ways. When clients don’t believe treatment will work, CBT therapists invite their skepticism and positively reinforce clients for expressing it. The therapist may gently say, “I don’t have a crystal ball, so I can’t guarantee you 100% that therapy will work—but I’m not sure you have a crystal ball, either. Is that right?” Then the therapist may ask, “Is it okay if I tell you why I’m hopeful?” Then the therapist provides genuine evidence about the client and the treatment plan.
For example, I remember saying to a client, “The fact that you came to treatment even though you don’t think it will work tells me that you’re at least willing to entertain the possibility that it can help. And I see coming to treatment as a sign of your bravery. You came even though you were sure you wouldn’t feel any better. You’ve been doing a really good job so far describing some of the challenges you have. That shows me you have insight and intelligence. You have a couple of good friends who see you in a positive light, and you’ve been able to maintain those friendships for several years now. And in the best period of your life, when you weren’t this depressed and anxious, you were able to hold down a job and live independently. All of these are good signs.”
Clients may also be reassured and feel less alone when the therapist relates how other clients, with similar problems, have benefited from CBT. Normalizing their difficulties builds hope. Many clients with mental health conditions feel isolated and are convinced that they’re fundamentally flawed. Therapists help them recognize that while they themselves are unique, others have shared similar struggles and recovered.
Learning this, clients gain a sense of solidarity and possibility. They switch from thinking, “There’s something terribly wrong with me,” to “Others have struggled and found a way through, so maybe I can, too.”
From the beginning, therapists help clients schedule activities that increase their sense of accomplishment, pleasure, spirituality, creativity, purpose, and/or connection to others. Then they help clients draw positive conclusions about these experiences:
- “I can do more than I thought.”
- “I didn’t think I’d have enough energy, but I did.”
- “People were glad to see me.”
- “It’s really good that I did that.”
- “Doing this shows I am strong and can persevere.”
Clients learn to give themselves credit for anything they do that’s even a little difficult, but they do it anyway. Doing this increases their sense of self-efficacy and inspires hope.
Building Hope Through Goals and Values
CBT therapists guide clients in setting goals that will lead to a consistent and strong sense of well-being and satisfaction. Achieving their goals helps clients live in alignment with their values (what’s most important to them in life) and their aspirations (their big dreams for how they want their life to be and how they want to be). CBT therapists emphasize helping clients increase feelings of connection, meaning, competence, and control. Clients who previously were overwhelmed by despair begin to recognize that they can not only overcome their current difficulties but also go on to thrive and flourish.
Very strong negative beliefs can interfere with clients’ ability to progress in treatment. They need their therapist to provide a rationale when they introduce a technique, describe how they will adapt treatment so it’s appropriate for them, and note that research has demonstrated the efficacy of CBT for their condition(s). Therapists outline their treatment plan based on their understanding of the client and the client’s struggles. When the plan makes sense to them, clients begin to change their thinking from, “Therapy won’t work,” to “This approach sounds about right.”
Action plans are the self-help assignments clients and therapists collaboratively design at each session. When clients complete these assignments between sessions, they go from believing, “There’s nothing I can do to change,” to “Maybe I can make changes and feel better.” Concrete treatment plans and initial success in implementing techniques clients have learned in session provide hope.
Hope is essential! When clients have hope, they believe that change is possible and that they play an important role in making that change happen. Hope provides the energy and motivation for clients to engage with their therapist, set goals, try new strategies, and persist with treatment even when they experience setbacks. For these reasons, hope is more than just an abstract concept; it’s a critical part of the therapy process.
To find a CBT-trained therapist near you, visit the Beck Institute Clinician Directory.