Looking at the list of the basic principles of CBT (Beck. 1995) in my previous post, I can see where CBT could be characterized as a rigid, formulated approach to therapy. However, it is important to note that CBT is based on an evolving formulation of a patient’s problems. In fact, CBT offers flexibility in dealing with patient problems as the formulation keeps evolving while the patient is progressing in therapy and as the patient’s cognition of their problems develops. I use assessments during set intervals in therapy to measure a patient’s progress and am now finding that patients who initially presented with one specific problem will uncover the underlying root of that problem in later sessions. For those of us with MS, we know our problem is physical...but...can we work out a different way to manage those pesky symptoms? Different as in not reacting with fear, anger, isolation, withdrawing, etc?