What is Cognitive Behavioral Therapy?
Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
What cognitive behavioral therapy can help with
CBT can help with a range of things, including the following mental health conditions:
- depression
- eating disorders
- post-traumatic stress disorder (PTSD)
- anxiety disorders, including panic disorder and phobia
- obsessive-compulsive disorder (OCD)
- schizophrenia
- bipolar disorder
- substance misuse
But you don’t need to have a specific mental health condition to benefit from CBT. It can also help with:
- relationship difficulties
- breakup or divorce
- a serious health diagnosis, such as cancer
- grief or loss
- chronic pain
- low self-esteem
- insomnia
- general life stress
It is important to emphasize that advances in CBT have been made on the basis of both research and clinical practice. Indeed, CBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CBT differs from many other forms of psychological treatment.
CBT is based on several core principles, including:
- Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
- Psychological problems are based, in part, on learned patterns of unhelpful behavior.
- People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.
CBT treatment usually involves efforts to change thinking patterns. These strategies might include:
- Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
- Gaining a better understanding of the behavior and motivation of others.
- Using problem-solving skills to cope with difficult situations.
- Learning to develop a greater sense of confidence in one’s own abilities.
Popular CBT techniques
So how does one go about reworking these patterns? CBT involves the use of many varied techniques. Your therapist will work with you to find the ones that work best for you.
Typical treatment often involves the following:
- recognizing how inaccurate thinking can worsen problems
- learning new problem-solving skills
- gaining confidence and a better understanding and appreciation of your self-worth
- learning how to face fears and challenges
- using role play and calming techniques when faced with potentially challenging situations
The goal of these techniques is to replace unhelpful or self-defeating thoughts with more encouraging and realistic ones.
For example, “I’ll never have a lasting relationship” might become, “None of my previous relationships have lasted very long. Reconsidering what I really need from a partner could help me find someone I’ll be compatible with long term.”
These are some of the most popular techniques used in CBT:
- SMART goals. SMART goals are specific, measurable, achievable, realistic, and time-limited.
- Guided discovery and questioning. By questioning the assumptions you have about yourself or your current situation, your therapist can help you learn to challenge these thoughts and consider different viewpoints.
- Journaling. You might be asked to jot down negative beliefs that come up during the week and the positive ones you can replace them with.
- Self-talk. Your therapist may ask what you tell yourself about a certain situation or experience and challenge you to replace negative or critical self-talk with compassionate, constructive self-talk.
- Cognitive restructuring. This involves looking at any cognitive distortions affecting your thoughts — such as black-and-white thinking, jumping to conclusions, or catastrophizing — and beginning to unravel them.
- Thought recording. In this technique, you’ll record thoughts and feelings experienced during a specific situation, then come up with unbiased evidence supporting your negative belief and evidence against it. You’ll use this evidence to develop a more realistic thought.
- Positive activities. Scheduling a rewarding activity each day can help increase overall positivity and improve your mood. Some examples might be buying yourself fresh flowers or fruit, watching your favorite movie, or taking a picnic lunch to the park.
- Situation exposure. This involves listing situations or things that cause distress, in order of the level of distress they cause, and slowly exposing yourself to these things until they lead to fewer negative feelings. Systematic desensitization is a similar technique where you’ll learn relaxation techniques to help you cope with your feelings in a difficult situation.
CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:
- Facing one’s fears instead of avoiding them.
- Using role playing to prepare for potentially problematic interactions with others.
- Learning to calm one’s mind and relax one’s body.
Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.
CBT places an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behavior.
CBT therapists emphasize what is going on in the person’s current life, rather than what has led up to their difficulties. A certain amount of information about one’s history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.
