After months of working through his anxiety and depression, Eric leaves therapy on a euphoric note. Overcoming his crippling symptoms has allowed him greater freedom to explore new interests, establish relationships, and just plain feel good. But after only three weeks of experiencing life beyond anxiety, all of his old panic and worry come rushing back to him. “That recovery was just a fluke,” he tells himself. “The therapy didn’t work.”

This hypothetical scenario is one Feeling Good author and cognitive behaviorist David Burns works hard to avoid. Before he wraps up therapy with recovered clients, he makes sure they’re well prepared for relapse. In this brief video clip, he breaks down the components of his Relapse Prevention Training, which includes 1) letting clients know that the techniques they’ve learned in therapy will work for life, 2) assuring them that they will relapse, and 3) role playing as the voice of relapse so that clients can practice defeating their negative self-talk before it happens.

David calls the role playing portion of Relapse Prevention Training the “externalization of voices” technique. He voices the typical thoughts that occur after a relapse of symptoms, such as, “I was fooling myself. I’m hopeless after all.” He then has his clients talk back to and conquer them. That way, instead of leaving therapy under the delusion that they’ll never have to do battle with their negative thoughts again, clients learn just what to say to the part of the mind that wants to cave in during relapse.

Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day. 

David Burns

David D. Burns, MD, is an emeritus adjunct clinical professor of psychiatry and behavioral sciences at the Stanford University School of Medicine. His best-selling books, Feeling Good and the Feeling Good Handbook, have sold over five million copies worldwide. Although he was a pioneer in the development of cognitive behavior therapy (CBT), he also created a more powerful approach called TEAM-CBT.

More than 50,000 therapists have attended his training programs over the past 35 years. His website,, offers many free resources for therapists and clients alike, including his tremendously popular Feeling Good Podcasts which draw more than 50,000 downloads per month.