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Cognitive Behavior Therapy as a Systemic Approach in Counseling : An Interview With Art Freeman
Patricia A. Robey
The Family Journal 2012 20: 327 originally published online 27 June 2012
DOI: 10.1177/1066480712449605
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Interviews

Cognitive Behavior Therapy as a Systemic

Approach in Counseling: An Interview With
Art Freeman

The Family Journal: Counseling and

Therapy for Couples and Families
20(3) 327-331
The Author(s) 2012
Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/1066480712449605
http://tfj.sagepub.com

Patricia A. Robey1

Abstract
This article presents an interview with Dr. Arthur Freeman, an expert in cognitive behavior therapy (CBT). Freeman shares the
process of his therapeutic training and the experiences that led him to choose CBT as the model for his work with clients.
Freeman provides a brief explanation of CBT concepts and discusses the application of CBT in work with family systems, with
couples, and with children.
Keywords
mental health, cognitive behavior therapy, families, couples, systems

Robey: Thank you for taking the time to talk with me today,
Art. Let me start off by asking you to tell me a little bit about
your background.
Freeman: My background, lets see, where to start . . . Im
board certified, first in clinical psychology in 1977, a long
time ago! And after I got board certification, I received a diplomate in cognitive behavioral therapy and then family and
couples therapy.
Robey: Then this is the perfect topic for you!
Freeman: Yes! I do individual and couples and family work
within a CBT perspective. As you know, in my early years
I trained from a psychodynamic perspective, from an Adlerian perspective, and certainly from the cognitive behavioral
perspective. I studied with Albert Ellis in New York also.
So, I see myself as a neo-Adlerian in many ways, but my
identification would be cognitive behavioral.
Robey: Tell us a little more about that evolution. Im somewhat familiar with your story and I think it is fascinating. I
think the readers would really enjoy it, too, if you dont mind
sharing it.
Freeman: Sure. I lived on the upper side of Manhattan and I
was walking around one day exploring the neighborhood and
I saw an apartment building, it was 333 Central Park West,
and there was a sign on the building that said Alfred Adler
Mental Hygiene Clinic. That interested me because I remember as a graduate student I was interested in Adlers work. At
that time I said to the graduate student teaching the course,
Are you going to spend any more time on Adler? And
he said, No. You know, he was a minor individual; were
not going to spend any time on him. The text for the course
was Hall and Lindzey (1957) Theories of Personality. In fact,
there was a chapter on Freud, a full chapter on Jung, and then

there was a chapter called the Social Psychologists, which

included Sullivan, Horney, Fromm, and Adler. So, its not
even given much focus in the text. But, I was interested in
Adlerian work, so that day I went into the Adler Mental
Hygiene Clinic, as they called it then. Were talking about
the late 60s, you didnt go walking into apartment buildings;
you could have been a stalker. It was a changing neighborhood as they called it. There was an older woman in the
room when I walked in and she spoke with an accent and she
said, What do you want? I said, Is this the Alfred Adler
Mental Hygiene Clinic? She said, Yes, what do you
want? She was rather abrupt! And, I said, Well, Im a
graduate student and Im interested in Adlers work. And
she said to me, Sit down. And, I sat down, and she said
Tell me what youre interested in. Her name was Danica
Deutch and she had worked with Adler in Vienna and that
was my introduction to Adlerian work. After our discussion
I told her the questions I had about Adler and why I was interested, and what parts of this theory I found interesting, and
she said, Ill make you a deal. If you work under supervision at our clinic, Ill allow you to take courses at our institute. And I thought, well hey, for free, thats good. In
addition to my graduate work, I worked, I think, 6 hours at
the clinic, under supervision. I took courses at the institute

Division of Psychology and Counseling, College of Education, Governors

State University, University Park, IL, USA
Corresponding Author:
Patricia A. Robey, Division of Psychology and Counseling, College of Education,
Governors State University, 1 University Parkway, University Park, IL 60484,
USA
Email: patrobey@gmail.com

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The Family Journal: Counseling and Therapy for Couples and Families 20(3)

with Kurt Adler, Alexandra Adler, Ernst and Helene Papanek, and others. So, it was a great opportunity!
I got my first teaching job in 66 at a community college. The
chair of the department was a fellow by the name of Marven
O. Nelson. When he interviewed me for the position of
Instructor, he asked, Do you have a theoretical orientation? And, I said, Well Im kind of psychodynamic, but
Im interested in the work of Adler. He said, Oh, tell me
about that, and I thought, oh shit, here I am applying for
a job and Im talking about a minor theorist. This guy is
going to think Im really limited. I kept trying to get away
from the topic and he kept bringing me back to it. What I
didnt know was Marven was an Adlerian, so I got the job
because of my Adlerian connection! He ended up as the Dean
of their institute, but at that time he was chair of the department at Rockland Community College.
One of the things Marven didremember, this was 1966was
sponsor a series called Sex in Contemporary Society. It
was 1966 and he had a series of speakers, George Hugo Beigel, who was head of a society lime that was interested in
the scientific study of sex, and others, including Albert Ellis.
And, here I was, the lowest man in the hierarchy. I lived in
Manhattan and I commuted up to Rockland County. Marven
said to me, Ellis needs a ride up, so well cover your classes
tomorrow if on your way up you pick up Dr. Ellis and then
drive him home afterwards. So, I picked up Ellis at his institute and drove him up there, and we were talking in the car.
We had a nice conversation, and he talked basically of his
view of sex and sexuality. I was impressed because he was
very straightforward. He was saying things like, This business about premarital sex is nonsense. He said that, Sex is
sex, whether its premarital, marital, post marital. When he
said these things to the audience, they were just shocked! But
he said, The only thing you have to do is be honest. You
cant say to someone, I love you, go to bed with me because
thats dishonest. But to say Id really like to go to bed with
you, thats honest. After [the sex workshop] a community
group demanded that we schedule another seminar that
would be paneled by a priest, minster, and a rabbi, to respond
to Ellis words. I was really impressed with this guy.
My own therapy had been psychodynamic. Im more psychoanalytic, psychodynamic; it can best be called a West End
Avenue psychoanalytic mode, which the New York readers
will understand that nobody else will. Basically, most of
these people were psychologists trained by Theodore Reik
and his students. I had individual psychodynamic therapy for
many years to deal with a number of life issues. When I had
problems in marriage, I went to the same therapist for marital
therapy. Later, I was finishing my doctoral program and I
was having trouble. I went through the first parts of the dissertation process; I wrote my introduction, I did the research
for the literature, I wrote my methods section, and I even did
the study, all approved. I got the print-out from the computer
center and it just sat on my desk for months. I never even
touched it and I was getting a lot of pressure. My advisor was
asking me Well hows the writing going? Its going good,
good, and my wife was saying, When are you going to finish? Oh, its going good, good, soon, soon. My mother was

saying, When are you going to finish this doctoral thing? I

said, Mom its really very complicated, its a lot of work,
but the bottom line was I wasnt doing anything. I was having
trouble sleeping; I was having anxiety dreams, and the pressure was just increasing. So, I did what any psychology student does, I went to therapy. I called my former therapist and
I said, I need to see you. He said, What for? I said, Im
having trouble finishing my dissertation. He said, Wow,
thats really interesting that you called because Im setting
up a group for people having trouble finishing their dissertations. So, we met on Thursday mornings from 8 a.m. to
10 a.m. and all of us were people from psychology, English,
history, people who just could nt get their asses in gear to
finish their dissertations, and we all had a story. My story was
from my psychoanalytic experience. I have an older brother
who is a dentist and he had the title of doctor. So, I was reluctant to finish my degree because then Id also be Dr. Freeman
and the sibling rivalry would create castration anxiety and I
was reluctant to deal with it. And my group would nod and
try to help me work this through.
But I was getting a lot of pressure and months were going by
and I wasnt doing anything. So, I decided, wait a minute,
there was this guy that I remembered and later had heard
on a couple of occasions. I had gone to several of his lectures
and I thought he made very good sense. So, I called the Institute for Rational Emotive Therapywhich is now called the
Albert Ellis Instituteand I said Id like to make an appointment to see someone. The intake person asked, About
what? I said, Im having trouble finishing my dissertation and she said What area? and I said psychology. She
said, Well, would you like to see Dr. Ellis? He always
likes to see psychology students. So, I said fine, sure, great.
So, he had half hour sessions for 25 bucks. This was 1970 or
1971. So, 25 bucks wasnt a lot even then! I came at the
appointed hour. His office was in a Georgian Limestone
building right off of Fifth Avenue in Manhattan. It was a former mansion. You walked in and there was this grand staircase and his office was at the head of the staircase. I stopped
for a second and was told to go upstairs; Dr. Ellis office was
up the stairs. So I did what I was told to do. The door to his
office was open and I walked in. He said Close the door and
sit down. I sat down and he said How can I help you? I
knew I had a half hour, so I had to talk fast. I said, Well Im
a doctoral student at Columbia and Im having trouble finishing my dissertation. He said: And why are you having
trouble finishing your dissertation? I said, Well,I was
ready for that questionI have an older brother, hes a dentist with the title doctor and Im reluctant to finish my doctorate because its sibling rivalry. And, he said to me, Stop.
Why arent you finishing your dissertation? So, I figured he
was hard of hearing, so I repeated, I have a brother who
is . . . and he said: Stop with the Freudian horseshit!
I was stunned because my analytic therapist never spoke to me
that way. He thought my insights were just dandy. And Ellis
said, You just dont get it, do you? Youre not finishing
your dissertation because youre too fucking lazy. I was
truly appalled at that point because he used the f-word and
secondly he called me lazy and Im a very hard worker. And,

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329

I said, Thats not true, Im not lazy. He said: Oh yeah,

why arent you lazy? He got me to convince himor so I
thoughtthat I wasnt lazy, what I have come to know as the
Socratic dialogue. He had me convince him that a dissertation was something I could do and within 3 months it was
done! So, I learned about CBT up close and personal. And,
then in 1975, when I moved from New York to Philadelphia
I called AlI had gotten to know him both professionally
and personally at this pointand I said, Im moving to Philadelphia, is there anyone I should contact there? And he
said, Yeah, give Aaron Beck a call. So, from there the rest
is history.

Concepts of CBT
Robey: You said you learned CBT up close and personal, but
Ellis was actually RET [Rational Emotive Therapy] and now
REBT [Rational Emotive Behavioral Therapy]. Whats the
difference between the two [CBT and REBT]?
Freeman: REBT is a cognitive behavioral therapy. Its one of
several that are brand names. Cognitive Therapy is Aaron
Becks work. Multimodal Therapy is Arnold Lazarus work,
Acceptance Commitment Therapy is Steven Hayes, Dialect
Behavioral Therapy is Marsha Linehans, but were all first
cousins in that theyre all cognitive behavioral therapies,
plural. So, I started learning and I learned CBT or the REBT
of CBT up close and personal, but REBT is a cognitive behavioral therapy.
Robey: Currently you would say youre leaning more towards
the way Beck would practice CBT rather than the way Ellis
would practice it?
Freeman: I think nobody practices it the way Ellis practiced it. I
think I would consider myself a more traditional Beckian if I
have to label it, but after studying Ellis and talking with Ellis
over many occasions, I think Im influenced by his work. But I
would consider myself more a classical Beckian CBTer.
Robey: I know theres a lot that you could talk about with
CBT, but could you just give us the short version of the central concepts in CBT?
Freeman: Well, again, CBT didnt invent the wheel, nobody
ever said we did. But one of the basic concepts that cognitive
behavioral therapy talks about are cognitions and behavior.
[People may ask] Dont you talk about feelings? Of course
we talk about feelings. What about family systems? Of
course we talk about family systems. When I get a patient
and I interview the patient, one of the things that Adler talked
about was lifestyle, but one of the things that was key for
Ellis and then Beck is the whole idea of schema, looking at
basic templates for understanding your life and the world
around you. The question is, where do you acquire these?
Family of origin. So, let me explore with this patient, where
they learn to be who and what they are. But I already know
the answer to that. You learn to be who and what you are in
your family of origin. CBT looks very carefully at the family
system and may indeed take a systemic approach. I think systemic people use cognitive behavioral interventions that are
more directed, more focused, more structured. I dont think
family systems people are totally family systems, I dont
think anyone is totally anything.

The basic model of CBT is to look at a variety of aspects of the

individuals development and what they learned. You want
to look at the way they process informationcognitions
the way they behave, how they feel, looking at family structure, and what theyve learned from their families, looking
at biological aspects, looking at neurochemical, physiological issues that certainly can play a part also. One of the
things I find interesting . . . Ill read an article or a chapter
and the first thing Ill do when I read one of these chapters
is to look at the reference section. I want to see who theyre
quoting. Ill see a reference to Becks book, Cognitive Therapy of Depression; thats the CBT reference or the Beckian
reference. I think what nonsense, what stupidity, what poor science. That book was written in 1979; CBT has grown since
then. It would be like saying, Freud wrote a paper and we have
to go with exactly what Freud says; there are no modifications.
Well, then Adler writes a paper and theres no revisions to systemic work. Well, then Erikson wrote a paper and the use of
Eriksonian work died when he did, that they cant think of anything new.
So, CBT, when I first started working in this model in the late 70s,
was very limited. We worked on depression and then we added
on anxiety and then personality disorders and we looked at family systems and we looked at family context, and we looked at
family development as they all contributed to the development
of schema. Theres a guarantee that if you have a patient sitting
in front of you, they acquired their major schema though middle
childhood in their family of origin, an idea that Adler put forth
more than a century ago. You cant reject understanding the
system. When we choose to work within the system, its something else. For example, a systemic therapist is working with a
family system in Chicago. Lets suppose there is a sibling at the
University of Michigan, whos an undergraduate, and another
sibling whos married and in Florida. When you have family
system sessions, do the Florida sibling and the Michigan sibling
have to come in? [Some therapists might say] you gotta be
there, we want the whole system. Its interesting, but not
necessary.
Robey: As youre talking about this, one of the things Im
thinking about is bringing the past into the present. Where
do you stand with that? Do you go into a patients childhood
and talk about where patients developed their schemas?
Freeman: Sure, of course. The difference is that what I have
sitting in front of me, that person, is a product of their experience. So, Im more interested in what they learned [from
their past experiences]. No, let me say it differently, in the
process of learning, Im more interested in what they have
taken out of the life experiences. If theyve experienced
trauma, what did they learn from that traumatic experience?
If they were sexually abused, what did they learn? Some people learn Ive got to be more careful, and some people
learn Im helpless, I can do nothing. What is it that the person learned that then is coded as schema? From a CBT perspective, I will ask, Where did you learn this particular idea,
this way of thinking, this way of behaving, this way of feeling? Who taught it to you? And, again, we know generically
where they learned itfrom home and from credible people
in their experience. The cognitive behavioral therapist

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The Family Journal: Counseling and Therapy for Couples and Families 20(3)
definitely asks about the past, but our focus is much more
here and now. So, its not why you are the way you are; its
what keeps you that way? What keeps you stuck? What keeps
you from the things you say youre unable to do?

CBT with Couples, Families, and Children

Robey: Suppose now that you have a couple that comes to you
for counseling. Youve upped up the ante because youve got
two people with the schemas that are driving their lives right
now . . . So, how do you work with a couples system?
Freeman: I think what we see very quickly are the schemas
they come in with. I ask them what are you views on relationships, on marriage? And, where did you learn it? How does it
come into play in your relationship? So, these are things we
would ask about.
Robey: Once youve discovered something . . . for example,
youve got a couple who has two very different schemas
about the way things should be and this is getting in the way
of their relationship . . . where do you go from there?
Freeman: Making those schema explicit, so its clear to both of
them, the way that they view the world. Also, asking them
what theyre willing to change. What is it you would like
to do differently?
Robey: So, this is where the behavioral piece comes in?
Freeman: Yeah. Its great to have insight, but that in and of
itself doesnt bring about change. I find for most individuals who come in for couples counseling that one of the
major issues is skill deficits. They can get from point A
to point B and now their life experience and now their
relationship therapist wants them to go to point C or D
and they dont know how to do that. Just because they can
go to A to B doesnt mean they can go to C or D. A lot of
what we do in working with couples is skill building communication skills, building skills of empathy, all
kinds of skills.
Robey: Are there assessments that you use when working with
couples?
Freeman: There are a huge number of cognitive and behavioral
scales that one could choose from. In fact, Im developing
one called the relationship status scale, looking at how people look at relationships. Yes, there are all kinds of screening
tools.
Robey: What about working with children, within or without
the family system?
Freeman: I think its a huge waste of time to work only with
kids and not with the system. I think whatever you do in the
consulting room is going to get undone on the way home. If
youre working with kids, it is essential that you work with a
system. That system might include the school, social system,
the church, the family.
Robey: Is there an age range for children before you would
invite them into therapy?
Freeman: I think it depends on the system. If what the parents do
all the time is fight, I dont think the kids need to be a part of
that, they see that at home. As a general rule, Pat, I do not work
only individually with kids because, as I said, I think its a
waste of time. So if I have a 50 minute session, I might spend

10 minutes with the kid and 40 minutes with the parents or I

might spend 20 minutes with the family, 10 with the kid and
then with one or both of the parents. Im willing to do somethingand I know my systemic colleagues will get very upset
with me for thisbut I do meet with individuals within the
system. I dont think everything has to be done with everybody in the room. I think some things can be done best individually. And, I dont think that breaks up the family, theyre in
our office because of major problems, and then you may learn
family secrets. I think its good that I would learn the secrets
and to see what theyre doing that screws things up.
Robey: Say you were working with a family, including parents
and children. As youre working with behavior changes, are
you likely to introduce homework? If so, would everyone
have their own assignment?
Freeman: Yes, family homework, and everyone has their own
individual homework. Homework is an essential part of what
we do in CBT. Im not so grandiose to think that everything
that needs to be done in therapy gets done in my office, in my
presence. An awful lot can get done at home.

Future of CBT
Robey: Tell me what you see as the future of cognitive behavioral therapy.
Freeman: I think CBT will continue to grow. I think in some
ways its kind of reached a circular point where people want
to see their name on a theory. So, they come up with cognitive
therapy some other factor, for example CBT emotion,
CBT compassion; but all cognitive therapy is emotion
focused and should focus on issues related to compassion.
So someone else came up with cognitive interpersonal therapy, but interpersonal therapy is the work of Harry Stack Sullivan. Someone else will look at attachment therapy. So,
theyre rediscovering all these other models. So, maybe I
should come up with a cognitive systemic therapy: CST.
When I was a graduate student I took my first course: Introduction to Counseling Psychotherapy. We had to do a role-play
and we had to audio tape it to a reel-to-reel tape. The
instructor would grade our effort. He would count words,
and if the therapist said 51% or more, you failed. Therapists
werent supposed to speak. You were not allowed to ask
questions. We were very Rogerian in those days. We had
to make statements. I think statements are fine, I think questions are fine. With some patients I may do more talking and
other patients less talking. Theres no single rule to all of
this. So, where I think CBT is going to go, its going to keep
being applied to more and more disorders to more and more
contexts. So, now there is a CBT family therapy, CBT
marital therapy, CBT childrens therapy. CBT is applied
to just about every context, every disorder, and every group.
So, it continues to grow.
Robey: And do you incorporate Adlerian concepts into your
work?
Freeman: Of course.
Robey: As you were talking about the future of CBT, I was
thinking about the concept of integrative therapy, which
might once have been called eclectic therapy, which has now
become sort of a dirty word.

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331

Freeman: It always was; eclectic meant you werent sure what

you wanted to do.
Robey: When I think of integrative, I think of borrowing tools
from other approaches, but that youre thinking aligned with
one particular theory.
Freeman: I agree with you, Pat. Its kind of like saying, Well,
Im religiously integrative; on Mondays Im Lutheran, Tuesdays I become Presbyterian, and then Friday night of course I
become Jewish, and Saturday night I become Catholic so I
can go to mass and sleep late on Sunday. You have to have
a model, so I think you start with a model and you know you
have a strategy, but you can borrow techniques from a variety
of places.
Robey: So, thats where its really important to understand
your theory, so you have a good knowledge about your clients even before they come in.
Freeman: Right. Let me illustrate with a story. Theres a story
about a very concerned father in this Russian Jewish Village.
He goes to the Rabbi very upset and he says his 18 year old son
told him he wants to become an atheist. The Rabbi says to send
the son to see him. The man tells his son he has to see the Rabbi,
and in the small village you couldnt turn down a summons like
that. The young man goes to the Rabbis study, sits down, and
the Rabbi says to the son, Your father says you want to become
an atheist. And he says: Yes, Rabbi I do, I dont believe in
any of this. The Rabbi says: Oh okay. Have you read and
mastered the Torah? He says: No, Rabbi. Have you read
and mastered the Talmud? No, Rabbi. So the Rabbi says,
Have you become familiar with the mystical Kabbalah?
And, the young man says: No. So, the Rabbi says: Heres
the answer. You have to go out and master Torah, Talmud, and
Kabbalah. Its only when youve mastered them that you can
become an atheist. And, I think its kind of the same in therapy. Youve got to master a model and its only after youve
mastered a model that you can decide to part from it.
Robey: Well, thats an interesting way of thinking about that.
My guess is once you master a model you begin to realize
that its a pretty good model and maybe you dont have to
search for another one.
Freeman: Thats a possibility.

Robey: Or you find thats just not the right fit for your style or
beliefs.
Freeman: Right.
Robey: As you were talking, I was thinking about something I
remember you saying in one of your presentations in class.
That is about the idea that the client is the expert on his or
her life and that therapists should avoid giving advice. I know
you have some strong feelings on that. Would you like to talk
about that a little bit?
Freeman: I think in some ways the person is the expert on
their lives and in some ways theyre not. I think there are
times when I give good advice and I think there are times
therapists give advice like I think its a bad time to kill
yourself, thats advice. I dont say, So youre feeling
really bad, so youre up on the window sill and seems like
youre pretty serious. No, Im going to push them off the
window sill into the room, and close the window, and say
sit down, thats a stupid thing to do. I think advice is
something we do; I never understood why its a bad thing
to do. I think if the person was that much of an expert on
their life, they wouldnt be coming to see us and save the
time, money, and effort.
Robey: This is just so interesting, I could keep you talking and
talking! I really appreciate this, but I do want to be respectful
of your time. So, to close, if people wanted to get more training or more information on CBT where would you suggest
that they start?
Freeman: Have them contact me. Let me give you my e-mail to
use. Its really easy: its artcbt@aol.com
Robey: Well, I really enjoyed having the opportunity to talk to
you about CBT and its application to systems work. Thank
you very much for taking time out of your busy day to talk
with me.

References
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive
therapy of depression. New York, NY: Guilford.
Hall, C. S., & Lindzey, G. (1957). Theories of personality. Hoboken,
NJ: John Wiley & Sons.

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