ARTICLE

In this article we focus on practical aspects of the use of cognitive–behavioural therapy (CBT) as an adjunctive treatment for people with chronic physical illnesses. The standard application of CBT for psychiatric disorders has been comprehensively described elsewhere (e.g. Beck 1995). We therefore concentrate here on features of treatment that are different or particularly pertinent for people who are chronically ill. The fundamental premise of CBT is that thinking, mood, physical symptoms and behaviours are all interrelated (Fig. 1). It is not merely what happens to a person that determines their responses, it is also their cognitive appraisal of the event. This appraisal will in turn be influenced by past experiences an