**Question:** All of the following are passive components of cognitive behavior change technique except:

A. Cognitive restructuring
B. Behavioral activation
C. Relaxation techniques
D. Problem-solving skills

**Core Concept:** Cognitive-behavioral therapy (CBT) is a psychotherapy approach that focuses on changing patterns of thinking or behavior that are behind people's difficulties. It combines elements of psychoanalytic, humanistic, and behavioral therapies. CBT aims to change negative thought patterns (cognitive restructuring), increase positive behaviors (behavioral activation), promote relaxation (relaxation techniques), and improve problem-solving skills.

**Why the Correct Answer is Right:** D. Problem-solving skills is the correct answer because it is an active component of CBT. In contrast to passive components, active components are those that the patient actively engages in and learns, such as cognitive restructuring, behavioral activation, and relaxation techniques. Problem-solving skills are an active part of CBT, as patients learn strategies to address and solve problems related to their condition, contributing to their overall improvement.

**Why Each Wrong Option is Incorrect:**

A. Cognitive restructuring: This is a passive component because the therapist guides the patient through identifying and challenging distorted or unhelpful thoughts.

B. Behavioral activation: This is also a passive component, as the therapist assists patients in identifying and engaging in activities that they enjoy or find rewarding, helping them build a positive daily routine.

C. Relaxation techniques: Relaxation techniques, such as deep breathing and progressive muscle relaxation, are passive components as the therapist guides the patient through the techniques and helps them develop coping skills for stress management.

**Clinical Pearl:** In cognitive-behavioral therapy, both active and passive components work together to improve patients' coping skills and modify negative thought patterns and behaviors. By focusing on active components, patients actively engage in their treatment, leading to improved outcomes and better retention of learned skills. In contrast, passive components, such as those mentioned above, are essential as they help patients develop coping mechanisms and improve their overall well-being.