Cognitive Behavioral Therapy
What is it?
Cognitive Behavioral therapy is just one of several different types of therapy that are available and provided to help empower and improve individuals lives and resilience. According to Leichsenring, Hiller, Weissberg, & Leibing, 2006, “cognitive-behavioral therapy and psychodynamic psychotherapy are the most frequently applied methods of psychotherapy in clinical practice”. The goal of CBT is to uncover distorted thinking patterns in order to build a more functional way of viewing/managing various situations. CBT assists the patient through training, to acquire skills to reduce psychological symptoms and to identify how distorted thoughts affect a person’s mood which in turn affects their behavior. CBT is widely used across the nation and has a plethora of science and research to attest to its efficacy. Its used to address the here and now, how are we thinking, how do these thoughts affect us and our emotions, and how do these thoughts and emotions affect our current behavior, and to move forward, as opposed to some other therapies which explore past situations, connections, traumas etc. and uncover how they are manifesting in our lives.
CBT helps equip individuals with the knowledge and tools to help identify distorted thinking and empowers them to manage their thoughts, emotions and behaviors.
How Does it Work?
We all have cognitive distortions also known as unhelpful thoughts, maladaptive thoughts or thought patterns, or simply, negative thoughts. A person doesn’t have to have depression, or anxiety, or any other host of diagnoses to experience maladaptive thoughts. How many of us have thought to ourselves, “I’ll never make it”, “nobody likes me”, “I’m not good enough”, “this/that will never happen”, “if it or I’m not perfect then its junk”, “that’s how it always is and how it always will be”? Those are just a few negative thoughts in the sea of possible and common negative thinking that occurs and can occur with anyone. For those who do have depression, anxiety, addiction, [insert diagnosis here], these thoughts can lead to significant decline in our mood, emotions and subsequently our behaviors and actions. CBT helps people identify negative thought patterns, and teaches them to understand what the thoughts are, why or what may be causing the thought in the context of the current situation, and how to change their perceptions and replace these negative thought patterns with more helpful and adaptive ways of thinking, which in turn positively impacts their mood and emotions leading to better behaviors and actions.
If unrecognized and unmanaged, our automatic negative thinking, emotions and behaviors can be a continuous vicious spiral.
There are several cognitive distortions that are employed by many of us. The most common of them include 15 different types:
Jumping to Conclusions,
Fallacy of Fairness,
Fallacy of Change,
Always Being Right, and
Heaven’s Reward Fallacy.
For the sake of brevity, an explanation of these cognitive distortions can be found here.
CBT can be categorized into six different areas of focus, which are discussed in no particular order.
The first area of focus in CBT is the cognitive and interpersonal focus. According to Blagys & Hilsenroth, 2002, “CB theory is based, at least in part, upon the notion that a patient’s emotions and behavior are influenced by his or her beliefs or thoughts about the world. By evaluating, challenging, and modifying a patient’s irrational or illogical beliefs, he or she presumably gains control over problems previously believed to be insurmountable and progress is made”. Challenging these distorted thoughts and beliefs can help us recognize the distortion in our thoughts and overcome them.
The second area of CBT is the focus on the direction of therapy session activity. CBT has more direct session activities by setting agendas, deciding what will be discussed prior to the session, setting agendas and directing the patient toward specific topics of discussion and tasks (Blagys & Hilsenroth, 2002). This type of direction and focus can help us work through specific tasks and areas of need. Using CBT to direct the session can help the patient open up about specific topics and work towards a common goal.
The third distinction of CBT is the focus on teaching skills to the patient. A CBT approach according to Blagys & Hilsenroth, 2002, “espouse a psychoeducational approach, teaching [patients’] new ways of coping with stressful situations…patients are presumed to be able to manage their difficulties more effectively through a greater understanding, awareness, and insight about their difficulties.” Teaching individuals new skills can help them use newly acquired skills to overcome stressful situations.
The fourth area of focus is on the use of homework and outside-of-session activities. The use of homework according to Blagys & Hilsenroth, 2002, “provides an opportunity for the patient to practice skills learned in therapy. Practice is designed to make the work of treatment more concrete and helps a patient generalize skills learned in therapy to the real world.” Working with individuals, the use of homework can help us adapt new coping skills and reinforce strategies learned in therapy sessions.
The fifth area of focus in CBT is the emphasis on future experiences. CBT according to Blagys & Hilsenroth, 2002, focuses more on, “the impact a patient’s present illogical thoughts have on his or her current and future functioning”. Focusing on how our present distorted thinking affects us currently can help us move forward and engage in endeavors that will have a positive impact for our future.
The last area of focus is providing patients with information regarding their treatment, disorder, or symptoms. Using CBT according to Blagys & Hilsenroth, 2002, “providing information may serve to orient patients to the technique being used and increase their hope that his or her difficulties can be alleviated”. Understanding and giving thier anxiety, depression, etc. a label and informing them of the intent behind the specific techniques discussed in therapy can help increase thier confidence in the process.
CBT is a process and it takes work and dedication on both the therapist and the patients part. There’s no magic pill that can cure our hurt, our traumas, our thought patterns, our reactions to situations or anything else in life. If we put in the work, the time, the dedication, we can start to make a paradigm shift and alter the trajectory of our future for the better. Nothing worth having in life comes easy, and spending the time and effort on improving ourselves can be one of the greatest investments we can make. CBT may be the right therapy modality for you, having an understanding of what it is, what is involved and being prepared to do the work, to do the homework, and to allow yourself to progress through the process will assist in success. In order to benefit from any progress in life you must be willing to change.