Understanding the philosophical foundations of cognitive–behavioural therapy (CBT) is vital to drive theory and research forwards and to effectively conduct therapy using varied methods and techniques from different CBT models that may be rooted in distinct philosophical tenets. In the evolution of CBT as the most empirically validated form of psychotherapy, each of its three waves (behavioural therapy, cognitive therapy and acceptance-based therapies) has brought unique contributions to improve its effectiveness. Although some of the philosophical assumptions underlying the different CBT waves may be considerably dissimilar, in this clinical reflection I review the distinctive and cross-cutting features of such backgrounds, while suggesting a conciliation of epistemological perspectives that is capable of informing the practice of CBT in a consistent manner.

Clinicians trained in cognitive–behavioural therapy (CBT) are frequently not trained to work with dreams. Given the high prevalence and impact of nightmares and bad dreams, empowering CBT therapists to effectively work with these sleep phenomena is crucial to improve therapeutic outcomes. This article briefly outlines a cognitive–behavioural model of dreams and reviews some clinical guidelines for directly and indirectly addressing nightmares and bad dreams in CBT practice.