Strategic Decision Making in Cognitive Behavioral Therapy

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Wenzel, A. (2013). Strategic Decision Making in Cognitive Behavioral Therapy. Washington, DC: APA Books.

Cognitive behavioral therapists must make clinical decisions in numerous instances during each session and across the course of treatment. These “decision points” include such instances as a specific intervention not achieving the desired effect, the patient not understanding or accepting the rationale for particular techniques, or a crisis emerging that requires a shift in focus. This book describes strategic decision making, a flexible yet evidence-based approach to working through decision points in order to move treatment forward in cognitive behavioral therapy. It dispels the myth that there is a single “right” therapeutic intervention; in fact, many course of action can facilitate change, provided that they are implemented strategically. Strategic decisions (a) follow logically from the case conceptualization, (b) are arrived upon collaboratively between the therapist and patient, (c) allow the patient to leave the session with something new, and (d) are seen through in their entirety before their effectiveness is evaluated. This compelling, accessible book will benefit all cognitive behavioral therapists, especially those who have mastered basic concepts and are refining their skills.

Praise for Strategic Decision Making in Cognitive Behavioral Therapy

This book is a wonderful distillation of Wenzel’s approach to cognitive behavioral therapy (CBT), which includes her “four principles of strategy” and emphasizes the ongoing need to recognize decision points in therapy. The practical suggestions offered, coupled with several extended case examples, ensure that this will be a book that trainees and seasoned practitioners alike will want.

— Keith S. Dobson, Ph.D., Professor of Clinical Psychology, University of Calgary and Past President of the International Association of Cognitive Psychotherapy


This book is an outstanding resource for students and teachers of CBT. It combines state-of-the-art therapeutic techniques with a pragmatic and methodical approach to complex patients.

— Donna Sudak, MD, Professor and Director of Psychotherapy Training, Drexel University, Philadelphia, PA, Past Present of the Academy of Cognitive Therapy


The development of a meaningful strategy for change is a crucial feature of skilled CBT practice. This book illustrates the importance of collaboration in deciding on the selection of techniques and discusses how to use the patient’s experience as the criterion for their evaluation. I highly recommend this volume to all CBT practitioners.

— Nikolaos Kazantzis, Ph.D., Founder/Director, Cognitive Behaviour Therapy Research Unit, La Trobe University


This well-written text provides a clear and concise road map for treating virtually any mental disorder. Using rich case examples and concrete clinical problems, this comprehensive book provides in-training and more seasoned therapists with the necessary CBT strategies to develop and successfully implement effective treatment places. It should be on any clinician’s bookshelf.

— Stefan G. Hofmann, Ph.D., Professor of Psychology, Boston University, and author of An Introduction to Modern CBT.