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Common difficulties with working with values in CBT

Updated the 12th of April 2023

Working with the patient's values in CBT can have many advantages. Values are not syndrome-specific, and can help with both treatment outcomes and motivation in treatment. Values are a common part of what is called third wave CBT - and specifically takes inspiration from Acceptance and Commitment Therapy (ACT). Values can be valuable components of treatments, but are not always easy to obtain.

What are values?

Values can be defined as specific areas of life that a person finds meaningful to engage in. The term "valued direction" - common in ACT - can thus be defined as a person's consistent behavioral action in areas that a person feels meaningful to engage in. Values has two central components. Degree of importance, as well as commitment. Some values may be very important to a person, while their grave of commitment to values is very low. But values can also be less important, even if the behavioral commitment is high. When you work with values, you want to try to get patients to engage in behaviors that align well with what they find important in life.


Values differ from goals in that they can never be achieved, while goals have quantitative metrics that can be achieved and then checked off. Values are also positively formulated, and not focused on symptom reduction.

Resistance to working with values

Three different types of difficulties can arise when working with values.


1. The values are socially controlled

Some patients may have difficulty identifying individual values, but find it easy to define values in terms of environmental pressures. It is important to ensure that the values are as far as possible intrinsically oriented.

2. It is difficult to rank values

Some patients may have difficulty distinguishing nearby values connected to the acute problem, from broader values in larger areas of life. For such patients, it may be valuable to start working with values that are more local to the current problem, in order to work over time with broader values about larger life goals.

3. The values go against the purpose of the treatment

In general, all patients' values are valid, and people are generally pro-socially oriented. However, there may be times when the values go against the purpose of the treatment, or clearly go against the psychologist's or wider society's accepted norms of what constitutes functional behaviour. This can be an important basis to include in the case conceptualization. Often there is an underlying motivation worth exploring

Are you curious about working more structured with values in CBT? Get in touch with us, and we can help you.

O'Donohue, W. (2009). Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice (2). John Wiley Sons Inc.

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