Struggling with depression, anxiety, panic? Here is one Psychologist’s framework that helps with these issues and many more.

Early in my training as a clinical psychologist, I took a course on Cognitive-Behavioral Therapy. In this class, I was presented with a theoretical framework that would dramatically affect my professional development and views on what motivates people towards unhelpful versus healthy activities. I nearly always present this model to the clients that I am assisting and it greatly informs my thinking while providing care. Please note that within the research on Cognitive Psychology, there are many different perspectives and models available. This approach is one of many that attempts to understand the nature of psychological struggles and how to find relief. Below you will see the model followed by a brief description of the components. In my use of Cognitive Behavioral Therapy, I’ve found great utility in this conceptualization and I hope that it might help you as well.

S.T.E.B – Situation, Thoughts, Emotions Behaviors

The Situation is the external component of the model. Situation refers to the setting, environment or external stimuli that is presented to a person. A person can use memory and visual imagery to help to conjure the details of the context or event.

Examples of Situations include:

• Saturday night at home alone
• Your boss asks you to stay late at work
• You do not get back a text as expected from a friend
• A car suddenly cuts you off on the freeway

Thoughts are the next step in this model. Situations will evoke different perceptions and interpretations regarding the events. Thoughts refer to the ongoing “parade” of words, memories, images, perceptions that are constantly streaming through one’s mind. Most of our thinking is on a subconscious level. Effort is often required to develop greater mindfulness and become more aware of this thought process. When identifying, I strongly encourage writing down or communicating these thoughts. One can also start to identify patterns of thought that may not be accurate or helpful.

Examples of Thoughts Include:

• “Another night of nothing to do.”
• “Why does he hate me so much?”
• “They must not really care about me.”
• “That person is a complete idiot!”

This model then presents a direct connection from Thoughts to one’s Emotions. Emotions refer to the internal feelings and sensations associated with our experience. Similar to thoughts, emotions can often happen outside of conscious awareness. To help identify the emotional experience, I often encourage clients to use their emotional vocabulary. This refers to finding a word that approximates or resonates with the experience. This vocabulary can range from straightforward terms such as mad, sad, glad, like/dislike to more complicated verbiage such as dysphoric, ennui, confused, tempted. Using some of the following terms can help improve your awareness of your feelings and almost automatically conceptualize how to address the emotion.

Examples of Emotions include:

• Depressed, Lonely.
• Singled out, Angry.
• Ignored, Sad.
• Anger, Enraged.

Behaviors refer to the physical manifestation of the emotional energy and refers to observable actions the body engages. Behaviors can also include situations when a person acts with restraint or manages to avoid engaging in an action. People can often carry out behaviors in an automatic and unconscious manner. Becoming more mindful of the extent and duration of behaviors can help to address the decision making process.

Examples of Behaviors Include:

• Staying on the couch for hours on end.
• Remaining quiet, complying without push back.
• Repeatedly checking phone without sending a message
• Yelling, screaming or honking the horn.

In my approach to Cognitive Behavioral Therapy (CBT), a good amount of work is used to bring a client’s awareness to the four components of the S.T.E.B model. Though there are different theoretical perspectives, I like to emphasize how behaviors are driven by emotions, how what we feel relates to the beliefs and stories we tell ourselves and that our thoughts can be shaped and modified.
In following blog posts, I will dive into more detail for the S.T.E.B model and how this can help to decrease depression, anxiety, cravings, panic and many other uncomfortable states. When using Cognitive-Behavioral Therapy techniques, the hope is to develop more insight into unhelpful thoughts, exaggerated emotions and unwanted behaviors. When practiced, CBT tools and tricks can provide you with greater relief, satisfaction and meaning.

If you would like to learn more about my approach to Cognitive-Behavioral Therapy and how it could help with depression, anxiety, panic or other conditions please call 619-414-0042 or send me a message to schedule a free consultation.

All the Best,
Dr. Chad K. Cox PsyD
Licensed Psychologist PSY23320
San Diego, CA